interpretation and translation

Interpretation and Translation Policy

Version 2.1 August 2018

Interpretation and Translation

Target Audience

Who Should Read This Policy

All Staff in contact with patients and service users n/a


Version 2.1 August 2018 2

1.0 Introduction 4

2.0 Purpose 5

3.0 Objectives 5

4.0 Process 6

5.0 Procedures connected to this Policy 7

6.0 Links to Relevant Legislation 8

6.1 Links to Relevant National Standards 8

6.2 Links to other key policy/s 8

6.3 References 8

7.0 Roles and Responsibilities for this Policy 9

8.0 Training 10

9.0 Equality Impact Assessment 10

10.0 Data Protection And Freedom Of Information 10

11.0 Monitoring this policy is working in practice 11

Appendices

1.0 Good Practice Guide for working with Interpreters 13

Ref. Contents Page



Explanation of terms used in this policy

Interpreter - A person who facilitates communication from one language into its equivalent, or

approximate equivalent, in another language

Interpretation - The oral transmission of meaning from one language to another, which is easily understood by the listener or receiver. This covers the conversion of speech from one

language, including British Sign Language (BSL), to another method. It includes palantype, which is the

conversion of spoken to written speech

Translation - The written translation of meaning from one language to another, including Braille



1.0 Introduction

The Black Country Partnership NHS Foundation Trust (hereafter referred to as ‘The Trust’) is a major provider of mental health, learning disability and community healthcare services for people of all ages in the Black Country. The goals of the Trust are to reduce inequality by recognising diversity and celebrating difference, to improve and promote the health and well-being of local communities, to provide high quality care, in the right place, at the right time, and to put people and their families at the heart of care. Part of this is ensuring that the services provided are appropriate and accessible to all who use our services including those from vulnerable or diverse communities, their families and carers. The Black Country is becoming more ethnically diverse and the make up of its population is changing. Overall, 26% of the population is from Black and Minority Ethnic Groups (BME). We are also aware of new and emerging communities in different parts of the Black Country, including asylum seekers, who are not specifically reflected in these figures. This diversity in the Black Country results in many people accessing the Trust’s services for who English is an additional language and also includes those who have a sensory impairment or a learning disability with particular communication needs. The Trust is fully committed to implementing ‘Play Fair’, our Equality Strategy, ensuring that we promote race equality in the provision of services and employment of staff and that there is equality of opportunity in the provision of services and employment for people with a disability. One of our Trust’s values is openness, and one way of putting this into practice is to consistently improve information and communication. Good communication is fundamental to providing a high standard of service. Poor communication in healthcare can lead to a risk of wrong diagnosis and treatment and service users feeling misunderstood or confused. With these issues in mind we have a robust system for accessing interpreting and translation services and are aiming towards information in and around the Trust being in formats that are clear and accessible and appropriate to their context. Prior to October 2010, equality legislation, including the Race Relations (Amendment) Act 2000 and the Disability Discrimination Act 1995 (DDA95), required public authorities, like the Trust, to take steps to ensure that there was equal access to services and that The Trust was doing all it could to eliminate unlawful discrimination. Under the Equality Act 2010 these core duties remain and include ensuring that we have appropriate provision of interpreting and translation services. The Act extends the duties of the public sector to include 9 personal protected characteristics of age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion and belief, sex and sexual orientation. Duties to eliminate unlawful discrimination remain central to equality legislation as do duties around equal access to services and promotion of race equality. The 2010 Act also makes clearer the type of reasonable adjustments that should be made to help people access services. To offer a service all staff are responsible for ensuring that the services are accessible to all people by providing services and information about the services in ‘alternative’ formats, e.g. using interpreters, large print,



Braille, and audio. This means that information leaflets, instructions and appointment letters should all be available to patients in their preferred format where requested. Where a physical feature is a barrier to a service, finding a reasonable alternative method of delivering the service will be sought. The Department of Health (2001), in ‘Good Practice in Consent implementation guide: Consent to examination or treatment’, states that patients for whom English is an additional language and who have difficulty communicating, should receive information for consent. Furthermore the Department of Health’s ‘Reference Guide to Consent for Examination or Treatment’ (2009), states that in order to assess capacity to consent, the patient must be able to communicate their decision and highlights the need for sufficient information. This requires healthcare professionals to take all steps, which are reasonable in the circumstances, to facilitate communication. This includes using interpreters or communication aids as appropriate. The NHS Constitution (2010) makes it clear that people who use health services have a right to not be discriminated against, and are to be equipped to make informed choices about their care through easily accessible and relevant information. This emphasises the need for effective interpreting and translation services.

