- Dr Anne-marie Boxall, Commonwealth Chief Allied Health Officer
- Andrew Graham and Bronson Mace, Translating and Interpreting Service (TIS) National
- Gulnara Abbasova, Migrant & Refugee Health Partnership
Video and presentation
Dr Anne-Marie Boxall:
Hi everyone. My name’s Dr Anne-Marie Boxall. I’m the Chief Allied Health Officer for the Commonwealth Government Department of Health and Aged Care. And welcome to our live webinar today on the Free Interpreting Service or the FIS for allied health professionals. Thanks for joining us today. We appreciate that you’ve taken time out of your busy day to learn about the FIS and we are really excited to tell you about it and we hope that you have questions and you will submit them as the webinar continues.
Before we go too far into the webinar though I would like to acknowledge the traditional custodians of the lands on which we are all meeting today around the country and pay our respects to Elders past, present and emerging. And I’d like to particularly welcome any Aboriginal or Torres Strait Islander people who are joining us today. I’m today in Canberra on the lands of the Ngunnawal people.
Next slide please.
So today we have a number of speakers. We’re joined today by our colleagues from the Department of Home Affairs from the Translating Interpreting Service or TIS National who deliver the FIS. And I’m sure they’ll explain the difference to you later on. So welcome to Andrew Graham who is the Manager and to Bronson Mace the Account Manager. I’d also like to welcome Gulnara Abbasova who’s the Executive Officer from the Migrant and Refugee Health Partnership. So welcome to Andrew, Bronson and Gulnara. Next slide please.
So just a little bit of housekeeping. So today we are recording this webinar so that it is available to allied health professionals who can’t make it today. We will make the webinar available on the health.gov.au website and we will send that out to you participants today and we hope that you’ll find it as a useful resource and please of course share it with other allied health professionals that you think may be interested in the information.
We will present some information to you today but another important part of it is obviously the questions and answers. We do this through Slido which is the built-in application in Webex and it should appear automatically on your screen. We encourage you to submit questions. Submit them whenever you think of them. That’s perfectly fine. We’ll get to questions at the end of the presentations but it’s okay to submit them at any time. There will be an option to upvote questions. If you have a similar question to one that’s already been posted that’s fine. Just upvote it. And we will be able to look at the questions and answer them to the best of our ability. If there are questions asked today that we cannot answer we will take them on notice and we will come back and we will post those questions on the health.gov.au website. All right. Next slide please.
So the agenda today. First of all we’re going to do an overview of the FIS program. We’re also going to cover how to access interpreting services through FIS. We’ll also provide you with some information about how to effectively work with interpreters and then finally we have a short video that’s how to direct an interpreter session. And we then of course have time for Q&A. Next slide please.
So moving in to the agenda. An overview of the FIS program for allied health professionals. So the FIS expansion for allied health professionals was an announcement of the Federal Government in the March ’22 Budget. It means that eligible privately practising allied health professionals in one of the 32 listed local government areas, which will be on the next slide, can access the Australian Government’s Free Interpreting Service and it’s to provide support to targeted populations with low English proficiency.
The program commenced on the 24th of October this year so it’s already operating and it’s being delivered by the Department of Home Affairs, the Translating and Interpreting Service, TIS National. And hence we’ve invited our colleagues to speak to you. It is being funded by the Department of Health and Aged Care here in Canberra. It’s a really important program and we know that deferring or avoiding healthcare because of language barriers does lead to poorer health outcomes for patients and poorer economic outcomes as well. So we really think this is a fantastic program and we do encourage you to use it.
We know that from the 2021 Census that Australians were born in almost 200 different countries and speak more than 350 different languages. And a survey undertaken by the Migrant and Refugee Health Partnership and Allied Health Professions Australia found that 25% or a quarter of all interpreting services provided to patients were not using a qualified interpreter. And that’s a real problem. The FIS will address that problem by providing access to high quality interpreting services by competent qualified interpreters. It will help you as allied health professionals as well as your patients. It can help make sure that you have accuracy of communication particularly when you’re trying to convey really complex or technical information to a patient. It reduces confusion. It actually saves you time in the end if you’re able to communicate effectively with your patient as well. And it also protects you from professional risk. So we would again encourage you to use this free service as well.
Initially the FIS will be rolled out in 32 local government areas. We are going to do an evaluation of this program and the findings will be provided to Government for their consideration of an expansion of the FIS. Next slide please.
So in terms of eligibility on the slide there are the local government areas or the LGAs that are eligible for FIS for allied health professionals. I won’t read them out because they’re there listed and we will make the slides available to you. And you can also find this information on the TIS National website which is tisnational.gov.au. These LGAs were selected because they are known areas of low English proficiency. If you are unsure about the LGA eligibility you can also email the address that’s on the screen and ask a question and they will answer your question for you.
And a really important piece of information is that eligibility to use the FIS for allied health professions is determined on the allied health professional’s location, their practice location. So that’s really the most important information. It’s not about where the patient is located. It’s about where the allied health professional’s practice is located. And as I said earlier we will be evaluating this program to see if there’s any information that leads us to changes or cause an expansion over time. Next slide please.
All right. This slide’s about which allied health professionals are eligible. So this service is for private sector allied health professionals in the disciplines listed on the screen in front of you. So the important information here is for privately practising allied health professionals. Allied health professionals working in state or territory Government services are able to access interpreter services through other means. So this is for privately practising allied health professionals. Again I won’t read out the list. It is available there and of course it is on the TIS National website as well.
So eligible allied health professionals can access the FIS when they are delivering services that are in private practice, they are a suitably qualified eligible professional, so listed on the screen then, but also provided to a patient or a client who has a Medicare card. We do recognise that these eligibility requirements can provide some limits on access to the FIS but these decisions have been made by Government as policy decisions and again we will look into any changes following the evaluation.
