‘Making Information Accessible and Available means independence and

better patient experience’

The Accessible Information Standard

Training

2

Breaking the Ice

• Introductions

– Who are you

– Where do you work

– What do you want to get out of today?

• Ground Rules

• Housekeeping

Learning outcomes • At the end of the session learners will be able to:

– Recognise the two areas that the Accessible Information Standard focuses on

– List the five steps to implementing the Accessible Information Standard

– Describe which people the Accessible Information Standard supports

– Identify different types of accessible information and communication

– Understand your role in support the Trust to implement the Accessible Information Standard

What is it? The Accessible Information Standard is a new mandatory standard from NHS England: for health and social care

Dual focus:

1.Accessible information

2.Communication support

Accessible Information Standard at the Trust

• It is about our patient’s experience of the services we deliver – ensuring they receive positive experiences, which will encourage the patient to continue to use the service.

• The Trust is implementing the Accessible Information Standard which; – aims to make sure that disabled people who are our patients,

service users and their carers and parents have access to information that they can understand and any communication support they need.

– This includes making sure that people get information in different formats if they need it, such as large print, Braille, embossed, easy read, via email and visual/British Sign Language (BSL) etc.

The Accessible Information Standard – the right thing to do

The Standard follows the PLATINUM RULE – ‘treat people how they want to be treated’ and if you are not sure ask

them!’

Who is it for?

Particular relevance to people who:

• Are blind

• Are deaf/Deaf or have hearing loss

• Are deafblind

• Have a learning disability

Also, of course, people with (for example):

• Aphasia – this is an impairment of language, affecting the production or comprehension of speech and the ability to read or write

• A mental health condition that affects communication

• … and many more …

People with

a disability, impairment or sensory loss e.g. this includes patients, carers and parents with such needs

• Deaf people are people born deaf at birth.

• deaf people are people who have gone deaf over a period of time

5 Steps to implementation • Ask people if they have any information or communication needs, and

find out how to meet their needs.

• Record those needs in a set way on patient records.

• Highlight a person’s file, so it is clear that they have information or communication needs, and clearly explain how these should be met.

• Share information about a person’s needs with other Trust Teams/Departments, NHS and adult social care providers, when they have consent or permission to do so.

• Act to make sure that people get information in an accessible way and communication support if they need it.

Ask people about their needs • Staff should be asking directly in

person or by phone • Admission assessment forms – should

include the information • Referral letters – should include the

information • GP referrals – should include the

information • Communication & Information Needs

Passports • Communication Passports – Speech

and Language Therapy

• My Traffic Light Hospital Passports

How do you talk to someone with a communication impairment ?

Remember they may have difficulty understanding as well as speaking.

• Give the person plenty of time – be patient!

• Encourage the person to use any method that helps them communicate (Total Communication) e.g. gesture, writing, drawing

• Observe facial expression for clues

• Encourage all attempts at speech but don’t push too hard.

• If you do not understand the speaker, use questions for clarification . To narrow the topic/give choices e.g. “are you talking about your family?

• DO NOT PRETEND TO UNDERSTAND - admit when you don’t understand!

How you can help- talking to a person with aphasia

• Talk normally but use a slightly slower pace

• Use clear, short sentences , using simple vocabulary

• Give only one piece of information at a time and allow the person plenty of time to absorb the information

• Don’t shout

• Use gesture and facial expression to help get your message across

• Ask questions that can be answered with a ‘yes/no’ answer

• Don’t talk ‘through others’ or as though the person is not there

If you need any further information / support or would like some additional training, please contact the Speech and Language Therapy Department at your site ( details on the intranet)

What should I ask? • Questions you can ask to identify if a person has

communication or information support needs include:

– Do you have a Communication and Information Needs Passport? • if yes - log the details on PAS and make sure the clinical staff

know about the need.

• if no then you will need to ask additional questions as below:

– Do you have difficulties understanding information or letting people know what you need ?

