Abstract
BackgroundWith increasing globalisation, the challenges of providing accessible and safe healthcare to all are great. Studies show that there are substantial numbers of people who are not fluent in English to a level where they can make best use of health services. We examined how health professionals manage language barriers in a consultation.Methods and FindingsThis was a cross-sectional study in 41 UK general practices . Health professionals completed a proforma for a randomly allocated consultation session.Seventy-seven (63%) practitioners responded, from 41(59%) practices. From 1008 consultations, 555 involved patients who did not have English as a first language; 710 took place in English; 222 were in other languages, the practitioner either communicating with the patient in their own language/using an alternative language. Seven consultations were in a mixture of English/patient's own language. Patients' first languages numbered 37 (apart from English), in contrast to health practitioners, who declared at least a basic level of proficiency in 22 languages other than English. The practitioner's reported proficiency in the language used was at a basic level in 24 consultations, whereas in 21, they reported having no proficiency at all. In 57 consultations, a relative/friend interpreted and in 6, a bilingual member of staff/community worker was used. Only in 6 cases was a professional interpreter booked. The main limitation was that only one random session was selected and assessment of patient/professional fluency in English was subjective.ConclusionsIt would appear that professional interpreters are under-used in relation to the need for them, with bilingual staff/family and friends being used commonly. In many cases where the patient spoke little/no English, the practitioner consulted in the patient's language but this approach was also used where reported practitioner proficiency was low. Further research in different setting is needed to substantiate these findings.
Highlights
Overcoming language barriers to health care is a global challenge [1,2,3,4]
It would appear that professional interpreters are under-used in relation to the need for them, with bilingual staff/family and friends being used commonly
Within one health authority, the Heart of Birmingham Teaching Primary Care Trust (HOBtPCT), the Black and minority ethnic communities are in the majority comprising 71% of the population in the 2001 Census [9]
Summary
Overcoming language barriers to health care is a global challenge [1,2,3,4]. In the US about 22 million residents are unable to speak English fluently, with over half of these non-English speakers speaking Spanish and 15 million people speaking 24 different languages [5]. The UK is a diverse society with 7.9% of the population from the Black and minority ethnic groups [7] This is a heterogeneous group with different migration and settlement patterns, culture, religion, and languages spoken. Within one health authority, the Heart of Birmingham Teaching Primary Care Trust (HOBtPCT), the Black and minority ethnic communities are in the majority comprising 71% of the population in the 2001 Census [9]. At the health authority level the number of non-English speakers is not known though the Birmingham Integrated Language and Communication Support Service provided interpreters for 30,000 consultations at a cost of over £1,000,000 in 2007/8 and this is expected to rise substantially over the few years with new migrants from the expanded European Union. We examined how health professionals manage language barriers in a consultation
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