Patient Accessible Information Standard

Learn about the Accessible Information Standard

Introduction to our Policy

The Accessible Information Standard directs and defines a specific, consistent approach to identifying, recording, flagging, sharing and meeting the information and communication support needs of patients, service users, carers and parents, where those needs relate to a disability, impairment or sensory loss.

It is of particular relevance to individuals who are blind, d/Deaf, deafblind and / or who have a learning disability, although it will support anyone with information or communication needs relating to a disability, impairment or sensory loss, for example people who have aphasia, autism or a mental health condition which affects their ability to communicate.

Identify Needs

• The patient registration form includes questions on communication and information needs which is used for all new patients. Patients are also asked if they have a communication passport.
• Existing patients will be asked their communication and information needs when possible when they come into the practice, or if they have a new diagnosis or produce a letter/certificate which makes them eligible for the standard.
• Patients that meet the criteria for this standard will identify which information formats/contact methods/communications professionals/communications support professionals they need.
• Carers are added to the carers register. If the carer is one of our registered patients their information and communication needs will be captured at registration or on their next visit to the practice.

Record Needs

• The needs identified on the patient registration form are entered using the EMIS registration template, on the patient accessible information standard (PAIS) page which records the relevant read codes.
• For existing patients the PAIS patient accessible information standard template can be added to EMIS F12 menu for easy access.
• We will not record needs on paper records, as there is an equivalent electronic record for these and all communications will be driven from the electronic record.
• Online users – view/record their own needs – we have contacted Informatica and they are aware of the requirement and will be providing appropriate functionality in future releases of the software but are unable to commit to a timescale for this.
• For Carers (including parent carers) if the carer is one of our registered patients and have an identified information/communication need, an alert will be added to the caree or child record to advise staff to load the carer or parent record to check their needs. The protocol alert will automatically trigger for identified needs for the carer.

Flag Needs

• If a patient has been asked what their information and communication needs are they will be allocated a read code of 9r with free text of “info and communication needs”. An EMIS search (Population Reporting – FMP/Ad-Hoc/PAIS Patient Accessible Information Standard/patients who have NOT been asked about information or communication needs) can be run to determine how many patients have not been asked about their needs. An EMIS protocol alert could also be activated to prompt for patients that have not been asked.
• Any patient that has one of the needs recorded will trigger an EMIS protocol alert to say “this patient has information and communication needs – would you like to see these needs now?” If “Yes” is selected each need will be displayed in turn and actions can then be taken as necessary
• Any patient that has identified communication needs will be set up with an Informatica (Frontdesk) alert so that members of staff are aware when booking appointments, and can arrange for interpreters or longer appointments, or anything else that is needed for their appointment. To see their identified needs the patient record needs to be opened on EMIS
• Paper records will not be marked as electronic records are used as the primary record

Meet Needs

• All in-house created patient information (letters/forms/leaflets) should be created in plain language using Arial 14 font where possible. The bottom of these letters should include the following paragraph – “If you need this letter or information in another format, or if you need help communicating with us, please let us know. Examples include letters in large print or easy read format, or using a British Sign Language interpreter. If your needs change please let us know so that we can update your record”.
• Online translation using the World Lingo website can be used to have a written conversation with someone who is deaf or hard of hearing. Please also see Policy for Supporting Patients Attending the Practice.
• Sources and contact details of communication support professionals and alternative formats can be found in the spreadsheet named “Patient Accessible Information Standard Sources and Contacts” and priorities of use are assigned where appropriate. Where possible more than one source for each type is included in case of unavailability. If problems are encountered with sourcing the Patient Information Champion will investigate and try to find another suitable source.
• To assure the quality of information in alternative formats we will check that companies used are members of the UKAAF UK Association for accessible formats or offer their own assurances of quality.
• To try to ensure alternative formats can be obtained in a timely manner we have sourced at least two companies that can provide alternative formats. Any problems with sourcing will be investigated by the Patient Information Champion.
• To ensure that communications professionals have appropriate qualifications, are enhanced DBS checked and are signed up to relevant professional code of conduct we will check they are on the NRCPD National Register of Communication Professionals or that we use companies that assure this.
• To try to ensure that communications professionals can be obtained in a timely manner we have sourced at least two companies that can provide communication professionals. Any problems with sourcing will be investigated by the Patient Information Champion.
• In an emergency situation or in the walk in clinic or drop in clinics if communications support is required we have the option to sign up to use InterpreterNow for online interpreters. We will make a decision on this if there is an identified patient need. Should we use e-learning to train frontline staff (eg deaf communication matters, learning disability matters, vision matters, basic sign language etc). We have created two sets of flashcards that Care Navigators or clinicians can use to help communicate which are kept at the Information Desk & the Walk In Clinic Desk
• Patients must be asked if they would like a professional communications professional to attend their appointments and it must be recorded in the patient record if this is declined.
• If a patient requests that a family member/carer/friend is used for communication support this must be recorded in the patient record. This should be checked regularly in case the patient changes their mind.
• Frontdesk alerts will be used to prompt members of staff to ensure that identified patients get longer appointments or need carer at appointments. The needs can be viewed by opening the patient record on EMIS
• The complaints leaflet is available in easy read format. Other leaflets, letters, documents etc. can be converted to other formats when required.
• To ensure that identified patients are always contacted by their preferred method when producing letter in bulk, there is a base EMIS search to include all of the patients that have identified that they should not be contacted by letter and these patients will be excluded from the searches used to produce the bulk letter. The excluded patients would then need to be contacted instead by their identified method
• Web accessibility – The website includes a page about the PAIS and how we support patients. The website is designed to support screen readers. Other accessibility options are out of scope of this standard.

Sharing Identified Needs

• NHS e-referrals – recorded needs will be automatically added to the e-referral document.
• Other Referrals methods have been reviewed to ensure that information and communication needs are shared.
• Summary Care Records – recorded needs will automatically be shared as part of the additional record.

Training

How and when will we train staff?

• All staff will have a one off training on Accessible Information Standard via Blue Stream Academy
• Communicating with patients with sensory loss – Disability Matters e-learning, Action on Hearing Loss, Deafblind UK, The Makaton Charity?
• Communicating with patients with a learning disability – Blue Stream Academy e-learning, Disability Matters e-learning?

Monitoring

• To monitor whether the patient is getting what they need we will run an annual audit of patients with recorded needs to see if they have had appointments or information sent to them & if this was done to meet their needs. Also to check if interpreters were present if they were required. Any breaches will be raised as a significant event.
• When this policy is due for renewal the patient accessible information website will be checked for any updates
• How will we monitor needs – At the bottom of all letters include standard paragraph to ask patients to let us know if their needs change. This is also shown on the practice website Patient Accessible Information Standard page. There is a slide on the patient information screens explaining about the standard & reminding patients to let us know about their needs
• We will construct a patient survey in accessible formats to be approved by the PPG to check if identified patients have had their needs met.