SPEAKER:Can you hear me, Ai-Media? We are ready to start. Starting.

SPEAKER:All right. Mark, would you be able to (inaudible). Maybe at the end there. Thank you, everybody for coming. This is the first Peterborough Deaf Health Forum.

I would like to welcome two people from Cambridgeshire, and Peterborough NHS to talk to you about your issues with health, and what is going on in Cambridgeshire and Peterborough.

I would like to welcome Ian Wellar and Susan Lanst. I'm just going to give you some facts and figures. An overview. The reason we are having this meeting is, deaf people have worse health outcomes than hearing people.

Even though deaf people, in general, smoke less. Deaf people, in general, drink less alcohol. Deaf people do roughly the same amount of physical exercise as hearing people.

But deaf people are twice as likely to have high blood pressure, four times likely to be diabetic, and more likely to suffer from strokes or heart disease. Sue will remember, she came to a meeting of ours in Cambridge where we talked about these results.

We started these forums as a way for people in Cambridgeshire and Peterborough to give feedback to the NHS about your experience and we can start to work together to try and improve it.

I want to say thanks to you guys are coming along. First of all, there is going to be a presentation from the NHS from Susan and Ian about their system transformation.

Then after that, it is your opportunity to give feedback and discuss any issues you have. So, I will hand over now to Susan and Ian.

SPEAKER:Hello. Thank you very much. It is really nice to be here. I was a bit startled by your statistics there about deaf people not living as long and having problems.

I think it is really important that we understand that, so when we design our services for patients we are absolutely clear about your particular group of people.

So, I wanted to bring your attention to the work we are doing, and to really think about some of the issues facing the system at this moment in time, and over the next five years.

If you remember, there was an election about two months ago, where the NHS was a key topic of conversation.

And leaders, David Cameron was very keen to preserve the values of the NHS and make the NHS more accessible, a better quality, and to be more affordable.

The chief executive of the NHS set out a vision before the election called 'The Five-Year View'. A five-year plan for the NHS.

In order for us to design that plan, we need to have your feedback. If at any time you want to ask me a question about anything, then please do.

This is quite a good slide, it shows why it is really important why we have engaged with people like yourselves. One of the key facets, or key strands of work in the five-year forward view is about empowering people to stay healthy.

It was about developing a sustainable health and social care system, and it was about improving quality. That is really what we are about in the NHS. I think one of the key elements of the plan is prevention.

Because there is a lot of money spent on treatment when, arguably, it could be prevented. But patients and people have got to be at the centre. We cannot do change on our own. There are lots of really big providers, really big players who deliver healthcare services.

In Peterborough, we have the new hospital. In fact, this slide shows the partners involved in our health care system in Cambridge and Peterborough.

These are the big players, you can see the hospitals, community services, mental health services. The council. They are all involved in the delivery, health and social care to the population.

So, the plan we are developing, that we are looking at, is based on this design, if you like. This house, which is got prevention at the bottom, which is absolutely key.

And that we understand the needs of the population. Primary care, which is your GP, is really key to that agenda.

They are the first contact you generally have with the health care system, is that right? Along with mental health, older people's services, vulnerable adults, children and maternity. If you then look at the design of how, if you like, patients flow through the system through the elective procedures, and the non-elective procedures, that creates the basis of the plan you're trying to develop.

When I say "non-elective", I mean A&E services. When I mean "elective", I mean when you go to your GP, and they may refer you to see a consultant, which then may turn into a hip replacement, for example. Or a planned operation.

So, that is the difference in the two. This slide is just a timeline of where we are in the main program of trying to look at the issues and create some plans for the future.

We are in the design and propose phase, which leads us up to the end of this month. In order for us to plan services, or look at services, we need to have a detailed understanding of the issues in the system.

We need to understand patient need, demand for services, we need to understand capacity, we need to understand the geography, how far people have to travel, how many beds there are, how many births there are, how many deaths there are.

You have to have a detailed understanding of health. We also need to be working with those other stakeholders in the system to understand what is important to them, and what their needs are as NHS providers because they also need patients, they need money, and they need workforce to be able to survive.

We need to recognise that we are not going to destabilise any of that by this process. We also need to understand what is really important to you, from your healthcare provision, and take that information to feed into the design of any services going forward.

