Every so often a single phrase in a Government response does more to clarify a situation than a hundred pages of strategy. This month it was two words: no plans.
Responding to a parliamentary petition calling for guaranteed British Sign Language support throughout emergencies, the Department of Health and Social Care confirmed there are “no plans” to introduce a national funding stream for British Sign Language (BSL) interpreters in the emergency services. The department’s position, in essence, is that “The Government expects NHS organisations to consider accessibility requirements as part of the delivery of their services”, with ambulance services required to comply with the Accessible Information Standard, helping to ensure that patients’ communication needs are identified and accommodated.
Translated out of civil-service into plain English: nobody is sending a cheque. The duty, and the cost, sits with individual trusts, GP practices, care providers and charities. That’s not a new legal position, but it does mean the waiting game is over. If you commission care, the obligation was always yours; now it’s official that reinforcements aren’t coming.
The legal backdrop hasn’t changed, even if the funding picture has
None of this alters the underlying duty. Guidance for NHS commissioners has long treated communication support for Deaf patients as a reasonable adjustment, noting that interpretation and translation should be provided free at the point of delivery, with sign language interpreters for people with hearing loss likely to be considered a reasonable adjustment under the Equality Act 2010. Ombudsman casework has already found against a GP practice that left a Deaf patient without BSL support for years, concluding the practice failed to take into account its responsibilities under the Equality Act 2010, which requires taking reasonable steps so a disabled person is not put at a substantial disadvantage. For solicitors advising NHS bodies, charities or care homes, the message is straightforward: a funding gap at national level does not create a defence at local level. The question for your client is no longer “should we provide this?” but “which model do we provide, and can we evidence that the choice was reasonable?”
Three models you can commission without waiting for Westminster
1. Video Relay Service (VRS) for unplanned and out-of-hours contact
VRS puts a remote interpreter on screen so a Deaf patient and a hearing member of staff can communicate in real time, even when nobody saw the need coming. As one NHS trust describes the distinction, a Video Relay Service is when the people who want to communicate are all located separately from each other, with the British Sign Language user and the interpreter communicating over a secure video call while the interpreter relays everything to the hearing person. This is distinct from Video Remote Interpreting, where the Deaf and hearing parties are together in the same room and dial a video interpreter via a computer, tablet or phone, who translates between them in real time. For A&E, out-of-hours GP services and unscheduled ward admissions, VRS is the pragmatic default: no advance notice required, and it fills exactly the gap the Government has just confirmed it won’t fund centrally.
2. Pre-booked face-to-face interpreting for planned appointments
For outpatient clinics, mental health reviews, consent discussions and anything emotionally or clinically complex, a screen is rarely the right answer. One trust’s own model separates the two deliberately: planned video appointments are arranged through a booking platform with an interpreter arranged in advance, while non-planned emergency communication within the hospital uses an on-demand video service. The lesson for commissioners is to build that same split into local policy — a pre-booking pathway for anything diarised, and VRS reserved for the unplanned. Building this into referral and booking systems, rather than leaving it to ad hoc requests on the day, is the difference between compliance on paper and compliance in practice. Our online interpreter booking request page is built for exactly this kind of advance scheduling.
3. Trained support workers as a bridge, never a substitute
Where qualified BSL interpreters genuinely cannot be found at short notice, some charities have begun training existing support staff in basic signed communication to reduce the number of appointments where patients have no support at all. This is a sensible stopgap for low-stakes, routine contact — but it is not a substitute for a qualified interpreter when a diagnosis, a consent form or a safeguarding conversation is on the table, and commissioners should be explicit in policy about where that line sits.
What good commissioning looks like on paper
Whatever mix of models a trust or charity adopts, the Accessible Information Standard still expects communication needs to be recorded, flagged and acted upon consistently — not rediscovered at every single appointment. Practically, that means: recording BSL need once, prominently, in the patient record; agreeing which model applies to which appointment type in writing; and keeping a simple log of bookings and any gaps, so that if a complaint or an Equality Act claim ever lands on a solicitor’s desk, there’s a clear paper trail showing reasonable steps were taken. Using a service provider who is well established like Connect can help — not least because a single point of contact for both pre-booked BSL interpreting and wider interpreting needs reduces the number of separate contracts a busy commissioning team has to manage.
None of this requires a new Whitehall budget line. It requires a policy document, a booking workflow, and a decision about which model applies when. The Government has told you funding isn’t coming; the Equality Act hasn’t moved an inch in the meantime.
Get a commissioning conversation started
If you’re reviewing BSL provision across a trust, GP federation or care organisation, we’re happy to talk through pre-booked and video-based options. Contact our team or get in touch via our contact page to discuss what a workable model looks like for your service.
Frequently asked questions
Does the Government's 'no plans' response mean NHS trusts have no legal duty to provide BSL interpreters?
No. The Equality Act 2010 reasonable adjustment duty sits with individual service providers regardless of national funding decisions. The Government's response simply confirms that no new central funding stream will be created, so trusts and care providers must continue meeting the duty from existing budgets and local commissioning.
What's the difference between VRS and VRI for BSL support?
Video Relay Service (VRS) connects a Deaf patient and a hearing person who are in different locations, with an interpreter relaying between them remotely. Video Remote Interpreting (VRI) is used when both parties are together in the same room and call in an interpreter via a screen.
Can a GP practice or care home be challenged for failing to provide a BSL interpreter?
Yes. There is Ombudsman casework confirming that failing to properly consider BSL interpreting as a reasonable adjustment can breach duties under the Equality Act 2010, regardless of funding pressures or staffing shortages.