Accessible communication and information standards in healthcare

The purpose of these standards is to ensure our healthcare services are accessible to those with additional communication and information needs. The standards of service delivery for people with additional communication and information needs should be met when they access healthcare in Wales are set out below. These standards apply to adults, young people and children.

These standards have been developed in collaboration with organisations that represent people with additional communication needs (listed in stakeholders section). They will continue to be reviewed in line with the agreed review schedule.

This document uses the social model of disability as it refers to those with additional communication and information needs. The social model of disability makes an important distinction between "impairment" and "disability". It recognises that people with impairments^{[footnote 1]} are disabled by barriers that commonly exist in society. These barriers include negative attitudes, and physical and organisational barriers, which can prevent disabled people’s inclusion and participation in all areas of life.

The term "people with additional communication and information needs" is used throughout this document to refer to the following:

• people who are D/deaf, deafened or hard of hearing, and British Sign Language (BSL) signers (it is important to also note the linguistic differences between the Deaf BSL signing community, and those who are deaf, deafened, or hard of hearing)
• people who are blind or partially sighted
• people who are deafblind
• people who have language and communication access barriers arising from disability (including dementia, learning disabilities and mental health conditions)
• people who have language and communication barriers arising from neurodivergence
• people who have language and communication barriers arising from low literacy
• parents and carers who experience language or communication barriers
• people whose preferred language is not English or Welsh (including people seeking sanctuary, refugees and migrants)

There is a legal duty under the Equality Act 2010 to ensure reasonable adjustments are made to deliver equality of access to healthcare services. This duty is anticipatory and requires public bodies to be proactive in making adjustments to ensure all access and communication needs are met. Effective and appropriate communication is fundamental to ensuring services are delivered in ways that promote dignity and respect. The evidence also demonstrates that ineffective communication is a patient safety issue and can result in poorer health outcomes.

Creating accessible communication opportunities for patients in the NHS directly supports and aligns with the principles of the Well-being of Future Generations (Wales) Act 2015 (the act). The act emphasises the importance of long term thinking and aims to improve the social, economic, environmental, and cultural wellbeing of Wales. By ensuring communication within the NHS is accessible to all patients, including those with learning disabilities or language barriers, NHS Wales will be able to deliver a more inclusive and equitable healthcare system.

A key goal of the act is to create "A healthier Wales". Accessible communication ensures all patients, regardless of their communication needs, can fully understand their health conditions, treatment options, and care plans. This empowerment, through understanding leads to better health outcomes, as patients are more likely to follow medical advice, adhere to medication regimens, and engage in preventative health measures when they understand fully the information provided to them. Additionally, accessible communication fosters a sense of trust and safety within the healthcare system, encouraging patients to seek care when needed and participate actively in their healthcare decisions.

Furthermore, the act promotes equality and reduces socio-economic disparities, which are critical components of sustainable development. By providing accessible communication, NHS Wales addresses the needs of under-served populations, such as those with sensory impairments, neurodivergent people, those with learning disabilities, or limited proficiency in English or Welsh. This approach ensures that no patient is left behind due to communication barriers, thereby reducing health inequalities. It also supports the cultural wellbeing of Wales by respecting and accommodating the linguistic diversity of its population, including the use of Welsh, as well as BSL and community languages.

All NHS bodies in Wales are subject to the Welsh Language Standards Regulations 2018 under the Welsh Language (Wales) Measure 2011. These standards promote and facilitate the Welsh language and ensure the Welsh language is not treated less favourably than the English language in Wales. The standards directly align with the aims of more than just words / mwy na geiriau which is the Welsh Government’s plan for the Welsh language in health and social care. Specifically, there are shared priorities between the standards and the aims of "More than just words". For example, in terms of providing person centred care, supporting access to services in a person’s preferred language, and the recording of a person’s preferred language and communication needs in patient records.

The health and care quality standards were introduced on 1 April 2023 as part of the duty of quality through the Health and Social Care (Quality and Engagement) (Wales) Act 2020. The standards apply to all NHS Wales services and include a domain for equitable services. The standards set the expectation that everyone should attain their full potential for a healthy life which does not vary in quality by organisation or personal characteristics. Equality and human rights are embedded in our healthcare system.

