TW11/023 (SOP) Interpreting and Translation Services

TW11/023 (SOP) Interpreting and Translation Services

Version 3

Inclusion and Diversity Lead

Approved: PARC May 2017

Next review date: May 2020

STANDARD OPERATING PROCEDURE: / INTERPRETING AND TRANSLATION SERVICES
SOP No: / TW11-023 SOP 1
VERSION NO: / 3
APPROVING COMMITTEE: / Corporate QEC
DATE THIS VERSION APPROVED: / April 2017
RATIFYING COMMITTEE: / PARC
DATE THIS VERSION RATIFIED: / May 2017
Author(s)
(Job title) / INCLUSION AND DIVERSITY SERVICE LEAD
Division/Directorate / CORPORATE
Trust wide SOP (Yes/No) / YES
Links to other Policies, SOP’s, Strategies etc: / TW11/023
INTERPRETING AND TRANSLATION POLICY
TW13-046 OVERSEAS VISITORS POLICY & SOP
Date(s) previous version(s) approved (if known): / Version:2 / Date: 2013
DATE OF NEXT REVIEW: / May 2020
Manager Responsible for Review: / Trust Board Secretary

Your hospitals, your health, our priority

CONTENTS: / Page No.
1. / Introduction / 2
2. / Details of Interpreting Organisations / 2
3. / Guidelines for using Interpreters / 2
4. / Procedure for Using Telephone Interpreters / 4
5. / Criteria for Booking Face to Face Interpreters / 7
6. / Procedure for Booking Face-to-Face Interpreters / 8
7. / Procedure for Out of Hours / Emergency / 10
8. / Consent / 11
9. / Procedure for Accessing Translation Services / 11
10. / Guidance Documents / 13
11 / Human Rights Act / 13
12 / Accessibility Statement / 13
APPENDICES – GUIDANCE DOCUMENTS: / Page No.
1. / Frequently Asked Questions / 14
2. / Checklist and Guidelines for working with Interpreters / 21
3. / What to do when talking to a person with a hearing impairment / 23
4. / What to do when talking to a person who is visually impaired / 25
5. / What to do when talking to a person with a speech impairment / learning difficulty / 28
6. / What to do when talking to a person who is Deafblind / 29
7. / What to do when talking to a person whose first language is not English. / 30

1.INTRODUCTION

1.1The Trust has accessto the following Interpretation and translation services:

1.1.1Access to Telephone Interpreters.

1.1.2Access to Face to Face Interpreters (other languages) – Must meet Trust Criteria.

1.1.3Access to Face to Face Interpreters (British Sign Language).

1.1.4Written Translation of correspondence / patient information (in other languages).

1.1.5Written Translation of correspondence / patient information into other formats (audio, large, print and braille)

1.2All Trust Clinical, Nursing and Admin Staff on all Wards and Departments should be aware of how to access interpreter and translation services.

1.3Interpreter and Translation Service Guidance Handbooks are available on all wards and departments and can be accessed via the Interpreter Services Web Pages on the Intranet.

1.4This Standard Operating Procedure should be read in conjunction with the Trust’s Interpreting and Translation Policy (TW11/023). This document sets out the process for booking telephone and face-to-face interpreters and how to translate correspondence / patient information into other formats.

2.DETAILS OF INTERPRETING ORGANISATIONS

2.1Language Line:

The Trust currently has a service level agreement with Language Line which is a telephone interpreting service. When a patient requires a telephone interpreter, Language Line should be used.

2.2Language Empire:

The Trust currently has a service level agreement with Language Empire which is a face-to-face interpreting service, providing interpretation for other languages and British Sign Language.Sign language interpretersinterpret from one language to another. In the UK this is usually from British Sign Language (BSL) to spoken or written English, or spoken or written English to BSL.

2.3Face to face interpreters will only be provided if requests meet the Trust Criteria for booking face-to-face interpreters/the practitioner can provide evidence for specific clinical reasons/or sign language interpretation is required.

3.GUIDELINES FOR USING INTERPRETERS

3.1When is an interpreter required?

As a Healthcare provider it is our responsibility to provide appropriate interpreter services. An interpreter will be required in the following situations:

3.1.1If the patient does not speak English.

