Document Title
Interpretation and Translation Policy
Document DescriptionDocument Type Policy
Service Application Trust Wide
Version 2.0
Lead Author(s)
Name Job Title
Garry Perry Patient Relations Manager
Change History
Version Date Comments
1.0 March 2007
1.1 March 2010 review date
2.0 June 2015 Draft review and policy refresh
Executive Director / Director / Manager
If you are assured that the correct procedure has been followed for the consultation of this policy, sign and date below:
Name Mr Amir Khan Date 3rd July 2015 Signature
Links with External Standards Equality Act 2010
European Convention for the Protection of Human Rights and Fundamental Freedoms (1950) Human Rights Act (1998) CQC and Health and Social Care Act 2010
Regulation 10, Dignity and Respect
Key Dates DATE
Ratification Date Review Date
Executive Summary Sheet Document Title: Interpretation and Translation Policy
Please Tick (þ)
as appropriate This is a new document within the Trust This is a revised document within the Trust þ
What is the purpose of this document?
The purpose of this policy is to provide guidance on our responsibilities to staff, volunteers, patients and carers who may require support from interpretation or translation services. It will ensure that patients have equal access to excellent patient care, and enable compliance with equality legislation and Care Quality Commission outcomes and other standards.
In addition this policy and associated guidance is to improve access to, and information about services for patients or carers for whom English is a second language or those who require communication support. This policy and associated guidance is intended to ensure measures are in place to support communication with non-English speakers, people for whom English is a second language, sign language users, people with hearing or visual impairment, people with learning disabilities and people who require Deaf or Deaf Blind Communicators. It describes arrangements for face to face interpreting, and for the translation of written material.
What key Issues does this document explore? • Aims and Objectives of the service
• Roles and responsibilities • Procedure for using the service
• Good practice in working with interpreters • Guidelines for staff requiring translated material
• Guidance for provision of communication support for sign language users, people with hearing or visual impairment, people with learning disabilities and people who require Deaf or Deaf Blind Communicators.
Who is this document aimed at?
All staff working within Walsall Healthcare NHS Trust.
What other policies, guidance and directives should this document be read in conjunction with?
• Complaints and Concerns Policy 2015– Walsall Healthcare NHS Trust • Equality Analysis Policy – Walsall Healthcare NHS Trust 2014
How and when will this document be reviewed?
This policy will be subject to review every three years by the Medical Director, or nominated deputy. If any legislation / changes in practice occur prior to this review, the policy will be subject to a minor review to ensure compliance with the latest legislation / best practice.
CONTRIBUTION LIST
Key individuals involved in developing the document
Name Designation
Garry Perry Patient Relations Manager
Phao Hewitson Head of Clinical Governance
Zubbair Khan Together our Health Linkworker
Circulated to the following for consultation Name / Committee / Group
Walsall Healthcare NHS Trust web forum Policies and Procedures Group
Divisional Quality Teams
Version Control Summary
Significant or Substantive Changes from Previous Version
A new version number will be allocated for every review even if the review brought about no changes. This will ensure that the process of reviewing the document has been tracked. The comments on changes should summarise the main areas/reasons for change.
When a document is reviewed the changes should use the tracking tool in order to clearly show areas of change for the consultation process.
Version Date Comments on Changes Author
1.0 March
2007 Draft Policy Developed
1.1 March
2010 Policy review – no changes
2.0 June
Document Index Pg No
1.0 Introduction 5
2.0 Aims 5
2.1 Objectives 6
2.2 Definitions 6
3.0 Roles and Responsibilities 6
4.0 Procedure for using the service 6,7,8
4.1 Use of staff to interpret 8,9
4.2 Service quality people can expect 8,9
5.0 Good practice in working with interpreters 9
5.1 What to expect from interpreters 9,10
6.0 Guidelines for staff requiring translated material 10 6.1 People with Sensory Impairment and Learning
Disability
10
6.2 Cultural and Religious Considerations 11
7.0 Budgetary Responsibilities 11
8.0 Monitoring and Evaluation 11
Appendices Pg No
1.0 Introduction
Walsall Healthcare NHS Trust has had a comprehensive interpreting service since September 1997. The current service covers languages for the South Asian ethnic community such as; Gujerati, Urdu, Hindi, Punjabi, Mirpuri, Bengali and Sylethi. The Trust Interpreting team consist of the ‘Together Our Health Linkworkers’ who embarked on a 12 months training course in Health related issues to enable and understand the determinants affecting the use of cultural awareness, access uptake and prevention relating to the Health Service, learning how to provide a service which is culturally sound and able to respond effectively to clients from other minority ethnic groups.
