Criterion C1.4 – Interpreter and other communication services

Why this is important

Patients have a right to understand the information and recommendations they receive from their practitioners.⁴

Practitioners have a professional obligation to communicate effectively and to understand their patients’ health concerns.

Meeting this Criterion

Communication with patients who do not speak the primary language of our practice team

Unless specifically requested by the patient, avoid using a family member or friend of the patient as an interpreter because:

• information about the patient’s diagnosis may not be translated effectively, which might result in harm to the patient (eg there have been instances where regulatory action has occurred and allegations have made of patient harm due to inappropriate use of family members being used, rather than a qualified interpreter)⁵
• it may impose unreasonable responsibility and stress on the selected individuals, particularly if they are young or a very close relative (eg a child)
• it might upset the friendship dynamics and family relationships.⁶

Appropriately qualified medical interpreters are the preferred choice. Private medical practitioners (defined as GPs and medical specialists) providing services eligible for Medicare rebates can access interpreters free of charge, as can reception staff who need to arrange appointments and provide results of medical tests. This free service is available through TIS National. 

Consider developing a policy that explains how the practice team can communicate with patients who have low or no English proficiency. The policy could include:

• how to identify that a patient requires an interpreter or communication service (eg placing a specific flag in the patient’s health record)
• how to use the practice’s telephones when using interpreting services (eg setting up a three-way conversation or using speaker phones)
• displaying the national interpreter symbol in the reception area where patients can easily see it
• what information (such as the need for an interpreter, the patient’s preferred language, and gender and cultural sensitivities) is to be recorded in a patient’s health record and referral letters
• training the practice team in using interpreters.

Although Aboriginal and Torres Strait Islander peoples may appear comfortable with English, they may still benefit from being offered an appropriate interpreting service.

Patient refusal of interpreter

There are potential risks when treating patients who decline to use an interpreter. This is particularly problematic when there is a possibility of a detrimental outcome if specific information is not communicated correctly to the patient.

If a clinician decides an interpreter is needed, and one is available and offered, but declined by the patient, you could manage any associated risks by recording that the patient declined an interpreter in the patient’s health record.

More information regarding informed patient decisions is available at Criterion C1.3 – Informed patient decisions.

More information regarding respectful and culturally appropriate care is available at Criterion C2.1 – Respectful and culturally appropriate care.

Using an interpreting service – Telehealth

In cases where an interpreter is required, ensure that the interpreter can be effectively connected to your telehealth platform when they cannot be present in person. Engage a qualified medical interpreter if possible.

Communication with patients who have a communication impairment

The practice team must consider the needs of patients who need assistance with communication due to hearing, speech or vision impairment, disability, or cognitive impairment.

The practice team could consider the following when communicating with a patient with a communication impairment:⁷

• Ask the person about the best way to communicate if you are unsure
• Speak directly to the patient, even if they are accompanied by someone without disability
• Confirm that you have understood the reason for their visit, their symptoms and other issues, and confirm that the patient has understood the information you have given them
• Your practice needs to know how to access the National Relay Service (NRS) for patients who are deaf or have a hearing or speech impairment. 
• Further information about how your practice can communicate with patients who have communication impairments is available at Communication Rights Australia and at Novita Children’s Services.

Translated and plain English resources

Consider having a directory of resources, services, online tools and websites that will help you provide information in languages other than English. If most of your patients speak English, you may not need to have printed copies of these, as you might not use them often.

The Health Translations Directory provides health practitioners with access to translated health information if they are working with culturally and linguistically diverse communities.

Meeting each Indicator

C1.4 A Our practice endeavours to use an interpreter with patients who do not speak the primary language of our practice team.

You must:

You could:

• have a policy addressing the use of interpreter and communication services
• register all your practitioners with TIS National
• use appropriately qualified interpreters
• make sure all team members can access a list of contact details for interpreter and other communication services.

C1.4 B Our practice endeavours to employ communication strategies to engage with patients who have difficulty accessing the service due to a communication impairment.

You must:

You could:

• educate practice team members so they know how to contact and use services such as Auslan interpreting services for patients who are hearing impaired
• develop a policy for how communication impairment is managed for a telehealth consultation.

C1.4 C Our patients can access resources that are culturally appropriate, translated, and/or in plain English.

You could:

• maintain a list of websites and services from which patients can access translated resources
• keep information sheets in the common languages of the patient population in the consultation spaces.