A woman who speaks limited English is sent an appointment letter in English. She asks a relative to telephone and request an interpreter.
The request is noted somewhere. On the day, no interpreter is present, the clinician cannot safely proceed, and the appointment is rebooked for eleven weeks later.
Nobody was careless. The request was made by telephone to one part of the organisation and needed by another, and there was no reliable mechanism connecting the two.
1. Capture the requirement at booking
Rather than waiting for somebody to think of telephoning. Asking at the point of booking is the only reliable moment.
2. Ask in a way people can answer
Plain language, without requiring somebody to name a category. Do you need help with language, with moving around, or with anything else about attending.
3. Capture the language specifically
Including dialect where relevant, since the wrong language interpreter is as useless as none and it happens frequently.
4. Distinguish interpreting from sign language
Different provision, different booking and different lead times, and conflating them produces exactly the failure this is meant to prevent.
5. Capture the communication support needs
Hearing loops, lip reading, quiet environments, written information and anybody who needs an advocate present.
6. Capture the mobility and transport needs
Whether somebody needs help from the entrance, whether patient transport is relevant, and how far they can walk, which connects to directions parking and accessibility questions for clinics.
7. Capture the appointment length requirement
Some needs require longer, and a clinic that schedules a standard slot cannot deliver the appointment regardless of what was recorded.
8. Attach it to the appointment, not the person
So it travels with each booking and reaches whichever clinic is delivering it, rather than sitting in a record nobody opens.
9. Confirm it back to the patient
In the appointment confirmation. A patient who can see the arrangement recorded does not spend the intervening weeks worrying.
10. Confirm it to the clinic beforehand
A reminder to the service a few days ahead, since a request made three months earlier is one nobody has looked at since.
11. Provide information in accessible formats
Appointment letters, preparation instructions and results, which are frequently sent in a form the patient cannot read.
12. Handle the relative making the request
Since a large proportion of these requests come from family, and a process assuming the patient makes contact excludes exactly the people it serves.
13. Record what failed when it fails
A wasted appointment through an unmet access need should be recorded as that, so the pattern is visible rather than appearing as non attendance.
14. Ask what worked last time
A patient who has attended before usually knows exactly what helped and what did not. Asking that directly, and recording the answer, produces better arrangements than any standard category list and takes one question.
15. Capture the access requirement at the first contact
An assistant that asks about language, communication, mobility and appointment length in plain words at booking, attaches it to the appointment, confirms it back to the patient and reminds the clinic beforehand prevents an appointment wasted and rebooked eleven weeks later. The wider provision is set out in interpreting and accessibility support questions, the booking questions in appointment and referral questions patients repeat, and the design principles in accessible website assistant. See features, start at try, and the sector view sits under healthcare.