Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board

4. Ms P complains about the ICB’s failure to commission a British Sign Language (BSL) service that can provide specialist deafblind services between March 2023 and May 2024. She says the ICB’s commissioning service, Total Communication (TC), did not provide qualified BSL interpreters.

5. She says the ICB failed to meet her individual needs for a specialist BSL interpreter. She says she attended numerous appointments where the interpreter could not provide her with the service she needs.

6. Ms P says she experienced anxiety and distress about medical appointments, and whether the interpreter would be qualified in deafblind communication. She says she had barriers in accessing the health service.

7. She says she has paid privately for interpretation services to ensure she could access health appointments. She says this has been a financial burden.

8. As an outcome, Ms P would like the ICB to provide an interpreting service that meets her needs. She would like a financial remedy, and she would like the ICB to answer her unanswered questions.

9. Between 2012 and 2021, NHS England (NHSE) held responsibility for commissioning interpreting services. In 2021, this responsibility was transferred to the ICBs. The ICB inherited the existing contracts for these services in July 2022.

10. The ICB holds responsibility for commissioning a BSL interpreting service in Ms P’s area. It subcontracted this service to Reading Borough Council (RBC), which subcontracted it to TC.

13. Ms P complains the ICB failed to commission a BSL interpreting service with qualified and specialist interpreters that could meet her needs as a deafblind person. We are sorry Ms P faced difficulties in accessing health appointments.

14. In the ICB’s response to Ms P’s complaint, it said the service it had procured is in line with the NHS England guidance and it regularly holds contract review meetings with contractors.

15. To consider Ms P’s complaint, we requested the ICB provide us with evidence that it commissioned a BSL service, including any contracts. We also requested any audits, meeting minutes or other evidence of the ICB and/or RBC monitoring the BSL service.

16. The ICB conducted a search, but unfortunately it has been unable to locate a copy of the interpreting service contract covering the period of 2012 to 2025. The ICB advised the original contract was between NHSE and Reading Borough Council, both have confirmed they cannot locate the contract.

17. The ICB has provided a letter between NHSE and RBC confirming the continuation of these arrangements until 31 March 2021. In July 2022, when the ICB was formed, the ICB continued this arrangement despite the formal agreement having ended on 31 March 2021.

18. The ICB has been unable to provide evidence relating to the monitoring of the BSL service during this period.

19. The ICB have also been unable to provide evidence of how it considered Ms P’s needs for a deafblind interpreter. In our correspondence with the ICB, the ICB has recognised Ms P’s needs were not met.

20. The NHSE guidance sets out principles for commissioners to use in providing interpreting services. It says patients should be able to access primary care services in a way that ensures their language and communication requirements do not prevent them from receiving the same quality of healthcare as others. It says commissioners should consider what support is in place to support deaf or deafblind people.

21. The NHSE guidance says commissioners of NHS care have to comply with the Accessible Information Standard. This sets specific requirements for all NHS providers with regards to the provision of accessible communication support for people with a disability, impairment, or sensory loss, including people who are deaf, blind or deafblind. It says commissioners of NHS care are required to support compliance by organisations from which they commission services.

22. The NHSE guidance says commissioners should monitor the interpreting services it provides as part of the commissioning and contract procedure.

23. We cannot consider whether the contact held between the NHSE and RBC, inherited by the ICB, was in line with guidance or whether it was complied with by the ICB due to the ICB being unable to locate the contract.

24. As the contract cannot be located and there is no evidence of this being monitored, the ICB has not commissioned a service that it knows complies with the guidance above. The ICB has not monitored the service it has commissioned since it took over this agreement in July 2022. This is an indication of failing by the ICB.

25. As an impact to this failing, Ms P says she experienced severe worry and distress for over 12 months during 2023 and 2024, wondering whether she would be able to access her medical appointments.

26. Due to the extended worry and distress she experienced, Ms P decided to pay privately to use her preferred interpreting service in 2024. We are sorry to hear about Ms P’s distress and that she had to pay privately to access the health service. We consider the ICB should do further work to remedy this.

27. As outcomes to this complaint, Ms P would like an interpretation service that can meet her needs, a financial remedy for the distress she has experienced, and answers to her questions.