According to the 2011 census there has been a significant increase in the level of ethnic diversity in Walsall over the past decade. While ‘White British’ remains the largest single group at 76.9%, the number of residents from a minority ethnic group has risen to almost one in four. This figure of 23.1% residents is an increase on the 14.8% in 2001 (and higher than the 19.5% in England and Wales in 2011). The largest increase is in people of Asian background, with a rise from 10.4% in 2001 to 15.2% in 2011. Within this group, those of Pakistani background have increased the most to 5.3% of all residents (although Asian Indian remains the largest minority ethnic group).
Levels of English proficiency in Walsall are high, and in line with the average for England and Wales. Overall, 92.6% of residents speak English as their main language; a further 5.0% do not consider English their main language but speak it well. However, this still leaves 3.3% of households in which no one speaks English as their main language, and over 6,200 residents who cannot speak English well (1,200 of whom cannot speak the language at all). (Walsall Census Summary report May 2013)
The Trust is committed to providing fair access to services for all people and to reduce health inequality. We recognise the disadvantages that people who are unable to understand spoken or written English language experience when attempting to access health/social care services. We are therefore committed to ensuring that appropriate alternative means are available to address the communication gap.
2.0 Aims of the service
Together Our Health Linkworkers aim to provide a confidential face-to-face interpreting/advocacy service to South Asian patients, facilitating communication between health professionals and clients, thereby helping to overcome the language and/or cultural barriers within the health environment. Thus providing a more personalised and reassuring service, enabling non-verbal cues to be picked up. In line with our Trust promises this policy aims to reflect a patient experience that is not only clinically excellent but also emotionally and culturally supportive in all aspects.
2.1 Objectives
• Enhance the patient experience for those whose first language is not English • Help the Trust to plan services, with complete inclusion of ethnic minorities • Help set performance standards relevant to patients diverse cultural needs • Assist in focussing changes in attitude and culture within the Trust
2.2 Definitions
This policy is aimed at addressing the formal process of interpreting or translations i.e. see the following definition. It is not intended to prevent a member of staff from generally communicating with another person in a different language or through BSL.
‘Translation is often used as a generic term to refer to the transfer of thoughts and ideas from one language (source) to another language (target) regardless of the form of either language (written, spoken or signed). When the form of the source language is either spoken or signed, the transfer process is referred to as
interpretation (Brislin, 1976;cited in Cokeley, 1992a,p1)1
• Interpreting
Is the oral transmission of meaning from one language to another, which is easily understood by the listener. This includes interpretation of spoken language into British Sign Language, (which is a recognised language in its own right) Interpreting can be provided face to face or by telephone. Interpreting is different from advocacy and should not be used as a form of advocacy.
• Interpreter
‘An interpreter is someone who is (at least) bilingual but also has the ability and training to be able to work between two languages and facilitate communication between people’2
• Translation
Is the written transmission of meaning from one language to another, which is easily understood by the reader or the conversion of written information into Braille or the production of visual formats to transfer information using British Sign Language.
3.0 Roles and Responsibilities
• The Medical Director has overall responsibility for the TOHL/Interpreter service within the Trust. Line management responsibility is held by the Patient Relations Manager.
• Senior Sisters/Nurses in charge/Department Managers or their equivalent are responsible for ensuring that all staff who might to use the interpreter service or book via an external agency are aware of this policy and that it is implemented appropriately.
