As part of NHS Scotland’s commitment to the national BSL Action Plan, a comprehensive policy to ensure that NHS Scotland has an updated, clear, consistent and equitable approach for the provision of all interpreting and translation support services for patients, their family members and/or carers who have limited ability to communicate in English must be produced.
NHS Scotland have put their interpreting and translation policy out for consultation. The following response is submitted by The National Union of British Sign Language Interpreters.
The National Union of British Sign Language Interpreters (NUBSLI), represents BSL/ English interpreters working across the UK, including in Scotland, and our members have contacted us to request we provide feedback on the 2018 National Interpreting and Translation policy that is currently out for consultation.
As part of our remit, NUBSLI works to ensure that those responsible for creating policy and working with, and commissioning the services of, these interpreters recognise the necessity of engaging with registered professionals, as well as campaigning to ensure that interpreters’ fees and terms and conditions of business are respected.
Our reasons for this work are straightforward. By working with registered professionals, organisations will be in a better position to meet their legal obligations by having assurance that those providing services have the proper qualifications, skills and experience for assignments. In addition, by compensating providers appropriately, it ensures the sustainability of the profession.
We understand that arrangements for and procurement of interpreting services is the responsibility of individual local NHS Boards and that the aim of this policy will be to inform best practise with regard to doing so.
For this reason, it is vital that the information contained in this policy is accurate and takes into account the reality of the landscape regarding the BSL interpreting profession in Scotland. To that end, we welcome the fact that NHS Scotland are seeking feedback on this policy but would have to say that, having looked at the questions in the survey, it is apparent that this has not been devised specifically as a means to collating feedback and views from interpreters.
For that reason, and in order that our feedback can be meaningful, we will post our response in the section for ‘any other comments’ although it will encompass all points we wish to comment on and address.
The scope of the policy
This is aspirational; to ensure that only those registered interpreters who have satisfactorily completed additional training in healthcare settings will be engaged to provide BSL/English interpreting services. In the current landscape, however, we believe this aim currently unattainable. NUBSLI are aware that a ‘landscape review’ of the BSL/English interpreting profession in Scotland is underway and we would urge that you do not put this policy into force until that review is completed and reported upon. Rather, it is imperative that this policy with such far reaching scope must be informed by the landscape review in order that it might be attainable.
Not working with trainee interpreters in healthcare settings
This policy is advises that the services of trainee interpreters should not be engaged in healthcare settings. By putting this into policy, NHS Scotland will severely reduce access to the number of interpreters available to provide services to NHS Boards which in turn will make BSL users’ access to services worse instead of better.
It is recognised that the services of trainee interpreters should not be engaged for certain appointments including, but not restricted to, taking patient consent or mental health assignments. However, there is no reason that Trainee interpreters cannot provide services in healthcare settings in general provided clear guidelines are in place as to what settings would and would not be appropriate.
This also highlights the responsibility NHS departments must take when requesting BSL interpreting services to ensure they provide sufficient details in order that the interpreter with the appropriate skills can be secured for specific bookings.
Supporting professional interpreters’ professional development
It is welcomed that NHS Scotland would look to support the professional development of interpreters, including affording trainees opportunities to develop their skills. However, NUBSLI condemns the proposal that NHS Boards should not pay interpreter fees when a trainee BSL Interpreter is present on patient appointments. As stated above, there is no reason that trainee interpreters cannot be engaged for some healthcare assignments within clearly agreed parameters.
Services procured under framework agreements
NUBSLI are clear that framework agreements do not benefit interpreters nor the organisations or Deaf clients we work with. Rather, these have led to a decrease in quality of service provision, placing clients at risk in all areas they have been used, as well as the first organised industrial action taken by interpreters in the history of the profession. For more information on this, see NUBSLI Dossier of Disgrace.
Benefits/issues of a third party managing services for NHS Boards
Where the services of BSL/English Interpreters are to be procured via a third party, the preferred option should be for contracts to be awarded to specialist providers of BSL interpreting services. It should be clearly stated in the terms of the contract that they must work only with those interpreters that are registered with one of the regulatory organisations in the UK: NRCPD, RBSLI and SASLI. A further condition of the contract must be that they provide evidence of this for 100% of bookings.
Where it is not possible to procure services via a specialist provider, it is anticipated that, following appropriate tendering processes, the contract is likely to be awarded to a non- specialist provider, e.g., a spoken language interpreting agency. In this instance, it should again be clearly stated in the terms of the contract that, to deliver the BSL interpreting services, they must work only with those BSL/English interpreters that are registered with one of the regulatory organisations listed above, and it should be a condition that they provide evidence of this for 100% of BSL bookings.
