James Watson O'Neill, CEO of SignHealth

In the latest in our series of interviews with charity leaders doing amazing work with digital during COVID-19 we spoke to James Watson O’Neill, CEO at SignHealth about how he and his team set up a new digital service to help their users during the pandemic. 

1. What is BSL Health Access?

BSL Health Access is a new service that the deaf health charity SignHealth set up in response to the pandemic. It is a Video Relay and Interpreting Service – it gives online access to British Sign Language Interpreters so that a deaf person can contact anyone in any health setting 24 hours a day for free. For example, a deaf person might want to call their GP – they connect to the service through the website, www.BSLHealthAccess.co.uk, or InterpreterNow app and engage with a qualified BSL Interpreter who then places a call on their behalf and relays the phone call backwards and forwards. The service can also be used to provide BSL interpreting to a meeting of two or more people in the same room – the conversation is relayed in the same way with the remote BSL Interpreter ensuring that hearing and deaf BSL users can communicate effectively in their first languages.

2. How did the idea come about?

It quickly became clear that the pandemic was having a significant impact on deaf people’s access to healthcare and deaf people’s health was already worse than hearing people’s because of an overall lack of accessible information and services for deaf people who use British Sign Language. But the introduction of face coverings, which makes lip-reading or using BSL impossible; social distancing meaning that deaf people are more likely to be on their own when attending health appointments; and the lack of accessible information on COVID-19 in BSL, all combine to mean that deaf people are really struggling to access healthcare. Additionally, many services like access to GPs or other clinics are now expected to be done over the phone, which immediately excludes deaf people.

A colleague of mine had a very difficult experience in early April. She and her husband are both deaf BSL users and he had been taken to hospital with COVID and communication had been impossible. He had communicated with his doctors using handwritten notes, exchanging messages such as “Am I going to die?” to which his doctor wrote in response “I don’t know”. My colleague eventually had to hire BSL Interpreters privately and use FaceTime to communicate with them so that he had some way of talking with his doctor. It was awful.

We are the deaf health charity – our whole purpose is to improve deaf people’s health and wellbeing, but in a pandemic I realised that it’s surely our job to make sure that deaf people’s health doesn’t deteriorate further – if we weren’t able to come up with a solution then no one would.

We know InterpreterNow, the fantastic company that provides BSL access to NHS 111, so I contacted them to ask about their experience of calls during the early weeks of the pandemic. Calls had increased very dramatically but were being managed well. I asked them if it would be possible to just “open the doors” and make access to BSL Interpreters free for everyone, everywhere, in any health setting 24 hours a day. They said that it would be possible, but it would be expensive.

3. You launched the service impressively quickly. Can you tell us more about how you did it?

My first conversation with InterpreterNow happened on Thursday 9 April – the day before the long Easter weekend. I’m so grateful that I have a fantastic Chair and Board of Trustees as I spent most of Easter weekend talking to them individually about the service we wanted to put in place and also, critically, that we wanted SignHealth to underwrite the cost so that we could begin immediately. We know that the NHS is legally obliged to pay for communication support for deaf people in health settings but we knew it would take time to agree funding with the NHS and that deaf people couldn’t wait. So I was asking permission not just to set up the service but to foot the bill from the charity’s reserves. I had immediate support from my Chair, Jackie Driver, and also from all of my trustees, the majority of whom are deaf and understand these issues very well.

So, having got the go ahead from my Board, we worked very hard with InterpreterNow over the next few days to develop the service – we named the service and had a logo designed, built a website, developed a marketing plan, wrote and filmed FAQs (in both English and BSL) and then we launched on Thursday 16 April, exactly one week after my first conversation with InterpreterNow and about ten days since I’d spoken with my colleague about her husband’s story.

4. What has the impact of BSL Health access been?

Although we’ve spent a lot of time trying to raise awareness of BSL Health Access, to deaf people and everyone who works in health settings, the service has had a real impact from the very beginning. On the very first day we supported a 76 year old deaf man to contact his GP – he couldn’t do that the day before.

And the service has really grown over the last 5 months. In our first week during mid-April we took 389 calls. In the first week of September we took 1,122 calls. We’ve had more than 14,000 calls so far and provided more than 77,000 minutes of BSL interpreter time.

It’s great to see the service being used in a really wide range of settings too. While about 60% of the calls are to or from GPs, we also take calls in pharmacies, opticians, dentists, COVID wards, health clinics – every health setting you can imagine. And we also regularly take calls from paramedics who are trying to communicate with deaf people when they arrive at an emergency. This service is saving lives.

5. What support do you need to make the service sustainable?

We need the NHS to pay for it! The Equality Act and the Accessible Information Standard make it clear that the healthcare provider has the responsibility to pay for communication support and we’ve had really positive responses from NHS England – I think their difficulty is more in how to pay for it rather than whether or not to do so. But we’re working hard to make those wheels turn as quickly as possible as SignHealth is continuing to pay for it in the meantime and we are already draining our reserves to do so – we won’t be able to do that for much longer.

6. Finally, what would you advise other charity leaders about using digital during COVID-19?

I’m always nervous of giving advice as I don’t have a magic wand and there are lots of people with a great deal more experience than me. Every charity leader I know is working really hard to do their absolute best. But, if I just reflect on our experience of setting up a new digital service – I was pleasantly surprised by how quickly we were able to start offering a service and that was mostly due to the hard work of a small group of people who rallied around and supported one another. And, as cheesy as it sounds, we dared to dream of an ideal solution – something that would be free at the point of use, available to everyone 24/7, and would make a real difference – we didn’t spend much time worrying about it not working, we just got on with it!