And that is where we are today.

SPEAKER:Sorry. Sorry.

IAN WELLAR:Welcome. And so the feedback from people like yourselves is very important. Often people will say, "Why does the NHS need to change?"

It is facing unprecedented levels of activity, there is a growing and ageing population. That population has healthcare needs, which need to be supported. Of course, that costs taxpayers money.

In the system, locally, in the Cambridgeshire and Peterborough system, if we do nothing, we're going to have a deficit of at least 250 million. At least. That could be a lot higher.

If we continue as we are, the deficits will affect patient care, because there is not enough money. And it could affect quality. It is not just about money at all.

But it is about understanding that health needs are changing. Demand is increasing. And there is a mismatch between how much demand there is, and how much capacity varies to meet that demand.

For example, obesity is probably one of the biggest contributions of demand. People going to hospital, or going to see their GP. 30 years ago, it was smoking. But today, it is obesity.

Also, there is a real crisis occurring in GPs, whereby there is not enough GPs. There are a lot more patients to see, and their money has been reduced. As a result, that is not a very attractive career for...

Welcome.

Have some tea. GPs' primary care is not a very attractive career at the moment. David Cameron did say 5000 more GPs would be recruited into the service. So there are gaps in workforce.

There are gaps in mental health provision and children's services. It is not joined up enough in certain areas.

The NHS is a massive organisation, which is difficult to join together. So, if no change, demand will rise. It is quite likely GP practices, particularly small ones, will go out of business.

It just will not be cost-effective to keep going. As a result, more people will go to hospital. Hospitals are busy places. More people go to hospital through the A&E department means that capacity cannot be used to conduct elective procedures. Therefore the waiting list gets longer.

Quality can be affected. More funding problems and pressures across the system. Hospitals also struggle to recruit staff and there are lot of agency and temporary staff working in hospitals, which is very expensive.

[Martin.Captioner is Live]

If that continues, it is highly likely there will be decreasing quality of care and poorer outcomes. And, for you guys, that's not good because of what we heard at the beginning, about the statistics on health outcomes for deaf people.

So, things have changed since 1948, which is when the NHS started. I think at that point there was more infectious diseases being brought in from Spanish galleons and so on and so forth, from abroad, and you died a lot earlier. 48% of the population die before the age of 65. That figure is now 14%.

Life expectancy now is 21 years greater forwarding and 19 years greater for men. So, the average age is about 80-81, for the population.

Unfortunately we are living longer, which is good, but along the way we pick up lots of different health issues. We call those long-term conditions. Diabetes. Heart failure. High blood pressure. Etc. Those are some of those conditions.

Also, we have what is described as an epidemic in obesity. Being overweight can cause an awful lot of health conditions, particularly in later life, associated with diabetes, heart failure, hip replacements, etc. So what happens In years to come, there are more and more people who are obese, and that will cause huge demands for NHS services.

There is also a bigger population. Migrants are coming into the community, ageing population, people coming to live in Peterborough because it's a nice place to come and work and live. All of that creates additional demand.

Cambridge and Peterborough are one of the biggest expanding populations across the country.

I think you can see that there is, if you like, a gap between the capacity of the NHS to cope with the increasing demand for healthcare services, and therefore, if things don't change, there's likely to be poorer quality and people waiting longer to see a doctor, to see a hospital doctor, and to get their operation. That's not good for our own health care.

Talking with obesity and the population change, the demand if we do nothing, it's likely that, over the next five years, we will need another 430 hospital beds to meet the demand for people needing hospital services. That is the size That is nearly the size of another Peterborough hospital. That is expensive and unsustainable.

So what's the answer?

Increase prevention. Prevention is better than cure. The population understanding how lifestyle can affect health and how things like physical exercise and health prevention can reduce the need for hospital services or GP services.

We need to develop alternatives to bed based services. So, at the moment, often people go to hospital and they end up in bed. That's not necessarily the right place to be. If you do go into hospital and you do need a bed, that's fine, but you don't want to stay too long. You can easily become unwell, and hospitals are not the best place to be. There's lots of bugs and lots of sick people. So we want to get you out as soon as possible, back home.

