Blog - Access to Healthcare: Lifting the Lid on Language Barriers

How often do you hear someone say, “I’ll cross that bridge when I come to it” As a phrase, it’s used as an “off the cuff” analogy for a barrier to get over or find a way around on a journey to achieving an aim. How could you relate that to someone needing to access healthcare but can’t speak the language? “When I get there, I don’t understand what anyone is saying to me” ...it just doesn’t work…

NHS trusts and other healthcare providers face a growing challenge to meet the changing communication needs of the UK’s increasingly diverse population. Around one in ten people in the UK don’t speak English as their first language, and in areas like London, the figure is around one in five people. As a trend, this is set to continue with data from the ONS showing that over the next 25 years, net international migration will account for almost three-quarters of UK population growth.

Language barriers can prevent people from engaging in conversations with their doctors and other clinicians – so how can healthcare providers deliver a quality care service to someone, if they can’t understand what a clinician is telling them? Studies conducted over the past thirty years show that a clinician’s ability to explain, listen and empathise can have a huge impact on health outcomes for people as well as their levels of satisfaction for a service.

Language barriers can result in miscommunication that affects a person’s understanding of their condition or treatment – this can be potentially life-changing or even life-threatening. It is therefore, crucial for healthcare providers to think carefully about how they can remove language barriers, to help people who don’t speak English as their first language. The growing number of people with limited proficiency in English is concentrated around large urban areas, which means the need for language support is already acute in large cities like London.

Whilst healthcare providers can use interpreters, they must rely on the availability of one when needed, and ensure consistent quality of translation to build and maintain trust and understanding. Getting those elements of need in place consistently is unlikely to be realistic.

The cultural beliefs of individuals also need to be considered, and clinicians may often see people that rely on their family members and friends to act as their interpreters. This too can, however, present a number of problems. Those asked to step in as impromptu interpreters may lack appropriate language skills, knowledge of medical terminology, or fail to translate complex information correctly. Their actions could also present difficult and serious issues around a person’s confidentiality.

For clinicians whose time is already scarce, owing to pressures on health organisations in local communities, relying on interpreters also requires spending time organising and overseeing the process. Finding a solution to helping people facing language barriers to navigate through their health care experiences is the key. Whilst many local healthcare providers might already use over-the-phone translation services to summon help from an interpreter, perhaps this is where the right modern technology as an addition, could can make a huge difference by accessing tools such as translation devices or apps.

The Lancashire and South Cumbria NHS Foundation Trust for example, is one of the healthcare providers using Pocketalk – a real-time language translation device, used to overcome language barriers during the Covid-19 pandemic.

Having clinicians who are bilingual would also be helpful for people; not only can they help translate important information, but they can also help their organisation communicate in a way that takes cultural differences into account. Encouraging clinicians to be more visual and use visual prompts could be another way of overcoming communication barriers. People are more likely to remember and understand information much better with clear visual prompts like diagrams, images and models.

What matters most is that ultimately, healthcare providers should use a combination of the right people and translation technology to break down and remove communication barriers, and improve the outcomes for patients who don’t speak English as their first language.

-Author- Richard Vann, Healthwatch Officer

*This article was first published on 24th February 2021 on Faith Action's website*