GP funding should be reviewed to make sure resources can be adjusted depending on patients’ need for translation or interpreting support, a watchdog has said.
Healthwatch looked at issues faced by ethnic minority groups when trying to access healthcare, and pointed out that a shortage of interpreters means that some people are forced to wait longer for an
appointment.
This contributes to people in ethnic minority groups waiting longer to receive care, the watchdog said.
It proposed a review of GP funding so that it can be adjusted according to people’s needs for translation or interpreting support.
The watchdog’s report said: ‘A significant proportion (1.8%) of England’s population either doesn’t speak English well, or doesn’t speak it at all.
‘Yet we still hear from people who don’t have the tools they need to communicate in healthcare settings.
‘In 2016, the NHS developed the Accessible Information Standard, making it compulsory to offer care and information in accessible formats for people with learning disabilities or sensory impairments.
‘But this doesn’t include translation services for those without sufficient English language.’
Last month, GP practices in Yorkshire were asked by their ICB to change how they use telephone translation services in a bid to save money amid ‘financial deficits’.
West Yorkshire ICB asked GP practices in Leeds and Wakefield to stop using the ‘on-demand service’, opting for a cheaper, scheduled service through which GPs can still organise translation for urgent and last-minute appointments, but these must be booked in advance via a portal.
Leeds LMC ‘raised serious concerns’ about the impact of the changes, saying that they could ‘widen health inequalities’ while also increasing administrative work for practice teams.
The LMC also highlighted that as consultation rates rise, so does the demand for translation services, and that these contracts should be a ‘core part of ICB funding’ rather than ‘subject to wider system financial
pressures’.
Following pressure from the local LMCs and PCNs, the ICB agreed practices are still allowed to use both options.
Dr Richard Vautrey, assistant secretary of Leeds LMC and incoming RCGP president, told Pulse that with practices delivering more appointments than ever before it is not surprising that the cost of translation
services has also increased.
He said: ‘The ICB have significant financial pressures and said they hadn’t got the budget to cover this increased cost.
‘They proposed that practices should pre-book translation services rather than use the on demand service as this was cheaper.
‘However following representation from LMCs and PCNs about the difficulty of doing this and the impact it would have had on workload and widening health inequalities they have listened to these concerns and enabled practices greater flexibility in using both options.
‘It is though clear that the wider NHS needs to provide the proper funding to cover the increased costs of more consultations in general practice and not assume this is a cost-free option.’
In April, a report by the Healthcare Safety Investigation Branch warned that patients who do not speak English are at risk of delayed diagnosis because hospitals do not provide appointment letters in other languages.
GPs also told Pulse that patients often come to them for translation of complicated hospital letters, which adds to their workload.
Last year, the BMA said ethnic minority patients were being ‘failed’ by the NHS, with the NHS Race and Health Observatory highlighting the need to invest in interpreter services for all modes of GP appointments for those who do not speak English.
Healthwatch’s recommendations:
- We support the NHS Race and Health Observatory’s 10 steps hospitals can take to tackle ethnic inequalities in waiting lists.
- We urge NHS providers to investigate any instances of patients being refused access due to ethnicity or symptoms being dismissed. Under the NHS Constitution, patients have the right to access NHS services and not to be refused on unreasonable grounds. They also have the right not to be unlawfully discriminated against.
- Integrated Care Boards should collect and publish data on disparities in waiting times between patient groups, including different ethnicities. This is so providers can understand and address any inequalities.
- Adapt the NHS e-referral system or other care record systems to ensure that people’s communication preferences, including language, are recorded as early as possible.
- Review GP funding arrangements to make sure resources can be adjusted depending on the local population’s need for translation or interpreting support.
- Review Integrated Care Systems’ duties in providing interpreting and translation services.
Source: Healthwatch
“The watchdog’s report said: ‘A significant proportion (1.8%) of England’s population either doesn’t speak English well, or doesn’t speak it at all.”
That is a gross underestimation given the fact that I would say at least 25-50% of first language English speakers don’t speak English well.
The acceptance of this figure belies an ongoing paternalistic approach that patients don’t really need to be involved in their healthcare and so, providing the absolute basics seem to have been (mis)communicated job’s done.