Dental mythbuster 20: Using language professionals and interpreters

Page last updated: 2 October 2023

The Equality Act 2010

The Equality and Human Rights Commission (EHRC) enforces the Equality Act 2010. This protects people’s rights to fairness, dignity and respect. Some provisions of the Equality Act 2010 are written into CQC regulations.

All registered providers must have due regard to the protected characteristics defined in the Equality Act 2010.

You must work with a person to make any reasonable adjustments and provide them with support. This is to help them understand and make informed decisions about their care and treatment. This includes the extent to which they may wish to manage these options themselves.

The NHS Accessible Information Standard (AIS)

The AIS aims to make sure that people who have a disability, impairment or sensory loss can read or understand the information they need. This is so they can communicate effectively with health and social care services. It covers people who use services, their family members, and carers.

Providers of NHS care must, by law:

Identify people who have any information or communication needs, and find out how to meet their needs.
Record those needs clearly and consistently.
Flag their file or notes to make clear that they have information or communication needs and include how to meet those needs.
Share people’s information and communication needs with other providers of NHS and adult social care, when you have consent or permission to do so.
Meet people’s needs by making sure they receive information that they can access and understand. People should also receive support with communication if they need it.

If you’re a private dental provider, who is partially funded by the NHS, you must comply with the AIS. If you only provide private work, the AIS does not apply. However, you must abide by the Equality Act 2010.

Arranging interpreting services

NHS England has published Guidance for commissioners: interpreting and translation services in primary care. The guidance covers both spoken languages and British Sign Language (BSL).

BSL interpreters

Reasonable adjustment provisions in the Equality Act 2010, relating to disability and the AIS, apply to both NHS and private dental treatment.

It is unlawful for a dental provider to ask a deaf person to pay for a sign language interpreter (section 20 (7) of the Equality Act 2010).
The decision on whether a dentist must arrange, and pay for, a BSL interpreter depends on an individual assessment of what’s reasonable. The courts will decide each case. The Equality and Human Rights Commission's 'Services, Public functions and Associations: Statutory Code of Practice' confirms that financial help from an NHS England area team could be a factor in this judgement.
If a practice fails to apply for available financial help, it could be breaching the duty to make reasonable adjustments and open to legal challenge.
If no financial assistance is available, the practice should consider whether it’s reasonable to pay for a sign language interpreter. For example, would protecting some appointments for deaf people and booking an interpreter for these be reasonable? If providers do not consider how they might make a reasonable adjustment, they could be open to challenge.
If a dental practice refuses to supply a BSL interpreter, they should have evidence that they considered the options for making reasonable adjustments. For example, by investigating support from NHS England or considering paying for an interpreter.

Language interpreters

The AIS does not apply to translating foreign languages, but the Equality Act 2010 does.

Not providing an interpreter can:

affect patient experience and health outcomes
increase missed appointments
make consultations less effective.

Under the Equality Act 2010, it can also be indirect discrimination on the grounds of race.

If you refuse to provide a language interpreter for NHS care, you must consider what interpreting services are available locally.

Your conclusion and decision must fulfil a test of ‘due regard’ under the public sector equality duty.

Using family or friends as interpreters

Section 2.1 of the General Dental Council’s Standards for the Dental Team requires dentists to:

“Communicate effectively with patients – listen to them, give them time to consider information and take their individual views and communication needs into account.”

Some practices may allow a family member or friend to interpret for a patient. This is not without risk as there is no guarantee that this person is able to interpret properly. Practices cannot therefore be sure that dentists are communicating effectively with patients. Family members may also struggle to remain calm and translate effectively if there’s a medical emergency.

However, there may be times when a patient specifically wants a family member, or friend, to act as their interpreter. In this case, you must obtain the patient’s informed consent to do this in their own language and independently of the family member or friend.

You can reduce the chances of mistranslation by:

monitoring the communication between your patient and their family or friends
checking whether the translation appears correct.

We recommend that you discuss the matter with your defence organisation if you allow a family member or friend to interpret. This is to ensure you would be covered if there are any mistakes.

BSL and language interpreting

Your practice must ensure that language translators or interpreters:

hold relevant qualifications
have appropriate insurance
have an enhanced disclosure from the Disclosure and Barring Service.

All BSL and English interpreters should be registered with the National Registers of Communication Professionals working with Deaf and Deafblind people.

Translating written material

Your practice should respond to the needs of the population you serve.

You should consider providing written information and leaflets in other languages if this meets your patients’ needs.