1. Appointment booking

There are three potential ways to improve the appointment booking experience for people with hearing loss: maximising the potential of existing landline telecoms, harnessing mobile telecoms and implementing an online capability.

Maximise the potential of existing landline telecoms

Make sure practice staff are aware of Text Relay. This service allows communication between textphones and telephones. Text Relay is a national telephone relay service, letting deaf and hard of hearing people use a textphone to access any services that are available on standard telephone systems. A practice does not need any new or special equipment to use Text Relay. The link between the patient and the practice is a highly trained Text Relay operator, who provides a discreet and confidential service.

Text Relay is a national service and operates 24/7. Practice staff can also use Text Relay to contact a patient by dialling 18002, followed by the patient’s contact number.

What does it cost?

For outgoing calls from the practice to a UK landline or UK mobile number, the call should cost you no more per minute via Text Relay than it would for a voice telephone call – although it may take longer. Because calls from a textphone can take longer, some telecommunications providers offer a refund on textphone calls.

Training

Practice staff need to know how to answer and make calls using Text Relay. Everyone who might answer a telephone in the practice should be able to recognise an incoming call from a patient using Text Relay.

Surveys show that this is not always the case in a busy practice with multitasking staff. A quick solution may be to ensure that every staff member knows that when a call is received from an automated voice, ‘Please hold for an operator-assisted call from a textphone user’, they should pause to allow the connection to be made and the relaying of the patient’s words. Practices will need to think about how any out-of-hours services need to be briefed in order to take Text Relay calls. However, practices should bear in mind that automated telephone systems can be problematic for deaf and hard of hearing people. These systems cannot be accessed easily using Text Relay, particular where the different options are read out quickly.

Surgeries should take into account the fact that it will take longer for a Text Relay call to be connected. For example, many surgeries offer a same-day appointment if you make contact at a particular time in the morning. Phone lines are often very busy at these times and require the patient to redial many times – something that places patients using Text Relay at a disadvantage. Therefore, surgeries might consider offering a bespoke telephone or minicom number offering direct access to deaf patients.

Full instructions for Text Relay are available at: www.textrelay.org/files/Typetalkleafletv7.pdf

Harnessing mobile telecoms

Patients with hearing loss can use text messaging (SMS messaging) to book appointments. It is a relatively inexpensive option to set up, but careful consideration is needed to ensure that processes, roles and responsibilities in the practice are agreed and communicated.

The key tasks for a practice are to:

• dedicate a phone number to receive the messages and publicise it to patients;
• secure the equipment or applications to receive the messages and ensure reasonable visibility if the equipment is shared with other tasks. A PC or terminal in the reception area is ideal. Suitable applications are available free from many of the usual mobile contract providers; and
• ensure practice staff know how to receive and send messages, and whose job it is to check for incoming messages on a regular basis.

Implementing an online capability

Providing an online capability need not be as complicated as providing real-time access to the live appointments database, with all the potential issues around security and interfaces to the clinical system. A simple email account, set up to receive emails from patients, may be a good compromise between increasing access for patients and increasing complexity for practice staff. As with SMS, the technology exists and is inexpensive.

However, a practice would need to think carefully about confidentiality and data security issues before setting up an email facility. Just as with SMS messaging, the practice would need to address new processes, roles and responsibilities. (See section 2.2 Internet appointment booking for more details.)