3.1.2If the patient speaks English as a second language but there may be barriers to understanding.

3.1.3The patient may be able to speak English but whilst under distress, their understanding becomes impaired.

3.1.4The patient has a sensory impairment (hearing or visual) and requires specialist support.

3.1.5The patient has a learning difficulty / impairment and requires specialist support.

3.2The Trust’s required method of accessing an interpreter is via the telephone and should always be the first option for any staff member requiring an interpreter. No special equipment is required in most situations, only a telephone. Mobile and cordless devices can be used with the speaker facility turned on and the volume raised so all parties can hear one another. If however, a health care professional makes a clinical decision that telephone interpreting is not adequate for specific clinical reasons, then face to face interpreting can be arranged. Divisional authorisation and evidence of clinical need must be obtained.

3.3Identifying the need for an interpreter

A key element in providing appropriate services is ensuring that the health care staff and the service user can effectively communicate throughout the individual’s journey of care.

An individual’s communication needs and preferences should be recorded at the onset or first point of their care. Where requirements change, these will need to be updated so that other staff involved with the individual, have up-to-date information.

3.4Bilingual staff should only be used to help communicate basic information about care orpersonal history, signposting and basic information such as visiting times etc. Staff must not be used to interpret clinical information, medical terminology or to facilitate decision making in relation to care. An interpreter must be used where effective communication is critical to patient care outcomes, such as:

3.4.1Admission/Initial Assessment

3.4.2History taking and care planning

3.4.3Consent for treatment and research

3.4.4High risk/life threatening situations

3.4.5Pre-operative procedures including patient identification

3.4.6Explanation of medications and treatments

3.5If the need for language support has not been identified at the time of referral, or the patient is admitted as an emergency the person delivering the care is responsible for identifying the need for support. This should be recorded in the patient’s records and that person is responsible for ensuring that language services are provided.

3.6It is not always easy to determine how much someone can understand – this applies to the patient/family/carer. Some tips to support your initial communication with persons whose first language is not English:

3.6.1Speak clearly and in plain English.

3.6.2Give time for responses (30 seconds is not unusual).

3.6.3If you do not receive a response this may indicate that the question has not been understood and you may: Repeat the question, ask the person to repeat the question back to you.

3.6.4If the person cannot respond or repeat the question an interpreter’s assistance may be required.

3.7The following questions support you in determining the language competency of persons who speak English as their second language:

3.7.1Do you need an interpreter?

3.7.2Even if the answer is no, continue to assess the need for an interpreter by asking questions such as:Can you tell me where you were born?How long ago did you move to ……… /this community?Are you satisfied that we can go ahead in English or do you think we need an interpreter? Even if the patient/carer answers all the questions there is no guarantee that their level of English is/will be sufficient.

3.7.3In stressful situations such as illness a person’s command of English may decrease. It is crucial that the patient has full understanding and there are no misinterpretations by patients or staff

3.7.4In order to ensure the communication needs of the patient are met the following should be clarified where possible before booking an Interpreter: Language/Dialect/Country of Origin/Gender.

3.8Role of the Interpreter:

The role of the interpreter is to facilitate communication between two individuals, typically a service provider or freelance interpreter, and a patient or carer with aconcern, enquiry, request, or an out-patient visit or consent to treatment/treatment as an inpatient on a ward.Trained interpreters are bound to maintain confidentiality and adhere to Code of Ethics for Interpreters/Translators. The interpreter’s role should be respected and does not include:Giving their own opinion; Chaperoning; Advocating for the patient; Undertaking other tasks such as translation; Lifting patients.

3.9The interpreter does not analyse information, or decide what information should be given or not conveyed. Neither should the interpreter be used as a form of direct support to the patient or provide any other service, e.g. counselling. The interpreter is there to repeat what the healthcare staff and the patient/carer say to each other in a language that they can all understand.

3.10See Appendix 2 for further information about interpreter practice.