So GP services, primary care, is also not sustainable. We need to have a strong health system, which is underpinned by a new model of GP services. The first time people see a doctor is generally the GP. Most of the time, the GP can sort you out and you don't need anything else, which is good. So they are the key element, component, of NHS provision. They are vitally important.

Also, the GP workforce is ageing. Local GPs are looking at retiring. Their staff are also looking at other work opportunities. People also want to work part-time, and it's difficult to recruit staff. There's 107 practices in our system. Nearly all of them have been affected by funding changes to their income, having adverse effects.

We know this. We know what is going on, which is good. We are aware of the gaps. We need to work together across the system, in partnership, to fix those gaps. We've already gone a long way in terms of developing services for older people, and recently introduced a new provider, Uniting Care, provide older person services across the region in an integrated way.

That is good for patient care and it is good for access. Te also know that mental health services and children's services need to follow a similar approach, where we have more integration. The NHS is very fragmented into different services. Therefore, patients often seen multiple doctors and have multiple assessments when they don't need to.

So, mental health services are really important. It costs about 100 billion annually. At least one in six have mental health illness during their lifetime. 75% of people with a mental illness never receive treatment. There are huge gaps in mental health services.

The demand for mental health services is going up. 44,000 adults over 18 had depression in 2013-14. A&E attendances for psychiatric conditions are higher than the average in England in our area. Suicide rates in Peterborough are very high.

We need to intervene early in mental health, improve access to mental health, and we need to improve care in crisis. Often people have a crisis and they don't know where to go, they don't know where to turn to, and a few other services aren't there.

So, children in maternity services. There is evidence that children's experience before birth has a major impact on health outcomes, and, if you like, lifestyle chances.

IAN WELLAR:We need to prevent the impact of alcohol substance misuse, obesity, etc. Children's services are not joined up. They are provided by councils, community services, hospitals.

It is very fragmented. We need to think of a more radical solutions to a joint approach to children and maternity services.

Finances, this is very depressing, isn't it? We could be in a position of 430,000,000 by 2019, that is a significant gap.

Each NHS hospital, each provider has plans to save money, we all have. It is a bit like your home, we all plan to save money, it doesn't always work.

We hope to be more efficient, it may not be, therefore the size of the debt could be very substantial. We might not be able to close the full gap in finances while changing NHS services, I think there would need to be some additional funding by the government.

Also, things to think about, how services are delivered. We may have to look at reductions in services, potentially. Or we may need to seek ways of generating income rather than just through the taxpayer. And there are ways of doing it.

What is critical, is that services need to work together. We all face the same challenges around how we want to improve patient care. And we need to be financially and clinically sustainable as well as affordable.

Next steps between October and November there will be a period of engagement. We will talk to the public about ideas we have formulated, feedback from the public and group etc. And start to think about what changes we are going to make with that idea, that aim of being more sustainable but offering quality.

So, I would like to offer you the opportunity to talk to me and Sue about your experience of health care, and what you would like to see, and what is important to you about your services.and I will have a cup of tea!

SPEAKER:We can go for a quick break.

SPEAKER:(inaudible)

SPEAKER:The NHS can save 30 million, and provide better health care for deaf people. (inaudible).

The question was, was at 30 billion for disabled or just deaf people? It can be saved through prevention for the deaf community.

SPEAKER:We will go for a quick break now, 10 minutes. We will come back in 10 minutes, start again and think about what feedback you want to give.

[Martin.Captioner is Live]

SPEAKER:Ai, can you still hear us OK?

(multiple speakers)

SPEAKER:We might be all right, Sue.

(multiple speakers)

SPEAKER:Can I get everyone's attention? Is everybody ready?

Think about different things, your experiences of hospital, GPs, A&E, mental health services, different things. At the end of the meeting, we will talk about three (inaudible) for the future. Then, in six months, we will come together to review, to see what we are going to do. OK?

So if you can feed back now You don't need to tell us all the detail. Try to tell us that experience rather than the detail. OK?

I will pick people.

Andy was talking about the 30 million that could be saved. If that only for the Cambridgeshire area or the whole of the UK? UK wide? Thank you very much.

I will try to be choosy and brief.

There is (inaudible) deficit, and that is a real worry.

(inaudible)

For example, if I go to the GP doctor, (inaudible).