- If yes offer a blank passport and follow flow charts

What is a Communication and Information Needs Passport?

• The Communication and Information Needs Passport is a practical and person-centred way of supporting patients/service users, carers and parents who cannot easily speak for themselves.

• The passport is small and can fit into pockets or purses

and is a way of pulling complex information together and presenting it in an easy-to-follow format that will help Health and Social Care organisations record and act to meet a person’s communication and information needs.

With the passport we aim to: • Present the person positively as an

individual, not as a set of 'problems' or disabilities;

• Provide a place for the person's own views and preferences to be recorded and drawn to the attention of others;

• Describe the person's most effective means of communication and how others can best communicate with, and support the person;

The passport is owned by the individual and not by

professionals.

Who needs one? The Passport can be used by anyone who has a disability, impairment or sensory loss (and in our Trust people with a language barrier) e.g.

• Patients

• Adult Social Care Service users

• Carers

• And parents

This is in line with the Accessible Information Standard.

• Remember the Passport belongs to the individual however they should be reviewed at least once a year or every six months if the child is very young.

Where can they be used?

• The passport should go with the patient to all health and social care appointments.

• The advantage of the Communication and Information Needs Passport is that they are easy to read, informative and useful.

Who should fill in the passport? • This should ideally be completed

by the person who has the communication and information need where possible or

• their carer, family member or advocate.

• Where necessary a member of

staff or a volunteer can help the individual to complete the passport.

• All our volunteers are receiving

training too to support the implementation of the Standard.

An example of a completed passport

Jessica says she needs information in a video – this might need to be reviewed and she may require information on a DVD the AIS code would be 2DVD

She requires email or SMS text – the AIS codes for electronic records is 2EM and 2SMS

BSL is her first language – the AIS code for electronic records is 1BSL

Jessica’s mum is also deaf and we would need to know this as she is her next of kin

Piloting and Evaluation • The passport will be pilot in its current

format for 6 months until May 2017 • We will be taking feedback from people

who use it including: – Patients – Service users – Staff – GPs and Practice Staff – Carers – Parents

• Evaluation of the passport will take place after the 6 months period and reviewed at the Pennine Partnership Meeting.

• It MAY be relevant to use as prompt or follow-up questions when communicating with particular individuals and / or in particular care settings are as follows:

– Do you have difficulty hearing, need hearing aids or need to lip-read what people say?

– Do you have difficulty with memory or ability to concentrate ?

– Do you have any difficulties with reading or writing ?

– Do you have difficulty speaking or making your needs known?

Record the need… • This is the second step in the

successful implementation of the Accessible Information Standard

• It is based on the recording of a person’s communication and information needs in their records, this includes electronic records and paper based records.

What Records at PAHT? • Primarily we are looking at Electronic Systems

and phasing this in as we use several different systems, but we also need to include paper records too:

• Phase 1 of implementation – PAS, Patient Centre, Evolve & paper records AIS Codes go live on 12/12/16

• Phase 2 of implementation – PARIS , EMIS WEB, Symphony, CRIS etc.

Currently We record Communication Needs at PAHT?

This reflects a record where it does not tell us what the patients communication and information needs are, only their disability

Patient Centre view – Patient Enquiry function

This reflects a record where it does not tell us what the patients communication and information needs are, only their disability

PAHT AIS Draft Codes

Please do not take out any existing clinical codes or over write them

This is just a snap shot of the codes to be used – full list of codes can be obtained from the equality team Equality.Diversity@pat.nhs.uk

Recording Patient Needs in PAS

• From the Function Set Patient Needs

• Select Function

• RPN Record Patient Needs

Recording patient needs in PAS

Enter Patient Details

District Number

Or

NHS Number

Recording Patient Needs in PAS

Basic Details

Confirm and Press Return

PAS view – RPN function

Enter code if known

Or

‘Press the F9 (Superhelp) key on your Keyboard

Inputting Codes into PAS Screen shot of codes below has not been agreed yet by Salford – could

change?

