NECS Consultancy with NHS England and NHS Improvement


NHS England commissioned NECS to undertake an independent national Rapid Review of British Sign Language (BSL) services which would set out recommendations to inform future NHS commissioning of interpreting services and comply with legal responsibilities.
Work to achieve the NHS long-term plan targets has accelerated at pace as a result of the COVID-19 pandemic and has also been a catalyst for shaping future strategy and system transformation.

However, the pandemic also highlighted some of the health and wider inequalities that persist in our society with the pandemic continuing to demonstrate a disproportionate impact on d/Deaf communities including a reduction in the number of non face-to-face BSL speaker consultations as services delivered digital solutions. This had a direct impact on BSL speakers meaning that services no longer met their health and care needs.

The national Rapid Review was time-limited to eight weeks therefore rapid mobilisation was key to programme success.  NECS’ operating model was based on a number of methodologies:

  • Scrum to configure a cross-functional expert team to deliver a Rapid Review delivery model within strong governance and reporting arrangements.
  • Agile working to respond to and flex their approach when working with a range of key stakeholders with feedback forming a critical component.
  • Strategic planning process as a framework to guide the Rapid Review phases.
  • Stakeholder management to ensure critical and effective engagement with a range of stakeholders and manage expectations.
  • Evidence based approach drawing on international and national best practice.

NECS’ framework for the Rapid Review (Framework 1) comprised of four key stages of engagement with relevant stakeholders, review of legal issues relating to commissioning of BSL Services, an options appraisal of where commissioning responsibility rests and how access to BSL interpretation can address health and inequalities and recommendations on the most appropriate and effective commissioning options.

Figure 1:  Project Workstreams

  • Stakeholder engagement formed a fundamental part of the Rapid Review with NECS facilitating interactive engagement sessions and interviews with key stakeholders focusing on the challenges faced in accessing services and how future services could be improved to meet patient expectations.
  • This engagement was supported by a literature review; researching key documentation associated with health inequalities and highlighting the variation in the quality of BSL services and areas that needed to be addressed by the recommendations.
  • NECS formulated policy recommendations underpinned by the following three fundamental requirements:
    Each ICS working with BSL speakers establish a single integrated service covering all health and care providers reducing service variation.
  • Deliver national digital BSL interpreter provision through increased use of NHS 111 services.
  • Delivery of training and education for health and care providers.

These recommendations collectively place BSL speakers at the centre of future commissioning arrangements to address health inequalities and will deliver improved patient outcomes through a sustainable solution that is aligned to NHS England policy and fundamentally addresses the concerns identified by the consultation process.

View the NECS Consultancy profile in the MCA Members Directory.