NHS England has released ‘Rapid Review’ Report to on commissioning arrangements for BSL interpreting.

For Full Report Click Here


This is a substantial report, if implemented the recommendations could provide a major improvement.

This page focuses on the recommendations from the Review.

The key challenges are briefly summarised in the Review as follows:
● Timely, consistent face-to-face access to a suitably qualified interpreter –the reviewers were told of delays greater than 2 weeks.
● A lack of choice of both the type of consultation and the interpreter.
● Lack of awareness of NHS staff of the needs of d/Deaf and BSL users, lack of knowledge of Accessible Information Standard: legal entitlement and how to book an interpreter.
● Lack of information for BSL patients on changes to service due to Covid-19 and how to book a Covid test or receive a vaccination.
● Lack of communication of patient interpreter needs as patients are referred by one medical professional to another.
● Perceived poor access for unscheduled, out of hours/ emergency BSL Video Relay Support (VRS).

Overall recommendations

● Each Integrated Care Systems (ICS) to establish consistent provision across primary and secondary care through a single BSL service to improve local services.
● Provide face-to-face and video-based support.
● Work with national charities and local representatives.
● Improve responsiveness, wrap-around care and advocacy support.
● Bring together the many diverse arrangements currently handled separately.
● Include wrap-around care and advocacy support.
● Strengthen local provision by recommending improvements to the current 111 BSL interpreter provision in cases of emergency, urgent and out of normal working hours.
● Address the variations in
● Quality of interpreter support
● Awareness of the need for timely BSL services.
● Support for clinicians, managers, and administrators to access and manage local BSL support provision more effectively.

The recommendations are aligned to the legal responsibilities of NHSE and service providers in accordance with the Public Sector Equality Duty (‘the PSED’) as set out in section 149 of the Equality Act 2010 and the Accessible Information Standard (AIS).

5.3 Specific recommendations
5.3.1 Developing a single ICS system- level BSL service
The specific recommendations to be badged as Best Practice are that:

R1: NHS England should produce a best practice guide which will
set out issues faced by BSL users and recommend:

1 A coordinated ICS approach that provides face-to-face and video-relay BSL provision based on clinical need.

2 A single point of access and accountability for users, clinicians and administrators, irrespective of which local NHS services they are accessing.

R2: As part of the best practice guidance, each ICS should be encouraged to establish a lived experience panel to support a review of existing BSL services and to undertake an initial Equality Impact Assessment (EIA) to consider the impact of COVID-19 on BSL users in their system.
The lived experience panel should play a role in the ongoing review and monitoring of improved local BSL provision and undertake future EIA reviews.

R3: Each ICS should be encouraged to agree a system plan to commission coordinated BSL services for the populations in their ICS, based on agreed national minimum standards that enable work with local VRS providers.

R4: Each ICS should be encouraged to set out a plan, including provision within their service specifications, to promote and increase awareness across clinicians, managers, and administrators.

R5: Each ICS should be encouraged to establish a BSL advocacy support service to address operational and quality issues on behalf of BSL users.

R6: A set of best practice case studies are to be developed to share alongside the ICS guidance to demonstrate the positive impact of bringing services together and of involving service users and the local workforce in the process.

R7: The best practice should also encourage local work to understand the availability of BSL interpreters within each ICS. Each ICS is encouraged to develop an adequate market for suitably qualified and experienced interpreters and/or to consider an employment model. This work should be based on an understanding of the potential to provide services with the local VCS including consideration of the necessary payment levels to ensure access to high-quality interpreter support.

5.3.2 Developing the national urgent and emergency 111 BSL interpreter support service.

The specific recommendations are that:
R8: An enhanced national service should be developed for urgent BSL support across England within NHS 111. This would include the BSL interpreter input to the Clinical Assessment Service and provide urgent and emergency BSL support.

R9: A national group involving ICSs, national charities, 111 BSL leads and BSL users is to review the existing 111 BSL support service and co-produce revised specifications to meet the needs of BSL users. Declarations of interest will need to be recorded.

R10: The potential volumes of additional activity should be modelled by the 111 analytical team. This work would identify the future demand on service provision with additional levels of urgent support.

R11: A review should be undertaken by national 111 commissioning leads as
to the best commercial, contractual and procurement routes to implement this service enhancement and how any recharge would work.

R12: NHS England and Improvement and each ICS should promote the availability of the enhanced NHS 111 BSL service to healthcare professionals, managers, administrators, users, and relevant stakeholder groups alongside improved local system service provision.

5.3.3 Improving quality and education linked to BSL support
The specific recommendations are that:
R13: Minimum national standards should be applied for the qualification and experience of interpreters across all lCS and national services.

R14: National work should be undertaken with relevant charities to promote
education for BSL users on how to make best use of empowering digital technology, and support to successfully access health services including promotional and tutorial videos in BSL.

R15: The AIS should be reviewed and updated to reflect the changes in the system provision supported by a local implementation plan

R16: National work should be undertaken with clinical professional bodies to promote awareness of the issues and solutions linked to BSL service use.

R17: National work with the CQC should be considered to increase their role in ensuring that the needs of BSL service users are included within regulation.