The standards are also supporting the delivery of a healthier Wales which is the Welsh Government’s long-term plan for health and social care which includes a specific commitment to “ensure that all citizens can receive timely health and care services equitably, regardless of the language or communication format they need”.

These standards also directly align with the all Wales dementia care pathway of standards published in 2021. In particular, standard 2 is focused on ensuring that services at the points of contact will provide reasonable adjustments to care that is meeting the person’s needs and personal preferences. This will include all people that access community and inpatient services, recognising that people with dementia are a vulnerable group.

The effective and efficient commissioning of interpretation and translation services is vital in ensuring people with additional communication and information needs can access healthcare services.

Interpreting and translation services provide a service for patients, carers and clinicians to help them communicate when they do not speak the same language. Communication barriers between healthcare providers and patients may affect diagnosis, decrease effectiveness of consultations, harm patient experience, affect health outcomes and increase instances of patients not attending appointments.

The standard operating procedure: commissioning interpreting and translation services in primary and emergency healthcare is a document that sits alongside these standards. The standard operating procedure aims to support primary and emergency healthcare services in Wales when securing translation or interpretation services or when reviewing existing services. It provides guidance for NHS Wales services enabling them to ensure the communication and information needs of all patients, parents and carers are routinely and consistently met.

The standard operating procedure has been written with primary healthcare care services (GP surgeries) and emergency care settings in mind, but the contents will also be applicable to other settings, such as other primary care settings:

• community pharmacies
• dentists
• opticians
• dieticians
• podiatry and physiotherapy
• community or hospital sites
• secondary care settings, such as midwifery and mental health services

Capturing and retaining information

Capturing, retaining and sharing accurate patient information ensures healthcare services are accessible to people with additional communication and information needs.

Healthcare providers already subject to the accessible information standard (AIS), as well as other healthcare providers subject to these standards, must ensure that they include all patients with additional communication and information needs when identifying, recording, flagging, sharing and meeting the information and communication needs of patients, service users, carers and parents. Welsh language preferences should also be recorded in line with the aims of "More than just words".

A ‘flagging’ system on a patient’s digital or paper record will enable primary and community staff, emergency department receptionists and ambulance call takers to understand the needs of the patient when they attend or contact the practice or service. This will also apply to any patient appointment carried out within the patient’s home or within a community setting, including care homes. This will enable providers to meet the communication requirements of all patients.

The following actions must be taken: 

• all staff must be made aware of their responsibilities for recording such information in order to support individuals with additional communication and information needs, where those individuals are within the scope outlined in this document with immediate effect
• all systems in procurement, or for future procurement, must comply with these standards with immediate effect
• all relevant actions must be taken in order to comply with the supporting action plan for the standards with immediate effect

Digital technology should be utilised where possible to efficiently and effectively facilitate the capture and retention of patient information.

Assessing and meeting information and communication needs

All frequently used information leaflets and documents intended for patients and the public must be available in accessible formats (such as Braille, large print, easy read, audio) as well as BSL and other community languages for people with additional communication and information needs.

All public and patient areas must be assessed to identify the needs of people with additional communication and information needs. This should include hospital wards, outpatient areas, accident and emergency, primary care and community services. The assessment must involve people with additional communication and information needs and ensure their views are reflected in any proposals to design, develop or change a service. Effective engagement is critical to developing relationships of trust, and understanding the experiences of people with additional communication and information needs as recipients of healthcare.

These assessments will enable NHS bodies to understand and meet the information and communication needs of people with additional communication and information needs through robust action planning. An agreed implementation plan will be led by a designated senior officer in each NHS body and set out clear timescales and actions for delivery. The plan will identify and address the policies, procedures and protocols, existing or in need of development, to effect the changes required to deliver the Standards. Progress on the delivery of the plan should be monitored regularly and reported formally to the NHS body’s Board and executive team.

First points of contact

Reception areas should include information on a patient’s right to an interpreter, and these should be available in community languages, including a relay service for BSL signers.