Allied health professionals that are not eligible to access the FIS can still access interpreter services on a fee paying basis. So there is another option. And any question about the fee paying interpreter services can also be answered by emailing the address on the screen, email@example.com.
So I’m now going to hand over to our colleagues from Home Affairs, to Andrew Graham and Bronson Mace to give you some more information about the FIS. Over to you Andrew.
Good morning everyone and thanks Anne-Marie very much for the introduction. It’s fantastic to have the opportunity to talk to you all today. Just as a bit of a summary today’s presentation we’re going to provide a little bit more of an overview of TIS National as a language service provider. Many of you may already have used TIS National services and been aware of us as an organisation but I thought it was important to run through particularly the interpreting service provisions and the different channels that can be accessed.
Then we’ll move into where allied health professionals can go to get more information about the allied health professional Budget measure and how to apply for access through FIS for that particular account type. Further to that also point you to and we’ll run through some resources available through the TIS National website to be able to effectively promote interpreting services in your particular clinics and with your culturally and linguistically diverse clients. Further to that there will be a number of supports that are available through TIS National either by email or phone. We also have dedicated senior account managers that are working on this program that can provide customised help to clients wishing to access the program.
Finally my colleague Bronson will round out the presentation by talking in a little bit more detail about the types of interpreting services available and which are more appropriate to use in which circumstance or situation within a clinical environment.
So with no further ado I’ll kick off my presentation now. So the Translation and Interpreting Service is an interpreting service that is provided by the Department of Home Affairs. The Free Interpreting Service itself is delivered by TIS National on behalf of the Australian Government and one of the major objectives of the Free Interpreting Service is to ensure that there is equitable access to key services for the Australian community that have low English proficiency. And not only that. It’s to provide support to agencies, businesses, professionals in a range of situations and environments to enable them through interpreters and credentialed interpreters to support their CALD clients in delivery of information and key services.
Further to that we’ve been over and we’ve confirmed that since the 24th of October the program has been live and we at TIS National have been in a position to be able to receive and process applications. So at this point in time we are open for business and more than happy for you to apply for access to the program. And we’ll jump to the next slide thanks.
So TIS National as an organisation delivers a very high volume of language services annually. So to give you an idea over the last two financial years TIS National’s delivered over a million individual telephone interpreting jobs and also over 100,000 individual on-site and remote video or telehealth engagements.
Further to that in terms of talking about TIS National’s service capability I want to talk about three components of that. Leading off I want to talk probably about the most important service delivery component at TIS National and that’s the interpreter panel. The interpreter panel that TIS National uses are individual service providers who are contracted and are located nationally. At the moment we have over 2,700 registered interpreters providing over 150 different languages and dialects to our TIS National clients.
As many of you know in terms of providing that very high level of interpreter capability and quality TIS National aligns itself with the NAATI credential system. Over 85% of the TIS National interpreter panel hold an NAATI accreditation and the allocation policy at TIS National is to offer the highest credentialled NAATI interpreter available at the time the request is made.
So much so that the internal measure that we look at at TIS National is allocating a NAATI credentialled interpreter to a booking in over 90% of situations. So very high number. Slide please.
Okay. So I want to move now into the second component of service delivery and that is our TIS National Contact Centre which is located in Melbourne. The TIS National Contact Centre supports the delivery of the immediate telephone service and this is probably the largest area of service provision for TIS National. It’s an on demand interpreting service that can be accessed 24 hours a day seven days a week every day of the year. It is supported by a Contact Centre and a unique identifier which is a 131 450 number. The key things the immediate interpreter phone service is important for is it’s an on demand service, so it can be used at any time when for instance you have a client come into the clinic that you’re unprepared for or you need an interpreter quite urgently.
All you need to do is have a registered client code which participants or clients of TIS National get when they register. You need to have the language that you require of the interpreter. You have the ability to pick the gender of that interpreter through the Contact Centre, and finally just to notify the operator whether you are with your client at the time or whether we need to actually make a call out to conference you in with a client externally. So there’s all that functionality within that service and that is again subject to the allocation policy. So when a request is made the highest accredited NAATI interpreter will be allocated to your call. Slide thanks.
Okay. So a complementary – and I thought I’d just bring this other service type up into this equation. A complementary immediate telephone service is the ATIS service. Now this differs from the immediate phone service in that it’s completely automated. So you bypass the TIS National Contact Centre by calling 1800 131 450. When you register an account with TIS National you’re also provided an ATIS account and PIN number. So that’s one thing that you would need to input once you call this number. The voice recognition software will identify what language you need and also you can select the gender of the interpreter. Once that goes through you’ll be automatically connected with an interpreter and bypassed through the Contact Centre. So the key benefits of this program are that it can result in quicker allocation times but it’s also an important note to make that you’ll need the functionality within your own phones if you want to conference external parties into your call. Okay. We’ll go to the next slide.
Okay. And this is the third component of the TIS National service provision and it’s basically an online booking platform called TIS National. TIS Online I should say. TIS Online manages all of the bookings for the pre-booked phone service, the face to face on site services and the video remote telehealth services. So again when you register for a client code you’d be given access to login to this system. The link to this system is available through the TIS National website. Once you login you’ll be able to access the booking forms which are self-service and allow you to go ahead and make a booking for a particular client in whatever channel you choose.
Some of the benefits of this system is that it’s all done in real time. So once you make the booking itself it will be posted to interpreters, the highest accredited NAATI interpreters first, who will be able to allocate or accept that job immediately in real time. You’ll also have the ability within the account to monitor the status of your jobs as to when they’ve been registered, allocated to an interpreter, or if you need to make any changes or cancellations to those bookings it’s all available in real time within that system. Okay. I think we will go into the services in a little bit more detail towards the end of the presentation but we’ll keep moving for now. So that’s just a bit of an overview over service provision.
