NSW Health Policy on Working with Interpreters
NSW Health Policy is to use professional interpreters.
Interpreting is a professional skill. Health Care Interpreters are not only bilingual, their language and interpreting skills have been tested, they are trained in medical terminology and they operate under a strict code of professional ethics, which ensures that their services are impartial and confidential. They also attend a number of professional development courses related to interpreting in the health care field. See Professional Development for Interpreters.
Standard Procedures for Working with Health Care Interpreters
NSW Health issued updated Standard Procedures for Working with Health Care Interpreters (Policy Directive PD2017_044) on 20 Dec 2017. The Policy Directive applies to all NSW Health Services.
The Policy Directive provides clear direction to health care staff and services about when and how to work with health care interpreters, including in an emergency or if a health care interpreter is not available.
The Policy Directive states:
All Health organisations are required to comply with this Policy Directive.
Health care interpreters are to be engaged in all health care situations where communication is essential for patients/clients who are not fluent in English, including people who are Deaf.
Working with health care interpreters allows health professionals to fulfil their duty of care and ensures that the quality of communication is the best it can be when a language other than English is involved.
In particular, working with an interpreter is essential when patients/clients are required to give valid consent for medical treatments, such as an operation, medical or surgical procedures or blood transfusion, or to participate in medical research, except where immediate treatment is necessary to save the person’s life or prevent serious injury to health.
When must Health Care Interpreters be used?
For those patients whose language spoken at home is not English, professional interpreters must be used for admission, medical histories, assessments, treatment plans, consent for procedures, pre-operative and post-operative instructions, explanation of medication, counselling, discharge and basically anything more than simple matters of patient comfort.
Country of birth and language spoken at home must be recorded on admission/intake.
Obtaining consent to treatment
Consent to treatment will not be valid if it is obtained through a child or family members, other patients, visitors or staff acting as interpreters. Consent obtained over the phone may not be valid.
A full copy of the policy can be obtained by contacting WSLHD HCIS or visiting the NSW Health website
Use of Relatives/Friends and Bilingual Staff to Interpret
NSW Health policy is to use professional interpreters.
The use of non-professional interpreters such as relatives, friends, children, or bilingual staff is not only a breach of the official Standard Procedures, but also a breach of the duty of care owed to the patient/client, and could result in legal action.
Relatives have an emotional involvement, their language ability is untested, and they are not skilled in medical terminology. The use of relatives to interpret is also breaching confidentiality for the patient/client, and there is no guarantee of impartiality or professional conduct.
Bilingual staff are encouraged to deliver their service directly in their other language, if fluent, without using an interpreter, but the use of bilingual staff to interpret is inappropriate. Although they are not involved emotionally, their language ability is untested, and they may not possess the necessary skills in medical terminology, or understanding of professional interpreting techniques.
Bilingual staff need to be aware of their legal position - basically, if interpreting is not in your job description, think carefully before you do it, and make sure that every attempt has been made to obtain a professional interpreter. If anything goes wrong, you could find yourself in court trying to explain why you considered it necessary to act outside of your job description. Leaving your normal duties to perform interpreting services may also cause difficulties in your workplace.
Patient/Client Refusing the Services of an Interpreter
If a patient/client declines the offer of an interpreter AND the health care provider is unsure in any way about what is being communicated, then the health care provider has both a right and an obligation to organise the interpreter. Patient/client should be explained that it is the NSW Health policy to use professional interpreters. Reassure the patient/client that the interpreter will keep everything confidential, and insist that the interpreter be there at least for the first session. If it becomes apparent at the first session that the interpreter is not needed, you may not need to book them for further sessions.
If a professional interpreter is not used because the patient/client has refused to use one, record these details in the patient/client’s medical record, with details of the discussions that have taken place about the use of an interpreter and inform the patient/client that this is being done.