2.0 Purpose

The purpose of this policy is to provide information for staff to enable them to support those who use our services to access interpreting and translation services and, through this, to reduce language, cultural and physical barriers to good communication. This policy sets out guidance to support communication with service users and carers who are non-English speakers, people for whom English is an additional language, people with hearing or visual impairment or who have learning disabilities. It sets out standards across the organisation to promote good practice and minimise risks that stem from communication barriers and it covers the use of face-to-face, telephone interpreting and written translation services in accordance with identified need.

3.0 Objectives

The Trust will promote equity of access to services by providing interpreting or translation services wherever possible, for service users who request, or are identified as needing, an interpreter. This includes those for whom English is an additional language, those with hearing or visual impairments or those with a learning disability with particular communication needs. It will be achieved by:

Facilitating communication for those for who English is an additional language, those who do not speak English, those who have difficulty understanding more complex English language, as well as people who are deaf, use British Sign Language (BSL), or who are blind and/or partially sighted

Providing a prompt and efficient interpreting and translation service which is equitable and accessible to all

This will result in:

Reducing the scope for wrong diagnosis and treatment

Enabling service users and/or their carers, to be more effectively involved in decision making



4.0 Process

The process for booking an interpreter or for written translation work can be found on the Trust’s Intranet. 4.1 The Trust’s Preferred Provider of Interpreting Services The Trust has a preferred provider for face to face spoken language interpreting, telephone interpreting, and translation services, including British Sign Language and Braille. Details can be found on the Trust’s Intranet. 4.2 Staff as Interpreters Staff who have not been trained to interpret, or who do not have interpreting as part of their role specification, should not be used as interpreters. There are three main exceptions to this:

In an emergency/crisis situation where clear communication is needed immediately, and there is either no time to get an interpreter, or communication is needed whilst waiting for Scheduled Telephone Interpreting. In this situation, a bi-lingual member of staff who is present on site may be used but they must explain to the service user that they are not qualified interpreters. This will be documented in the patient notes

It is acceptable for staff communicating basic information, such as, an appointment time, offering a choice for next appointment, or giving directions to a particular area or department, to act as an interpreter if they possess the knowledge of the appropriate language or communication skill

If speaking a particular language is part of the person specification for a role and the staff member is employed to speak that language, for example, as part of the South Asian Counselling Service, then this isn’t classed as interpreting as they will be speaking directly to their client in their chosen language as part of their role

4.3 Children as Interpreters Children should not be used as Interpreters. If a service user brings a child under the age of 16 to interpret, they should be discouraged from interpreting and a choice of a professional interpreter offered. The service user should be aware at all times that they can have an interpreter. In the case of acute emergencies, healthcare professionals could use an accompanying child to elicit and communicate basic information, for example “What happened?” or “How did you get here?” or any necessary demographic information, such as “Who are you and where do you live?” Most parents or carers will not discuss problems or worries in front of their children. Interpreting serious problems may traumatise children and, in many cases, using a child to interpret could upset a family’s social order. If a patient insists on a child interpreting or translating then this must be documented in the patient’s notes. 4.4 Use of relatives, friends, or carers for interpreting Relatives and friends should not be encouraged to interpret. The patient should be aware at all times that they can have the support of a skilled and professional Interpreter provided by the Trust. It should also be remembered that while some friends and relatives may be able to help with the interpreting, this could be distorted, due to a particular concern, bias or conflicting interests. This may not be beneficial to the imparting of confidential information, whereas an independent interpreter is qualified and trained to maintain and respect confidentiality.



Health professionals should be aware that although relatives and friends may speak the same language, they might not be skilled or competent enough to interpret in a health care setting. If a patient insists on using friends or relatives for interpreting, then this must be documented in the notes. In cases where the patient clearly has concerns about using an interpreter, and would prefer to use family or friends, the health professional may need to work with them to understand more about why they don’t wish to make use of this service, and be able to discuss the benefits and reasons for using qualified interpreters as stated above.

