FAQs for Primary Health Interpreting

Here are some basic tests to help you assess whether your patient / client speaks, hears and understands adequate English to participate equally in discussion:

• Ask the patient / client open-ended questions that require an answer in the form of a sentence (i.e. avoid questions that require only a Yes/No response)

• Ask the patient / client to repeat a statement back to you in their own words

• From the patient / client's response or lack of response, try to determine if they have a hearing impairment, speech impairment or limited English proficiency

In general, an interpreter should be used in situations where a patient / client's lack of ability to speak or hear and understand English could restrict both the patient / client's ability to understand the information provided and the staff understanding of the patient / client's needs.

Important Considerations:

• The ability to greet or converse in English does not always mean the patient / client fully understands clinical information.

• A patient / client's capacity to speak and understand English ability can be affected by stress, being in unfamiliar environment or acute medical condition, e.g. illness, shock, pain, delirium, etc.

• Failing to use a professional interpreter may result in misdiagnosis and inappropriate care and treatment

The following resources are available to assist in identifying the patient / client's language:

• List of Languages Available
  

• Brochure with "I speak xxxxxx" translated into 70 languages

Sometimes the patient / client's language is provided in advance from documentation provided by the patient / client or from referring agencies, GPs or other services. However it is important to confirm the language spoken for new patients / clients to avoid booking an incorrect language interpreter.

You can request a Telephone Assignment from WATIS to book an interpreter to confirm the language with the patient / client.

A professional interpreter should be used when:

• the patient / client has no or a limited understanding of English

• there is a concern about the patient / client's health literacy

• the patient / client is deaf or hearing impaired and understands Sign Language

• the patient / client or family requests for an interpreter

• the need for an interpreter is indicated on the GP referral

• the need for an interpreter is indicated on the patient / client's written consent for participation in research

Principles Determining Use of Interpreter

The principles determining the use of a professional interpreter include requirements for:

• decision making, e.g. informed consent

• accurate communication

• patient / client confidentiality

• managing sensitive and emotional issues

• medical complexity

In a situation that a competent interpreter is necessary, arrange for one if it is practical to do so.

'Untrained' interpreter refers to family members, friends, support persons, staff or anyone who has not had professional training as an interpreter.

Untrained interpreters should only be used in the following situations:

• When it is strongly preferred by the patient / client and the health professional feels it is acceptable

  • For example: If a patient / client strongly refuses to use a professional interpreter because they come fro a small ethnic community and consider it inappropriate for a third party outside their family group to interpret for them. This is a decision to be made by the patient / client and their family in conjunction with the health professional and the reason should be clearly documented in the patient / client's notes.

• When immediate access to a professional interpreter is not possible and a delay in obtaining a professional interpreter would result in harm to the patient / clients, this needs to be documented in the patient / client's clinical notes

• To interpret information that, at the discretion of the responsible health professional, is:

  • non-clinical

  • non-technical

  • non-confidential

  • non-sensitive

  • not at risk to the patient/client if it is not accurately translated

Important Considerations for Health Providers

• The use of an untrained interpreter can be unsafe from a clinical safety perspective and can be culturally inappropriate. It is not recommended that untrained interpreters be used due to the potential risks. Refer to "Risks of Using an Untrained Interpreter"

• Children under the age of 20 should not be used to interpret for their parents or other family members

Telephone interpreting is most appropriate in the following situations:

• in an emergency situation where there is a delay in obtaining an interpreter for a face-to-face session, to facilitate faster assessment / treatment of the patient / client, e.g. to obtain symptoms and/or medical history from a patient / client

• for non-complex discussions, i.e. where the information is is of a type that could ordinarily discussed with the patient / client over the telephone, e.g. admission and check out procedures;

• for sessions less than 45 minutes

• in community, rural settings, e.g. for district health nurses carrying out a home visit

Important Considerations

The following are important issues to consider about the use of telephone interpreting:

• Some cultures require visual communication, therefore telephone communication is seen as non-effective

• Communication can be impacted by poor quality telephone or speaker phone systems

• Some patients / clients may not be comfortable with communicating personal or sensitive information over the phone

• It is not suitable for patients / clients with speech, hearing or cognitive impairments

WATIS Interpreting Service manages all interpreting service bookings and will assign and roster interpreters accordingly.

In general, we do not accommodate a patient / client's preference as to which interpreter they wish to engage for interpreting except when there is a good reason to use, or not to use, a particular interpreter.

Rostering Rationale

We apply this rostering policy because there is a need to:

• ensure equal distribution of workload to interpreters

• train and provide work to help new interpreters gain skills and experience

• discourage interpreters from promoting their service to patients / clients

• avoid conflicts of interest

• avoid service disruption and arguments between interpreters

• avoid job cancellation fees because patients / clients refuse to use an interpreter who has been booked by WATIS

Accommodation of Preference

WATIS will only accommodate a patient / client's preference for the following situations:

• for mental health, disability or sexual health related consultations or treatments agreed by health professionals

• when gender match is considered as culturally appropriate, e.g. for family violence, breast screening, bowel screening, urology assessment, gynaecology related procedures

There are bi-lingual / multi-lingual healthcare professionals who are accredited interpreters contracted by WATIS to provide after hours interpreting services. An employee who is an accredited interpreter may be used by their manager and for other areas if there is an agreement between the manager and employee concerned

Please refer to "Risks of Using an Untrained Interpreter".

Please refer to our Bookings section for more information

1. Go to My PHI Online Account

2. Click on "Register"

3. Select your organisation from the list of registered organisations, then click on "Start Register"

   • If you are an individual or your organisation is not registered with WATIS, please contact us directly

4. Complete the User Registration form and submit

5. WATIS will check your information and confirm your registration

Please refer to our Eligible Agencies section for more information

If you have feedback or concerns about the quality of the interpreting service provided to patients / clients and healthcare professionals you can provide your feedback by the following methods:

The minimum payments to interpreters for our core services are:

Subsequent charges are by 15 minute blocks.

To ensure you use your time effectively, please allocate time to pre-brief and de-brief the interpreter within the booked time.

Primary Health Interpreting Service is available free to patients / clients when they:

• are eligible for publicly funded health and disability services in New Zealand

• do not speak English or have limited English speaking language proficiency

• have hearing impairments requiring sign language interpreting

The top 10 languages requested for Primary Health Interpreting provided by WATIS from Jul 2010 - Jun 2014 were:

Mandarin, Korean and Cantonese alone usually account for over 50% of our requests. This is consistent with the population profile and English language proficiency of the Asian population residing in the Waitemata district.

However the languages of note are those common to our Refugee groups (Burmese, Arabic, Farsi, Tigringa and Chin). This is due to the regular appointments for Refugee clients with primary healthcare services within their 2 years of arriving in New Zealand.