Lost for words - Healthwatch evidence on how language barriers contribute to health inequalities

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Summary of report content

The Accessible Information Standard (AIS) ensures people with a learning or sensory disability can understand and communicate with healthcare providers. However, it does not currently cover the needs of people who have limited or no English. Healthwatch England's research delves into the experiences of people from minority ethnic communities who live in England and find it challenging to communicate with the NHS because they don’t speak English well or at all. They also look into the issues faced by healthcare staff when caring for such people. Six local Healthwatch interviewed 109 people and 38 members of staff between October and November 2021. 

The research concluded that people who experience language barriers struggle at all points of their healthcare journey. They find it difficult to register with a GP, access urgent care, navigate large healthcare premises, explain their problems, or understand what the doctor says. 

Lack of interpretation support further compounds their issues. They may not be aware of professional interpreters, find it difficult to access one when needed, or even understand them if interpreters don’t speak their dialect. As a result, they don’t get the healthcare that they need. 

Some people preferred to use family or friends to translate for them, but others felt uncomfortable doing so. Cultural and privacy concerns can affect someone’s preferences, for example women wanting same sex interpreters. Whilst staff were keen to use technology to translate, some people with language barriers didn’t have confidence in it. 

Staff said that there were no common systems for recording people’s language requirements or sharing this information with other parts of the healthcare system. Staff wanted more training and support to help people with language barriers. Staff also felt constrained by ever-reducing budgets for interpreting. 

The consequences of not having these in place included people missing appointments or experiencing delays to their care. Staff, patients and family members made suggestions for change which would improve their experience, including automatic alert systems to flag people’s language needs, easier access to translated resources, and flexible support based on individual needs. 

 

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General details

Local Healthwatch
Healthwatch England
Publication date
Date evidence capture began
Date evidence capture finished
Type of report
Enter and View
Key themes
Access to services
Accessibility and reasonable adjustments
Administration (records, letters, results)
Booking appointments
Communication with patients; treatment explanation; verbal advice
Consent, choice, user involvement and being listened to
Service organisation, delivery, change and closure
Written information, guidance and publicity

Methodology and approach

Was the work undertaken in partnership with another organisation?
No
Primary research method used
Focus group
Interviews
If an Enter and View methodology was applied, was the visit announced or unannounced?
N/A

Details of health and care services included in the report

Details of health and care services included in the report
General Practice (GP)
Hospital services- not stated

Details of people who shared their views

Number of people who shared their views
109
Age group
Not known
Gender
Women
Ethnicity
Arab
Asian / Asian British: Bangladeshi
Asian / Asian British: Chinese
Asian / Asian British: Indian
Asian / Asian British: Pakistani
Asian / Asian British: Any other Asian / Asian British background
Black / Black British: African
White: Any other White background
Seldom heard groups
Refugees or asylum seekers
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