Background
In 2022, a working group was formed to understand and improve health literacy in communities. The group included colleagues in our Health Improvement Team, Shetland Community Connections, and support from members of the Person-Centred Care Team and an Improvement Advisor from within the Scottish Government.
Why British Sign Language?
Shetland Community Connections (SCC) supported a community action research project which resulted in publication of ‘Show Me That You Think Of Me’ report. During planning conversations, the issue of barriers faced by BSL users in accessing services was raised. The example of accessing Primary Health Care was recognised as a health literacy issue and SCC proposed this became part of the Scottish Government Health Literacy Project. This led to Shetland being invited to take part to further understand what is working well and areas for improvement in accessing primary care services.
The project aimed to understand how to improve access to Primary Care Services for people who use British Sign Language, and to gain a wider understanding of current services and how people use and experience them.
What we did
We were aware of the importance of hearing directly from BSL users themselves in their first language, therefore BSL communication was at the heart of the engagement process. After engaging with our local community to encourage BSL users to come forward, we carried out interviews with 3 BSL users using an in-person interpreter to gather their lived experiences of accessing primary care services in Shetland.
We used quality improvement thinking and tools throughout the project. BSL users were supported to map out their experiences of their journey in accessing the health centre, including how they felt when accessing the services, which helped us to understand what works well, what the challenges are, and to identify solutions to these.
What we have learnt so far
Some of the feelings expressed by the BSL users when accessing a primary care service included:
The top 3 areas of challenge highlighted were:
- lack of communication from staff;
- written notes are misunderstood or too concise;
- lack of deaf awareness in staff.
The top 3 areas for improvement suggested were:
- BSL video relay service (remote).
- basic sign language and deaf awareness training for staff;
- BSL user coding and preferences held on patient file;
“Crucial to all of this taking place was having access to a BSL interpreter during the interviews as the BSL users were able to express themselves in their first and preferred language.”
Health improvement team
Next steps
The next phase of the project involves engaging with health centres further to host workshops seeking to understanding opportunities for service improvement. This work is currently underway (2025); more information will be shared after this engagement.
BSL Resources & Support
We have gathered a number of resources available for BSL users and for professionals supporting people who use BSL. You can find these here: BSL Support