Okay. Slide please.
Okay. So the next component of the presentation is talking about where to go to get information and how to apply for FIS under the allied health professional program. Slide thanks.
The TIS National website has developed a dedicated web page for the allied health professional measure. This can be accessed by going through to the FIS category on the TIS National website and scrolling through to allied health professionals. I really encourage everyone to get on there at some point and have a look at the resources available there. The information available on the web page is the detailed eligibility criteria that Anne-Marie had gone through previously talking about the 32 selected local government areas, the professional disciplines that are included as part of the measure and other eligibility criteria, and requests for information are available there. There’s also additional information around TIS National services and again resources such as dedicated videos, promotional materials, catalogue also that can be used by professionals to promote the service within their clinics.
So again we do have support available to all people involved or who have enquiries for the FIS and that can be through our firstname.lastname@example.org email address or through our dedicated 1300 line which is available during business hours weekly. So we encourage you also to reach out to us if you have any enquiries regarding the program. Moving to the next slide.
Okay. So the application form itself is embedded within the information page on our website. Important to make the differentiation between the two application forms on our website. So typically allied health professionals can also register for a fee paying account and that’s through our general registration page. On that general registration page there is also a link across to FIS but the main thing is to be aware that there’s a specific free interpreting service application form for allied health professionals under this page. So you can actually access that. It’s a one page form. It’s relatively straightforward. What will happen is it will ask for specific information and once that information is included and submitted it will come through to us for assessment. Typically assessment will take up to one to five days just depending on the level of applications that we have coming through.
In terms of the information on how the booking form is laid out it’s important to note that access to the FIS under this program is at an individual professional level. So we’re looking at each individual having to register their own application, own account instead of creating it at the agency level which is done sometimes in the fee paying space. So the types of information provision within the application form are for the professional’s full name and profession obviously. It has an upload function to be able to upload your AHPRA certificates or any professional accreditation that substantiates your professionalism in that field. Also talks about providing web addresses, ABNs so we can locate your business. And importantly the addresses of the clinics where service provision is taking place. So there’s provision for an initial primary address but in some cases where allied health professionals might be providing services across multiple clinics there’s an ability to create a secondary address as well and provide that through.
Really encourage if anyone has any problems with the application form or has any additional information or enquiries before submitting an application to get in touch with us. Be more than happy to talk through it. It’s just really important that we get that accurate and full information come through on the application form. Typically we will if we need to get in contact with you if we need any additional information.
Okay. So we’ll move to the next slide.
So moving to the point at which the application’s been approved. TIS National will register a client code on behalf of the allied health professional. What we will do then is send through two emails, one of which will have a link to the TIS Online platform. If you click on that link you will be able to establish access password and credentials through the TIS Online booking platform. The second email will be a welcome email which will contain your client code details, ATIS details and all of the supporting information and supports needed to get going. The client code itself will be live at that point and be able to be used from that point onwards.
Okay. We’ll move to the next slide.
So some key things to remember once you’ve got your client code. Because it’s registered to you as an individual it’s really important that you keep it secure and you keep it private. Because once you lose it we can track it back for you but it can be quite difficult to find in some instances. It’s really important too that only authorised users under the program actually have access to the account. So if you have any administration staff that are using the account just to also let them know to ensure that the right account’s being used by the right professional.
Also just wanted to make note of the pre-booking form. So when you set your account up again if there’s administration staff that are making bookings on your behalf please set it up with an account email address that can be accessed by multiple people because all of the booking notifications come through to the email registered on the account. Really important to also be aware of the cancellation policy at TIS National. So cancellations beyond 24 hours before the start time of a booking can incur costs to the program so it’s really important that if a cancellation or major change to a job needs to take place that it takes place before 24 hours. If there is a situation where you need to make a booking within 24 hours and it’s uncertain whether that patient will be available you may want to consider using one of the immediate services where a cancellation charge is not incurred for the program. So more information on the cancellation policy is available on the website as well.
And finally just wanted to talk a little bit about the web forms themselves for the bookings. So they allow for provision obviously to select gender, allows to select for the NAATI credential as a minimum. It also allows if you’re working with children for instance to select other certifications such as Working with Children Check or in the case if it’s possibly an NDIS worker screener check. And it also has ability for selecting security clearances which are probably not required in a clinical setting but they are available. And importantly there is a field called specific requirements for jobs. So this is a field that we really encourage all clients to use if there’s particular information that needs to be relayed to an interpreter or to TIS National as an agency that might affect the allocation of the job. An example might be if you’re looking at having an interpreter come in to a clinical setting and there’s requirements for PPE or potential vaccination requirements we can select or put that information into that field so that’s flagged with the interpreter prior to allocation so it can inform that decision for the interpreter to select that job.
I think that’s my last slide. At this point keep going. I’ll pass over to my colleague Bronson who will take you further through the presentation but more than happy to take any questions at the end of the seminar.
Thanks very much.
Thanks Andrew. So I’m just going to quickly go through some resources that we have at TIS National and I’ll also cover what type of services you should use when choosing to use an interpreter.
Next slide please.
Okay. So on our website we’ve got a Help and Support page. The Help and Support page has got lots of things that you would need, lots of resources. We’ve got FAQs. There’s service guides and instructions, so how to book an onsite interpreter or how to use ATIS. There’s a list of languages that we offer as well and information for allocation policy and interpreter credentials. There’s information about our cancellation policy and working with interpreters. We’ve also got a few videos on the website as well. There is one video that we had made specifically for allied health. It’s a three minute animation and it provides a summary of why to use interpreters and how to use TIS and also working with interpreters, so how to use your time with your interpreter effectively.
