I’m steeling myself for an outbreak of inappropriate hand gestures and speaking very s-l-o-w-l-y in the NHS. I wrote in another post about how the staff at my local hospital some years ago all seemed to have been sent on a very bad deaf awareness course, resulting in them accompanying their speech with (for me) quite superfluous “thumbs up” signals, pointing and grinning. Thankfully, it died out (or the staff had better training). But I quaked as I read this week about very laudable new legislation, about which more in a minute, because there it was again. “Use gestures and facial expressions to support what you are saying.” “Speak a little slower than you would do usually.” Aagh……….
I’d better explain what I’m talking about. On 31 July new legislation (the Accessible Information Standard) comes into force which requires NHS England and providers of adult social care (including residential care and nursing homes) to provide information in a format which people with disabilities can understand. The organisations must ask what help with communication the person needs, record that need and how they are going to meet it, highlight the need in their records, share the information (with the consent of the person involved) with other organisations and then act – that is, provide the help the person has asked for. It is particularly aimed at people with a visual loss, hearing loss or learning disability, although people with other conditions affecting their ability to communicate are also included. The sort of assistance involved would include providing a sign language interpreter for a member of the Deaf community, providing written material in large print, offering communication via e mail rather than the telephone etc.
It is legislation which is much needed. Action on Hearing Loss found in 2013 that 28% of people who replied to their survey had left their GP’s surgery unclear about their diagnosis and 14% had missed an appointment because they missed their name being called in the waiting room.
I’ve never experienced the first problem (I will double check if I think I’m missing something) and I’m lucky that in my local medical practice it is hard to miss your name being called. There are two small waiting rooms depending on who you want to see. When it’s your turn the doctor or nurse will come out into the waiting room and call your name. I pick a seat with a good view of the whole room so I can spot all “name callers”, do a bit of hearing/lip reading and all is straightforward. (I did once leap to my feet when someone else’s name was called but they turned out to be a Deirdre Bean instead of a Vera Brearey – a very excusable hearing/lip reading mistake).
However, long, long ago when we lived in London I can recall that the receptionists at one surgery announced appointments from behind the glass (bullet proof?) screen that encircled their desk (like at a bank). Even in those far off days my hearing couldn’t cope with that and I would have to negotiate a special deal with them – I’d sit right opposite and get them to wave when it was my turn. Happy days – there are still probably places like that…..
I am doubly lucky that my local audiology department is a small and friendly place, where there are only ever a few people waiting to be seen. No missed names there. But when Nigel and I used to take his mum to the audiology department where she lived it was an entirely different story. There was a massive, busy, noisy waiting room, with lots of chairs positioned where you couldn’t see the people who were calling names out (surely illogical for an audiology department…..) and, on top of that, a big TV in the corner with the sound on. Nightmare.
So the legislation is an excellent step forward and it is coming soon to a surgery near you (in England anyway) or indeed a care home near you (but care homes are a topic for another day). All new and returning patients at a GP’s surgery must be asked if they have any requirements so, next time you are at the doctor’s, they should ask. Tell them that you read it here first.
Back to my gripe. The quotes at the beginning of the post came from a list of tips in the Implementation Guidance for clear face to face communication. It’s unfair to pick out just two examples from the list, especially when the list is trying to address ALL disabilities, but it should have been prefaced with a clear “above all find out what the person needs and wants” and it wasn’t. For some people, speaking more slowly and using sensible gestures will be very helpful, but for others it will be (a) of no practical help at all and (b) embarrassing.
A specialist teacher of deaf awareness would always stress the need to tailor the approach to the individual. However, most organisations won’t be employing specialist help – it’s too expensive – so a hard pressed manager will be using the guidance to train their staff (I know, I’ve been that public sector manager). So I’m bracing myself for the return of some inappropriate strategies. But, this time round, if it happens I’m going to speak up. I really don’t want to be gestured at again.