4.PROCEDURE FOR USING TELEPHONE INTERPRETERS

4.1Where there is a need for communication support, telephone interpretation should be considered the first option forservice users. No special equipment is required in most situations, only a telephone. Mobile and cordless devices should be used, with the speaker facility turned on and the volume raised so that all parties can hear one another.Face to face interpreters will only be authorised if requests meet the Trust Criteria for booking face-to-face interpreters or British Sign Language Interpretation is required.

The following Flow Chart summarises the Telephone Interpreter Booking Process:

HOW TO USE A TELEPHONE INTERPRETER

(When the service user is present)

HOW TO USE A TELEPHONE INTERPRETER

(When the service user is not present – outgoing / incoming calls

For incoming calls – If you have conferencing facilities

1.Put your patient on hold using the conference call facilities (try to obtain your patient’s telephone number in case they hang up whilst on hold).

2.Follow steps above – but advise the operator that your patient is ON HOLD.

If you do not have conferencing facilities:

1.Note your patient’s telephone number,language and, ideally, name.

2.Assure your patient that you will call backshortly with an interpreter.

3.Follow steps above

5.CRITERIA FOR REQUESTING FACE-TO FACE INTERPRETERS

5.1Face to face interpreters will only be provided if requests meet the Trust Criteria for bookingface-to-face interpreters/the practitioner can provide evidence for specific clinical reasons/or sign language interpretation is required.

5.2Criteria for Requesting Face-to face Interpreters:

• Patient uses non-verbal communication such as:

-British Sign Language
-DeafBlind Manual
-Makaton
-Lip Reader

• Child (under the age of 18)

• Vulnerable Adult

-Learning Disability
-Mental Health

• Patient has communication, cognitive or learning disability which would make telephone interpreting difficult.

• Bereavement or Breaking Significant News

• In specific areas where telephone interpretation cannot be facilitated (i.e. MRI Unit)

• Where conversation needs to be recorded for legal reasons.

For all other reasons, divisional authorisation must be obtained

All requests for face-to-face interpreters (which do not meet the above criteria) must be authorised by Divisional Managers / Named Divisional Leads. Evidence for specific clinical reasons must be provided.

5.3Requests for divisional authorisation should be submitted by e-mail. Requests which are granted should be documented by the Divisional Manager/Named Divisional Lead in the return e-mail. A copy of the e-mail should be forwarded to the Interpreter Services Booking Team and documented in the On-Line Booking Request Form on the Interpreter Services Web-Pages on the Intranet.

5.4Reasons for face-to-face interpreters must be clearly specified on the On-Line Booking Request Form. Divisional Manager Authorisation must be obtained for requests which do not meet the above criteria. Reasons must be for specific clinical reasons. Requests will be monitored to ensure compliance is adhered to.

6.PROCEDURE FOR BOOKING FACE-TO-FACE INTERPRETERS

The following Flow Chart summarises the Face-to-Face Interpreter Booking Process:

(Must meet Trust Criteria / be based on specific clinical need) –

WITHIN WORKING HOURS

FACE-TO-FACE

INVOICE AUTHORISATION

6.1On-line Booking Request Form

Face to face interpreters will only be provided if requests meet the Trust Criteria for booking face-to-face interpreters/or the practitioner can provide evidence for specific clinical

reasons/or sign language interpretation is required.

6.2A face-to-face Interpreter Booking Form will be required to be completed. This is an on-line Booking Request Form and can be accessed via the Interpreter Services Web Pages on the Intranet. If you are unable to gain access to the on-line booking request form, you can contact the Interpreter Booking Team directly by telephone. Switchboard will connect you.

6.3For details of how to access interpreter services during out-of-hours/emergency situations, please refer to Section 6 of this document.

6.4The following table summarises the information you will be required to submit via the On-Line Booking Request Form:

ON-LINE BOOKING REQUEST FORM

Patient’s NHS Number / Free Text
Directorate / Drop Down Box
Referring Speciality / Free Text
Date Required / Free Text
Start & Finish Time / Free Text
Site / Drop Down Box
Clinic / Ward / Department / Drop Down Box
Reason for Face-to-Face Interpreter / Drop Down Box
Divisional Manager Authorisation obtained from? (attach copy of authorisation e-mail if does not meet Trust Criteria) / Drop Down Box
Language Required / Drop Down Box (None & List of Languages)
Gender of Interpreter Required / Drop Down Box (Male / Female)
Sign Language Interpreter Required / Drop Down Box (Yes / No)
Contact Name / Free Text
Contact Telephone No. / Free Text
Date Form submitted On-line / Free Text
Additional Information / Requirements / Free Text
Confirmation that the request has Divisional Manager authorisation / Drop Down Box (Yes / No)

