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Why you should be recording patient communication needs now

What are the rules and what deadlines do we need to meet?

This accessible information standard (AIS) is a requirement under the Health and Social Care Act. By 1 April 2016 you must identify and record communication needs of patients, carers and parents with sensory loss or learning disabilities.

By 31 July you must fully implement the standard by identifying, recording, flagging, sharing and meeting these needs. From then, you could be open to legal challenge if you don’t provide correspondence, prescriptions and patient health information such as leaflets in appropriate formats – Braille, large font, easy read. The CQC may also look at this during inspections.

Consultations should be accessible, but to some extent it is up to the practice what this means. You must offer an interpreter if needed and, where necessary, longer consultations to accommodate a three-way conversation with an interpreter.

How do I identify a patient’s needs?

Patients must have the chance to define their communication needs, when they first register or when they book an appointment, get results or order a repeat prescription. You should review their needs annually.

Record their needs, not their disability – if someone is deaf, it does not mean they use British Sign Language (BSL).

The needs must be highly visible on the patient record, for example on the front of a document or electronic record. They should be included when you refer a patient to other health professionals (with patient consent).

Can we just change our ordinary methods of communication?

Yes. You can make text at least size 12 (preferably 14) in a sans serif font such as Arial, aligned to the left (not justified), with plenty of white space and on matt paper. Face to face, use plain language, avoid figures of speech, ensure you have someone’s attention before communicating with them and speak clearly and slowly.

How do I arrange for a BSL or deafblind manual interpreter?

The website of the National Registers of Communication Professionals working with Deaf and Deafblind people can help you find an interpreter.

Interpreters need appropriate qualifications and DBS clearance, and should be signed up to a professional code of conduct. A member of staff may interpret for the patient, but still needs to comply with these rules and have patient consent. Patients must be offered a professional interpreter unless they explicitly prefer using friends and family.

For more information, contact the members of the standard’s steering group: RNIB, Action on Hearing Loss, Sense and CHANGE or visit the NHS England website.

How we did it

As a small practice of around 5,000 patients, we have identified 67 with potential needs but so far only had contact with two. At registration we ask: ‘Do you have any special communication needs and are you happy for us to share this information with other healthcare providers?’ We reproduced practice leaflets in large type (font size 18), added a line to our ordinary leaflets letting patients know other formats were available, and created easy-read letters. We learned Braille is being replaced by computer voice-talk, so we have not made a Braille leaflet as no patient has requested it.

Ros Whitehead is business manager at Ellison View surgery, Hebburn, Tyne & Wear