4.5 Use of other clients or patients for interpreting It is unacceptable to ask other patients or clients to help with interpreting, for similar reasons to the ones stated above. The Trust recognises that the use of an unskilled person to interpret is highly inappropriate and may lead to risk of misunderstanding, resulting in the intervention of inappropriate care or treatment. 4.6 Service user’s own choice of interpreter The Trust cannot prevent a patient from bringing in their own choice of interpreter, instead of using the preferred provider, but the Trust cannot be held responsible for the quality of interpreting and will not pay for this service. 4.7 What to do if an Interpreter is refused If a patient is refusing to use an interpreter provided by the Trust, and this results in the staff member feeling that this will actually prevent them from providing quality, safe and effective care, then the staff member may state that they don’t feel that they can continue with their appointment or assessment on that occasion. This should be recorded in the case notes with reasons for this clinical decision. 4.8 Use of Advocates Staff should be aware that there is a distinct difference between providing an interpreting service and an advocacy service, but that these roles may sometimes overlap. Professional advocates can be arranged on request through the PEI (Patient Experience & Involvement Team) Office. 4.9 Budgetary Implications The Trust pays for all the interpreting sessions that are booked by staff members on behalf of those using Trust services. When the patient books the interpreter themselves, they will usually pay for that service unless special arrangements have been made. In special circumstances, such as the unavailability of a specific interpreter through the Trust’s preferred providers, the Trust may agree to pay for other qualified interpreters. The interpreter should be suitably qualified and registered. Any special arrangements must be agreed with the Service Manager and Equality & Inclusion Team in advance. The Trust will not pay for unqualified interpreters. It is the responsibility of each Group to ensure that the budgetary implications of interpreting and translation services have been considered and planned for. Each Group is responsible for funding interpreting within its own areas.

5.0 Procedures connected to this Policy

There are no standard operating procedures connected to this policy.



6.0 Links to Relevant Legislation

Human Rights Act 1998 The Human Rights Act is a UK law passed in 1998. It means that you can defend your rights in the UK courts and that public organisations must treat everyone equally, with fairness, dignity and respect. The Human Rights Act may be used by every person resident in England or Wales regardless of whether or not they are a British citizen or a foreign national, a child or an adult, a prisoner or a member of the public. The human rights that are contained within this law are based on the articles of the European Convention on Human Rights. The Act ‘gives further effect’ to rights and freedoms guaranteed under the European Convention. It does two things: Judges must read and give effect to legislation (other laws) in a way which is

compatible with the Convention rights It is unlawful for a public authority to act in a way which is incompatible with a

Convention right Equality Act 2010 The Equality Act came into force on 1 October 2010 and brought together over 116 separate pieces of legislation into one single Act to provide a legal framework to protect the rights of individuals and advance equality of opportunity for all. The Act simplifies, strengthens and harmonizes the current legislation to provide a new discrimination law which protects individuals from unfair treatment and promotes a fair and more equal society.

6.1 Links to Relevant National Standards

There are no links to National Standards.

6.2 Links to other key policy/s

Information Sharing Policy This policy provides clarity and guidance for staff to comply with the many different rules in relation to the release of patient information for requests to access any other types of information, please refer to the Trust’s Freedom of Information Policy. Patient Information Policy The aim of this policy is to ensure that service users, their carers and families receive the right information at the right time with the support they need to use it.

6.3 References

Black Country Partnership NHS Foundation Trust’s Play Fair: Trust Equality Strategy

The Trust’s Vision & Values and Strategic Objectives

The Department of Health (2001) ‘Good Practice in Consent implementation guide: Consent to examination or treatment’

NHS Constitution (2010)

Department of Health (2009) ‘Reference Guide to Consent for Examination or Treatment’



7.0 Roles and Responsibilities for this Policy

Title Role Responsibilities

Strategy &

Transformation Director

Executive Lead

- Lead responsibility for the implementation of this policy

- Allocation of resources to support the implementation of this policy - Any serious concerns regarding the implementation of this policy are brought to the attention of the Board of Directors

Trust Board Strategic - Ensure that funding for interpreting and translating is taken into account by the commissioners of services

Equality and Inclusion Board

Responsible - Oversee the implementation of a systematic and consistent approach - Approve all policies and procedures that relate to their subject matter or area of practice

Equality & Inclusion

Team

Operational

Lead

- Ensure that Interpreting Services are provided for the Trust - Ensure that a robust and quality system for booking and accessing interpreting and translation services is in place that is cost

effective and provides value for money

Group Directors/

Managers Operational

- Ensure that the budgetary implications of interpreting and translation services have been considered and planned for

- Each Group is responsible for funding interpreting within its own areas

Service Managers/

Team Leaders/ Professional Leads

Implementation

- Ensure that this policy is correctly followed and implemented and that all relevant staff are enabled to support those who use our

services to access interpreting and translation support

- Authorise the use of and payment of services in a timely manner - Ensure that responsibilities have been delegated, where appropriate, and particularly during any absences, to ensure a prompt

response to needs

Trust Staff and

Volunteers Adherence

- Communicate effectively with all service users

- Be aware of the requirements to meet the communication needs of patients

- Understand their responsibilities and the correct procedures when accessing interpretation or translation services - Implement the policy effectively and bring any issues that may affect implementation to their managers

