Leading doctors have called for all hospitals to start providing appointment letters in other languages to prevent patients whose first language is not English getting a delayed diagnosis.
It comes after a report found that NHS trusts often send letters about radiology appointments only in English and expect a patient’s relative or neighbour to translate for them.
The study by The Healthcare Safety Investigation Branch warned that for people whose first language is not English “there is a risk that they may not attend the appointment” or if they do not understand some information this could “prevent the procedure taking place and it being cancelled on the day.” The report also cautioned that a patient can be “lost to follow-up” as they are not tracked and appointments are not re-scheduled and this can lead to a delay in diagnosis and care. NHS England standards do not require written appointment information to be given in any non-English language other than for people with a disability.
Dr Nikita Ved
Dr Nikita Ved MBE, a visiting academic at the University of Oxford, believes this rule should change and hospital and other healthcare related information should be easily accessible to people across diverse communities. She told Eastern Eye: “By restricting it one language, not only are we assuming that patients have someone that will translate for them, we also assume that they want to share this sensitive and private information.“ Nor is it fair to rely on GPs to translate on top of their existing workload. This type of gatekeeping will only widen the disparities in healthcare faced by minority communities.”
Dr Ved is co-founder of the 1928 Institute think-tank whose research has shown that 50 per cent of British Indians face barriers in accessing healthcare and language was one of the issues cited. She added: “By offering letters in multiple, region-specific languages, like they offer in Wales, the NHS can help prevent conditions getting needlessly worse as people await translation services, give people the agency to manage their own healthcare needs and take a step in addressing health inequity.”
GPs said patients often come to them for translating complicated hospital letters which adds to their growing workload. Dr Chandra Kanneganti, a GP in Staffordshire, told Eastern Eye: “I would suggest hospitals should always consider the request of the patient for translation services.
“Health trusts should also proactively get the support of the voluntary sector for this.” We at the GP surgery always offer translation services for a consultation appointment. “The NHS should invest in this. More patient empowerment in their diagnosis and receiving the basic information.”
Dr Kanneganti, chairman of the British International Doctors Association, added: “Some patients from the UK will have an accident in another country, they go to hospital there and they don’t translate the [report] from Spanish of German into English for doctors here.” “We sometimes struggle to understand what happened.”
The HSBI investigation found that some patients are not tracked for follow-ups and their appointments are not rescheduled. Investigators found 34 national database incidents in one year across England related to issues of keeping track of patients. Recent research by the Taxpayers Alliance found that NHS trusts spent at least £113,974,561 on interpreters during 2019-20 to 2021- 22. Around £43.1 million was spent on interpreters in 2019-20, which dropped to £39.8m in 2021-22.
Barts Health NHS Trust in London was the English trust with the highest spending on interpreters at around £5.5m. Dr Kieran Sharrock, acting chair of the British Medical Association’s GP committee England, said in a severely overstretched NHS it is nonetheless vital that patients can access information they need in a language they understand.
“Failure to offer this is only going to lead to worse health problems and more pressure on the service down the road, not to mention the distress caused to patients who are not being made aware of their situation.”
“Adequate funds should be made available to ICSs to commission and provide interpretation and translation services when required. This would ensure that NHS Trusts can provide hospital letters written in a language patients understand, and enable them to answer patient queries so that GP practices can focus on care in the community. Without this, non-English speaking patients are at a disadvantage and health inequalities will worsen.”
The latest data from the Office for National Statistics (ONS) shows that, in 2021, 7.1 per cent of the population in England and Wales were proficient in English but it is not their main language. This works out to 4.1 million people.
Rachel Power, chief executive of the Patients Association, said it is essential that people understand the letters they receive from the NHS about their health and care and they should be written in plain and accessible language including in the patient’s preferred language. She added: “If patients don’t understand a letter, for whatever reason, they may miss key information including diagnoses, appointment times, and advice. “High-quality translations provided by a trained translator should always be available, online translation tools should not be relied on.”
- For more about the Patients Association, see www.patients-association.org.uk or www.patients-association. org.uk, or call helpline on 0800-345 7115.
Vikram Doraiswami
Andrew Quintman
Lord Jitesh Gadhia