Revealed: UK NHS Hospital Trusts and Ambulance Trusts’ emergency BSL policy

Posted on January 4, 2018


This article is by Liam O’Dell.

Distressed, in pain, in an unfamiliar environment with no means to communicate.

It’s a feeling of isolation one would usually associate with your typical horror movie, but if the right provisions aren’t in place, it can be a real-life nightmare for the 50,000 deaf people in the UK that use British Sign Language as their first language.

Over the last few months, I’ve undertaken a detailed investigation, which saw me send nearly 170 Freedom of Information emails to hospital and ambulance trusts across England, Scotland, Wales and Northern Ireland.

For hospital trusts, I wanted to know whether interpreters were available for 999 callouts and if they weren’t, what policies the trust had in place for deaf patients.

Similarly, with regards to ambulance trusts, the request was similar: do any of their paramedics know sign language, and if they don’t, what procedures do they have in place?

The 20 working day deadline for them to get back to you means a lot of twiddling thumbs, waiting for a response. It also gave me enough time to think about what I expected from them, and what would be the ‘best’ reply from those I contacted.

The best answer – to me, at least – would be if the hospital had BSL interpreters on hand at short notice and out of hours in order to help deaf patients communicate.

With emergencies being so sudden and having the potential to take place in early mornings and late evenings, it’s vital that there’s someone there at whatever time to break down the communication barrier during such a stressful time.

So, soon enough, the deadline passed, responses came in and I was pretty surprised.

In England, 149 hospital trusts responded to my request (two failed to respond in time) along with 10 ambulance trusts. In Scotland, 14 health boards responded, plus with the Scottish Ambulance Service. The Welsh Ambulance Service responded to my request, and I received a response from 5 out of 6 Welsh health boards. The Northern Ireland Ambulance Service Health and Social Care Trust also responded to my request.

What I found was that the ambulance trusts didn’t have a record of paramedics in their team that knew sign language. Most said that they encouraged people to sign up to the Emergency SMS service to text 999, and a few mentioned handbooks which professionals could use to communicate.

As for English hospital trusts, seven trusts had a response which were particularly interesting to me:

  • Ashford and St Peter’s Hospitals NHS Foundation Trust has three computers on wheels which they use to access an online Video Relay British Sign Language (BSL) service, as opposed to physical interpreters.
  • Bedford Hospital NHS Trust say they require up to seven days’ notice to book an interpreter. In emergency situations which lead to the patient visiting Accident and Emergency (A&E), staff would have to write down questions or rely on a member of the patient’s family to interpret
  • Birmingham Community Healthcare has an external interpreting provider, but they are not available for 999 callouts. They also do not have a specific policy concerning emergency cases regarding deaf patients.
  • Cambridge University NHS Hospitals Foundation Trust does not have any emergency interpreters available and only has manual processes such as access books (small books with pictures and common phrases to help medical staff communicate with patients). They are, however, exploring an online interpreting option.
  • Oxford University Hospitals NHS Foundation Trust is currently looking into a video-based BSL interpreting service, as whilst they do have freelance interpreters, ‘they are not an emergency service’.
  • The Queen Elizabeth Hospital, Kings Lynn, NHS Foundation Trust have no designated BSL facility for 999 callouts.
  • University Hospitals of Morecambe Bay NHS Foundation Trust currently directs cases to regional services on a case-by-case basis, but does not offer a BSL service in its hospitals.

In Wales, the majority of health boards had suitable procedures in place, in the sense that BSL interpreters could either be booked by hospitals or they have a contract with a BSL provider.

Except for Betsi Cadwaladr University Health Board. Although it does have an interpreting service, it is mainly available Monday to Fridays, 9am to 5pm. Anything outside of this time is dependent on interpreters being available at short notice.

There was a similar thing for Dumfries and Galloway NHS Board in Scotland, where the interpreting service is only available ‘during office hours’. Outside of these hours, patients have to rely on contactScotland – BSL, which is a video relay service for Scots to get in touch with public bodies. However, this can’t be used in emergency situations, such as 999 calls.

Elleanan Siar Western Isles Health Board say they have no interpreters available to patients and that their patients would have to rely on contactScotland – BSL in an emergency. Lothian has support available during ‘core opening hours’, and is currently investigating out-of-hours services. Shetland’s response also referred to a video relay service, which they can use to contact medical experts, yet they did not state whether this could be used in emergencies.

The large amount of trusts which have good procedures in place (that is, BSL interpreters available out-of-hours, 24 hours a day, at short notice) is good to see, but the odd few without certain support available is worrying for deaf patients who may attend those hospitals without having full communication.

So with that in mind, there’s still more work to be done on making hospitals more accessible to deaf people. While the average patient may experience anxiety as a result of the intense hospital environment and fearing the unknown, a deaf patient also has to deal with the anxiety and frustration that comes with not being understood.

Even if emergency interpreters are in place, a BSL user may still not feel at ease or comfortable in hospital if there is not good levels of deaf awareness. Providing an interpreter is one thing, making deaf people feel completely comfortable and assured is another.

From the results I gained, it’s clear than in some areas, an urgent visit to the hospital still has the potential to be a nightmare scenario for deaf people in the UK.

Read more of Liam’s writing for us here.

Liam O’Dell is mildly deaf and uses hearing aids in both ears. Alongside studying for a degree in journalism, Liam enjoys presenting his own radio show, listening to music and reading one of the many books on his ’to-be-read’ list. You can find out more about Liam over at his blog:, or follow him on Twitter: @lifeofathinker.

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