Access to health and social care services for Deaf people

This report examined the barriers faced by Deaf people who use British Sign Language (BSL) when accessing health and social care services in York. Healthwatch York undertook the work after members of the local Deaf community reported significant difficulties accessing services and communicating effectively with healthcare professionals. The investigation involved a public meeting attended by 25 Deaf residents, during which participants shared 48 separate experiences and several more detailed personal accounts. 

The report found that communication problems were widespread across health and social care services. Many Deaf people reported that organisations did not recognise BSL as their first language and often relied on written English communications that were difficult to understand. Participants also felt that there was a general lack of awareness about Deaf culture, the different communication needs of Deaf people, and the distinction between Deaf people who use sign language and people with hearing loss. 

The most common concerns related to GP services. Deaf patients reported difficulties booking appointments, obtaining interpreters, communicating during consultations, and being alerted when it was their turn to see a doctor. Some patients said GP practices refused requests for BSL interpreters on the grounds of cost, while others were offered remote interpreting services that they found unreliable or unsuitable. There were examples of family members, including children, being used as interpreters during consultations, which patients felt was inappropriate and potentially unsafe. 

Patients also described situations where they missed appointments because there were no visual systems to indicate when they were being called. Others reported receiving important medical information without adequate interpretation, leaving them uncertain about diagnoses, medications, test results, or follow-up arrangements. Several participants felt that communication difficulties put their health at risk. 

Problems were also reported within hospital services. Patients described appointments where interpreters had not been booked despite requests, where they waited for long periods without communication, or where unqualified signers were used instead of qualified interpreters. Some Deaf parents reported that, although interpreters were provided for their own care, they were unavailable when attending appointments relating to their children, limiting their ability to understand medical advice and ask questions. 

Concerns extended beyond healthcare into social care. Participants highlighted the isolation experienced by many older Deaf people and called for improved access to social workers and interpreters. Several attendees wanted regular opportunities to meet with a hearing social worker accompanied by an interpreter so that issues could be resolved quickly and effectively. 

The report also identified problems accessing interpreters in other services, including dentistry, opticians, counselling services and voluntary sector organisations. Some people were told that interpreters could not be provided because no funding was available. 

Healthwatch York concluded that Deaf people in York experienced significant inequalities when accessing health and social care services. The report argued that these barriers potentially breached the Equality Act 2010, which requires service providers to make reasonable adjustments for disabled people. It also highlighted potential risks associated with delayed treatment, misunderstandings, inappropriate care, missed appointments, and reduced involvement of Deaf people in decisions about their own health and care.

A central theme of the report was that Deaf people were not seeking special treatment but equal access to services. Participants wanted health and care providers to communicate with them effectively, provide appropriate interpreting support, and ensure they could participate fully in decisions about their care. 

The report made ten recommendations to improve accessibility. These included providing Deaf Awareness Training for frontline staff, improving promotion and availability of interpreting services, reviewing how communication needs are recorded and identified, offering multiple methods for booking appointments such as text and email, making public meetings accessible through BSL interpretation, exploring a dedicated clinic for Deaf people, creating a shared pool of interpreters, considering Deaf access when commissioning services, introducing visual call systems in waiting rooms, and reviewing the accessibility of written communications. 

Overall, the report concluded that poor communication and inconsistent access to qualified interpreters were creating substantial barriers for Deaf people across health and social care services in York, and that coordinated action was needed to ensure services were accessible, inclusive and compliant with equality requirements.