Top of Form

6.5Face-to-Face Timesheet and Monitoring Form

In order to allow the Trust to monitor the usage / efficiency of interpreter services, all staff who sign the Face to Face Interpreter’s Time-Sheet will be required to check the start and finish times and total hours claimed and complete the ‘Quick Feedback’ Section on the Form. A copy of the completed Time-Sheet must be retained on the ward / department. Divisional Staff responsible for authorising payment, will need to contact the ward / department to confirm invoice details.

7.PROCEDURE OF OUT OF HOURS/EMERGENCY:

7.1In an emergency situation it may be necessary to use staff members and adult family members to help communicate basic information about care or personal history, but they should not be used to interpret clinical information, medical terminology or to facilitate decision making about clinical care. An interpreter must be requested at the earliest opportunity. In the event of an emergency situation, consent or treatment decisions must be made in the patient’s best interests by a clinician and should not be delayed waiting for an interpreter. This should be fully documented in the health record of the patient. An interpreter must then attend at the earliest opportunity.

7.2The Trust’s required method of accessing an interpreter is via the telephone and should always be the first option for any staff member requiring an interpreter. If however, a request for a face-to-face interpreter meets the Trust Criteria/or the practitioner can provide evidence for specific clinical reasons / or sign language interpretation is required, staff should follow the following process during out-of-hours (between 5.00pm to 9.00am Monday to Fridays and all Weekends and Bank Holidays):

OUT-OF-HOURS/EMERGENCY PROCESS

Please Note: In the event of an emergency, the provision of an immediate Face-to-Face Interpreter is unlikely (although Language Empire will do their best to source an urgent interpreter, this could take up to 12 hours) – Please access
Telephone Interpreter Services (Language Line: #6 888 or 0800 9179031)

8CONSENT

8.1The legal position regarding obtaining a person’s consent to treatment is that the treating/operating clinician has a duty to ensure that a valid consent to the proposedtreatment/operation has been given by the patient. Where there is a need for communication support, telephone interpretation should be used. Face to face interpreters will only be provided where the practitioner can provide evidence for specific clinical reasons or Sign Language Interpretation is required.

8.2If the patient is not offered as much information as they reasonably need to make theirdecision, and in a form they can understand, their consent may not be valid. Consentmust be given voluntary: not under any form of duress or undue influence from health professionals, family or friends.

8.3In an emergency situation it may be necessary to use staff members and adult family members to help communicate basic information about care or personal history, but they should not be used to interpret clinical information, medical terminology or to facilitate decision making about clinical care. An interpreter must be requested at the earliest opportunity. In the event of an emergency situation, consent or treatment decisions must be made in the patient’s best interests by a clinician and should not be delayed waiting for an interpreter. This should be fully documented in the health record of the patient. An interpreter must then attend at the earliest opportunity.

9Procedure for Accessing Translations

9.1The Trust is committed to providing patient information in differing forms to support the needs of the patients accessing our services. Information can be translated in to other languages or other formats (including large print, audio and braille).

9.2 If a patient/carer requires the translation of any Trust document:

9.2.1First check that the document has not already been translated by searching the Trust Intranet. If it is available print off a copy and give or send to the patient / carer.

9.2.2Ask the patient/carer whether they would prefer to have the document explained in their first language by an interpreter. This can be done by telephone or by an appointment. If there is difficulty in communicating with the patient, a telephone interpreter should be used as described in the Telephone Interpreting procedure.

9.2.3If the patient/carer requires a written translation for any documentation, e-mail Patient Information Administrator, Membership and Engagement Department, Tel: (01942) 773106, E-mail: (). You must advise the patient / carer of the time-scale for translation (at least 3 to 5 working days).

9.3The following Flow Charts summarises the process for obtaining information in other formats, including audio, large print, braille or other languages: