Simon is a GP who approached us to find out how he can support SignHealth’s campaigns for better access to the NHS for deaf people. Here he shares his perspective as a GP on the importance of improving deaf awareness in primary care.
We are sharing Simon’s story to educate and encourage hearing health professionals. This video is in spoken English with subtitles. If you would like this video translated into BSL, please email us at communications@signhealth.org.uk.
Transcript
Simon: My name is Simon Braybrook. I’m a doctor at Butetown medical centre in Cardiff Wales.
As a teenager I did level 1-3 in SSE, which was what was being taught locally in the 90s when I was growing up. Then that changed and rightly the focus is more on BSL, so I stopped that and went to university.
I started again when I met a lady who is a BSL teacher on holiday in Italy. I didn’t understand much sign at that point, but I did understand a few signs she was using at the dinner table. She meant everyone was talking and I can’t follow. So I made the effort then to get to know her and I’m glad I did. We had a lot in common and we stayed friends and that inspired me to learn again. And the more I learnt, the more interesting the language became, but also the more I learned about the deaf community.
I always say learning a language, it’s not just a language, it’s accessing a community. And I learnt about their passions and their history and the different challenges faced in a hearing world, and I wanted to develop more.
Access to primary care
I think general practise, primary care is the most neglected area when it comes to access. I mean, we know access to booking an interpreter for a hospital appointment is fraught with problems. We often don’t get enough choice. Often there’s problems with communication, knowing it’s booked cancellations, appointment changes. But often in primary care, people need an appointment now. They’re phoning for an appointment now, which is the main way most appointments are allocated. And that’s something that’s just not accessible for the deaf community.
If they are phoning for appointment, what that means is they’re needing somebody else to phone on their behalf, which is a confidentiality issue, potentially. And then if they’re getting an appointment that day, the chance of being able to book an interpreter is minimal as well, which means that they’re either going to have to make do without one, or perhaps they’re going to need to ask a friend or a family member who they may not feel it’s appropriate to know their medical problems to come with them. The problems in primary care are huge.
Access for everyone, not just the majority
I think the biggest thing goes with anything when we’re talking about any health access in primary care, often what we do is we make it accessible for the majority. And because it’s good enough for most people, it’s good enough. Whereas that’s always going to exclude some people, people without phones, people who have got chaotic lifestyles, people who have got communication differences that make accessing that different. If you make it accessible for those people, then everybody else will fit in.
So, thinking about the parts of the process when a patient is coming for an appointment or wanting to book an appointment and thinking of that from that perspective, you know, do they have to phone? What’s communication like at the front desk? Are there other ways of booking an appointment, like using an automatic relay service or an email or those things? If you, you’re setting these things up, are people actually checking them, checking the emails to make sure they’re looking for those appointments? Looking and thinking through that process from the start, from somebody wanting to book an appointment, arriving here, getting here that whole process and seeing are we making that accessible for everybody or are we just making that accessible for the majority?
Deaf awareness in primary care
GPs are very time poor, they are very, very stressed. They have got a lot on and I do understand that. I mean if I could show people the excitement that I had from my staff after that session on deaf awareness where they learned a little bit of BSL. A number of them said I’m going to go and enrol on a level one course and they did.
I think it’s not just a matter of this is what you should be doing. It’s about understanding why, having training that is delivered by deaf people themselves who are passionate about it, who are able to communicate their own experiences. That makes people excited at the opportunity of providing a language provision for a unique language group who unlike other spoken languages, can’t always simply just learn to speak English and certainly can’t learn to hear English. Getting people excited about that is important.
What’s needed to make interpreters available
From a governmental level it is going to take organisation and it is going to take money. It is important that people have a right to an interpreter, preferably an interpreter of their choosing. So if they have an interpreter locally that perhaps they socialise with, they have the opportunity to choose somebody that they’re not going to see on a daily or regular basis. Or indeed I think it is important having the opportunity to choose a video interpreter from elsewhere. That shouldn’t be a substitute, that’s forced on people who want a face to face interpreter. And indeed a face to face interpreter shouldn’t be forced on people who choose that. It’s having the opportunity to choose. There’s advantages to both models of interpretation and both are valuable.
We are going to need some degree of central organisation to make sure that we have access to video interpreting and video relay services for perhaps the more simple communication. Because let’s not forget that an interpreter isn’t just for the consulting room, it’s also for when you’re making the appointment or when you’re phoning up for the blood results or these other things, the interactions with staff. We need it for that as well.
Learning sign language
I would love for every GP practise to have somebody who has learned to sign. That would be wonderful. But I also recognise that that’s not always going to be realistic. There is so much that we can do without doing that. And as I say, I would encourage it. You know, learning sign language is one of the best experiences of my life and I’d encourage people to do that.
Little things make a big difference
Simple things. I mean, to give an example, I was speaking to a deaf lady who went to see a receptionist for advice. And when the receptionist realised they were deaf, they physically recoiled with a look of panic on their face to go, I don’t know what to do. And you give them an impression from the very, very outset of that situation. So actually having a very basic level of deaf awareness training, and as I say, deaf awareness training, not disability awareness training, it’s different to recognise how the basic skills for how we can communicate:
- facing somebody
- making sure that we’re properly lit
- making sure that background noise is minimised so it’s not being amplified by hearing aids
- making sure that we’re speaking in a clear way so that we’re not shouting or slowing down our speech, that makes it difficult to lip read
- using gestures or pointing to things
- or writing down things to assist with communication.
All of that can be done without a great deal of training or expense. And as I say, booking a deaf awareness training session through a deaf-led organisation, best decision you will make.
