Interpreters, iPads & the impact on NHS Fife 

To learn more about the human aspect of our services and how it affects patients' care, we caught up with Heather Kirkbride, a Senior Administrator to the Equality and Human Rights Team at NHS Fife. We wanted to learn how our services impacted her, the trust, and how the patients have adapted to it.

 For context, NHS Fife is one of 14 territorial NHS Boards in Scotland. The organisation provides healthcare to a population of more than 370,000 and currently employs around 8,500 staff. It's a large, rural area with varied geography and several population centres. NHS Fife is working to improve health services with the involvement and support of various partners, including Fife Council, Fife Health and Social Care Partnership, other Health Boards in Scotland, the voluntary and independent sector, and most importantly, the public.

 Our services in real life

We started the interview by discussing our services, initially Video British Sign Language Interpreting, and its usage. Heather found that some departments were familiar and comfortable with traditional face-to-face interpreting. As a result, they were cautious and sometimes slightly reticent to try the new way of providing an interpreter. 

 However, the Radiology Department emerged as an early adopter, using the video service through the customised Interpreter-on-Wheels devices (IOWs) supplied by LanguageLine. The IOWs continue to be used by Radiology for most of their appointments. 

 The Antenatal Department was another service to use IOWs. Heather explained: 'Using the IOW for video and audio interpreting means that the conversations can happen with a minimal number of people in the room. Whilst we don't use the IOWs for all instances, such as complex appointments, we use them wherever feasible and appropriate, which reduces the occasions when we need a face-to-face interpreter.

 Real-life limitations

Overall, usage of the devices is about getting the right balance, making the most of the efficiencies and enhanced access afforded by the service, whilst maintaining a patient-centred approach. Heather explained, 'If at an appointment you're giving someone bad news, or if the appointment involves more than one service like X-ray back to A&E and then back to the clinic, it can be complicated to use. For these appointments we still tend to use face-to-face interpreters. We also feel that having someone who speaks the patient's language present at these appointments ensures there is also communication via body language, and this is seen as a more person-centred approach which is important to NHS Fife.'

 During our interview, we also learnt more about their interpreter booking process before working with LanguageLine. Heather states, 'When I first came into the job, there was no booking system for arranging interpreters. Staff used to go to the local company and use the telephone interpreters for a few appointments per month.

 Heather continues: 'So we changed things around, began working to increase using LanguageLine. If you look at the figures for telephone service usage alone, it went from 45 calls to 500 calls per month. Using telephone interpreters is a cost-effective way of providing an interpreter. Using the LanguageLine service means we have more access to different languages and the service is instantly available which is a benefit to NHS Fife and our patients.'

 The InSight App

Heather also raised interesting points around the indirect benefits of using video interpreters. 'In Fife, patients may often know the interpreter when it comes to some languages like Romanian or Cantonese (as Fife is a small county). Using LanguageLine audio or video interpreters will mean that the patient will not know the interpreter and ensures no possible conflict of interest.' 

 NHS Fife recently purchased more IOWs to support patient communication throughout the hospitals. They have also added the app to Family Liaison iPads, in most of NHS Fife's hospital wards. The iPads were purchased to help patients keep in-contact with their families. They provide a 'virtual visiting' opportunity. By adding the app, staff and patients access both BSL and community languages. 'The iPads are used if the patient, in their language, would like to speak to the ward staff and enables them to feel more included during their hospital stay.'

 If we've learned anything from the last two years, it’s that communication is crucial, and it makes us happy to hear that we have enabled that for those who most need it.