There’s a promotion page as well. So we actually have an online catalogue should your agency require any physical copies or print materials. So we’ve got brochures for staff explaining how to use TIS. There’s some posters for your non-English speaking patients so if you wanted to have a poster in your waiting room, or there’s also some PDFs. So you can download the PDFs and upload them to your website. There’s also an option to order promotional material. So if you need some physical hard copy promotional materials like the posters or you could have some ‘I need an interpreter’ cards at your front desk or TIS business cards, you can fill out the form on the promotions website and it will come through to us and we can send you out a pack.
Next slide please.
Okay. So which type of service should you use when using your interpreter? So we have the phone interpreting and onsite and video. So I’m just going to go through which would be appropriate for considering your booking. So for our phone interpreting we’ve got the immediate phone service and ATIS. So you want to use these for your short, unplanned interactions. So for example if you have a client who calls you and they need an interpreter to book an appointment or perhaps you had a non-English speaker walk into your front door and go to the front desk and have an enquiry, or for example maybe you’ve got a client who’s an adolescent and you need to speak to their mum and their mum doesn’t speak English. So it’s really good. You can just call our Contact Centre and be connected with an interpreter in a couple of minutes.
What else have we got here? So for a pre-booked service. So you want to use a pre‑booked service for your scheduled appointments. It will give you the peace of mind that your interpreter will be waiting for your call. So when you make the booking you’ll be provided with a priority line to call. So this just means at the time of the booking you’ll skip the queue in the Contact Centre so it will save you time because you won’t have to speak to an operator and provide your details, wait for them to allocate the interpreter. The priority line will just connect you straight to your interpreter at the time of the booking so it will be a bit quicker for you. It’s also useful if your appointment’s going to be complex. So maybe if it’s got a lot of complex terminology that requires a higher credentialled interpreter you can pre-book your interpreter and make sure that you’ve got that higher credential in advance. It’s also going to be useful for lower demand languages. So there’s a few languages where we only have a few interpreters that speak them. So if you’re calling the Contact Centre it would just be dependent if they’re there at the time. But if you pre‑book then you can assure that you’ll have that interpreter for your booking and you’ll have them for the full booking time as well.
And lastly of course we’ve got the on-site and video interpreting. So this is going to be good if perhaps you’ve got a group of people coming in on the same day that speak the same language. Maybe it’s a family that are all booked in for the same time. So it would be good to have an onsite interpreter there for the whole day rather than having to continue calling us. It’s also good for discussing complex ideas again. So perhaps it might be better having a physical face to face communication with your client. It might make it easier to build rapport using body language and eye contact and non-verbal cues. And it’s also going to be better for your long appointments. So if you need somebody there for a few hours it’s better for them to be there in person rather than having to reconnect on the phone all the time.
And we’ve also got our backup video interpreting. So remote video interpreting is a good alternative if you require all those things but you don’t have an onsite interpreter available. So of course the onsite interpreter availability is going to depend if the interpreters live near where the booking is going to be. So if you don’t have any interpreters in the language that you need that live nearby you can then access your interpreter via video and then you can still have all of those things like the body language and eye contact and all of those. Next slide please.
So lastly for our client support and feedback. The FIS team, we’re your dedicated team for the Free Interpreting Service. We’re here Monday to Friday 9:00 to 5:00. We can help you out with any questions that you’ve got about accessing the service, help with your client code, updating your accounts. We also provide some staff presentations and training. So perhaps you might have a team meeting where you want an explanation on how to use TIS. We’re more than happy to facilitate some training sessions for you. We’ve also got our frontline which will help you with general enquiries. And importantly we’ve also got our feedback, complaints and compliments area. So we’ve got a team dedicated to that. The form is on our website. It’s a dedicated feedback team. They acknowledge the feedback within two days. They will respond to all your feedback within 15 days. They’ll investigate and respond within 15. And it’s really important because we use the feedback for performance management and quality assurance of our interpreters and operators.
So I’m just going to conclude my presentation here and I’ll hand over to Gulnara from the Migrant Refugee Health Partnership. And she’s just going to speak about why to use our interpreters and how to effectively work with them.
Thanks so much Bronson. That’s right. So my presentation will focus on the importance of engaging interpreters and how to know when to engage one and how to work effectively with interpreters in care settings.
And skip to the next one please. Thank you. So the information I’ll share today is very much based on evidence and good practice and specifically it draws on the guidance developed by the Migrant and Refugee Health Partnership which is a national multicultural health peak body and endorsed widely by peak professional bodies for health practitioners.
In 2019 the Partnership published Culturally Responsive Clinical Practice: Working with People from Migrant and Refugee Backgrounds. This is a competency standards framework for health practitioners that establishes recommended and optimal cultural responsiveness competency standards for all healthcare settings. The theme of effective communication and working with interpreters specifically goes very much across the entire framework. The framework was developed over an extensive consultation process with health professions peaks and community sector peaks particularly in the migrant and refugee sector. It was also widely endorsed as I said by peaks for health professions including the Allied Health Professions Australia.
In addition to the framework the partnership also published a guide to working effectively with interpreters which is a complementary resource. It was endorsed as an RACGP approved clinical resource and deals specifically with effective communication in the event of practitioner/patient language disorders which is very much what we’re talking about today. So some of those practices that I’ll be discussing today are very much grounded in that evidence-based good practice that’s outlined in the framework and in the guide and I do encourage you to look those resources up because they’re much more detailed than what I’ll cover today.
Can we skip to the next slide please? Thank you. So why engage an interpreter? There’s an extensive body of literature and research that demonstrates that people with limited English proficiency are recognised to have poorer health outcomes and substandard contact with health practitioners. They tend to have limited access to care and particularly to preventative services. Ineffective communication between the patient and a health practitioner can result in limited care, delayed care, insufficient care, leading to more costly treatments and interventions.
