Taking responsibility, translation costs and correct toilet behaviour.

Take heed

Having headed up a professional regulatory body (UK Central Council for Nursing, Midwifery and Health Visiting from 1995 to 2002), all that Lisa Rodrigues’ letter (feedback, page 20,1 March) and Alastair McLellan’s editorial (leader, page 3,1 March) had to say about individual staff taking responsibility rings refreshingly true and all concerned should pay much heed.

Sue Norman, former chief executive, UK Central Council for Nursing, Midwifery and Health Visiting

Lid down

Recent research by Mr EL Best and colleagues at Leeds General Infirmary has shown that flushing a toilet without placing a lid down increases the amount of C difficile that becomes airborne and contaminates surrounding surfaces. The bacteria can settle on any surface nearby, including sinks, towels and toothbrushes. 

Therefore, it is an appropriate public health measure to raise public awareness of the need to close toilet lids before flushing, particularly in healthcare settings where some patients have diarrhoea illnesses. As well as signs in toilets saying “wash your hands after using the toilet” there should also be signs saying “close the toilet lid before flushing”.

This simple action of placing the toilet seat down before flushing has the potential, in community and healthcare settings, to reduce the incidence of C difficile and other infections and subsequent outbreaks, at virtually no cost.

Dr Marie McDevitt, specialist in public health, NHS Stockport

Lost in translation?

Transcription Global has a number of issues with Dr Samantha Gan’s report on the cost of translation services in the NHS, commissioned by 2020health.

The questions Dr Gan tries to answer, as she sets out at the beginning of her report, are “how much is translation costing the NHS, and how can we both cut costs and improve service provision”. Unfortunately for Dr Gan, the answer to the latter question is: you can’t.
This week we have seen the consequences of the decision by the Ministry of Justice to outsource all court interpreting services to one agency at the expense of the interpreting community. With 60 per cent of professional interpreters refusing to work under the new contract, a contract that cut interpreter pay and expenses, the ministry was forced to all but abandon the contract as interpreting jobs weren’t being filled and important tribunal hearings were being forced to postpone.

Of course, there are certain aspects of translation services in the NHS that need rectifying, as highlighted by Dr Gan’s report. The revelation that 45 per cent of the 247 NHS trusts surveyed could not break down the cost of written translation is frankly unacceptable, especially in an age when financial transparency and accountability has become paramount. It also seems bizarre that the NHS does not use a central repository of translated information that is available to all NHS trusts.

However, the recommendations derived from the conclusions to Dr Gan’s report are mostly counter-productive.

First, translating materials into “easy read” English rather than other languages doesn’t actually require any translation at all. The NHS would be better off training their staff to write these materials in “easy read” English to begin with, which would then make them far easier to translate into other languages. Translating public health information is not a contributing factor to the UK’s integration problem, and like the provision of court interpreting services for non-English speakers, these individuals also have a right to the free take-up of healthcare information in their native language.

Second, the suggestion that NHS trusts should provide more written translations through free web-based tools such as Google Translate is entirely misguided and ill-advised. Google Translate is not consistent enough for use in a professional environment, let alone the healthcare industry. This is not to suggest that Google Translate doesn’t provide reasonably accurate translations (for community websites or school reports) - it just doesn’t provide reasonably accurate translations all of the time. To suggest that NHS trusts should use Google Translate is the equivalent of telling researchers to use Wikipedia or te doctors to use Web MD.

Ryan Owen Gibson, online marketing manager, Transcription Global

Easing the burden

As a supplier to the healthcare sector, I have watched with interest the growing furore about planned changes to the NHS. On top of the much vaunted restructuring it seems that knee-jerk proclamations such as the need for nursing staff to carry out routine checks every hour are also to put added administrative pressure on an already over-burdened NHS.

It is disturbing to think that, while the majority of hospitals already carry out routine patient checks, they must now dedicate additional resources to proving that this is the case, instead of just getting on with delivering patient care. The good news is, however, that the technology already exists to deliver that proof in the shape of ethernet-based nurse call systems with integrated presence detection.

Our IPiN system logs nurse call activity on a dedicated IP network, providing accurate, real-time data about the location and timing of calls. When integrated with presence detection, this could easily form the basis of accurate routine checks data, thereby avoiding all the paperwork that would otherwise be involved in documenting checks.

It’s just one small example of how the government needs to think more holistically about how leading-edge technology (manufactured in the UK by a UK company, by the way) can help the NHS to deliver services. Frontline NHS workers have a difficult enough job without having to fight their way through a mountain of red tape at every stage. Instead, government should be looking to healthcare technology specialists to advise on how technology can be used to ease the administrative burden and help hospitals plan patient delivery more effectively so that nurses and clinicians can get on with doing the job for which they trained.

Gary Stevens, managing director, Wandsworth Group