- Recognise that a language need exists - Inform service users and carers that an interpreter can be arranged at no cost to them

- Assess which language is being spoken and make provision for language required by liaising with the service user or carer, where

appropriate - Liaise with the interpreting service to arrange for an interpreter following the booking arrangements set out in this policy

- Define or explain complex terminology or acronyms and accurately document within the service user’s clinical records, the language and dialect used and any hearing or visual impairment or learning difficulties needs identified

Interpreters Adherence

- Assist in the interview, interpreting accurately, maintaining confidentiality, advising on cultural differences, declaring if the service

user knows them, where appropriate - Facilitate communication between people who do not have a language in common. Key factors that influence the requirements for

interpreting are ensuring equitable access to services making sure the best possible patient outcomes are reached - Facilitate communication to all involved & work towards fostering trust and maintaining confidentiality. Interpreters sometimes

know important information about the service user’s culture, country of origin and religious beliefs that others may not be aware of.

It is useful to ask the interpreter to point out any areas of cultural significance that they would help to improve the understanding of the service user’s world. In particular, interpreters may help to establish whether certain behaviours beliefs or reactions are usual

within the service user’s culture



- The interpreter is not responsible for conducting the interview, giving advice or acting as an advocate

8.0 Training

What aspect(s) of this policy will

require staff training?

Which staff groups require this

training?

Is this training covered in the Trust’s Mandatory and Specialist Mandatory

Training Needs Analysis document?

If no, how will the training be delivered?

Who will deliver the training?

How often will staff require

training

Who will ensure and monitor that staff have

this training?

4.0 Process

Managers and team

leaders to ensure that their staff

know how to

identify, assess or respond to an

interpreting need and how to access

the interpreting service

No Internally via ‘Working

Effectively with Interpreters’ training

programme

The Equality &

Inclusion Team

As necessary

and on request where there

was a higher

than usual demand for

Interpreters

Equality & Inclusion Board

9.0 Equality Impact Assessment

Black Country Partnership NHS Foundation Trust is committed to ensuring that the way we provide services and the way we recruit and treat staff reflects individual needs, promotes equality and does not discriminate unfairly against any particular individual or group. The Equality Impact Assessment for this policy has been completed and is readily available on the Intranet. If you require this policy in a different format e.g. larger print, Braille, different languages or audio tape, please contact the Equality & Inclusion Team on Ext. 8067 or email [email protected]

10.0 Data Protection And Freedom Of Information

Data Protection Act provides controls for the way information is handled and to gives legal rights to individuals in relation to the use of their data. It sets out strict rules for people who use or store data about individuals and gives rights to those people whose data has been collected. The law applies to all personal data held including electronic and manual records. The Information Commissioner’s Office has powers to enforce the Data Protection Act and can do this through the use of compulsory audits, warrants, notices and monetary penalties which can be up to €20million or 4% of the Trusts annual



turnover for serious breaches of the Data Protection Act. In addition to this the Information Commissioner can limit or stop data processing activities where there has been a serious breach of the Act and there remains a risk to the data. The Freedom of Information Act provides public access to information held by public authorities. The main principle behind freedom of information legislation is that people have a right to know about the activities of public authorities; unless there is a good reason for them not to. The Freedom of Information Act applies to corporate data and personal data generally cannot be released under this Act. All staffs have a responsibility to ensure that they do not disclose information about the Trust’s activities; this includes information about service users in its care, staff members and corporate documentation to unauthorised individuals. This responsibility applies whether you are currently employed or after your employment ends and in certain aspects of your personal life e.g. use of social networking sites etc. The Trust seeks to ensure a high level of transparency in all its business activities but reserves the right not to disclose information where relevant legislation applies. The Information Governance Team provides a central point for release of information under Data Protection and Freedom of Information following formal requests for information; any queries about the disclosure of information can be forwarded to the Information Governance Team.

11.0 Monitoring this policy is working in practice

What key elements will be monitored?

(measurable policy objectives)

Where described in

policy?

How will they be monitored?

(method + sample size)

Who will undertake this

monitoring?

How Frequently?

Group/Committee that will receive and

review results

Group/Committee to ensure actions

are completed

Evidence this has

happened

Data gathering on range and

prevalence of languages

(including BSL) used across all Groups

7.0 6 monthly data request to

Preferred Provider


Team

Every 6

months


Board


Board

Data to be

included in

Public Sector Equality Duty

(PSED) published

report

Cost spends evaluated at financial year-end.