There is research that demonstrates that engaging interpreters has been found to decrease communication errors, increase patients’ comprehension, reduce unnecessary treatments and tests, improve clinical outcomes, raise the quality of care and improve the person’s satisfaction associated with understanding of self-care, follow up plans, reduced errors, better treatment adherence. And finally it also improves the health practitioner’s satisfaction.
It is effectively a matter of good practice to ensure that the patient understands the discussion and therefore it is absolutely essential to engage interpreters for patients with low or no English proficiency but it is equally important for health practitioners themselves. One critical point is around consent. Engaging interpreters is essential for obtaining informed consent from patients. That mainly has to do with the complexity of information and ensuring that the patient fully understands and is fully informed about their underlying condition, the nature of their treatment, the consequences of not having the treatment, the degree of certainty around the outcome and the time for recovery as well as costs of course. And it is also to ensure that the patient has the ability to raise any concerns about any particular issues of relevance to them.
Can I skip to the next one please?
So the certification scheme for interpreters in Australia is provided by the National Accreditation Authority for Translators and Interpreters. This is a quality assurance scheme effectively. The interpreters are bound by the Code of Ethics which is auspiced by the Australian Institute of Translators and Interpreters and includes confidentiality but beyond that issues around impartiality and boundaries.
On the other hand there are significant concerns around engaging what we refer to as personally involved individuals or family and friends in healthcare consultations particularly around obtaining consent but more broadly of course. Personally involved individuals, so family and friends may lack interpreting competence, may potentially breach confidentiality or may have conflict of interest so they are really not appropriate facilitators of interpretation. There are particular risks around misleading information or miscommunication that may occur when they engage family or friends to facilitate communication with patients. There is research that demonstrates the risks around inaccurate or inadequate transfer of meaning, the lack of terminology of course, lack of specialised knowledge, inappropriate behaviour due to lack of professional ethics, possibility of information being withheld or distorted because of family dynamics, there are particular risks and circumstances of family, domestic or intimate partner violence or due to emotional or sensitive nature of health issues more generally.
There is also a risk of causing potential trauma to family members and in particular what we emphasise strongly in the guide is that it is absolutely unacceptable to engage minors. There are significant ethical dilemmas with engaging minors and patients’ children to facilitate communication. It may undermine a parent’s authority, it may affect family dynamics. There are dangerous emotional responsibilities upon minors to facilitate communication in health settings. Some cultures have topics that are considered out of bounds for discussion. There’s parental privacy, confidentiality, enormous emotional burden that’s placed on minors if they are requested to facilitate a communication. It may also traumatise minors. So this is a really strong point that the guide makes and I just wanted to make sure that I transfer that through today’s presentation. Next please.
So how do we know when to engage an interpreter? There are some dot points on the slide but effectively a person’s ability to engage in general conversation in English is not a measure of their capacity to discuss or understand health related matters. People may have sufficient English for day to day social engagements but once it gets to health terminology or just the complexity of a health consultation or the stress around it might create those added layers where it is really inappropriate to rely just on the person’s English competence.
People may also have gaps in confidence and competence between receptive English, so understanding English and the express of English, so being able to ask questions or to convey their thoughts and ideas. In practice a legitimate assessment for an interpreter may be made either by the patient or by the health practitioner and either of those should be actioned. As I said earlier interpreters are not there just for the patients. They’re equally there for health practitioners because both need to communicate effectively. Next please.
I will now go through a few practice points. There are nine in total that we have developed in consultation with interpreters, with health practitioners and the community and health consumers that provide some guidance around how to work effectively with interpreters. The first practice point is around briefing interpreters on the nature of consultation if possible.
It’s not always possible and we accept that however it is good practice for health practitioners to provide brief information to the interpreters describing the context of the consultation immediately before it occurs. This is really to ensure that interpreters are in the better position to accurately interpret and particularly if they join over phone, so they don’t have the benefit of being present in the room. Just to describe the activities that will take place and to also flag if the consultation might be potentially distressing, if it may include counselling or are there other complex matters that need to be discussed. So informing interpreters is particularly relevant in those circumstances. And it can be a very brief and it is just there to provide some context for interpreters to be better prepared.
The second practice point is around health practitioners beginning the consultation by introducing the interpreter to the patient and very briefly explaining their role, that the interpreters are there to provide accurate interpretation, to maintain confidentiality and that they are impartial. This is important because patients may not understand that interpreters are in fact bound by a code as we discussed before and also credentialled by the National Accreditation Authority in majority of cases. So that provides that additional reassurance for the patient that it is a professional facilitated communication and will maintain confidentiality.
Alternatively the health practitioner can ask the interpreter to introduce themselves and explain their role to the person.
It is also good practice for health practitioners to ensure that whenever they engage in discussions with interpreters or other health practitioners that the interpreter is given the opportunity to inform the person about what was being discussed. This is to maintain the patient’s linguistic presence.
The third practice point is around debriefing which again may not always be possible but for some consultations might be important and relevant. And again it can be quite brief and it can be in the form of exchanging feedback between health practitioner and interpreter. Sometimes it can be on the back of difficult or traumatic consultations which both health practitioners and interpreters participate in. And in some circumstances it might be to provide feedback. So it may be for example for an interpreter to provide feedback to or discuss with the health practitioner some context around the person’s lexical or grammatical speech errors or other linguistic characteristics particularly in speech pathology or neuropsychology or mental health settings. It may also be just to acknowledge that it was a complex consultation and there might be some context that can be shared.
Again it is acknowledged that it’s not always possible but if it is necessary and appropriate and there is a possibility to do it it is very much welcomed by interpreters.