28. Our NHS Complaint Standards say an organisation should identify what learning can be taken from a complaint and identify how it can improve its service.

29. The ICB told us that it has recognised significant inadequacies in its interpretation arrangements and identified a need to rectify its service to ensure it meets national interpreting service standards. It told us it has undertaken this work over the past year, and has procured a new service which started in April 2025. It says this new service should resolve the issues Ms P had with the previous interpreting service.

30. The ICB has provided us with evidence of its new contract, with DA Languages Limited. This contract ensures that all BSL interpreters are registered with the National Register for Communications Professionals working with Dead and Deafblind people (NRCPRD). The contract confirms this service will extend to deafblind people.

31. The contract also states the provider will be subject to systematic monitoring of the quality of services it provides. The provider must provide the ICB with data to evidence its performance which will be reviewed on a yearly basis. It states performance of the contract will be discussed in quarterly review meetings.

32. In line with our NHS Complaint Standards, we can see that the ICB has identified an issue with the service it provided since Ms P’s initial complaint, and it has undertaken extensive work over the past year to rectify this issue. The ICB had procured a new contract, which it says will meet Ms P’s needs and resolves the issues with the quality of interpretation services she had previously.

33. We consider the ICB has improved the service it has provided and has provided us with evidence of how it will monitor this. Therefore, we consider the ICB has now done enough to improve its service which has remedied some of Ms P’s impact and achieved one of the outcomes she wanted.

34. Our guidance on financial remedy says when someone is left out of pocket because of an organisation’s actions, we will recommend their expenses are reimbursed for any amount they have lost.

35. The ICB has agreed to reimburse Ms P for any additional costs she incurred due to the lack of access to a suitable interpreting service.

36. Our NHS Complaint Standards say that if it is not possible to put a person back to where they would have been, organisations should consider what actions it should take to help remedy what went wrong. This can include a financial remedy.

37. We asked the ICB if it would be willing pay Ms P a financial remedy to remedy the distress and worry she experienced. When we consider financial remedy, we review similar cases, along with our guidance on financial remedy. Following this review, we suggested the ICB should pay Ms P £2700. The ICB has agreed to pay this amount to Ms P.

38. Ms P had outstanding questions about the procurement process, overall responsibility for providing a service and the contract held between the ICB and RBC. We hope to have provided a further explanation for Ms P. However, we recognise she may still have questions about the commissioning process which would be suited for the ICB to respond. As such, the ICB has agreed to answer any outstanding questions Ms P has either in person, written, or over telephone.

39. Taking everything into consideration, we think the ICB has appropriately provided a resolution that remedies Ms P’s impact and is in line with the outcomes she wanted. The ICB has already improved its service which remedies part of Ms P’s complaint, and it has agreed to take further action to remedy the impact it caused through financial remedy, reimbursement and answering any questions Ms P may have. This in line with our NHS Complaint Standards.

40. We are very sorry to hear about Ms P’s struggles with accessing the health service. We understand the importance of this complaint. We recognise this caused Ms P ongoing distress and worry about accessing appointments. We hope we have been able to provide a further explanation of what happened. We are satisfied with the work already carried out by the ICB, and the further outcomes it has agreed to in order to resolve Ms P’s complaint. We would not recommend anything further, as we think the ICB’s actions remedy the complaint. Therefore, we will not investigate any further and we consider Ms P’s complaint resolved.

1. We have carefully considered Ms P’s complaint about Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board (the ICB). We are very sorry to hear Ms P was not provided with an interpreting service that suited her needs. We recognise this was a barrier to Ms P accessing the NHS, and we thank her for bringing this to us.

2. From our consideration of the complaint, we have seen indications of failings by the ICB to commission a service in line with NHS England’s guidance for interpreting services. As an impact of this, Ms P struggled in accessing care and treatment for over a year due to issues with the interpreting service commissioned by the ICB. Ms P decided to pay privately for an interpreter who met her needs.

3. We have undertaken further conversations with the ICB, which has agreed to take further steps to correct its mistakes. We consider those steps remedy the complaint and the impact caused. Therefore, we consider the complaint resolved.