• Senior Sisters/Nurses in charge/Department Managers or their equivalent are responsible for making the decision that the interpreter service is required for
a specific patient or member of the public in order to ensure that their needs (clinical or otherwise) are met. On rare occasions, for example a security incident out of hours involving a visitor unable to communicate with a guard, responsibility for deciding to use the interpreter service rest with the Hospital Co-ordinator/night manager.
4.0 Procedure for using the service
• Staff members interacting with patients or visitors should identify any communication difficulties and document these (for patients). Where a staff member has reason to believe that a patient or visitor may not have full understanding of information being given or that the patient or visitor is not able to communicate effectively with staff then the interpreter service should be used.
• A patient must not be expected to struggle with communication if English is not their first language. Staff must not routinely use family members or friends as interpreters unless this is specifically requested, where consent of the patient is provided (where the patient is able) and there are no viable alternatives. If a patient arrives with a family member/relative//carer then it is accepted that implied consent will have been given.
• Staff members with any doubts or concerns about the need for use of the interpreter service should contact the Patient Relations Manager or Together Our Health Linkworkers.
• Together Our Health Linkworkers work to a ‘set’ rota that operates Wednesday and Friday from 9am till 9pm, Monday, Tuesday and Thursday from 9am until 6pm and Saturday morning from 9am until 2pm. Together Our Health Linkworkers can be contacted directly via telephone 01922 605844 mobile 07920 537710 an internal extension number 5844, voicemail facility when unavailable. You can also page the team via bleep numbers 8160/8029. • As much notice as possible should be given when requesting an Interpreter,
especially for languages other than South Asian as some agencies require 3 days’ notice. Planning ahead can reduce the costs considerably as the agency will always arrange for an Interpreter closer to the place of work and if not contacted in time the Interpreter may live further afield hence the expense of extra travelling costs and travel time may then be incurred.
• When booking an interpreter all relevant details should be provided -time and place for attendance of interpreter, language required, estimated length of visit / meeting, details of service user requiring interpreter (gender and whether child or adult) and any other information that would be relevant to the request for interpretation services.
• Each day, apart from pre-booked appointments, in-patient wards are visited where possible by the TOHL team in order to explain the interpreting services available to south Asian patients. This is sometimes when an Asian Advocate is also required.
• When booking an interpreter confirmation of the booking should be received by telephone or email giving details of the interpreter who will be attending. • Keep a record of the request and the confirmation (date, time and name) on
• In an emergency (where life, health or liberty is at risk) an interpreter should be requested immediately. This may mean an interpreter having to leave a less urgent appointment (if in-house) or an urgent request to the agency being made
• Out of hours the hospital switchboard will try to provide an interpreter by ringing one of the recognised agencies. Switchboard have a list of agencies of whom to ring, do not ring the agency yourself. As much notice as possible should be given when requesting an Interpreter, especially for languages other than South Asian as some agencies require 3 days’ notice. Planning ahead can reduce the costs considerably as the agency will always arrange for an Interpreter closer to the place of work and if not contacted in time the Interpreter may live further afield hence the expense of extra travelling costs and travel time may then be incurred.
• When booking an interpreter all relevant details should be provided -time and place for attendance of interpreter, language required, estimated length of visit / meeting, details of service user requiring interpreter (gender and
whether child or adult) and any other information that would be relevant to the request for interpretation services.
• Each day, apart from pre-booked appointments, in-patient wards are visited where possible by the TOHL team in order to explain the interpreting services available to south Asian patients. This is sometimes when an Asian Advocate is also required.
• When booking an interpreter confirmation of the booking should be received by telephone or email giving details of the interpreter who will be attending. • Keep a record of the request and the confirmation (date, time and name) on
the individual’s record / appropriate file.
• In an emergency (where life, health or liberty is at risk) an interpreter should be requested immediately. This may mean an interpreter having to leave a less urgent appointment (if in-house) or an urgent request to the agency being made
• Home visits can be arranged with Together Our Health Linkworkers in the same way as all the above, but please allow 1 days’ notice so that staff can rearrange their workload. Home visits are usually carried out via our nurse specialists/community nursing teams requiring an interpreter.
