 Welcome to Yechidda. Croeso i Yechidda. Yechidda is a Welsh language awareness video aimed at all of us who work within the NHS in Wales. Now, being a Welsh language awareness video, you might well think that it's to do with the language. Well, yes it is, but it's more than that. In fact it has much more to do with patient care. During the video we'll be hopefully finding some things out about the Welsh language. But also we'll be looking at how crucial language is to the quality of care received by patients. How well are we caring for our bilingual nation? Well, I normally start off with a Welsh-speaking person, with the sentences, esgais o'r ochi, vici sumach, sy'n adwi onrwy'n dusg i Cymraeg, dwi'n yn siarad Cymraeg yn dipyn bach, which just basically says my name's Vicky. I'm learning Welsh. I just tries to show them that I have made a bit of an effort. Yes, some days we can come across Europeans, Spanish Italians. So it's not just most people that we come across, it's quite a few languages really. One of the first things any visitor to Wales notices is that we're a country of two languages, a bilingual nation. Both the Welsh and the English languages are visible in all parts of Wales, on road signs, shops, offices, cafes, pubs, vans and lorries, and yes, on hospitals and ambulances as well. Welsh is also heard all over Wales, from Bridge End to Menai Bridge, from Denby to Tenby, in the street, at work, in the community, at school and at play. Apparently over one in five of the population of Wales admit to the authorities that we can speak Welsh. Admit to the authorities. The census. Ah, well that must be well over half a million people. Yep, although most probably around a quarter of us could actually hold a simple conversation down the pub or over the garden fence, and about half of us have some useful knowledge of Welsh. Useful knowledge, like what? Well, like bod y da, iechyd da, and for healthcare workers, sy'n edrych i. Fine, thanks. So, where would you say these half million Welsh speakers live then? Is this a quiz? Yes. Okay, here in that case in the north and west, isn't it? There, there, are they? Yes, well that's the general view because the communities there have a higher percentage of Welsh speakers, but they also live there, there, there and there. In fact, more Welsh speakers live in urban areas of Wales than do in the rural areas. Do they? With the growth of Welsh medium education over recent years, young people are much more likely to be able to speak Welsh than older generations, and the trend is increasing. Many young children, of course, don't speak any language other than Welsh. Language is crucial to the way we all live our lives. We use language every day in all sorts of ways to convey information, to send messages, to chat to friends, to convey thoughts and describe feelings. It's a vital part of the everyday currency of life. For Welsh speakers, being able to speak Welsh rather than English actually feels different. People often feel that they're not quite themselves when talking in a second language. Life does not quite ring true as it were. The window is somehow obscured. For health care workers, putting people at their ease and ensuring effective communication is a vital role. In the year 2000, the Welsh Consumer Council published a report called Welsh in the Health Service. It called on health professionals to do more to facilitate Welsh language services for patients. Language is very important in the realm of health care because communication is of the utmost importance and making sure that when you explain things to patients, it's really important to choose your words properly, make it understandable but not patronising, phrasing things in a way it's acceptable to people, especially if it's bad news. Yes, well, right you are, I can see that Welsh speakers might prefer to speak Welsh with their health workers, it's only natural I suppose, but surely they can all speak English anyway, can't they? Young children of Welsh speaking families often don't speak English before starting school and some don't speak English fluently until they're about nine or ten. Elderly patients who have often lived in a Welsh speaking community all their lives might have serious difficulty in English, particularly if they're under stress. Some increasingly revert to using Welsh only as they get older, a condition known as bilingual aphasia. Mental health patients and patients with special educational needs often have a particular need to communicating Welsh. Seriously ill patients also might revert to speaking only Welsh or might only respond to Welsh conversation and instructions. Many Welsh speakers, however fluent they normally are in English, when they find themselves in stressful situations might find it difficult to express emotions and feelings in their second language and would generally feel much more comfortable in their first language. But it's not just an issue for special cases, all Welsh speakers have a right to express themselves in whatever language they choose, they should be given the opportunity, they might refuse, but the option should always be offered. Ah, so it's about providing equal opportunity as well then? It certainly is, care workers need to provide equal opportunity for all patients to express themselves in the language of their choice. It should be part of their total care package. Communication is the important thing. There's no doubt at all that talking to patients, one doesn't have to get hung up