When the Interpreter Doesn't Come

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An African-American nurse talking to a patient in hospital setting she's wearing a blue uniform with a stethoscope around her neck. Patient is female and has a ponytail and they are both facing each other.

Alan Graham was 75, Deaf from birth, and a BSL user. After a fall, he was admitted to Queen Elizabeth Hospital in Birmingham and diagnosed with heart failure. He was in the hospital for 11 weeks. During that time, the Trust provided a professional BSL interpreter on just three occasions.

So who filled the gap? His grandchildren. Connor, who was 16, and Mia, who was 12.

Staff asked them to relay medical information to their grandfather and their mother, Jennifer, who is also Deaf. On one occasion, Connor was asked to tell his mother that her father might not survive the night — and that CPR should not be attempted if the need arose.

Alan died the following day.

Let that sit for a moment. A child was asked to deliver the worst possible news to his mother because the hospital couldn't be bothered to book an interpreter. Not once, in a moment of crisis, but repeatedly over eleven weeks.

Jennifer said she asked for an interpreter every day. Her children just wanted to visit their grandad. Instead, they became unpaid, unqualified medical interpreters — carrying information no child should have to carry.

The Parliamentary and Health Service Ombudsman investigated and found the Trust had repeatedly failed to follow national guidance. The family received an apology and modest compensation. The Trust was told to produce an action plan.

It would be reassuring to think this was a one-off. It isn't.

Research by RNID and SignHealth, published in their 2025 report Still Ignored: The Fight for Accessible Healthcare, found that seven in ten deaf people have never been asked about their communication needs when accessing NHS care. Nearly half of BSL users said they didn't understand their diagnosis or treatment. Almost one in ten had avoided calling an ambulance because of communication barriers.

Think about that. People are choosing not to call for emergency help because they know they won't be able to communicate when it arrives.

The legal framework to prevent all of this already exists. The Equality Act 2010 requires reasonable adjustments. The NHS Accessible Information Standard, introduced in 2016, sets out clearly how services should identify and meet patients' communication needs. The obligation to book a BSL interpreter is neither new, ambiguous, nor optional.

So why is it still happening? I think it comes down to three things.

Some people simply don't care. Deaf patients are a small group, easily overlooked, and their needs get quietly deprioritised. Some people have no idea they should care — they've never been trained, never been told about the Standard, and don't understand that accessible communication is a legal duty, not a nice extra. And underpinning both of these is the absence of any real consequence for getting it wrong. Only 35% of NHS trusts self-reported full compliance. Just 21% have ever audited themselves. The Standard still isn't mandatory. The first self-assessments aren't due until March 2027.

When there's no enforcement, guidance becomes optional. And when guidance is optional, it's the people with the least power who pay the price.

Jennifer Graham-Petty put it simply: "Too often there is a lack of interpreters in healthcare settings all over the UK." She wants interpreters to be automatically provided for those who need them.

That shouldn't require a campaign. It shouldn't require an Ombudsman investigation. It should just be how things work.

https://rnid.org.uk/wp-content/uploads/2020/05/AIS-policy-report-England-UPDATED.pdf


 

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