This week a few of us went to the National Association of Deafened People (NADP) annual conference, and I’m dumping some personal notes and thoughts here.
We had a room with a few devices set up, and charmed or pressganged conference attendees into service. We ended up being able to interview six people. Each person told us a bit about:
- day to day life and how they handle things in general
- what tech they use for what tasks
- their relationship to healthcare, historical and ongoing
We observed that:
- hearing impairments sit on a spectrum, from trouble hearing in one ear through to profound deafness
- ways of perceiving speech vary wildly from lip-reading through to app-adjustable hearing aids
- fluency of communication varies between people, not severity of condition
Tyre kicking
Each person went through the live 111 online service. None had used the service before, and we asked them to bear in mind some symptoms they’d had in the past — or just have a muck about.
Every user was able to use the online service to reach a disposition. As luck would have it some managed to get to outcomes that meant a channel shift to telephone:
- a “call 999” outcome
- booking a call from a Clinical Assessment Service (CAS)
Literally everyone balked at the idea of a voice call.
Some faithfully filled in a telephone number and told us ways they might have to cope:
- hope that a proxy user is around to help take or make the call (partner, friend, etc)
- when entering a phone number in a field, add “text only” to try to indicate a need for textual over verbal communication
What channels are there?
At the moment, the 111 service is offered via a few channels:
- telephone (voice)
- online
- textphone
- a British Sign Language (BSL) interpreter service
It’s safe to say the online offering is lacking for some outcomes, which force a shift to telephony. Regarding textphone and BSL journeys I don’t currently know enough to have an opinion.
The online channel indicates that textphone numbers can be used for booking clinician calls, but we had an interesting response from the people we talked to.
Textphones, and the Next Generation Text Service (NGT) didn’t seem particularly well-loved by this particular bunch. One aspect that people commented on seemed pertinent in a healthcare context: these services use a call handler as an intermediary (transcribing speech to text and vice versa). There was a reluctance to have that unknown intermediary sitting in.
This also feels outmoded to be honest. Text-based communication is easily available in England these days - SMS, web chat, chat apps, blah. Why should anyone have to use a call handler to do this? The universal response to “what would be a good way of doing this?” was some variation of “web chat, obviously”.
So what next?
When we connect people to services, we’re reliant on data about those services.
At the moment we deal in generalities (“you can enter a textphone number”), because we don’t seem to have much else to go on. Is it the case we don’t actually know if a given service offers multiple communication channels?
So there’s investigation to be done:
- what channels of communication does any given CAS provider (for example) offer?
- in our directory of services what channel information is actually available?
I can hazard a guess as to what we’ll find out, but let’s at least try to give the semblance of an open mind, eh?
It would certainly be a positive step for 111 online to offer other channels of communication other than voice calls — even if it’s just for some services to begin with. Otherwise it really feels like the online channel is hamstrung and somehow lesser.