Practice point four is about using direct speech when addressing the patient. So speaking directly to the patient rather than asking interpreter to say to the patient. Continue speaking to the patient as if you were communicating with them in English. It is also important to continue maintaining eye contact where culturally appropriate of course, and facial expressions, gestures, appropriate body language. Just because there is an interpreter on the phone who is facilitating that communication the body language and the speech should maintain normal course.
Practice point five is about using a speakerphone or a hands-free phone. This is of course particularly important if you’re working with interpreters on the phone. It seems to be quite a straightforward thing to do however we may not always have a speakerphone available so it’s important to keep that in mind. Can we move to the next slide please?
Thank you. Practice point six.
This is to remind health professionals that interpreters working over phone do not have the presence so they don’t have the benefit of being in the room. So it is important to use visual language and to describe what is happening around the consultation, for example by indicating to the interpreter who is speaking or if there is more than one health practitioner present in the room.
It is to provide the verbal comments on visual surroundings or movements and acts and intentions, so for example if health practitioner is pointing to a chart or a document.
Practice point seven is about speaking clearly, using simple language, avoiding colloquialisms, avoiding technical language wherever possible or explaining acronyms. Interpreters may ask for clarifications or repetitions if needed. If technical terms are unavoidable they should be explained in plain English so the interpreter can convey those explanations to the person. It is health practitioners’ responsibility to explain the concepts and terminology. It should not be expected from the interpreter to simplify, to explain health concepts. And of course languages are quite different in their available vocabulary so some might require quite descriptive explanations around certain concepts.
Practice point eight is around pauses and breaks and speaking at a reasonable speed, using repetitions or speaking in manageable segments, avoiding omissions. So really keeping in mind that the interpreters particularly on the phone need to be able to keep up and interpret in a consecutive mode which means that they start conveying the message once the health practitioner finishes their sentence or their segment of speech.
And practice point nine is around multiple practitioners involved and that it is still important to manage the speech, the pauses, the turn taking to be able to facilitate a good quality – the accuracy of messages conveyed to the patients. I mentioned it earlier. If health practitioners are talking between themselves or to a patient’s parent or family member the interpreter still needs to keep the patient linguistically present and interpret what is being discussed so they do not feel excluded.
My final slide is about some key considerations. Can we skip to the next slide please.
And that is really about what to do if the patient refuses an interpreter. It may happen and we do hear a lot from health practitioners that sometimes patients say ‘No I’m fine’ or ‘My family member will interpret for me’.
The guide and the good practice around this recommends that the practitioner first of all addresses the person’s concerns. Sometimes they may be concerned about confidentiality, they might be concerned around gender discordance or concordance with the interpreter, or cost considerations. They may not know that this is free for them. It is important for practitioners to discuss the risks, to explain that the interpreter is not just there for the patient, it is there also for the health practitioner and it’s to help them communicate better. And sometimes it’s important to provide reassurance that if the patient would like for their family member to remain at the consultation they may still do so as a support person but that the interpreter is available and is a professional who can provide that accurate interpretation.
And finally if there is an absolute refusal around interpreters we do recommend documenting that because it is important ultimately for quality and safety of health practice. I’ll stop here and I’ll hand over to Anne-Marie. And thank you so much.
Dr Anne-Marie Boxall:
Thank you so much Gulnara and also to Andrew and Bronson for the fantastic information that’s been presented. Before we go to our Q&A session we do have a short video on how to direct an interpreter session. The video does depict a teacher so if you can present yourself in that, look past it’s a teacher. It’s about the principles so I think you will be able to apply it.
While you’re watching the video if you have questions please enter them into Slido. There’s a number of great questions there and we will be going to those immediately after the video. So if the team could play the video that would be great.
[START VIDEO PLAYBACK]
When using an interpreter your role is to conduct and manage the interview. It is your responsibility to ensure a free-flow of communication.
The first step in any interpreting situation is to introduce yourself to the interpreter and to brief the interpreter on the situation. As part of the briefing you can describe the type of telephone you are using. You should also allow the interpreter to introduce themselves to the client.
Hi. My name is Mrs Edwards. I’m a high school maths teacher. I’m currently here with Mrs Aden. Mrs Aden’s son Dennis is in one of my maths classes and Mrs Aden is here today for a parent‑teacher interview.
Could you please introduce yourself?
(Interpreter speaking in Mrs Aden’s native language)
Okay. We’re ready to go. Go ahead please.
Wonderful. Great. Thank you for coming Mrs Aden. How are you?
You can assist the interpreter to accurately recount what you say by using some simple strategies. Keep sentences short, limited to one or two ideas per sentence. Use simple language and avoid jargon and pause often to allow time for interpreting. Be patient with the interpreting process. Sometimes one short sentence in English may require several sentences in the other language.
(Speaking in her native language)
Dennis wants to go to university and study accounting. Are his grades good enough for that or should Dennis be doing more homework you think?
Okay. Well I’ll have to answer that in two parts. Firstly Dennis is receiving excellent results in all tests and assignments. He’s actually one of the best students in his class.
(Interpreter speaking in Mrs Aden’s native language)
And as he is receiving such good results I don’t think it’s necessary for him to do more homework. And if he continues to work hard in class I think he won’t have a problem getting into an accounting course.
(Interpreter speaking in Mrs Aden’s native language)
(Speaking in her native language)
Very good news. Thank you. Fantastic.
You should maintain eye contact with your client to show that they are the centre of your attention. However eye contact is a great example of how cultural differences in body language can affect communication. In some cultures looking someone in the eye indicates honesty and straightforwardness while in others it can be seen as challenging and rude. It helps to be aware of these differences when engaging an interpreter.
In any interpreting situation your role is to conduct and manage the interview. Make your client the centre of your attention by maintaining eye contact and speaking to them directly. To assist the interpreter keep sentences short and simple and pause often. By utilising the tips presented you can help bridge the communication gap between you and your client.