In addition to the above, whichever organisation is awarded the contract, a condition of the contract should be that monthly figures of how many interpreting requests have been met, as well has how many have not been met must be provided. If the contract is awarded to a spoken language agency, it must be a further condition that these figures are detailed separately to spoken language bookings to ensure accurate figures are reported.
Any organisation tendering for the contact for interpreting services should be doing so inline with the fees and business terms that BSL/English interpreting professionals charge for their services. Experience has shown that agencies have been awarded contracts by claiming they can provide interpreting services at below market rates, and with business terms that are not inline with industry standards.
The result of this has been that interpreters will not provide services to these agencies and they are subsequently unable to meet their contractual obligations. The knock-on effect of this is that the organisations who have awarded contracts to these agencies are failing in their legal requirement to make their services accessible to BSL users.
Procuring services from Registered Sign Language Interpreters directly
This is an option that does not seem to have been considered but which we believe merits consideration. By engaging services directly, a shorter supply chain and more efficient service would be established which would benefit all parties involved. By our reckoning this only yields positive outcomes:
- confirmation of availability is expedited;
- third party costs are removed, thus reducing costs overall while respecting industry standard fees and business terms;
- trusted working relationships are established allowing for a collaborative approach to provision leading to continuity for clients and safer working practices for interpreters.
NUBSLI fee and business terms guidance
NUBSLI has published guidance which details the fees and business terms that BSL/ English interpreters across the UK might charge. Please note that these are for guidance purposes only and should be taken as the baseline for fees for interpreting services. Interpreters will charge fees that are commensurate with their skills and experience, as well as reflective of skill specific domains. It should be anticipated that interpreters will charge higher fees for domains that require them to have specialist skills.
We would also stress that BSL/English interpreters do not charge by the hour, rather they will charge a call-out fee for a booking of short duration, and half-day and full-day fees, as appropriate, for bookings of longer duration.
Interpreters employed by NHS Boards
We have assumed that should NHS Boards decide to set up in-house interpreting services, interpreters would be either employed or contracted as and when their services are required. In terms of employment patterns, it is worth noting that the overwhelming majority of sign language interpreters are self employed. This is not to say that some would not wish to be employed, on either a full or part time basis, nor that this cannot be a workable arrangement.
However, for this to be a successful means of providing BSL interpretation services, we would suggest that staff at all levels (including managers) must have expert knowledge of the Deaf Community and their needs, as well as how interpreters work. Novice interpreters may be more likely to seek employment but it needs to be stressed that their inexperience must be given consideration given that, without appropriate knowledge and guidance, such interpreters may feel pressured to undertake assignments that are contradictory to their professional Code of Conduct and could quickly find themselves experiencing burnout and thus leaving the profession, or subject to complaint investigations from their regulatory organisation.
For these reasons, we would recommend that employed interpreters should have a range of experience and skills and that due respect is given to the Code of Conduct of their regulatory organisations, particularly where this may be at odds with council policy.
British Sign Language interpreting services on demand
The policy states “NHS boards should have access to BSL interpreting services on demand, i.e., ‘SLI now’”. It is wholly unacceptable to name and promote a specific organisation in a policy such as this, particularly when this service is managed by a private sector company.
In addition it is a grave concern of our membership that the company that owns and operates this service has and regularly continues to provide interpreting services at meetings where policy and content is discussed and currently manages the ContactScotland-BSL service. This alone should be flagged up as a conflict of interest, however, to name them in a document such as this does not allow for any fair competition amongst other providers and gives concern that NHS Scotland are effectively supporting a monopoly.
NUBSLI Dossier of Disgrace
In addition to addressing some the questions set by yourselves, we have attached a copy of NUBSLI’s Dossier of Disgrace . This document will be of interest as it clearly highlights the problems that arise when contracts for BSL/English interpreting services are awarded to non- specialist providers, and how they negatively impact deaf service users.
The Dossier of Disgrace includes evidence and case studies that demonstrate how spoken language agencies have put the lives of deaf people at risk by using unqualified and unregistered interpreters and how, by being unable to fulfil a large percentage of BSL bookings, they have left deaf users with no access.
We hope that this information is useful and helps to ensure that you meet the needs of deaf service users. Please feel free to contact us if you require any further advice.
You can view NHS Scotland’s draft Interpreting and Translation policy here. (PDF)