Seldom Heard Speak Up: People that don’t speak English and Access to Health and Wellbeing Services

In late 2015, Healthwatch Lewisham engaged with 95 individuals who don’t speak English as their first language including Vietnamese, Tamil, Polish, Turkish and Refugee groups.

The work was done as part of an engagement programme to gather the views of ethnic minority and refugee communities and how they access health services in Lewisham.

The report identifies key issues. People who don’t speak English as the first language often face similar issues to the general public such as difficulties in accessing GP services, problems with referrals and staff attitudes. However, there are also issues that are specific to some communities. Lack of trust towards medical professionals amongst some Polish participants, lack of referrals that leads to delayed diagnosis and treatment and use of private Polish clinics. Lack of clarity of eligibility to translation services and translation quality for Vietnamese participants combined with cultural differences and lack of knowledge about local service provision and access. Self-selection of GPs that speak Tamil amongst Tamil participants. Turkish elders were generally happy with the GP services but there was a distinct lack of clarity around waiting times for referrals. Many participants were not happy with medicine replacements offered by pharmacies or doctors prescribing low quality medicine. Refugee participants of Chinese origin complained about the lack of health checks available for younger people.

The report recommends :

- Improve access to GP services including improving access to urgent appointments and improving booking systems. Consideration should be given to people with communication barriers especially elderly, parents of young children and those with long term conditions.

- Increase the length of GP consultation appointments for people who experience communication problems especially the elderly, parents and those with long term conditions to allow safe and effective diagnosis and treatment.

- Improve waiting times at GP services and provide information and explanations for delays when they occur.

- Make appointments with a named GP more readily available.

- Identify, promote and encourage existing good practice amongst GPs including a caring approach, good listening skills and strong communication when faced with communication barriers.

- Improve staff attitudes towards patients by increasing the emphasis on listening to the patient, and by taking time to understand the community members.

- Provide appropriate training for staff to enable improved communication and cultural awareness.

- Provide information about services available locally, how to access them, what to expect with focus on vulnerable groups and migrants that are new to the system and do not speak English as their first language. The information could be in the form of a booklet or as information sessions delivered through local groups.

- Clarify and publicise the eligibility criteria for interpreting services for Lewisham residents.

- Improve access to interpreting services.

- Consider investing in local service providers for the provision of face to face interpreting services and advocacy.

- Improve diagnosis and support for people with mental health issues who don’t speak English as their first language.

-Inform the patient about the expected waiting time for a referral. Provide an acknowledgement so the patient is reassured of the access to service.

- Explain to patients what tests they are being referred for and the reason for the referral.

- Ensure patients understand the treatment plan and treatment options available to them such as medical test or escalation to the specialists.