GP mythbuster 20: Making information accessible

We are asked questions about whether practices are expected to provide information in different formats, access to translation services (written communication) or interpreters (verbal communications).

It is important to make the distinction between:

• people who have a disability which makes communicating in spoken and/or written English difficult or impossible, and
• people whose first language is not English.

In the Equality Act 2010 there are extra requirements to make reasonable adjustments for disabled people. This means that interpreting and providing written information in alternative formats are likely to be legal requirements for GP practices. For example, large print on request. Practices can consider the ‘reasonability’ of each case. There is no reasonable adjustments requirement for interpreting and translation because of race or nationality. The Equality Act does not specifically mention people whose first language is not English. The General Medical Council’s Good Medical Practice 2013 states:

 ‘you should make sure that arrangements are made, wherever possible, to meet patients’ language and communication needs’.

The Accessible Information Standard (AIS)

NHS England introduced the AIS to help clarify what is reasonable under the Equality Act. It aims to make sure people who have a disability, impairment or sensory loss receive information they can easily read or understand, and get support so they can communicate effectively with health and social care services. It covers patients, their parents and carers.

Since 2016, providers of any NHS funded care must, by law:

1. Identify/ask people if they have any information or communication needs
2. Find out how to meet their needs.
3. Record those needs in a clear and consistent way.
4. Flag their file or notes so it is clear that they have information or communication needs. Record how to meet those needs.
5. Share people’s information and communication needs with other providers of NHS and adult social care. This is only when they have consent or permission to do so.
6. Meet needs. Make sure people receive information they can access and understand. They should receive communication support if they need it.

When we inspect we look at how services meet the AIS. It is in our new health assessment framework. This is under key line of enquiry R1 “How do people receive personalised care that is responsive to their needs?”. 

Information in different languages

When looking at how caring GP practices are during inspections, one of our key lines of enquiry (C2) is: ‘Are people who use services and those close to them involved as partners in their care?’ Do staff recognise when people who use services and those close to them need more support to help them understand or be involved in their care and treatment? Do staff enable them to access this? This could include providing language interpreters where appropriate. It could also include providing printed information in different languages.

This does not always mean that we would expect all GP practices to have information leaflets in multiple languages. The key point is that services should be responsive to the needs of the population they serve. This will vary from practice to practice. A practice should be aware of the needs of the people on their patient list. This includes their language requirements. If they serve a large number of people whose first language is not English they should plan services appropriately. Practices should consider how they provide information about their services and how these people will be involved in their care. This might mean making printed information available in different languages. It may also mean making sure people who use services and those close to them can access interpretation services.

NHS England has published a draft principles framework for high quality interpreting and translating services in primary care. This covers both community language and British Sign Language (BSL) interpreting.

Further information

• Meeting the accessible information standard
• Accessible Information Standard (AIS) (NHS England)
• Following the Accessible Information Standard (British Medical Association)