4.1 Use of staff to interpret
On occasion it may be expedient to use a member of staff proficient in the language required to provide interpretation for initial day to day communication issues. Consideration of the potential risks and benefits of involving a staff volunteer should always be taken into account and care taken to ensure that there is no perceived or actual conflict of interest when using staff interpreters. If in any doubt please contact the TOHL team or the Patient Relations Manager.
It should also be remembered that before a member of staff offer their time to carry out this work, permission should be sought from their manager as some sessions may take up to or over an hour. This work is normally done whilst still on duty and within their shift pattern.
4.2 Service Quality People can Expect Principles of good practice should include:-
• The use of an interpreter/translator should be appropriate to need and whenever possible, have consent from the person who is using our service. • The interpreter/translator should be acceptable to the person, who should
match the person in gender, religion, dialect and as closely as possible in age (Code of Practice, Mental Health Act 1983 Paragraph 1.6) and the persons other protected characteristics (under the Equality Act 2010) should also be matched as closely as possible to promote effective interpretation/translation • Clarity of roles and boundaries should be agreed at the outset and briefing
and debriefing of interpreters should take place before and after each contact, with the appropriate health professional.
• Adequate time should be allowed for setting up, consultation and debriefing. • Unless clearly requested relatives and spouses should NOT be used to
interpret for People who use our service.
In these circumstances the services of a professional interpreter/translator should be used following initial contact on admission or in the community setting. Children should not be used in any circumstance.
5.0Good Practice in Working with Interpreters
• When the interpreter arrives check that they are who you are expecting – they should be carrying an Identity Card (with photograph).
• Before starting the interpretation session ensure that the interpreter is briefed regarding the purpose of the session /meeting.
• Always speak clearly, using plain language and stop after every sentence to allow the interpreter to communicate what has been said to the person using services.
• At the end of the session sign the Interpreter’s timesheet to confirm attendance and the length of time that the Interpreter was needed.
• Record the use of an Interpreter on the individual’s record.
• Report non-attendance or any concerns about the interpretation session to the appropriate Manager.
• Where an individual arrives at a location without an appointment please contact a member of the TOHL team in the first instance to obtain the necessary information and make an appointment as appropriate. Where South Asian language is not the identified need then language line may be appropriate in such circumstances
• Be prepared to provide feedback about the interpretation session if requested. 5.1 What to expect from Interpreters
Interpreters will:
• Be DBS (Disclosure & Barring Service) checked to enhanced level. • Carry and present an Identity Card (with photograph).
• Be skilled professional from an approved source recognised by the Trust. • Dress appropriately
• Honour appointments and arrive in good time
• Give adequate notice if they will not be able to keep the appointment (allowing sufficient time for another interpreter to be booked)
• Not ask someone else to attend in their place – if unable to attend let the provider organisation know immediately.
• Treat all information gained during their work as confidential.
• Not accept any gift or payment for their services other than their contracted fee.
During the Interpretation Session
Interpreters should:
• Allow time for briefing / de-briefing
• Present themselves and behave in a professional manner
• Interpret what has been said without leaving out or adding to the meaning • Not conduct dialogue with people who use services – just interpret
• Not give advice or personal opinions
• Be impartial / non-judgmental throughout the interpretation
• Obtain a signature from the requestor to confirm the duration of the session 6.0 Guidelines for staff requiring translated material
• An assessment of the communication needs of the intended audience should be undertaken
• Check with the Communications Department whether a suitable version of the document already exists
• Request should be made through Procurement with additional support from the Communications/TOHL team as required.
• The original document to be translated should be in plain English.
• Documents should have a potentially wide use and general application and a shelf-life of 1 – 2 years, unless consultation/targeted development work is being undertaken.
Exceptions to the above may be made for urgent or crisis situations where printed material is essential to meet individual health or social care needs.
