Deaf patient denied access to BSL interpreter at GP practice

What happened

Mrs E is from Northern Europe. She is profoundly Deaf and uses BSL when communicating with organisations in the UK. She has very limited literacy skills in both her native language and English, and does not use speech or lip–read.

Mrs E registered with the Practice in 2007. Until summer 2011, the PCT funded a BSL interpreter for appointments at the Practice. However, in mid–2011 the PCT withdrew this funding and in response, the Practice decided it would not provide interpreters. It offered Mrs E longer appointment times and said staff would communicate with her through written notes.

Mrs E complained about this decision, with support from an advocate. She explained that she could not understand written English because this was not her primary language.

She said she left appointments without knowing what was wrong or how to take her medication. Mrs E said she was worried about her health and that of her unborn child, and that the situation was causing her great distress. In response, the Practice said that it was the PCT's responsibility to fund interpreters, and that if Mrs E wanted an interpreter, it was her responsibility to arrange this. It repeated that it would communicate with her in writing. The Practice noted that Mrs E had been registered with it since 2007 and said that it 'would have hoped that her written language skills would have improved considerably since'. It added that 'lack of proficiency in English does not constitute a disability in the Disability Discrimination Act'.

The PCT told Mrs E that it did not agree with the Practice's position. It said that it was the Practice's duty, under the Equality Act 2010 to provide reasonable adjustments to make sure its services are available to disabled people.

It arranged the transfer of Mrs E's antenatal care to a local hospital where BSL interpreters were available, and in summer 2012 offered to help her move to a GP practice that provided online BSL interpreting services. Mrs E did not want to move practice, and the PCT took no further action to address the Practice's failure to provide communication support for Mrs E.

The Practice failed to take into account its responsibilities under the Equality Act 2010 as a service provider. The Practice is required to take reasonable steps to make sure that, as a disabled person, Mrs E is not put at a substantial disadvantage in comparison with people who are not disabled. The Practice tried to make some adjustments for Mrs E, such as giving her longer appointments.

However, because it did not take necessary steps to understand the way in which she communicated, its attempts were, on the whole, inappropriate and ineffective. The Practice wrongly concluded that Mrs E should be able to communicate through written English. She cannot, because she is a Deaf BSL user. In failing to recognise both of these important facts, the Practice has reached incorrect conclusions about its duties under the Equality Act 2010, which has led to its failure properly to consider whether the provision of a sign language interpreter is a reasonable adjustment under the Act.

What we found

The PCT knew about the effect of the Practice's decision on Mrs E, but did not use its powers as the Practice's commissioner to put the situation right. In failing to do so, the PCT did not demonstrate that it recognised the significance for Mrs E of the Practice's refusal to provide BSL interpreters.

Putting it right

Following our report, the Practice and the NHS England Local Area Team (which took over the PCT's responsibilities when the NHS restructured) acknowledged and apologised for their failings and paid Mrs E £3,000. They put together an action plan to show how they will meet Mrs E's needs in future, and they undertook to do the same for other patients with disabilities.