(inaudible)

SPEAKER:Just to say, the speech has gone a bit quick. If you could slow down a bit

SPEAKER:If I get another opportunity, I will say more.

Thank you very much.

SPEAKER:Is there anything you wanted to respond to?

SPEAKER:There is a legal requirement for NHS organisations, when planning any change, to consider equality of access. So, your point about GPs and interpreters, sign language providers, is really important. If we don't provide that, you cannot access services. So we will make a note of your concern. It's very important.

We will always consider, in areas of equality, that we don't make things worse.

SPEAKER:That point about access. Is there any more feedback on access?

SPEAKER:Yes. Cambridgeshire and Peterborough I can't see you. Would you mind standing up? No, we've got people behind you. Oh, OK.

It's linked to what Jason was talking about in access, about Cambridgeshire and Peterborough.

SPEAKER:(inaudible)

SPEAKER:GP surgeries, they need to be trained and aware of how to book interpreters and make the services accessible for deaf people. Maybe you can let the services know how to book interpreters to meet clients' needs.

It is the same. I went for an operation and I asked for an interpreter for the day. I arrived at the hospital. An interpreter was there. It was fabulous. But they said they were only there The doctor explained what would be happening and the interpreter said, "I have only been booked for one hour," which meant the doctor I ended up having to stay the night and they had to book another interpreter for the after operation. It was just a waste of time and a waste of money.

If they had used the interpreter for the whole day, I could have gone home that night. Then they could have used the bed for somebody else.

SPEAKER:So, I think in the future, GP services or GP practices will come together, because smaller practices will not be able to necessarily survive, because of the money. So they will come together in super practices or in federations, and I think that will help to have a critical mass and therefore the chance of getting interpreters consistently. So I think that will help. We will ensure your message goes to all of the GP practices around the need to have access to interpreters so that you can access services.

Hospitals do have interpreter services which they can use. I think it is right that we bring that back to their attention and that when operations are being booked, that they consider the need of the individual in terms of the length of stay in hospital, as a one-hour slot is not good. So we will do that for you.

SPEAKER:Also for family as well. I don't want a kid coming back!

Talking about a slot for a deaf patient, but also family members. If my father or mother or children were ill, I'm a deaf parent, I need access to that information.

Am I alright stood here? No, no, no up the front!

(Laughter)

Thank you very much.

I know people are talking a lot about GPs. My experience, for myself, is custom health centre has been really good at providing interpreters. When I had difficulty with my eyes and I had to go for a checkup every year, and my father needs to go for his glaucoma checkups, an interpreter is provided for that on a six monthly basis, and it is really good.

Sometimes there is a risk with my eyesight. They have said they are going to refer me to the hospital. That's fine. I asked them to tell the To book an interpreter at the hospital. The optician said they would pass the message on. The GP told me that (inaudible), so I was really relieved to hear that. I received a letter from the hospital and it had a date booked that had been two weeks in the past. That was fine. I asked work for a day off because I was having eyedrops and I would not be able to see problem. So I got the day off. I arrived at the hospital, where I was really disappointed because there was no interpreter available. They said, "Well, you didn't phone us to let us know." The letter said, "Please, phone us." I said, "Hang on, I'm deaf. How can I use the telephone to phone you?"

Telling deaf people to phone before the appointment just doesn't work.

It is impossible for a deaf person to phone. When you get that letter, if it states that you need to provide an interpreter, then they ask you to phone if you want one, it's just ludicrous. I don't know why they are asking deaf people to phone.

SPEAKER:That is not a good experience for anybody, and therefore we will make sure that hospital, the hospitals, are aware of their letters to patients and how interpreters can be and should be booked.

Most of the issues that I hear is just communication, and it needs to be better for you.

SPEAKER:Sorry, just to follow up on that. I work for adult social care, a lot of deaf people come in with letters from the hospital saying, "Please phone to arrange an appointment."

Then there is nothing on it to say an interpreter had been confirmed. If I phone to see an interpreter had been booked, the response is usually, "I did not know I had to."

It is a template they just do, but perhaps somebody could write on the bottom of it, just to reassure people that an interpreter is available, rather than deaf people having to come in to get their correspondence checked.

SPEAKER:Can I ask a question? Do you use email?

