Hospital staff used a teenage boy to tell his Deaf mother that her father might die that day, an investigation by England’s Health Ombudsman has found.
The boy’s grandfather, Alan Graham, 75, was born Deaf and his first language was British Sign Language (BSL).
After a fall, he was admitted to hospital and diagnosed with heart failure.
Hospital clinicians asked his grandson Connor Petty, who was 16 at the time and knew some BSL, to tell his mother that Alan may not survive the night and that CPR should not be provided if the need arose. Alan died the following day.
Alan’s daughter Jennifer Graham-Petty, 52, who was born Deaf and uses BSL, complained to the Parliamentary and Health Service Ombudsman (PHSO) about her father’s care and the use of her children as interpreters.
PHSO found that the University Hospitals Birmingham NHS Foundation Trust failed to comply with national guidance by repeatedly using Connor and his sister Mia, who was 12 years old at the time, to relay information to Alan about his care and treatment. This caused distress to the family and affected their ability to grieve.
The Ombudsman is urging healthcare leaders to make sure services are accessible to all and that providers make reasonable adjustments, such as BSL interpreters, to remove any barriers to services.
Rebecca Hilsenrath KC (Hon), Chief Executive at the PHSO, said:
"Public services must be accessible to everyone for the system to be fair and equitable. Deaf patients and their families should have access to the same healthcare as everyone else without facing additional barriers.
“This is recognised by national clinical guidelines which say that interpreters should be provided to those who face difficulties in speaking and understanding English. It is also enshrined in standards and legislation, such as the Accessible Information Standard and the Equality Act, which both set out that service providers should make reasonable adjustments for Deaf people to access their services.”
Alan Graham was a former furniture maker and keen fisherman from Dundee who moved to Birmingham to be closer to his grandchildren.
In June 2021 he had a fall at home and was admitted to Queen Elizabeth Hospital in Birmingham. Alan suffered swelling in his legs and chest pain and was diagnosed with right side heart failure before being discharged in August.
In September 2021, he was admitted again after experiencing similar symptoms and was diagnosed with heart failure. Alan died two weeks later.
During the 11 weeks that he was in hospital, the Trust provided professional interpreters on only three occasions. PHSO found that the Trust was regularly using two of his grandchildren to communicate with Alan, asking them to translate medical information and details about his prognosis.
Rebecca added:
"In this case, by not consistently providing BSL interpreters to Alan, the Trust caused unnecessary distress in the weeks before his death. Healthcare leaders and professionals must learn from this to make sure that another family does not go through the same experience.”
Jennifer said:
"It was extremely frustrating, every day I was asking for an interpreter. My children just wanted to visit their grandad and be there for him as family members but they were constantly being asked to translate by the staff.
“While they know some BSL, they are hearing so it is not their first language and they don’t have the same level of knowledge as a professional to interpret the medical jargon that staff were asking them to. Having to deliver the bad news about my dad’s prognosis was totally unacceptable and very upsetting for all of us.
“Too often there is a lack of interpreters in healthcare settings all over the UK, I have experienced it myself when being referred by GPs. There needs to be more awareness about the barriers faced by Deaf people and things need to change. A good place to start would be more joint working and better communication between health professionals so that interpreters are automatically provided for those who need them.”
The Ombudsman found that while a lack of interpreters did not impact the care and treatment Alan received, it caused worry and stress to Connor, Mia, and Jennifer, whose ability to communicate with medical staff about her father’s treatment was also affected.
PHSO recommended that the Trust create an action plan detailing how it will prevent this from happening again. It also recommended that the Trust apologise and pay Alan’s grandchildren £900 each and pay Jennifer £750 for the impact of the failings on them. The Trust has complied.
PHSO has raised its concerns about access to BSL interpreters with NHS England and RNID (Royal National Institute for Deaf People).
Victoria Boelman, Director of Insight and Policy at RNID, said:
The details of this case are entirely unjust and unacceptable, yet sadly unsurprising. We know from our research and campaigning work in this area that the levels of communication support and access to healthcare information for deaf communities and those with hearing loss are often woefully lacking.
“This is not an isolated incident – our recent report co-written with SignHealth, Still ignored: The fight for accessible healthcare, reveals seven out of ten deaf people and people with hearing loss have never been asked about their information and communication needs when accessing NHS care – something which providers are obliged to do under the Accessible Information Standard.
“Change is urgently needed as lives are being seriously disrupted, and even lost in some cases, because vital health information is not being communicated in a way that is accessible to all, and this should not be the case. We are calling on the Department of Health and Social Care to make a series of improvements, such as mandatory deaf awareness training to be introduced to all NHS staff.”
Read the investigation report.