Patient Needs Superhelp

• From the drop down list select appropriate code and enter

• Repeat to record any additional codes

• *** Please note that ‘Clinical Needs’ appear at the bottom in PAS but top in Patient Centre when selecting from the list offered ***

• *** CLINICAL NEEDS MUST BE RECORDED ABOVE AIS NEEDS. WHEN ADDING A NEED WHERE AN EXISTNG CLINICAL NEED IS ALREADY RECORDED USERS MUST RECORD THE AIS NEED UNDERNEATH THE CLINICAL NEED ***

Record Need Codes

• Enter Y to confirm

• If patient already has a need recorded – the user must press return until ‘need’ field is blank then Superhelp and select code from list offered to add further needs – see screen shot

• BUT – if adding a clinical need to a patient recorded where an AIS need is already recorded – see screenshot

• add both needs again ensuring clinical need is recorded first – see screen shot

• *** REMEMBER CLINICAL NEEDS MUST BE RECORDED ABOVE AIS NEEDS. WHEN ADDING A NEED WHERE AN EXISITNG CLINICAL NEED IS ALREADY RECORDED USERS MUST RECORD THE AIS NEED UNDERNEATH THE CLINICAL NEED ***

Patient Centre view – Patient Needs Add (PT) function

Click on ‘down arrow’ and select need from list offered

*** ‘Clinical Needs’ appear at the top in Patient Centre but the bottom in PAS when selecting from the list offered ***

Click ‘Add

• Need is added to list

• ***Beware – this

action does not save the need against the patient’s record ***

• Then click ‘Save’ to

save the need or ‘OK’ to save and exit the function *** REMEMBER CLINICAL NEEDS MUST BE RECORDED ABOVE AIS

NEEDS. WHEN ADDING A NEED WHERE AN EXISTNG CLINICAL NEED IS ALREADY RECORDED USERS MUST RECORD THE AIS NEED UNDERNEATH THE CLINICAL NEED ***

• In PAS users can rearrange the order of needs by overtyping needs in the order required to ensure clinical needs appear at the top of the list.

• In Patient Centre you can’t

overtype ‘needs’ or change the order in the ‘Patient Needs Add (PT)’ function - so, to re-order the sequence to ensure clinical needs appear at the top of the list users may need to delete needs in the ‘Patient Needs Delete (PT)’ function then add them on again in the correct order in ‘Patient Needs Add (PT)’

For example - Patient’s clinical need (ONC) has been added last on the list below

• Using ‘Patient Needs Delete (PT)’ – highlight the need(s) to be removed then click ‘Remove’

• Perform same action for all needs that require removal

When complete click on ‘OK’ or ‘Save’

• Access ‘Patient Needs Add (PT)’ function and re-add AIS need(s)

Highlighting the patient’s need • Where a patient has an identified communication and /

or information needs staff MUST highlight the need in the patients record.

• Highlighting or flagging the need will ensure that when the patient attends our services in the future or needs to be contacted staff will know what support they need and what actions they need to take to meet the person’s needs.

• Flags need to be ‘Highly visible’ e.g. they need to be:

– Obvious and overtly apparent; and – Visible on the cover, title and / or ‘front page’ of a document,

file or electronic record; and – Visible on every page of an electronic record (for example as

an alert, flag or banner); and / or – Highlighted in some way on a paper record so as to draw

attention to the information as being of particular importance, for example in a larger or bold font, and / or a different colour.”

Share information….. We need to share information about peoples communication/information needs with Colleagues who work in the trust and as part of referrals both within and between organisations, including (but not limited to):

e.g.

1. as a routine part of referral

2. Discharge

3. handover.

4. existing data sharing processes, including following Trust information governance protocols and processes for the obtaining and recording of patient / service user consent.

