RNID report claims ‘systemic discrimination’ is putting lives at risk

A NEW report published this week (April 24) has accused NHS Wales of widespread failings in care for deaf people and those with hearing loss—failings that campaigners say are not only unlawful, but also putting lives at risk.

The report, titled Still Ignored: The Fight for Accessible Healthcare, was compiled by RNID, a leading charity supporting people who are deaf, have hearing loss or tinnitus. It highlights what the organisation describes as a “hidden scandal” affecting more than 300,000 adults across Wales.

Despite clear legal duties under the Equality Act 2010 and a decade-old policy framework—the All Wales Standards for Accessible Communication introduced in 2013—the report finds that deaf people are routinely denied the support they need when accessing NHS services.

Missed standards, missed care

Among the most alarming findings is that more than 7 in 10 (73%) deaf patients and those with hearing loss say they have never been asked about their communication needs in a healthcare setting. This is despite it being a basic requirement under equality law.

Almost 1 in 3 (30%) reported being unable to contact their GP in a way that works for them, such as using text or email instead of a phone. More than 2 in 3 (64%) had difficulty knowing when they were being called from a waiting room, and 42% struggled to communicate symptoms or concerns with staff.

In more serious consequences:

• 8% said they had avoided calling an ambulance or attending A&E due to communication barriers.
• 18% said a health condition worsened because of poor communication.
• 11% believe their health was directly put at risk.

Family as interpreters

More than half of deaf patients (56%) said they had to rely on family or friends to relay medical information, often without professional support. 1 in 4 were denied the communication assistance they asked for outright. RNID warns this not only risks miscommunication, but also strips patients of their right to dignity, privacy, and autonomy in healthcare.

The consequences can be devastating. Kate Boddy, a Child of a Deaf Adult (CODA) from Wales, acted as interpreter for her father, Richard Boddy, when he was diagnosed with cancer in 2022.

She told The Herald: “There’s so little out there in BSL. When Dad got his diagnosis, I had to suppress all my emotions just to translate for him. Even though we knew he was going to pass away, I don’t feel like I ever got to say goodbye.”

Mr Boddy died in November 2023, aged 70.

Staff awareness low

The RNID also surveyed NHS Wales staff and found significant gaps in training and understanding:

• Only 57% knew how to record a patient’s communication needs.
• Fewer than half (48%) knew how to flag those needs in online records.
• Just 17% of staff said they always feel able to meet the communication needs of deaf patients.

Dr Natasha Wilcock, a deaf doctor working in palliative care, said: “Deaf insight training should be compulsory. I’ve met patients who didn’t realise their cancer treatment had ended and that they were receiving end-of-life care. That level of misunderstanding is unacceptable.”

Calls for urgent action

Polly Winn, RNID’s External Affairs Manager in Wales, said: “It is not acceptable for people to leave medical appointments without understanding their diagnosis, or to be forced to share intimate health details with family because NHS Wales won’t provide interpreters.

“This is systematic discrimination—an equality failure that is putting lives at risk. The situation demands urgent reform.”

RNID is calling on the Welsh Government to:

• Reaffirm and enforce the All Wales Standards for Accessible Communication;
• Introduce robust oversight systems to monitor compliance;
• Mandate deaf awareness training for all NHS staff;
• Ensure people with lived experience help shape future reforms.

A spokesperson for NHS Wales said the organisation is reviewing the findings and remains committed to improving access for all patients.

The Welsh Government has not yet issued a response to the report.

THANKS to generous donations, Hywel Dda Health Charities – the official charity of Hywel Dda University Health Board – has purchased two new Electrocardiogram (ECG) machines worth over £14,000 for the Emergency Department at Withybush Hospital.

Chest pain is a very common presentation at the Emergency Department which sees between 100 and 130 patients a day. ECG machines provide key information on a patient’s heart by measuring rhythm and electrical activity.

The additional ECG machines will help ensure that patients presenting with chest pain receive an assessment as quickly as possible.

Senior Nurse Manager Josephine Dyer said: “We are so grateful that generous donations from our local community have enabled us to purchase the two ECG machines for the Emergency Department.

“High numbers of patients present with chest pain and require an ECG, so we hope that having the additional machines will reduce waiting times and offer an improved patient experience.”

Nicola Llewelyn, Head of Hywel Dda Health Charities, said: “We are deeply thankful for the generous support from our local communities which allows us to offer services beyond what the NHS can provide in the three counties of Hywel Dda. Every donation we receive is greatly appreciated!”

For more details about the charity and how you can help support local NHS patients and staff, go to www.hywelddahealthcharities.org.uk

Two-thirds predict family sizes will shrink even further by 2040

NEW figures released by Fertility Family reveal that parts of Wales have seen some of the steepest declines in fertility rates across the UK, with the Isle of Anglesey recording a drop of more than 44% over the past 15 years.

The Beyond the Birth Rate report combines official birth statistics with survey data to explore why fewer people are choosing to have children – and why they’re waiting longer when they do.

Wales’ top ten fertility declines

The study identified the ten Welsh areas most affected by declining birth rates. The Isle of Anglesey tops the list with a fall of 44.21%, followed by Wrexham, Caerphilly and Merthyr Tydfil – all of which have seen declines of more than 27%.

Newport recorded the smallest decline in Wales, with a drop of just 8.6%.

How does the rest of the UK compare?

London has mirrored Wales’ dramatic decline, with boroughs such as Southwark also showing a 44.21% drop in fertility rates. However, some parts of England have been less affected.

Colchester has seen the smallest national drop, at just -3.95%, while other areas such as Runnymede (-5.19%), Lancaster (-6.04%), and Gravesham (-7.07%) have remained relatively stable.

Financial pressure tops list of reasons

The report suggests that the primary driver behind shrinking family sizes is economic hardship.

• 40% of people said financial stability was the key reason for delaying children.
• 23% described starting a family as simply unaffordable.
• 60% of respondents believe this financial strain is a major factor behind the rising age of first-time mothers.

Why are people waiting longer?

In addition to economic challenges, lifestyle and societal shifts are also playing a major role:

• 47% cited career ambitions and workplace pressures.
• 44% blamed difficulties in finding the right partner.
• 34% pointed to the housing crisis and lack of affordable homes.

These factors are leading to more people having children later in life – a decision which often reduces fertility and the total number of children they may have.

Smaller families likely the future

Over the past 15 years, the UK’s overall fertility rate has declined by 26.9%. That means for every two women of childbearing age, one fewer child is being born.

Looking ahead, 67% of people surveyed expect family sizes to shrink even further in the next 10 to 20 years.

The study also revealed:

• 40.7% believe more single parents will have children independently.
• 20.5% expect an increase in adoption and surrogacy.
• 14.9% foresee co-parenting arrangements becoming more common.
• A striking 47% said they believe more people will choose not to have children at all.

With both economic and social factors contributing to the trend, the report paints a clear picture: the traditional family model in the UK is evolving – and quickly.