SPEAKER:Not everybody, no.

SPEAKER:Some people do, some people don't.

SPEAKER:Even if on the bottom of the letter there was an email address, would that be helpful?

SPEAKER:The difficulty is, if the date is very close, there is not time to book an interpreter either. The appointment needs to be postponed, and it is another two week, or more, delay.

SPEAKER:This question about email, (inaudible).

SPEAKER:The difficulty is, a lot of people don't have email. Lots of deaf people don't have very good English. I am the same.

My English isn't very good, so I don't understand.

It is about five or six people saying the same thing.

Facetime, maybe, that would be good. I think we need something like that, so that I could do it in sign language.

SPEAKER:Talking about communication (inaudible). Recently, I received a hospital appointment by text. It was lovely, but I couldn't reply to it.

You could not reply by text. Maybe some details on that would be helpful.

SPEAKER:I think there needs to be a better solution, particularly in hospitals to cater for deaf people. Whether that is a disabled desk, or a dedicated service like a service for deaf people.

For maybe the GP to contact and make sure things were all right.

SPEAKER:Hello.

I have been to hospital a few years ago to visit my sick father. The doctor came round and had a discussion, and I said, "hold on a minute, I am deaf."

The doctor said, "Hold on a minute." Had a discussion with my mother and father about what was going to happen. When he finished, the doctor said to me, took me into the office and typed down what he had said to my mother and my sister.

I know it is difficult to book an interpreter at short notice, but he said, just wait a minute. And he typed it out. He wrote what he had actually told my mother. That is one option.

Thanks.

SPEAKER:(inaudible)

SPEAKER:One of the key promises from David Cameron's election would be a seven-day window of care. So how has that been affected now? What is the difference between seven day care as opposed to five day care.

So, there would be seven-day care.

SPEAKER:So, if you go to hospital, especially for the elderly, and get admitted on a Saturday, there is a 6% higher chance that you will die. Because the key members of staff who are able to look after you, diagnose you and treat you, don't work weekends.

So, it makes sense to have weekend working, so you can access and get the best hospital treatment. Unfortunately, that will cost money. And there isn't sufficient workforce for everybody to work seven days a week.

So, those services at weekends will need to be prioritised, so that in the beginning we can get people working in shifts that cover weekends. And they may have to have time off in the week.

But we need to work through achieving seven-day working over the next five years. It is starting now. It is very true that, generally, over the weekends, the level of service is less. People often just stay in beds waiting for care on a Monday morning.

That is not a good outcome for patients. So, it is the right thing to do, but it will take time and there will be cost. Anyone who works weekends probably wants more money. Quite rightly.

SPEAKER:My experience was when I went to a doctor and he provided an interpreter. The sign language was not particularly of a high quality. They had gone through an agency, but did not have an interpreter qualification.

The GP would say some words about medication, the interpreter kept asking the doctor what it meant. They tried to give an example, it just did not meet my language needs.

An interpreter should be fully qualified, we were talking about getting the right medication.

SPEAKER:(inaudible)

SPEAKER:There are a lot more people now. My own experience, I was referred to hospital in the middle of the night. They said, "can you bring a family member as an interpreter?"

I told him I could not rely on my mum, and they needed to provide a qualified interpreter. I had to wait for three hours in a room by myself doing nothing. I had no interpreter, no one to talk to. No one realised I was deaf.

I was really shocked when I read the report, there was nothing on there to say I was deaf. That is really all I want to say.

SPEAKER:I would like to see more qualified interpreters at the hospital. Not unqualified interpreters. They need to be accessible, qualified people.

SPEAKER:Can I ask a question? Is level 6 the right level of understanding levels of interpreters?

SPEAKER:The higher, the better.

SPEAKER:The interpreter has to be NRCPD interpreter. So, we can specify in contracts what level of interpreter is required.

We can put a timescale that interpreters should turn up in. And that might be two hours. Is that reasonable?

SPEAKER:I know interpreters cost money. But the difficulty is for people who stay in hospital for one or two weeks, I know every day the doctor comes and does the board rounds.

I think maybe it could be linked somehow, maybe if it is to do with pain and tablets. I don't think hospitals are aware of that.