5. referrals from primary into secondary care,

6. transfers and

7. handovers between wards or units,

8. and discharge from an inpatient setting into the community.

Note that this data-sharing is to support direct patient / service user care, and is not for reporting or analysis.

Data recorded as part of this standard should be included (with consent) as part of shared and integrated records, and using existing systems for the sharing of patient information with other services such as the Summary Care Record

Staff Must Act to meet the need…… • All services MUST provide one or more communication or contact

methods which are accessible to and useable by the patient, service user, carer or parent. Examples of accessible communication / contact methods include:

– email,

– text message,

– telephone and text relay.

• Information, including correspondence and advice, MUST be provided in one or more accessible formats appropriate for the individual – in line with records made in this regard e.g.: – Large font letters or patient information

– Easy read letters or patient information

– Letters or patient information on yellow paper

– Letters or patient information in Braille

– Patient information in visual and audio formats including British Sign Language

Staff Must Act to meet the need……

• Where needed, appropriate, professional communication support MUST be arranged or provided in line with the Trusts Interpretation and Translation Policy. E.G British Sign Language (BSL) Interpreter for a Deaf person who speaks BSL

• Staff will enable patients, service users, carers and parents to communicate, through staff modifying their behaviour/communication styles and supporting the use of aids or tools such as Signalong, picture dictionaries etc.

Meeting the Need for Accessible Information – what does that look

like • https://www.youtube.com/watch?v=SvCv5zi77eU

• Please view the video in this link you may be asked questions.

Monitoring and evidencing Internal – the Trust will be monitoring progress via these groups

• Equality Committee, Patient Experience, Quality and Performance and DQAG

• Evaluation of the passport pilot May 2017

NHS England will be monitoring progress and compliance

• The Trust has to report back to NHS England in January 2017

Commissioning organisations will monitor progress and compliance

• It is mandated in the local and national contracts

Third parties will monitor progress and compliance

• Our Patients

• CQC – it will be part of 5 key questions and KLOEs at inspections

• Healthwatch and interest groups will be monitoring us…..

• If you want more information about the Standard please contact Jules Wall Diversity and Inclusion Manager and Project lead at Pennine Acute Hospitals NHS Trust.

• Jules Contact details are:

• Email: Julie.wall@pat.nhs.uk

Resources Name Equality and Inclusion Team - equality@pat.nhs.uk

Myth Buster PowerPoint http://nww.pat.nhs.uk/corporate-departments/Equality%20and%20Diversity/Accessible%20Information%20Standard%20Myth%20Busters.pdf

Accessible Information Standard http://www.pat.nhs.uk/working-for-us/accessible-information-standard.htm

Accessible Information Quiz

Q1 - What are the main areas that the Accessible Information Standard focuses on?

a) Accessible information and staff

communications b) Patient needs and

communication support c) Patient Communication support

and accessible information d) Interpreting and translation e) Staff Information and

communication needs

C

Q2. Which of the following patient groups does the Accessible Information Standard focus on?

a) People who speak other community languages

b) People with a disability, impairment or sensory loss

c) People with good verbal communication but poor literacy

B

Q3. What are the five steps to implementing the Accessible Information Standard

a) Record, Flag, Inform, Act, Offer

b) Ask, Flag, Highlight, Inform, Act

c) Record, Ask, Flag, Share, Offer

d) Ask, Record, Highlight, Share, Act

D

Q4. What is the purpose of the Communication and Information Needs Passport?

a) It allows a person to record their communication needs and draws attention to their needs and preferences

b) It allows a person to record their personal contact requirements

c) It allows staff to record a patient communication needs and helps us flag these to the patient

d) It allows us to share a persons information with others

A

Q5. Which of the following may be an accessible contact or communication method for someone with a disability or sensory loss?

a) Telephone

b) Text message

c) Email

d) Letter

e) Face to face

f) none of them

g) All of them

G

Questions?