In the increasingly multicultural, multilingual United Kingdom, the needs of the community which the National Health Service (NHS) serves have changed significantly. The NHS has attempted to keep pace with these changes. While 92.3% of the population over 3 years of age gave English as their main language in the 2011 census, 4.2 million people reported having another main language; London had the highest percentage of such respondents at 22.1%. This data suggests that there are at least some groups in the UK who don’t possess a sufficient grasp of English to be able to understand the vital health information communicated to them by primary care providers.
Translation provided by the NHS
The NHS has a public duty to provide proper resources so as to ensure that all of its services are as accessible as possible at the point of use. From access to basic health information, accurate pharmaceutical translations and effective communication between clinicians and their patients, there is no real room for error. Thankfully, incidents of deaths caused by lack of adequate translation provision are exceedingly rare in the UK, due largely to the dedication of the NHS medical staff to patient care. But how do they achieve this? And how are NHS translations handled? The simple answer is that, in order to make a universal health care system accessible across language barriers, a multi-faceted approach is required
The first language service provision by the NHS is extensive text-based translation, mostly available online. The NHS has overseen the translation of large volumes of information on the NHS Choices website, including thousands of pages of health information, treatment options and even patient leaflets, that are now on offer in numerous languages. This website also directs patients, albeit in English, to other related organisations and third party sites that may contain further information in their respective languages.
The second language service provision may seem self-evident, namely interpreting. Each healthcare practitioner is ultimately responsible for ensuring that their patient fully understands the information provided about their health. This means that only professional interpreters can be used so as to guarantee accuracy and maintain patient confidentiality, whilst avoiding any attempt to communicate with patients via family members or well-intentioned friends.
The NHS relies on a mix of telephone, videolink and face-to-face interpreting services to aid in doctor-patient communications. Due to its cost-effectiveness and convenience, telephone interpreting is the most prevalent, which can even be preferable to patients due to the greater anonymity of the absence of a physical interpreter in the room. This can thus more easily facilitate personal disclosures and conversations between doctors and patients.
However, in certain instances, face-to-face interpreters are required and definitely preferable. For palliative care and end of life discussions, many NHS trusts call upon the services of on-site interpreters. This demonstrates not only greater respect to the patient, but also allows the interpreter to better support the patient in communicating in what may be a more emotionally charged situation, enabling a more compassionate approach than that afforded by a telephone call.
The NHS’ Investment in Translation
While there is no definitive figure for exactly how much the NHS spends on translation services per year, postulation is rife, with £23 million reported by 2020 Health in 2012, with some even speculating that the costs are much higher. While current provision of translation is highly commendable, there is certainly still room for improvement, such as on the NHS website. Regardless of the cost, with more than 10 main languages and up to 88 other dialects spoken across the UK by patients, the NHS needs to ensure that its provision is fit for purpose in order to continue to protect the health and safety of each and every one of its patients.