I was just saying about getting interpreters. They produce video as well, that could be a possibility for some short meeting.

SPEAKER:Can I ask a question? Are there bits of technology like apps which can be used to sign and they come up with something similar to this technology? Is there a technology that can be used?

SPEAKER:SignVideo. It is a big company with a lot of contracts with the bank, I think the hospital should have a contract with them as well.

SPEAKER:You're dependent on Wi-Fi.

SPEAKER:SignVideo was great, but we should not be expected to pay for that. It is the hospital who should pay for it. Deaf people should not have to pay for the service.

SPEAKER:One of the issues with interpreters in my experience, I have a daughter. Now the problem is solved. But she has had some mental health problems.

We went to one interpreter because I wanted to know what was happening and I wanted to be comfortable with what was going on.

The doctor said, "Come back in 2-3 weeks." I asked for a signed interpreter and they said, oh no, we cannot do that. When I asked why, they said if I had the same one...

Sorry.

We wanted the continuity of the same interpreter so my daughter would open up. We had that trust was that interpreter, which is why we wanted her. If we had a different interpreter they would have just said, fine, fine.

[Martin.Captioner is Live]

If I have the same interpreter, if I have a relationship with them I am comfortable with, it is easier. But they said, it is not your choice, it is our choice. Actually, it is my communication needs.

(inaudible)

We don't want her to have health issues later on. I think that is part of human rights.

SPEAKER:I think with a lot of the issues we talk about, it is awareness of your particular disability and how the hospital thinks about responding to that awareness, and it is communication and awareness. The more we can make the hospitals aware of your situation, that is going to help. It is clearly unsafe for you to have medication or be given medication when you don't understand, or if you can't communicate about the types, the dose, the frequency of medication, as an example.

So we need to raise the awareness of deaf issues to NHS providers locally.

SPEAKER:That was from a GP, not a hospital. It was a GP receptionist who just dug their heels in and wouldn't allow me to book the same interpreter.

I realise why they wanted the other interpreter because they were cheaper. They were trying to save money.

SPEAKER:Seven more minutes. That's it.

SPEAKER:Can I ask a question?

SPEAKER:OK.

(multiple speakers)

SPEAKER:One more minute of interpreters then we will go to the next topic.

SPEAKER:Can everybody see me?

Previously, I asked for an interpreter and I asked I gave them a list of interpreters. They said they would rely on an agency. I said, who is the interpreter of the agency? They said, "I can't tell you that." They just blocked that information. They would pass it on to me. I felt discriminated against because they wouldn't let me talk any more.

It has got to be my right to know who is going to be there. I know who the doctor is going to be. I want to know who the interpreter is. If I don't like that interpreter, I am going to be anxious. It's really important that we are able to say which interpreter we won so we can actually be open and say what our issues are.

I think because the deaf world is so small, we can be quite choosy about which interpreters we want.

Talking about the choice of interpreters, I know they want qualified interpreters. Sometimes an interpreter will come, and it is like, oh, I know that interpreter, I don't want to disclose that information in front of that person. That can be a real issue. I want to feel comfortable with the qualified interpreter. But sometimes, if I know the interpreter really well, that has an adverse effect because I might not want to disclose that information.

The doctor doesn't understand, because they have got an interpreter and they think that can solve everything.

We are all aware the hospitals have contracts with agencies. Hospitals have to be aware that if we ask for a specific interpreter, they need to (inaudible).

About 10 years ago I said I had (inaudible). For 10 years, I had no interpreter. My daughter, when she was born, it was the same. I had no interpreter. My mum had to come with me and try to interpret for me. It was like I got brief information, not the whole story of what was going on.

I just gave up. I think they were trying to save money or something. I didn't know what was going on. For 10 years, I had no idea, really.

SPEAKER:One more response and we will go on to the next topic.

SPEAKER:What you have said is really important and one of your key issues is around the quality of interpreters, the awareness of your issues. We are concerned about the safety and we will do what we can to raise awareness and improve communication.

I would like to move onto any other topics you would like to talk about related to how you receive or how you access or how you experience healthcare.

SPEAKER:(inaudible)

SPEAKER:I can't suddenly have issues!

So, the walk-in centre. I've had major issues, both myself and my partner. We are both deaf. My daughter is hearing, sorry. If health problems happen, usually we get together to the walk-in centre. If my daughter is ill, (inaudible).

