There is clearly a lack of public and professional awareness of the barriers to healthcare services that Deaf people encounter. Discrimination within healthcare in providing accessible and culturally appropriate services is well recorded (Dickson and Magowan, 2014). Yet, effective communication between healthcare workers (HCW) and patients is vital for safe and quality-focussed care.

Although British Sign Language (BSL) is recognised as a distinct minority language in the UK and the rights of users are protected under equality law, in UK healthcare, there continues to be low levels of provision of BSL for patients who need it.

Brighton and Sussex University Hospitals NHS Trust supports a comprehensive BSL service. We also provide Deaf awareness training for staff – clinical and non-clinical. For more information contact us.

Top 10 best practice guidelines

  1. Qualified BSL interpreters enable Deaf people to benefit from equitable care, helps HCWs to obtain accurate and comprehensive medical histories and helps explain treatment.
  2. The problems experienced by Deaf people trying to access healthcare begin at reception or first contact with a facility. The need to communicate, orientate yourself and to have an interpreter often goes unrecognised.
  3. All patients have a fear of the consequences of miscommunicating. This is more so for Deaf patients. Feelings of alienation, powerlessness and rejection can affect the experience of Deaf healthcare users and medical appointments are often an emotionally draining experience, especially for those without a certified interpreter.
  4. Service providers should include service users with disabilities in the process of planning adjustments to make. Think about offering same sex interpreters and interpreters who are aware of Gay Sign Variation where needed.
  5. Staff should be trained to respect the cultural and linguistic identity of Deaf people.
  6. Remember that communicating through spoken or written English can pose many challenges to Deaf people. There is no written form of BSL and it is a language in its own right. BSL is different from English in grammar and syntax.
  7. Accessing, processing and understanding health-related information is strongly associated with levels of literacy in adults. Yet, in the absence of a BSL interpreter, health professionals often resort to communicating with Deaf patients in writing.
  8. Although printed materials about health topics may be available to Deaf adults, the information may not be written at a level appropriate for them, putting them at a considerable disadvantage. It is a requirement of the NHS Accessible Information Standard that measures are put in place to ensure patients can understand the information they are given.
  9. Inadequate interpreting services leading to the use of family and friends increases the risk of medical error and is fraught with legal and ethical problems.
  10. Numerous studies show that positive experiences are characterised by the presence of medically experienced certified interpreters, health professionals with sign language skills, and doctors who made an effort to improve communication.



British Deaf Association

Department of Health (2005) Mental Health and Deafness: Toward Equity of Access

Dickson M, Magowan R (2014) Meeting Deaf patients’ communication needs. Nursing Times; 110: 49, 12-15.

Lieu CC et al (2007) Communication strategies for nurses interacting with deaf patients. Medsurg Nursing; 16: 4, 239-245.

SignHealth Sick of It Report

Wright D (1993) Deaf people’s perceptions of communication with nurses. British Journal of Nursing; 2: 11, 567-571.