GP Language Support and Accessibility: D/deaf and Nepalese communities communication needs in GP primary care

Healthwatch Kent and Healthwatch Medway examine language support and accessibility problems faced by patients accessing GP services in Kent and Medway, with a focus on the D/deaf community and the Nepalese community. It highlights that people with communication barriers continue to experience difficulties accessing primary care, despite national standards such as the Accessible Information Standard and local commitments to personalised care.

For the Nepalese community, national and local evidence shows that low English proficiency significantly limits access to GP services and impacts health outcomes. Many Nepalese patients struggle with telephone-based and digital-first appointment systems, particularly since face‑to‑face consultations have reduced. Research among Nepalese veterans and elders in Kent and Medway found that over 60% found it difficult to access NHS services, with barriers including limited English skills, low digital literacy, and increased reliance on remote consultations. Social factors such as isolation, financial hardship, and difficulties accessing pensions further compound health inequalities and increase the importance of accessible GP care.

The document also highlights significant barriers for the D/deaf community when communicating with GP practices. Many Deaf people use British Sign Language as their first language and may have limited confidence using written or spoken English. Evidence shows that appointment booking systems, particularly telephone and online methods, are often inaccessible, leaving patients dependent on family or friends. Interpreter availability causes delays, and patients report problems related to interpreter suitability, including dialect differences, privacy concerns, and the use of trainee interpreters.

The briefing explains that while translation and interpreting services are funded by the Kent and Medway Integrated Care Board, effective delivery depends on multiple steps working correctly, including advance identification of need, staff awareness, appointment length adjustments, and interpreter availability. It also notes that face‑to‑face interpreting and written translation materials require prior approval, which can restrict flexibility. Digital systems commonly used by GP practices currently lack built‑in translation features, creating further barriers as services move increasingly online.

The report concludes by outlining planned action in Kent and Medway, stating that the Integrated Care Board intends to conduct a full review of translation and interpreting services in 2026. This review aims to understand existing provision, identify good practice elsewhere, and explore more coordinated approaches to improving language support and accessibility in primary care.