Recording, inclusion and escalation

Record and hand over deaf awareness information so care is safer and consistent. If a patient prefers text messages, needs a BSL interpreter, uses a hearing loop, requires written aftercare, benefits from quieter appointments or does not want to be called aloud, note that in the approved record.

Keep records factual and respectful. Avoid labels such as "difficult" or "awkward". Describe the communication barrier and the reasonable adjustment that helps, for example: "Prefers text contact", "Staff should face patient when speaking", or "BSL interpreter required for clinical discussions".

Escalate concerns when communication prevents safe care. Examples include uncertainty about consent, urgent symptoms, safeguarding concerns, unresolved complaints, repeated missed messages, interpreter failures, equipment faults or staff not following agreed adjustments.

Urgent eye symptoms still require urgent routing. A Deaf or hard-of-hearing patient reporting sudden vision loss, flashes and floaters, a painful red eye, injury, chemical splash or contact lens pain should be escalated promptly in the same way as any other patient.

Inclusion applies to colleagues as well. Deaf and hard-of-hearing staff may need meeting captions, visual alerts, accessible induction, hearing support and fair access to training and speaking-up routes.

Record what helps, escalate what is unsafe, and treat repeated communication failure as a service issue rather than a patient problem.

Manager checks and accessible complaints