GP interpreting services in Barnet

Limited English proficiency is linked to health inequalities. Research has demonstrated that speaking English as a second language influences a patient's health outcomes. In a study conducted by the ONS, 88% of people who could speak English ‘well’ were in good health compared to only 65% of those who were not proficient in English.

All Barnet GP practices have access to language interpreters through Language Line Solutions; an over the phone interpreting service. However, Healthwatch Barnet has received anecdotal feedback that this interpreting service is not widely used by GPs or known in the local community or amongst practices.

Healthwatch Barnet has examined the awareness and use of interpreting services in Barnet’s GP practices and within the local community who speak English as a second language. A team of Healthwatch Barnet staff and volunteers conducted mystery shopping of all GPs in the borough to identify whether they offer and promote the service. In addition, the team engaged with patients, practices and community organisations to hear their views about the service.

Healthwatch Barnet found that while most surgeries said they offer the service, not all are actively promoting it to their patients. Consequently, most patients who took part in the research were not aware of interpreting services and, therefore, only a small number had used the service. A concerning finding emerged that over a third of the patients did not understand their GP during appointments.

It is particularly important that all local GPs offer interpreting services to their patients. It’s not acceptable for patients who require interpreters to rely on relatives for informal interpretation or have to travel to other GPs further away where the staff speak their community language. This expectation distorts the patient lists, does not provide patient choice and risks ghettoization as patients’ choice is restricted to certain areas.

Recommendations:

All GP staff should be trained to use Language Line. This should include instructions on the process, guidance on how to check requirements and engage with patients with no/limited English.

GP practices should update their websites to include clear information about interpreting services.

GP practices should clearly display the CCG ‘Did you know?’ poster in reception and waiting areas.

GP practices should follow good practice when using interpreting services:

• Practices should offer double appointments for those who require the service.
• All practices should ensure that patients’ need for an interpreter are consistently recorded in patient records, acted upon and passed to other professionals.
• Practices should avoid the use of informal interpreters such as family members, other staff members and Google translate in accordance with good safeguarding practices and the NHS Guidance on GP interpreting and translation services.
• Practices should use face to face interpreters for complex conditions or consultations (in response to the GPs’ concerns that Language Line was too impersonal).

Barnet CCG should update the ‘Did you know?’ poster to include the most relevant languages spoken in the borough and redistribute to the 53 practices to display.

The CCG should monitor the use of Language Line amongst practices and provide support to those practices who are not using the service or using it infrequently.

The CCG should maintain a good working relationship with practices by consulting and informing them about upcoming changes to policy and practice.

Healthwatch Barnet should continue to raise awareness about interpreting services offered in GPs to local patients through their engagement activities.