[END VIDEO PLAYBACK]
Dr Anne-Marie Boxall:
Fantastic. Thank you. And best of luck to Dennis. He sounds like he’s going to do very well in life which is great.
All right. So we’re going to go to the questions now. And so I will direct the questions to the appropriate people. There are a couple of questions there that I can answer straight off so I’ll do that and then we’ll keep working through them. So again if you have questions please post them into Slido now.
So the first question is we mentioned right at the beginning of this presentation that we will be doing an evaluation of the FIS and there’s a question saying:
Q: How can the peak professional bodies help in the evaluation?
The answer to that is thank you for your offer. We have not yet planned the evaluation but we will absolutely be reaching out to the peak bodies to participate in the evaluation when that occurs. We were planning on doing the evaluation in 2026 so it’s actually quite some time away. But your offer is noted. However the peak professional bodies can definitely help us now by promoting this FIS, this interpreting service to your members. Certainly I have learnt a lot by watching the presentations today and looking at the huge range of resources that are available. If you can help us by promoting those to your members that would be a wonderful service. So thank you for that question.
And the second question is easy so I’ll take it as well.
Q: Can someone tell me how to access a copy of the PowerPoint slides?
So we will be posting this presentation, a recording of this presentation and the PowerPoint slides on the health.gov.au website. We haven’t got them on there yet so give us some time to post it. But if you go to health.gov.au and look up ‘Allied Health Resources’ section we will have a tab there on the Free Interpreting Service. So you will be able to find the slides and this recording there. And again we really encourage you to share it with your colleagues who are working in eligible areas because clearly this is a really important service and we want to encourage the use of the FIS as much as possible.
All right. So I’ll now go to some of the questions for others. The next question I think is probably a question for Andrew and Bronson. The question is:
Q: What information is available to help allied health practitioners choose interpreters with specialised health knowledge or backgrounds?
Thanks Anne-Marie. I’ll have a go at that one. So in terms of the allocation of interpreters to a specific request we would always go with the highest NAATI credentialled interpreter available. There’s also the ability to specify that a NAATI certified interpreter, which is one of the professional levels of interpreting, is required within the job. So my recommendation in health settings is to select a certified interpreter for all engagements.
Now further to your question – and I might need to take elements of this on notice – specific information for the interpreters that work in specialised health knowledge backgrounds, I know that many of our certified interpreters are very experienced across a range of industries including health in emergency services, hospitals and the like so have extensive experience in dealing with these types of situations. I’m also aware that NAATI – and I’ve only got a small amount of detail on it – NAATI is working on a certified specialist health credential and I think that is part of a Monash postgraduate program where TIS National is involved in sponsoring a number of interpreters through the program. It involves testing through NAATI and once that testing is approved that we do recognise interpreters with that higher level of health specialisation. So just at this point in time there’s only very few interpreters available with that so it would actually impact your ability to secure an interpreter. But I think moving forward that category will expand and I know NAATI and TIS National are definitely behind trying to improve the numbers of interpreters with that specific credential.
Dr Anne-Marie Boxall:
Great. Thanks so much Andrew. So the next question I think is for Gulnara. I think you touched on some of this in the presentation but the issue of patient confidentiality I imagine is a really significant one. So can you just go through again a little bit more about how FIS interpreters manage patient confidentiality?
Thanks Anne-Marie. Really good question. And not limited to FIS interpreters but interpreters more broadly. The two frameworks that I mentioned in the presentation are of course the National Accreditation Authority for Translators and Interpreters that credentials interpreters at various levels. And this is a unique model globally so we should be very proud of this quality assurance model. And the second framework that is very specific around confidentiality, boundaries, ethics is of course the Code of Ethics by which interpreters are bound and that is auspiced by the professional body of AUSIT, the Australian Institute for Translators and Interpreters. So these are the really two quality assurance frameworks that are also key to interpreters maintaining the confidentiality, impartiality and boundaries.
Dr Anne-Marie Boxall:
Fantastic Gulnara. And it might be worth if you’re in a situation where a client is concerned about that, which would be a reasonable concern, to be able to point to that information that Gulnara has mentioned as well to give them that confidence that their information will be treated with professionalism and confidentiality. So thanks.
Anne-Marie I might just add in on that. TIS National interpreters that are on the panel, they’re engaged under an Interpreter Deed which is a legally binding document. And as part of that there is reference to confidentiality, conflict of interest under the AUSIT Code of Ethics. So as a professional and in terms of their employment contracts it’s very much contained in there. That should provide some assurance.
Dr Anne-Marie Boxall:
Great. Again that’s fantastic. I think that would be a lot of assurance for people so thank you. The next question I think is for you Andrew and Bronson. It’s about the late notice of cancellations.
Q: Is there provision for late notice of client being unwell for example included in the cancellation policy?
I’m happy to take that one. Again on the cancellation policy, so it’s quite strictly adhered to in terms of that 24 hour period prior to the start time of the booking. Completely understand that it can be a situation where a client or a staff member is unwell and unable to actually proceed with the booking. Unfortunately there’s not a provision around that for exclusion to the cancellation. One of the background reasons to that is really to do with the interpreters being contracted service providers. So in terms of them managing their work they may accept a booking ahead of time, say a week ahead, and once they accept that booking over that period of time that then excludes them from taking any other work. So if there’s a short notice cancellation that interpreter effectively is penalised for an opportunity cost as such. So in a way that is designed to protect as well the service provider to be paid in that situation.
But a recommendation. If it’s known that it may be uncertain that the client may or may not be attending that appointment you can choose to use an immediate phone setting so just to avoid a cancellation charge. The immediate phone service and ATIS are on demand so there’s no cancellation charges involved. But agreed. It is a tricky call.
