On May 26, 2021, BMJ published the following article, Covid-19: D/Deaf healthcare workers faced “widespread, systemic discrimination" during pandemic, study finds. (1)
The situation left one GP partner, who is profoundly deaf,
“demoralised and depressed” and on the brink of quitting the profession. It was
not helped by delays in the UK’s acquisition of clear face masks, which then
failed infection control tests.
The term “D/deaf” includes people who are “Deaf,” which
typically refers to those who use British Sign Language as their first language,
and people who are “deaf”—those who have hearing impairment but use spoken
English and lipreading. People in either group may wear cochlear implants or
hearing aids to help them hear environmental sounds and speech.
A research team from three NHS trusts in England surveyed
D/deaf healthcare professionals in the UK to determine their communication
challenges during the pandemic and to highlight areas where more support was needed.
There are no accurate data on the number of D/deaf healthcare workers, but the
researchers estimated this as “potentially several thousand” on the basis of
the 2.8 million employed UK adults of working age who have hearing loss, 6% of
whom work in healthcare.
The survey was distributed to the 194 members of the UK Deaf
Healthcare Professionals group on Facebook and the 145 members of the UK
Healthcare Professionals with Hearing Loss email group, and it was promoted on
social media. The researchers received 83 responses and reported their findings
in Occupational Medicine.(1)
Transparent masks were not prioritised
Most respondents (78%) believed that their communication
needs had not been considered during the pandemic, and some reported having
been moved away from patient facing clinical roles as a direct result of
communication difficulties caused by a lack of reasonable adjustments, such as
clear masks.
Nearly three quarters (74%) of respondents worked in the
NHS, over two thirds (68%) had severe or profound hearing loss, and 57% wore
hearing aids. Most (87%) said that they relied on lipreading, and 21% used sign
language and had interpreter support.
Nearly all respondents (77; 93%) had been working in patient
facing clinical roles before the pandemic. However, after the pandemic began,
26 (31%) worked at least partly from home, and 14 (18%) were removed from
patient facing roles owing to communication difficulties. These included three
doctors and five nurses. Some staff were redeployed to administrative duties,
but not all were given alternative work.
The researchers said that while efforts were made during the
pandemic to produce other required protective gear, the need for healthcare
standard transparent masks was not prioritised. This was despite 89% of
respondents reporting that opaque masks made it harder or impossible to
communicate with patients and colleagues.
Six months after the pandemic began the UK did finally order
ClearMask face masks, but they were not deemed suitable by infection control
teams for use in clinical areas or where FFP3 masks were required.
The researchers also found that just 19 D/deaf healthcare
workers were offered an occupational health assessment to discuss reasonable
adjustments during the pandemic. Only 33 (39%) were given the equipment or the
reasonable adjustments they needed, and in some cases the recommended
adjustments were not implemented because of objections from infection control
teams.
Demoralising and depressing
Rosie Knowles, a GP partner in Sheffield who is profoundly
deaf and lipreads, told The BMJ, “When all the masking and social
distancing and the move to all remote consulting came in with the pandemic, my
job became almost impossible.” She said that a lack of support from the
clinical commissioning group (CCG) and bodies such as the Royal College of
General Practitioners was “extremely demoralising and depressing” and that she
had been “close to leaving medical work altogether.”
“I’ve never felt so unheard and so uncared for by the NHS. I
was just left to find my own solutions,” she added. Unable to lipread over
video calls with poor internet connection and with none of the approved video
platforms providing automated captions, she switched to doing most of the
practice’s text and email consultations.
After a suggestion from a social media group for deaf
healthcare workers, Knowles applied for funding from the employment support
programme Access to Work for a live captioner. This took five months to obtain.
She also struggled to access the ClearMasks for face-to-face consultations, as
the local CCG took months to understand that it was the patients who wore them,
not the D/deaf doctor.
“Patients can wear makeshift masks so a ClearMask is no
different, but [the CCG] kept insisting that, as personal protective equipment,
it had not been clinically cleared,” Knowles explained. Eventually she managed
to get the message across, but again it took five months. In the meantime, she
had to meet patients outdoors without masks and then bring them inside for
examinations.
“My team were always supportive, but the strain on us all
was tough: the pandemic plus dealing with the lack of help and support from
anyone else,” she told The BMJ. “To be suddenly catapulted from a
highly competent and respected healthcare professional into a burden or a
nuisance to my colleagues—or to shop staff, to anyone who tried to talk to
me—was a major challenge to my mental health.”
Inquiry
The researchers said that any inquiry into the government’s
handling of the pandemic must tackle the discrimination faced by D/deaf
healthcare staff.
“Government and NHS policy must be more than platitude; it
needs to be translated into action and funding for required reasonable
adjustments, together with a culture shift among employers and staff to tackle
discrimination, and recognise disabled staff as an asset, and not a burden,”
said their paper.
The researchers noted some limitations to their study,
including the small number of respondents and the fact that they will have
missed staff who do not use social media, which likely attracted a younger
demographic.
This article is made freely available for use in accordance
with BMJ's website terms and conditions for the duration of the covid-19 pandemic
or until otherwise determined by BMJ. You may use, download and print the
article for any lawful, non-commercial purpose (including text and data mining)
provided that all copyright notices and trade marks are retained.↵
Mahase E. Covid-19: D/deaf healthcare workers
faced “widespread, systemic discrimination” during pandemic, study finds BMJ 2021; 373 :n1365 doi:10.1136/bmj.n1365
Cheers,
Donna
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