Contribution adjustments made by each Group

according to spend

4.9

Cost spend report request from Preferred Provider

matched against budget report extracted from

identified budget code

Equality & Inclusion Team

Annually Equality & Inclusion Board


Minutes of Equality &

Inclusion Board

meetings



Feedback on service experience request from

Preferred Provider and desktop survey

7.0 Feedback reports on customer experience

provided by Preferred Provider and Equality &

Diversity Team

Equality & Inclusion Team across

Groups

Every 6 months




Inclusion Board

meetings

Training audit request to Preferred Provider to ensure

Interpreters are fit for

purpose

7.0 Training report request from Preferred Provider

Equality & Inclusion Team

Quarterly Equality & Inclusion Board



Inclusion

Board meetings

Interpreting data collected 7.0 Monitoring report

provided including information on languages

covered, use of different

interpreting formats, number of bookings,

costs and demographic changes in the area


Team

Annually Equality & Inclusion

Board


Board

Minutes of


Board

meetings



Appendix 1

Good Practice Guide for working with Interpreters

Find out if new patients have requested an interpreter before admission or appointments

Remember that many service users do speak English. It is essential that the service user’s understanding of English is clarified prior to booking an interpreter

Ensure that you are booking qualified interpreters

Try to book interpreters as far in advance as possible

Remember to give the reason for an interpreter when booking, for example, consent, discussing treatment, to provide medical information

Allow additional time for appointments where an interpreter is needed. Time is required to provide a short briefing session, see the patient and then allow time to debrief the interpreter afterwards

Introduce the interpreter to any staff who will be involved

Clarify any legal aspects that must be given to the patient, for example say if the information is to help the patient to give consent prior to receiving Electroconvulsive Treatment (ECT)

Indicate to the interpreter how long the session might take. When the consultation is expected to be lengthy ask the interpreter if they are likely to need a break

Allow a short period for the interpreter to get to know the patient if they have not met before

Be aware of the environment and seating arrangements. Sitting in a triangular formation is a good idea and remember that people who are lip reading or use a signer find plenty of light helpful

Whenever possible find a private, quiet area to communicate and ask if the person wants a relative or carer present

Speak directly to the patient rather than the interpreter

Try to read body language. Does the patient look frightened, angry, or upset with the information that is being provided?

Speak in clear sentences and give the interpreter time to get a response from the patient

Take extra care in explaining procedures and sensitive issues

Do not ask the interpreter to make judgements. The interpreter is required to be neutral and independent

Ask the patient if there is anything else that they need to discuss about their care

Check that the patient has understood everything

Remember confidentiality. Only information that is essential to the interview should be divulged. The patient should have given consent for the interpreter to assist



Don’t use jargon or euphemisms. For example don’t say ‘waterworks’ when you mean ‘bladder’

Be careful not to stereotype. Not everyone acts in the same way or needs the same information

Try not to get suspicious or frustrated when a question needs a long discussion between the interpreter and the patient

Don’t shout at people who have hearing impairments



Policy Details

* For more information on the consultation process, implementation plan, equality impact

assessment, or archiving arrangements, please contact Corporate Governance

Review and Amendment History

Version Date Details of Change

2.1 Aug 2018

Reviewed with minor amendments- updated language of the Board, removed any reference to Absolute in case we go out to tender; no major content change.

2.0 Apr 2015 Full policy review and new policy format

1.0 Aug 2011 New policy for BCPFT

Title of Policy Interpretation and Translation Policy

Unique Identifier for this policy BCPFT-ORG-POL-01

State if policy is New or Revised Revised

Previous Policy Title where applicable N/A

Policy Category Clinical, HR, H&S, Infection Control etc.

Organisational

Executive Director whose portfolio this policy comes under

Director of Workforce & Organisational Development

Policy Lead/Author Job titles only

Head of Diversity & Spirituality

Committee/Group responsible for the approval of this policy

Equality and Inclusion Board/Workforce Development Committee

Month/year consultation process completed *

n/a

Month/year policy approved August 2019

Month/year policy ratified and issued August 2019

Next review date August 2022

Implementation Plan completed * Yes

Equality Impact Assessment completed * Yes

Previous version(s) archived * Yes

Disclosure status ‘B’ can be disclosed to patients and the public

Key Words for this policy

‘communication’, ‘language’, ‘speech’, ‘BSL’, ‘Braille’, ‘interpreting services’, ‘booking an Interpreter’

interpretation and translation

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