contractSCOTLAND: Review of the service extension pilot

1. Introduction

ContactSCOTLAND BSL is a pilot online British Sign Language (BSL) video relay interpreting service. It aims to connect Deaf BSL users to Scotland's public authorities through the use of BSL/English interpreters. It is a free service whereby a BSL/English interpreter will relay a call between an individual BSL user and public authority staff. It was first introduced in April 2012 as an NHS 24 service to enable better access to telephone health services for Deaf BSL users. An initial review^[5] found that uptake had been low but that stakeholders agreed that the service should continue in a revised form. An extended version of the service covering all Scottish public services was launched on 2 March 2015.

The aim of the contactSCOTLAND pilot is to provide a BSL online video relay interpreting service which is high quality, continually improving, efficient and responsive to user needs. The specific objectives are to:

• Extend the NHS 24 BSL interpreting service pilot to allow users to access a wider range of public services/agencies.
• Measure and evaluate the extended service and make recommendations on its future.
• Engage with BSL users to ensure that the service is fit for purpose, cost effective and to encourage uptake of the service.

In order to support these objectives Scottish Government Health Analytical Services worked with the Deaf Sector Partnership^[6] to review the pilot service. The purpose of the review was to understand uptake and usage of the extended pilot and gather information on stakeholders' views and experiences of the contactSCOTLAND service. This report presents the findings of the review. The methods used are summarised in Chapter 2 and the evaluation framework used to design the review is provided at Annex 2. Following a discussion of the policy, legislative and international context, the findings from the review are discussed. The findings relate to awareness and use of contactSCOTLAND; experiences of using contactSCOTLAND and reasons for not using it; and what works and what could be improved about the service. Recommendations are provided at the end of the report.

1.1 Policy context

Deaf people can face a range of challenges in accessing public services, such as a lack of information in BSL, and a lack of awareness and understanding of the needs of BSL users. Prior to the passage of the BSL (Scotland) 2015 Act, BSL was principally legislated for under equalities and disability discrimination laws. The NHS 24 BSL pilot developed from the NHS 2008 Annual Review which established a requirement to provide better access to telephone health services for users who are Deaf. Operational from April 2012, the initial uptake of the service was low and a preliminary evaluation was undertaken to determine the possible reasons.

The NHS 24 evaluation used a mix of interviews, questionnaires, meetings and other feedback to gather views of three major stakeholder groups: Deaf communities, interpreters and NHS boards. Within the time constraints of the evaluation the focus was primarily on the Deaf community and interpreters, and less so on medical professionals. The key themes that emerged from the evaluation related to: the need for improved communication and community outreach; a need for more information in BSL; the importance of maintaining choice (of interpreting format and of interpreter) particularly for older people; and a need for more user friendly technology. The consensus view from participants was that the service should continue but not in its current form. An extended pilot service known as contactSCOTLAND was developed from the NHS 24 pilot, and made available for all Scottish public services. The intention was to make the service more cost effective, more widely accessible to users, and to allow for preparatory work on a sustainable service.

The contactSCOTLAND service supports public authorities in meeting their equalities duties under the 2010 Act by making reasonable adjustments to a service to address a potential discrimination as a result of disability. The British Sign Language (BSL) (Scotland) Bill was passed by the Scottish Parliament on 17 September 2015. The main provision of the Bill is to promote the use and understanding of BSL and enable Deaf people who use BSL to enjoy greater participation in daily and public life. Listed authorities are required to prepare and publish plans regarding the use of BSL in the delivery of their functions. It is anticipated that contactSCOTLAND will support public authorities to meet their legislative requirements.

1.2 International context

BSL video relay translation services also exist in a range of other countries, although the nature of the provision and remit of the service varies as do the funding arrangements. A comprehensive review of the deployment of video relay services was undertaken on behalf of Ofcom in 2012^[7], which reviewed provision in eight countries. At this time permanent services were in place in Germany, the USA, New Zealand, Norway and Sweden. The similarities and differences in these are summarised in Table 1.

Table 1: High level comparison of VRS provision

Source: International Deployments of Video Relay Services (CSMG 2012)

In most cases these services are mandated through disability legislation, and have a mix of capped and uncapped funding. The demand and take up rates for these services have varied - in Norway for example the number of VR calls increased rapidly year on year, in the US there was a rapid increase for the first 10 years which has levelled off. The cost and availability of technology and awareness all influence the take up of services. The Ofcom report suggests that marketing and outreach activities can have a major positive impact on VR adoption by improving awareness. Work undertaken in the UK has estimated that it can take up to seven years for the full adoption of a video relay service^[8].

There is also a range of international evidence^[9] available that indicates some of the benefits and challenges associated with the provision of Video Relay and Video Remote Interpreting Services (VRS/VRI) for users and service providers. Studies of user's experiences in the USA and in Canada indicate that there is a demand for VRS/VRI services and that they are positively viewed by Deaf users. There were some concerns about privacy and the adjustments required for the process of using video. There were features of the interpreting process that were commonly highly regarded by users: good interpreting skills; good interpersonal skills; confidentiality; appreciation of culture and diversity and responsiveness. VRS can also present particular challenges for interpreters due to the spontaneous nature of the calls and the potentially wide range of topics which can arise. Call handling training and support are important for online interpreters. Professional standards are still developing in what is a relatively new and emerging field. A European Telecommunications Standards Institute report^[10] has suggested a range of potential economic and social reasons for the provision of relay services. These reflect the potential for better integration of deaf people into society; improving access to services; increasing the efficiency of interpreter services; and promoting equality.