Volume 06 / Issue 04 / December 2018
Page 36
boa.ac.uk
JTO Features
Use of Interpreters in Orthopaedics Grey Giddins I am writing this as an ‘interested amateur’ without claiming great expertise. I have, however, discussed this with other clinicians and interpreters. There are also published papers available which give some guidance. This is not the definitive article on the topic but the beginning of a discussion about the best way to use interpreters. Interpreters may be for patients who do not speak much or any English, or for deaf people requiring sign language interpretation.
NHS obligations There is an NHS directive entitled “principals for high quality interpreting and translation services”. The key principals are as follows: 1
a) Translation is free b) Additional time will be needed in a consultation, typically double the regular appointment c) There should be a visible alert on the notes warning of the need for an interpreter and the relevant language d) The interpreter should be registered and will, amongst others, need up to date Information Governance training e) The use of an interpreter should not unduly delay clinical care Grey Giddins
f) Patients should be able to have an interpreter of the gender of their choice
g) “The use of family, friends or unqualified interpreters is strongly discouraged in national and international guidance and would not be considered good practice” (note this does not mean it is barred, but strongly discouraged). If a family member is used, the patient should ideally be consented for this in their own language by someone else. h) “The use of anyone under the age of 16 for ‘interpretation’ or language broking is not acceptable under any circumstances other than when immediate and necessary treatment is required. In this case safeguarding and competency must be a consideration” i) “Professionals and primary care staff may use their language and communication skills to assist patients making appointments or identifying communication requirements (language broking),
but should not, other than where immediate and necessary treatment is required, take on the role of interpreter unless it is part of the defined job role and they are qualified to do so. Staff use of interpreters this way must be covered by indemnity insurance”.
Advice in practice The use of professional interpreters improves patient satisfaction2,3 but in practice patients often attend without an interpreter. Currently systems to identify patients needing an interpreter are not well developed in most hospitals. If the clinical problem can wait then it would be reasonable to review the patient in a short time period with an interpreter, although it is always a shame to bring patients back without offering anything in the first appointment. If the clinical problem cannot wait, it is a matter of doing the best possible but acknowledging that it is sub-optimal. In particular, any critical decision such as proceeding with surgery or not should ‘always’ be performed with a professional interpreter to avoid family bias influencing the patient inappropriately or inadequate interpretation, meaning that consent is poor or invalid. Phone interpreter services are encouraged by hospitals but experience with these is variable. In time, video >>