Reception areas should be provided with a resource that allows people to make staff aware of their communication requirements, including BSL and community languages, to initiate the process of obtaining language support.

Reception areas should be provided with a resource that allows people to make staff aware of their required format for written correspondence and patient information.

All reception staff must receive training so that they can confidentially record a patient's communication and information requirements on the patient record. Arrangements must be made to gather this information for new and existing patients.

All reception areas should be fitted with a hearing loop induction system or other appropriate technology, for example, portable hearing loops, allowing hearing aid users to make full use of their hearing aids in a potentially noisy setting. Staff should be capable of checking that loops are functioning and know how to use them. There should be appropriate signage to make patients aware of the provision of a loop system.

Digital points of contact should also be considered when providing a service to those with additional communication and information needs. These would include, but are not limited to:

• switchboards
• contact pages on websites
• portals and instant messaging services
• BSL video relay services

These points of contact should be easy to access and ensure that they:

• are compatible with screen reader technology
• have appropriate colour contrast for enhanced readability
• have a clear and concise layout
• avoid flashing content, excessive animations, auto-playing videos, and busy backgrounds
• have an appropriate font choice, as well as text spacing and font size
• use plain and clear language
• use descriptive links
• have images that use alt text
• offer content in multiple formats, such as text, audio, and video, to accommodate different accessibility requirements

Correspondence

Any correspondence should be easy to read, to the point, and include information that could assist someone in attending an appointment, for example a photo of the building, the nearest bus stop, what they should do on arrival, if there will be waiting times etc. Consider developing pre-arrival maps and guides at reception desk or downloadable content from the website that is accessible for all potential visitors.

All written communication, for example, appointment letters, should be provided in accessible formats for patients with additional communication and information needs and in plain English to help those who do not have English or Welsh as their first language, including BSL signers. As referenced in the patient information section, the individual patient should be asked to indicate the appropriate format and language for them, and this should be recorded and used routinely for them.

Written correspondence may include:

• letters
• emails
• text messages
• instant messenger
• information accessed via online portals

For those patients and service users who are blind or partially sighted, information should be sent in the format of their choice (as stated on the patient record). This could mean letters are automatically sent out in accessible formats, for example in Braille, in large print, as a text, email or audio file.

Patients with low literacy should also be issued correspondence that is accessible to them, which could include verbal correspondence or audio files.

Verbal correspondence by telephone should also be accessible in accordance with the patient’s communication requirements, as well as the use of a relay service for BSL signers.

All staff who are responsible for issuing correspondence will be required to check the patient record before issuing any communications to ensure that the required format and adjustments are put in place before making contact.

Facilities

It is important to recognise that environmental factors can influence effective communication for people with additional communication and information needs. It is important to check that the healthcare environment is accessible and that it encourages effective communication. For example, this should include sufficient, evenly spread lighting, colour contrast and limiting background noise with sound dampening fittings applied where possible. Private spaces should also be available to allow for sensitive matters to be discussed for those who require it.

All consultation areas should also be fitted with a hearing loop induction system or other appropriate technology, for example, portable hearing loops, allowing hearing aid users to make full use of their hearing aids in a potentially noisy setting.

Good graphic signage is important in ensuring people with additional communication and information needs are able to access the healthcare they need. To minimise the service user’s anxiety, all signs should be clear and easy to understand in both English and Welsh.

Visual supports and patient information should be provided in community languages other than English or Welsh in settings that have a high proportion of patients who use those languages.

Directional and locational, matt, tactile signage placed between 1400 millimetres and 1700 millimetres from the floor is important to ensure blind and partially sighted people can safely and confidently navigate their surroundings.

All messages displayed on screens should be accompanied with audio announcements and information to meet the needs of blind and partially sighted people.

Consideration should be given to on demand interpreter services such as telephone or video relay services where patients attend in-person and do not have English or Welsh as their first language.

Consideration should also be given if Personal Protective Equipment (PPE) is required, in particular face masks, as these will impact on communication. When purchasing and using PPE accessibility should be considered, for example through the use of transparent face masks where these meet technical standards.

