National Voices believe everyone should have equal access to primary care services.

National Voices includes primary care services supporting everyone’s communication needs.

National Voices have done a project to understand the key issues people with communication needs have experienced.

National Voices asked them what changes would make communication in primary care services better for them.

National Voices looked at barriers and challenges primary care teams have experienced with supporting communication needs.

National Voices looked at examples of what the primary care teams did well for people with communication needs.

Please read the easy read summary.

Plain English

This booklet is a summary of a report we did on communication needs in primary care services.

We have split the booklet into sections to make it easier to read.

What is in this booklet?

Primary care and communication

Primary care services are the front door to the NHS.

They include services like –

• GPs
• Dentists
• Pharmacy
• Eye Health

Primary care services are the first place you go when you are not feeling well.

The primary care team have an important role in making people feel welcomed, listened to and taken seriously.

What is communication?

“Communication” includes different ways you have contact with primary care team members, including –

• Interacting with staff              
• Emails
• Text Messages
• Phone calls         
• Letters
• Signs
• Information         
• Websites    

But we hear many people’s communication needs are not being met. For example –

• people with sensory impairments
• people with learning disabilities
• people who do not speak English
• people living with dementia

One example is a lot of Deaf people still have no accessible way of contacting their GP.

What did we do?

We believe everyone should have equal access to primary care services.

This includes primary care services supporting everyone’s communication needs.

We have done a project to understand the key issues people with communication needs have experienced.

We asked them what changes would make communication in primary care services better for them.

We looked at barriers and challenges primary care teams have experienced with supporting communication needs.

We looked at examples of what the primary care teams did well for people with communication needs.

Laws and guidance around communication

Laws are a set of rules about something made by the government.

Guidance tells people the best way to do something.

There is a wide range of laws and guidance which says –

• why it is important to meet people’s communication needs
• and how to meet people’s communication needs

Some examples of laws and guidance include –

• Accessible Information Standard sets out rules meeting the communication needs of people with a disability, impairment or sensory loss.
• Equality Act 2010 says an organisation that provides services to the public must not treat someone worse because they are from a particular group. For example, if they are Deaf.
• Public sector equality duty says public bodies, like the NHS, must think about how to make sure all groups of people are treated equally well.
• Interpreting and Translation Services in Primary Care advises decision makers in healthcare on how best to meet the needs of people who don’t speak English.
• Creating accessible websites Guidance advises anyone who makes websites for the NHS on how to do this well and meet everyone’s communication needs.

Why does communication matter?

The evidence shows that poor communication is linked to –

• Less people thinking they had good healthcare
• Less people getting care that considers their needs
• People not being involved in conversations about their health.

 For example, a doctor talking to a support worker and not the patient.

Communication challenges across groups

Communication challenges in healthcare include –

• Not keeping a good record of communication needs. This means people do not get information in a way they understand.
• Adjustments are not made for everyone
• Such as using plain language and offering alternative formats such as easy read.
• Lack of an ongoing relationship with health and care providers who understand a person’s needs. This means people must explain communication needs again and again.
• Lack of dignity and respect towards people with communication needs.
• Talking over or ignoring people with communication needs
• Health professionals not listening to carers or support workers

Communication challenges only faced by some groups

Some groups of people experienced communication challenges unique to them. For example –

• Many people with learning disabilities were not offered easy read information.
• Some people who don’t speak English got translators but in the wrong language
• Some people who can’t read were not given any support with filling out forms
• Many people who struggle to book appointments online were not given other options
• Many people who do not use words were expected to use words to access healthcare

Things are getting harder…

Recent changes have made communication challenges in healthcare worse for some patients.

Going online for appointments is really hard for some people.

Some buildings people go to are hard to get in. For example, they may have a doorbell which people need to speak into to get access.

Important information is sometimes given out using small text some people cannot read.

Staff sometimes sit behind screens or are wearing masks, which makes it harder for patients who lip read or cannot hear well.

Some people said they find it harder to get prescriptions.

Coping with communication needs issues

When primary care services fail to communicate well, people often try to work out a different way of getting support.

This can have a bad effect on their health.

For example, some people only see one or two staff members who are good at communicating.

But miss out when that staff member is unavailable or leaves.

Another example is if some people rely on family or friends to speak for them.

But don’t want to share things in front of them that they find embarrassing.

People may then avoid getting their health looked at.

Breakdowns in communication

We have heard that some people no longer trust primary care services.

This is because the communication was not good.

This made people avoid seeing doctors or using other primary care services.

This means people do not get their health problems looked at.

Or people may go to A&E when they do not need to.

What does good communication look like?

Offer people different ways of communicating, for example, options to communicate using pictures.

Checking that information has been understood.

For example, by getting people to ask questions and repeat back what they have heard.

Give people enough time and space to express themselves.

Do not make assumptions.

Make sure people do not have to repeat their needs or advocate support every time.

Offer support rather than waiting to be asked.

What needs to happen to have good communication?

1. Keep a record of communication needs. Share among primary care providers to improve communication.
2. Make communication more accessible by using things like plain language, accessible fonts, larger print sizes, and pictures.
3. Follow the law and guidance about communication, such as the Accessible Information Standard and the Equality Act.
4. Train all primary care staff in communication needs, involving people with lived experience.
5. Make sure people always have access to community support, like advocates, based on their needs.
6. Have strong partnerships between voluntary/community organisations and the NHS.

Voluntary, community and social enterprise sector support

The voluntary, community and social enterprise sector is a group of organisations that aim to make a positive impact on society and communities.

Some of these organisations support people with additional needs in accessing primary care. For Example –

SeeAbility’s Eye health support

Easy Health’s easy read

Groundswell’s access cards

Key issues and recommendations

Key issue

Many primary care staff don’t feel confident in meeting communication needs.

Proposed Actions

1. Better training on communication for primary care staff.
2. Create new tools and guidance to support people with communication needs.
3. Share information from the recent review of the Accessible Information Standard with primary care teams across England.
4. Create standard rules across health and care for asking for communication support.

Key issue

People with communication needs don’t always know what their rights are or feel confident speaking up for their rights.

Proposed Action

1. Develop simple tools to support people to know their rights to communication support.

Key issue

Digital systems are not being used to record communication needs.

Proposed Actions

1. Use digital tools to flag communication needs.
2. Include a focus on better meeting communication needs in the NHS’ work on better joining up services.

Key issue

No one in charge of making sure communication needs is thought about within primary care.

Proposed Actions

1. Appoint inclusive communications champions in every Integrated Care System.
2. Better rules to make primary care services meet communication needs.

Key issue

Primary care services not taking into account what they need to support communication needs.

Proposed Actions

1. Create guidance for commissioners on supporting inclusive communication in primary care.
2. Make sure primary care providers and community-based organisations work together to improve access to support around communication.

This report was made by National Voices.

Email: info@nationalvoices.org.uk

Website: www.nationalvoices.org.uk

Twitter: @NVtweeting

This document was translated into easy read by Ace Anglia.

Website: www.aceanglia.com

Facebook: aceanglia

Twitter: @aceanglia

Email: info@aceanglia.com

Date this booklet was made: June 2023