about the science of the whole business. It's just being able to communicate that sets people at ease and if we can do that in the patient's natural first language, obviously that's vitally important. Yes it is an important issue, especially here on elderly medicine and rehab, where the older generation Welsh may have been their first language and coming into hospital being poorly, they can often be disorientated and confused and often revert back to their first language. So there we have it, we need to care for our bilingual nation in both languages. Go felwch, defnyddioch gymraeg. Take care, use Welsh. In July 2002, as a result of the National Assembly for Wales's review of the Welsh language, the following announcement was made. In a truly bilingual Wales, both Welsh and English will flourish and will be treated as equal. A bilingual Wales means a country where people can choose to live their lives through the medium of either or both languages. A country where the presence of two national languages and cultures is a source of pride and strength to us all. So it's legal then? What? This bilingualism we have and I just thought we were pushing our luck. Cymraeg, Welsh has had equal status with English in Wales since 1993. So what happened in 1993 again? The Welsh Language Act and what did that mean? Basically it meant three things. It gave English and Welsh equal status in Wales. Yes. It made it a statutory duty that all public bodies in Wales should provide their services in both English and Welsh. Yes. And established a Welsh language board to oversee the matter and promote the Welsh language in general. So it's a must then, providing bilingual services? Certainly is. A statutory duty. Public bodies issue a Welsh language scheme that explains to staff and patients how it's done. All staff should be aware of how the Welsh language scheme relates to their daily work. The trick is to get them off the page and into action. And how do they do that? Well, let's find out. One section of a Welsh language scheme will deal with telephone calls. Which could be in either Welsh or in English. Exactly. Oh, I'm sorry. I'm afraid I don't speak Welsh. Would you like me to put you through to someone who can? Certainly. No problem. Just hold the line a moment. Another important area for the customer care is the reception area. That's often the first point of contact with the establishment for both patients and their families. Telephone and reception services are important first point of contact services. However, it's crucial for the quality of our health services that healthcare service providers also consider the language needs of their patients. We now have the results of the test back and they confirm what we thought clinically that Larry's got meningitis. As you know, it's a serious condition and especially since she's only six. But we've caught it very early on and with powerful antibiotics, I'm sure she'll do well. To be on the safe side, we think she should be transferred to the high dependency unit until she's better. I'm sure you have plenty of questions you want to ask me, so I'll leave you some time to think them over and I'll come back in half an hour and answer any questions you may have. Okay? Thank you doctor. Just before you go, you know that Larry only speaks Welsh. Have you got any Welsh speaking people in the unit? I'm sure he'll make a feel a lot more at home. I don't speak Welsh myself, but we do have doctors and nurses who do. I'll speak to the sister-in-charge and sure she'll be able to help you. Thanks again doctor. Diolch. Is it good that you're doing well? Oh hello, my name is Nisha Lachwellchee. Borrida. Oh hello, shumai. I'm sorry I don't speak Welsh very well, I just understand bits. Oh sorry, that was really rude of me. No, no, not at all. I see from your notes that you would prefer to converse in Welsh where possible. Yes, but I don't want to cause any trouble. No, no, it's fine. We try to router a Welsh speaker onto every shift where we can. Oh, here's Gwana, now maybe she'll be able to help you. Well, there you go with sensitivity, a little effort, teamwork, some useful Welsh, and good customer care practice. We can all go a long way towards delivering a Welsh language scheme. Never mind the scheme, that's just a document. It's the service that counts, especially if you're ill, distressed or bereaved. Do you know what that Welsh in the health service report also said? What? On the whole, Welsh speaking patients appreciate any efforts, however small, to acknowledge their language and culture, and to communicate with them, at least partially in Welsh. The message is that using the Welsh language with Welsh speaking patients, however little Welsh you actually have, can improve the quality of their care. It's about recognising people's identities and valuing their preferences, offering choices, and making them feel as comfortable as possible in often very uncomfortable situations. Let's recap the main points. Tell you what, let's not. Let's leave that to the experts. Ja chi dda. Recently, I was able to deliver a lady through the medium of Welsh. She had a premature birth, which obviously was a bit more complicated. Both her and her husband were Welsh speakers, it was their first language and I felt it was a great benefit for them to be able to speak to them in Welsh. Making the patient feel comfortable and at ease and that they can trust you and that you can pick up the vibes from them on how they're feeling is extremely important.