Primary care

A patient’s first point of contact with our healthcare systems is often when they register with a new GP. It is vitally important that patients are asked in an accessible format to describe their communication and information needs as part of the registration process. Arrangements must be made to gather this information for existing patients. The AIS directs and defines a specific and consistent approach to identifying, recording, flagging, sharing and meeting the information and communication needs of patients, service users, carers and parents for GP practices.

NHS bodies must ensure that their GMS contractors comply with the requirements described within the service delivery section of these standards to ensure the needs of patients, parents and carers are met when accessing a primary care setting in Wales. It is important that primary care staff have the necessary training or engage someone with the right skills to carry this out to ensure there is no missed communication.

NHS bodies in Wales must consider patients’ language preferences when it comes to accessing services in Welsh as set out in the Welsh language standards. This includes the delivery of the active offer where someone is provided with a service in Welsh without having to ask for it. Making an ‘active offer’ means not making assumptions that all Welsh speakers speak English. It ensures Welsh-speaking patients are treated with dignity and respect by asking them what their preferred language is and acting on it. It is also important to recognise any other language needs a patient may have, for example BSL, community languages, or language preferences that are not English or Welsh. In every instance it is important to ask the individual patient to describe their needs. Staff should avoid using machine translation applications and should instead use professional translators or interpreters to convey any sensitive or complex information.

When patients are referred from primary care for treatment in community or secondary care, their language and communication needs should be transferred using the referral process. Patients should not have to keep repeating their preferred language and/or that they have additional communication and information needs. Systems need to ensure that communication needs are clear.

People with additional communication and information needs should be able to make an appointment through a variety of contact methods as a telephone-based appointment system may be inaccessible to them. This would include:

• email
• text messaging
• textphones
• video relay services
• websites

When patients with additional communication and information needs arrive at a healthcare setting there must be arrangements in place to ensure they do not miss their appointments. For example, a member of the reception team could make sure a patient with additional communication and information needs is made aware of when the GP is ready to see them.

All display screens in waiting areas that notify a patient when they are next to be seen and which room to go to, must have audio to ensure blind and partially sighted people can access this information.

Every patient or service user who requires communication support must have this need met, by for example, arranging an interpreter, including community languages and BSL, or lip-speaker, or providing a hearing loop induction system. It is important to have an awareness of other communication methods that may not be as well known, for example, speech to text or live captioning.

Appropriate communication support should also be provided to people with additional communication and information needs who may be attending an appointment in the capacity of a carer or as the parent of a child.

It is important that the different forms of communication are promoted to patients and service users with additional communication and information needs, and they are encouraged to access them.

Healthcare professionals have a responsibility to make certain that patients with additional communication and information needs leave the healthcare setting having received and understood everything they need to know about their healthcare. Appropriate procedures should be in place to ensure communication is made using the individual’s identified and preferred communication methods or language during a consultation.

Where patients are referred on to other specialist services, for example, counselling services, it is important that their information and communication needs are met by other service providers. Patients should not experience unreasonable delays in accessing healthcare because of a need for accessible communication and information support.

Secondary care

As part of the referral process from primary to secondary care the communication needs of people with additional communication and information needs should be retained at primary care, and follow through, ensuring that arrangements are in place for appropriate and effective communication when they visit the secondary healthcare setting. Again, this also aligns with priorities in "More than just words" for the Welsh language. See the patient information section for further information.

People with additional communication and information needs should be able to make or change an appointment through a variety of contact methods as a telephone-based appointment system may be inaccessible to them. This could include email, text messaging, text phones, relay services and websites.

All secondary care settings must adhere to the requirements described within the service delivery section of these standards to ensure the needs of patients, parents and carers are met when accessing secondary care setting in Wales.

All staff who have daily contact with patients and service users, including receptionists, nurses, doctors, therapists, healthcare support workers and other support staff should be trained in how to communicate effectively with someone with additional communication and information needs. This training should reflect a person-centred approach which encourages staff to respond appropriately to individual needs. This includes using clear speech, asking patients what their communication requirements are, recording this information and actioning information in those formats. This applies in particular to staff based on inpatient wards with significant numbers of older patients.

