Exam Pass Notes

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Core Deaf Awareness

• Deafness and hearing loss vary between people and over time.
• Ask how the patient prefers to communicate; do not assume from age, speech, hearing aids, or notes.
• Some patients use BSL, some lip-read, some rely on written information, some use hearing aids; many use more than one method.
• Written English does not automatically substitute for British Sign Language.
• Hearing aids improve access to sound but do not restore normal hearing and can be affected by background noise.

Communication Support

• Gain the patient’s attention before speaking and face them clearly.
• Use natural speech; avoid shouting, over-enunciating, mumbling, or covering your mouth.
• Reduce background noise and avoid speaking while turning away or using noisy equipment.
• Use diagrams, brief written notes, stop signals, models, or mirrors when these help understanding.
• Check understanding, particularly for consent, risks, treatment options, and aftercare instructions.

Interpreters and Adjustments

• Book a qualified interpreter for BSL users when information is complex or consent is required.
• Family members should not normally act as interpreters for clinical discussions.
• Reasonable adjustments include extra appointment time, visual calling, written information, accessible contact methods, hearing loops, captions, or booking an interpreter.
• In England, the Accessible Information Standard sets a process for identifying, recording, flagging, sharing, meeting, and reviewing communication needs for NHS and publicly funded services.
• Equality law differs in Northern Ireland, but the practical duty to support safe, respectful communication applies across the UK.

Records and Speaking Up

• Record specific communication needs rather than vague labels.
• Make records visible before the next appointment.
• Avoid judgemental wording such as "difficult" when the issue may be an unmet communication need.
• Raise concerns if a patient may not have understood or is being excluded from their care.
• Use patient-centred wording, for example: "I am worried the patient may not have understood that."