Dr Anne-Marie Boxall:
Great. And I think again that Bronson mentioned there was a document on the cancellation policy available on the website, on the TIS National website, so it would be worth downloading that and having a look at it.
All right. Another question here which I think is one for me.
Q: If my service address is located outside of an eligible LGA can I travel into the eligible LGA or provide telehealth services into the LGA in order to access the FIS?
So the answer to this question is the FIS is only available if the practice location is within the eligible LGA. So no is the short answer. But there is an alternative and that is the Translating Interpreting Service where there is a fee payable. So it’s not that the patient is then not able to access interpreter services. It’s just that you would need to use the fee paying service. Does anyone want to add anything to that or is that – okay with that?
Okay. Great. All right. The next question is about:
Q: Can the interpreter help fill out any forms on behalf of the patient? And then can the interpreter complete the form for the patient prior - - -
The questions are moving. So let me just start again.
Q: Can the interpreter help me the allied health professional fill out forms on behalf of my patient and then interpret the complete form before the patient signs it?
So I might ask that one to Andrew first.
I can take this one Andrew.
Dr Anne-Marie Boxall:
That’s all right. So basically the interpreter’s role is verbal interpretation. A document translation is a different set of skills. So our interpreters are only able to provide verbal interpretations. They’re unable to translate any documents. There is a way around it. If you are willing to read out the form in a verbal form in English the interpreter can then interpret it into the language to the non‑English speaking client and vice versa. That’s one way around it. But unfortunately we don’t provide any document translations commercially at this point. Did you want to add anything to that Andrew?
No. Not at all. Thanks Bronson.
Dr Anne-Marie Boxall:
Great. So it does sound there’s an excellent workaround. If you can read it out then that would be a useful way.
Anne-Marie I might just add that the guide I referenced earlier deals with this particular issue because it did come up in our work to develop it. And yes that’s exactly right. That’s what the guide suggests, that it needs to be read out. In situations where interpreters are in the room there is also a practice that is called sight translation where an interpreter can be asked to read out the document in the presence of the health practitioner, however it needs to be used sparingly and only around 200/300 words. We’re not talking extensive forms or documents. Very short, as I said, up to 300 word documents can be sight translated. So yes there are particular points in the guide for those practitioners who are interested to look at good practice around it.
Dr Anne-Marie Boxall:
Wonderful. Great. Thank you. Another question. I think this one’s for you Gulnara. So it’s:
Q: I’ve been seeing a client who brings along a family member to translate. How could I suggest changing this arrangement to involving a FIS interpreter?
Very good question and we hear it so much from health practitioners. So what we recommend is first understanding why that is the case. Sometimes the patients might have issues or concerns about interpreters, confidentiality for example or potential cost. So they may not know that it is free to them. They may worry that interpreters will not maintain confidentiality around their health issues. So some of it is around addressing their concerns.
And as I mentioned in one of my last slides reassuring them that they can still have their family members there for support. However interpreters are there to ensure communication and not just there for the patient but also for the health practitioner. Is equally there for the health practitioner to be able to communicate effectively. And we find this approach quite useful and we know that some health practitioners we’ve worked with have adopted it in their practice successfully. Sometimes patients change their minds when they understand that these are professionals and they don’t have to pay for this service. And they’re also reassured that they can still have their family member there for support if needed. So that’s one way to get around it. But certainly a challenge but it really can be managed by reassuring and reinforcing that the interpreter is there for the health practitioner as well.
Dr Anne-Marie Boxall:
Yeah. Great. Excellent. Thank you. Thanks for the advice. All right. A nice practical question for Andrew and Bronson.
Q: How long does it take TIS National to review and approve an application form?
Okay. We say five days but it really depends on whether we need to follow up and get any additional information. And it also depends on the number of applications that we’re dealing with at any particular time. We do have a relatively small team so where we do get those peaks with applications it might take a little bit longer. But usually within a week.
Dr Anne-Marie Boxall:
Great. Excellent. Well I encourage everybody to put in their applications now and tell all your friends and colleagues as well who are in eligible areas and from eligible professions.
All right. We’ve got one final question here. So if people have other questions please submit them now. But the final question we have here I think is for me.
Q: Why weren’t diabetes educators and mental health nurses included on the list of eligible clinicians when they can claim chronic disease items through Medicare?
So the answer to that is that diabetes educators and mental health nurses are not allied health professions. So although they can claim items through Medicare the eligibility of allied health professions is not linked to Medicare. The list of allied health professionals has been developed in consultation with all of the Governments and they are all qualified allied health professionals. And at this stage it is limited to allied health professionals on that list. So diabetes educators and mental health nurses at this stage are not included on that list.
All right. So I’m going to give everybody a final moment to post any questions. I don’t see any coming up there. So what I might do is just again point you to the resources. So the webinar and the PowerPoint will be made available in the coming days on the health.gov.au website and if you search for ‘Allied Health Resources’ and ‘FIS’ you will be able to find them. And of course the TIS National website has a host of resources available for you as well. We would strongly encourage you to promote this webinar, its content or the resources or anything to allied health professionals who were not able to make it today because we want to see this service used. So if you could help us with that that would be wonderful.
And my final task is to thank our wonderful panellists for their wonderful presentations, all the detailed information and taking questions as well. Thank you to Gulnara, thank you to Andrew and to Bronson.
And there’s a late question that’s come in.
Q: Is this list publicly available anywhere on the Department of Health website?
I’m presuming that is the list of allied health professions. So it is definitely available on the TIS National website of the eligible list of allied health professions. So if you search TIS National and allied health professions you will be able to find the list of allied health professions that are included.
So with that thank you to our panellists and thank you to all of you for joining us today. Please promote the service. We want to make sure that people get the best available healthcare possible. And thank you very much again. See you.
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