NHS bodies in Wales must consider patients’ language preferences when it comes to accessing services in Welsh as set out in the Welsh language standards. It is also important to recognise any other language needs that a patient may have, for example BSL, any community languages, or language preferences that are not English or Welsh. In every instance it is important to ask the individual patient to describe their needs, and to do so using appropriate communication methods to establish their preference.

It is important that patients and service users with additional communication and information needs are made aware of the provision of these accessible forms of communication.

It is important to respect the autonomy of each individual patient and ensure that the way in which their healthcare is provided promotes independent living. Sometimes, some individuals, for example if they are neurodivergent, have dementia or have a learning disability may require extra assistance from a support person, for example on awaking from an operation. In such circumstances, the support person should be allowed to remain with the individual outside of standards visiting hours.

Every patient or service user who requires communication support should have this need met by, for example:

• arranging a British Sign Language interpreter or lip-speaker
• providing an induction hearing loop
• telephone or in-person interpreter for community languages

It is important to have an awareness of other communication methods that may not be as well known, for example:

• speech to text
• live captioning

Appropriate communication support should also be provided to people with additional communication and information needs who may be attending an appointment in the capacity of a support person, a carer, or as the parent of a child.

When people with additional communication and information needs arrive at a healthcare setting, there must be arrangements in place to ensure that they do not miss their appointment. A member of the reception team, for example, could personally alert someone when the healthcare professional is ready to see them.

Service providers may require the pre-booking of appointments, as well as longer appointment times to ensure that BSL or other specific language interpretation is available.

When people with additional communication and information needs require hospital care and treatment, their communication and information needs should be identified on their care plans and medical records. This should also describe a patient’s individual communication needs in a practical way. For example, a record should not only say that a patient is Deafblind but that they also require written communication in a minimum of Arial 14pt, and that speech should be clear. Arrangements must be in place to ensure that their needs are met during any period of stay on a hospital ward.

Healthcare professionals have a responsibility to make certain that patients with additional communication and information needs do not leave the healthcare setting feeling they have missed any information. Appropriate procedures must be in place to ensure that information is conveyed clearly to patients during a consultation.

Emergency and unscheduled care

Urgent and emergency care are defined as follows:

• urgent care: means health and wellbeing issues that may result in significant or permanent harm if not dealt with within the next 8 hours
• emergency care: means health and wellbeing issues that may result in significant or permanent harm or death if not dealt with immediately

Staff should use the skills and knowledge received through training alongside specifically designed resources to assist communication with people with additional communication and information needs.

On-demand interpreter support should be available for quick communication support in emergency and urgent cases.

It is important that the different forms of communication are promoted to patients and carers with additional communication and information needs and they are encouraged to access them.

When patients are being conveyed or referred to another healthcare provider, any communication and information needs of the patient, or their carer should be relayed as part of the referral or handover process.

A ‘flagging’ system on a patient’s digital or paper record should enable staff to understand the needs of the patient. In the case of 999 calls, any information about additional communication and information needs that arises during the call should be included on the patient record.

Staff should proactively ask if patients are able to communicate in English or Welsh, or if they require additional support. On-scene paramedics should also make sure they record a patient’s communication needs so that at handover this information is relayed to staff.

All written information must be provided in accessible formats, for patients and carers with additional communication and information needs and in plain English or Welsh to help those who do not have English or Welsh as their first language, including BSL signers. In every instance the individual must be asked to indicate the appropriate format for them.

Monitoring and reviewing

These standards should be subject to regular review and monitoring. Arrangements should be made for a designated senior officer in all NHS bodies to report to the board on the progress made with improving access to healthcare for people with additional communication and information needs.

The standards will be reviewed every 2 years.

NHS bodies will report progress against the measures in these standards via their biannual strategic equality plan reporting.

Concerns and feedback

Information on how to give feedback or raise a concern should be provided and publicised in a variety of accessible formats, for example:

• large print
• video clips
• audio
• plain English or Welsh
• community languages

They should also provide a variety of contact methods to meet individual needs.

The process of making a complaint also needs to be accessible to everyone with additional communication and information needs. Information should be shared on the role of Llais who have trained complaints advocacy staff.