Often it says, "Phone before you go in." Well, I can't. We often drive. The receptionist is really grumpy. She wants our name. She is like, "you must phone before you come in." Hold on, I'm deaf. My daughter has been throwing up, etc. She is being physically ill. We couldn't wait for the GP on Monday because it was the weekend. It was a bank holiday weekend, and it would mean waiting till Tuesday. If she is being physically ill and vomiting a lot, and she had diarrhoea as well, so the walk-in centre, they said, "Oh, no, you've got to phone before you come in," and I'm like, "Can you get somebody? I'm deaf. It's just impossible."

I know their attitude was really grumpy. I'm trying to smile and be nice to pacify her because I don't want to challenge her so we don't get a good service. It never stops.

I think it's the same. Lots of people are saying the same.

A&E, hospitals. My wife had to go to hospital. I'm deaf and the staff froze, pretty much. They said, "Are you all right?" They froze. They did know how to communicate with me as a deaf person.

I didn't know what was going on. They said they couldn't text me, it was impossible. It wasn't a very good experience.

Other people are saying the same issues.

My experience I work with a friend who is also deaf. They had an injury. We arrived and we said, "We are deaf, can we have an interpreter?" They said, "no, you can't do that straight away." There was no communication.

So I think there are some questions. They could have been signed or something. That would have been really useful in that situation. It is just thinking outside the box.

SPEAKER:It sounds like Sorry.

(inaudible)

I was in Basingstoke. I remember. I had (inaudible). My sister thought it would be better to go to A&E. I was in a lot of pain. My sister went with me. They said they would need to book an interpreter. Because it was last-minute, they said no. My sister came with me. They gave me tablets, etc, that they said I might have to stay the night.

I said, "Will you book an interpreter?" The doctor said, "Oh, we will try our best." In the morning, the doctor came. The consultant came but there was no interpreter. So we had to write. The person said they couldn't get an interpreter because it would only be attempting a conversation. It was 10 minutes of this. I had to write on a board.

(inaudible)

SPEAKER:Shall we start?

I have forgotten what I was going to say now!

(Laughter)

The amylin service. It's a big concern for me. I know a lot of deaf people, they pass out and then they need to go to A&E via ambulance. The paramedics might not realise we are deaf. They probably have to communicate through other people.

When you are in pain, how do you say you are in pain and how much, out of 10?

Also, one deaf person had a serious accident and the paramedic was shouting at the deaf person, and they thought they were dead. Obviously, they were just deaf. They took him to hospital and there was a massive communication issue. They didn't know what to do. They found a family and said, "oh, we have your son here." They said, "oh, my son is deaf," so they realised he was deaf. It was a big shock to them.

SPEAKER:I'm aware of certain cards

[Mel.Captioner is Live]

SPEAKER:Can I ask something, please? Slows signing, remember. (inaudible) email online from a GP recently, he was not aware of it.

The GP should have told people there was access in our service.

SPEAKER:Do you mean booking a doctor?

SPEAKER:Yes. Apparently, it started five years ago. Really cheeky, they should have told us.

SPEAKER:So, thank you very much for giving me and Sue your experiences. I think that by hearing what you say, there is a lot more that can be done.

And the use of SignVideo could be very useful as a tool. And we will also look to different means of communicating when people are sick.

SPEAKER:(inaudible)

SPEAKER:(inaudible)

SPEAKER:Do you mean like this?

The issue is we are deaf, we don't have a learning disability.

SPEAKER:But if you are in pain, and you're being seen by a paramedic, there could be a card that shows where the pain is.

Where the pain is, and how bad. Would that be useful or just another means of communicating in an emergency?

SPEAKER:Visual information is always better, visual information is a good thing.

SPEAKER:So, we will take your concerns, your feedback, and we will come back and see you and let you know how it is going in six months.

So, thank you very much. In January.

(Applause)

SPEAKER:Thank you for coming, for sharing all of your experiences. It means a lot, we will be back again in January next year. We will let you know and keep you informed.

Thank you, again.

(Laughter)

SPEAKER:You're talking about obesity, that will not work!

SPEAKER:Thank you, thank you again.4