6.1 People with Sensory Impairment Learning Disability and Mental Health Conditions
Arrangements should be in place to facilitate effective communications with people who use services and who may have a sensory impairment or learning disability or Mental Health Conditions. Facilitating communication could include provision of large
print, sign language interpreters, braille, audio-visual recorded information and Makaton. Staff should find out as soon as possible any specific communication needs of people with sensory impairments or learning disabilities who are going to be using services and make reasonable adjustments to enable effective communication.
The Trust has specialist link nurses who can provide advice and assistance. There is also a toolkit available called Making a difference together: A health toolkit that can be loaned form the Learning Disability Liaison Nurse.
British Sign Language (BSL)
• This service is also available through Together Our Health Linkworkers team
who will book a signer through a registered agency sending only Interpreters with qualifications of Level 4 or above. Out of hours, Switchboard staff will contact the registered agencies, do not book the agency yourself.
• Interpreters are expected to abide by the Code of Ethics and to follow the
Guidelines for Professional Practice, which covers issues of professional competence. The aim of the Guidelines for Professional Practice and the Code of Ethics is to ensure that communications across languages and cultures are carried out consistently, competently and impartially.
• In some case’s patient’s already utilise a BSL signer who is known to them and provide regular professional support. In these situations the TOHL/Patient Relations Manager should be contacted to ensure the patient’s needs are met and where possible continuity of care is respected.
6.2 Cultural and Religious Considerations
Staff need to be aware of, and sensitive to, the cultural and religious needs and requirements of people using services. For example, women from some cultural backgrounds will only want to be treated by female staff. It is essential that if members of staff are in any way uncertain of the needs of an individual that they undertake to ask the person using services or their carers about their needs as soon as possible and take this into account.
7.0 Budgetary Responsibilities
The Medical Director holds the budget for all interpreting services which includes, in-house Interpreting service (Together Our Health Linkworkers), all agency bookings which includes British Sign Lanaguage (BSL) and all other languages.
However, when Together Our Health Linkworkers make bookings through an agency on staffs’ behalf, they will inform the agency, ward staff and department staff that the booking is for 1 hour maximum of which is funded by the budget holder. All bookings made over and above the 1 hour will be met by divisions, therefore permission should be sort first from the manager responsible for that division if it is anticipated that the interpreter will be required for more than 1 hour.
• For monitoring purposes all bookings must be requested through Together Our Health Linkworkers office, bookings are usually made via a clerical officer either in Out-Patients Department or via the ward area. Bookings are also requested via nursing staff, doctors and other members of staff.
• The Trust Interpreters undergo regular training and learning sessions from relevant professionals. They meet regularly as a team and peer review to discuss issues and to look at reflective practice. Each month they also undergo regular performance management sessions to ensure continued high quality service delivery.
• To evaluate the effectiveness of these guidelines a check is made to ensure bookings occur as per the process and a regular check on concerns and complaints are made.
• Invoices are checked on a weekly basis to ensure bookings made are calculated correctly and that appropriate qualifications are met as stated in the agency contract. A ‘Yes’ and ‘No’ sticker is attached to the invoice that determines the invoice has been checked and before the budget holder signs for payment.
7.1 Monitoring and Evaluation
Monitoring Process Requirements
Who Patient Relations Manager
Standards Monitored • To evaluate the effectiveness of these guidelines a check is made to ensure bookings occur as per the process and a regular check on concerns and complaints are made.
When • Quarterly
How • Feedback via Interpreter Audit Form
• Incidents raised via Safeguard Presented to Patient Relations Manager
Monitored by • Patient Experience Forum • Community Leaders Forum Completion/Exception
reported to • Quality and Safety Committee
Should a member of staff encounter issues outlined in these guidelines, whether this be from staff or its process please refer to the Patient Relations Manager extension 6463 or complete the Interpreter Audit form (appendix 1) and return to the Patient Relations Team, Route 102, Manor Hospital, Walsall, WS2 9PS.