In every instance the individual patient should be asked to indicate the appropriate format for them.

It is also important to capture monitoring data from concerns, compliments, and patient experience to identify issues or gaps in service provision and good practice.

Information should also be collected from staff feedback, including what they think of guidelines, how it affects the care that they provide, and any concerns that arise from providing healthcare services in an accessible way.

Application within health services

All staff (including contractors) should be trained in any communication systems provided by the NHS body. This should include developing their awareness of the need for different forms of communication. Training should ensure that staff are aware of their legal duty to make reasonable adjustments under the Equality Act 2010.

All training should be provided by individuals or organisations that can deliver effective and informative training about single or multiple additional communication and information needs. This could, for example, include using a patient’s story which considers the communication needs of a person with additional communication and information needs. This training could also be part of a wider programme of training on effective communication skills.

Where appropriate, staff should be trained in the use of different communication systems, for example, the use of text messaging, voice notes, hearing induction loop systems, or using a BSL relay service. Training should ensure that staff are aware of wider contextual information such as the social model of disability, different types of impairments and how to access communication and language support to ensure patients can communicate effectively at the first point of contact. Training should also cover facilities to allow for accessible signage, audio announcements, braille, glass at reception areas being non reflective and moveable to allow for effective lipreading, and how patients are called to appointments within reception settings.

All staff should be trained in how to communicate effectively with someone with additional communication and information needs. This training should reflect a person-centred approach which encourages staff to be able to identify and respond appropriately to their needs. This is particularly important for clinical staff as patients and carers need to understand what is being communicated to them, for example when they attend for a consultation. The Paul Ridd learning disability training is available in all health boards.

The Wales Interpretation and Translation Service (WITS) has developed an e-learning module on working with interpreters and translators in the public sector.

Training should be provided to ensure that medical professionals are aware of specialist services available, for example, counselling in BSL.

The following 13 indicators will be used to monitor and evaluate compliance with the accessible information standards across NHS Wales, ensuring patients' communication needs are properly addressed and services remain accessible to everyone.

Patient records (AIS)

Indicator 1

Percentage of people having their communication and information needs (including Welsh language) recorded by their primary and community care settings.

This indicator measures how well primary and community care settings are recording patients' communication and information needs, including their Welsh language preferences.

Indicator 2

Proportion of GP practices sharing specific patient communication requirements, including Welsh language, with wider healthcare settings in accordance with the AIS.

This indicator measures the extent to which GP practices are sharing patients' specific communication requirements, including Welsh language preferences, with wider healthcare settings as required by the accessible information standard.

Facilities

Indicator 3

Reception areas: proportion of reception areas providing accessible resources to support patient communication.

This indicator measures the proportion of reception areas that provide accessible resources to support patient communication, including hearing loops, multi-language booking systems, and easy read information.

Indicator 4

Consultation areas^{[footnote 2]}: proportion of consultation areas providing accessible resources to support patient communication needs through the consultation process.

This indicator measures the proportion of consultation areas that provide accessible resources to support patients' communication needs throughout the consultation process.

Compliance

Indicator 5

Access to interpretation services.

This indicator is measured through 3 components:

• number of appointments or services in primary care accessed via WITS
• number of appointments or services in secondary care accessed via WITS
• number of appointments or services accessed via on-demand language services

Indicator 6

Proportion of same day appointments being made by people who are unable to use the telephone.

This indicator measures the proportion of same day appointments made by people who cannot use the telephone. This will be implemented in phase 2.

Indicator 7

Proportion of did not attend appointments (DNAs) and could not attend appointments (CNAs) recorded against people with additional communication and information needs.

This indicator measures the proportion of missed appointments (DNAs and CNAs) recorded for people with additional communication and information needs. This will be implemented in phase 2.

Training

Indicator 8

Proportion of NHS staff (including contractors) undertaking required training.

This indicator measures the proportion of NHS staff, including contractors, who have completed:

• mandatory "treat me fairly" training
• working with interpreters and translators in the public sector training (provided by WITS)

Indicator 9

Proportion of NHS staff, including contractors, declaring additional language skills on ESR beyond Welsh and English, including BSL^{[footnote 3]}.

This indicator measures the proportion of NHS staff, including contractors, who have declared additional language skills beyond Welsh and English (including British Sign Language) on the electronic staff record.

Indicator 10

Proportion of NHS staff, including contractors, completing additional CPD activity relevant to the standards.

This indicator measures the proportion of NHS staff, including contractors, who have completed additional continuing professional development activities relevant to the standards.

People's experience

Indicator 11

Percentage of people receiving information about their healthcare in a format they can access and understand, including Welsh language.

This indicator measures the percentage of people who report receiving information about their healthcare in a format they can access and understand, including Welsh language if preferred.

Indicator 12

Percentage of people indicating that they were able to communicate in their preferred language, including Welsh language.

This indicator measures the percentage of people who report being able to communicate in their preferred language, including Welsh if preferred.

Indicator 13

Percentage of people rating their overall experience.

This indicator measures the percentage of people rating their overall experience as:

• very poor
• poor
• neither good nor poor
• good
• very good

NHS bodies will report progress on these standards using data collected as per the measures and indicators, as well as other evidence on implementation via their biannual Strategic Equality Plan policy assurance assessment.

The measures and indicators in these standards also align with the People’s Experience Survey and the People’s Experience Framework, which is led by the NHS Wales Executive who provide oversight arrangements of this work. Alongside the National People’s Experience Survey, NHS bodies will be providing data on the People's Experience Survey biannually via local surveys and reporting to the NHS Wales Executive.

Work is underway to refresh the Putting Things Right complaints process within NHS Wales, which includes a focus on delivery of the principle of the Active Offer, and the requirements of appropriate language and communication requirements for individuals when accessing healthcare services. 

In addition to reporting biannually through the Strategic Equality Plan policy assurance assessment, scrutiny at an organisational level will be undertaken through the Integrated Quality, Planning and Delivery (IQPD) and Joint Executive Team (JET) processes to seek assurance of ongoing improvement.  

The Health, Social Care and Early Years Group (HSCEYG) Equality, Diversity and Inclusion Implementation and Challenge Board (chaired by the NHS Wales Chief Executive) will monitor the impact of the standards at a national level to seek assurance they are having the desired effect of improving equity of access and patient experience, thus realising the ambitions of the Welsh Government’s National Equality, Diversity and Inclusion (EDI) Plans and A Healthier Wales - our long term plan for health and social care. 

The implementation of the accessible information standards requires collaborative effort and commitment from the following key stakeholders across Wales. These represent healthcare providers, government bodies and advocacy organisations supporting people with diverse communication needs:

• Welsh Government
• NHS Wales Executive
• Aneurin Bevan University Health Board
• Betsi Cadwaladr University Health Board
• Cardiff and Vale University Health Board
• Cwm Taf Morgannwg University Health Board
• Hywel Dda University Health Board
• Powys Teaching Health Board
• Swansea Bay University Health Board
• Velindre University NHS Trust
• Welsh Ambulance Services NHS Trust
• Public Health Wales
• British Deaf Association
• Learning Disability Wales
• Lleisiau Dementia
• Royal National Institute of Blind People
• Royal National Institute for Deaf People
• Swansea University
• Wales Interpretation and Translation Service

[1] Impairments are characteristics of a person. They may or may not be lifelong and they may or may not arise from illness or injury. They may affect a person’s appearance or the way they function or communicate and/or they may cause a range of difficulties including pain and fatigue.

[2] The ‘consultation area’ is applicable within the following spaces:

• the space within a hospital, clinic, or home where patients reside, receive treatment, or have access to for daily activities
• any area within a healthcare facility where patients attend, including day cases, emergency attendances, in-patient wards, diagnostic settings, and community clinics
• a department or service directly related to the diagnosis, treatment, or rehabilitation of patients
• an ambulance

[3] Declaring language skills in the workplace should not require or create an expectation that staff undertake translation and interpretation as part of their professional work unless this is explicitly stated within their job description, this is discretionary according to individual staff confidence. This is not a replacement for a professional translation or interpretation service.