The impact of real-word experiences in shaping translation and interpreting services

Last week saw the publication of NHS England’s (NHSE) new Improvement framework: community language translation and interpreting services.  

This framework aims to ensure the NHS delivers reliable, high-quality translation and interpreting services for people with limited English proficiency. It is a practical guide for use throughout the NHS, including by NHS trusts and integrated care boards (ICBs), on how best to commission and use translation and interpretation services across different care settings. 

As part of the research for the framework, National Voices was commissioned by South Central and West Commissioning Support Unit to develop work that would then input into the overall Improvement framework led by NHS England’s Health Inequalities Improvement Programme. As part of our in-depth qualitative research, we determined six areas of concern with a resultant seven recommendations. You can read more about the final report and the communities who shared their real-world insights, here.  

We are delighted to see the extent to which the NHSE’s Improvement framework’s final five areas of action, and its following recommendations for different parts of the NHS, mirrored our own report findings. 

Across both resources, there is a clear recommendation for consistent, high-quality translation and interpreting services across health settings, highlighting professional standards and the use of appropriately qualified interpreters. There is an equal push regarding the importance of working in partnership with local communities, patients, and service users to ensure that services reflect real language needs and cultural contexts, in tandem with the collection and use of data to better understand language needs and locally identify gaps to inform planning and commissioning. 

Each resource also highlights the importance of training for healthcare staff in the effective use of language services and raising awareness about the availability and importance of these services. There is also clear recognition that health and care information (written and digital) should be available in accessible formats and languages, tailoring communication to meet diverse community needs. 

The importance of regularly monitoring and evaluating the effectiveness and impact of translation and interpreting services is also echoed in both documents, with recommendations to use feedback for continuous improvement. This is inclusive of accountability at senior level for ensuring these services work well. 

We are especially pleased to see recognition of our work around: 

1. Cultural sensitivity and rights, with explicit recognition of the negative experiences shared with us during our research by those with limited English proficiency. We called for collaboration with communities in coproducing and improving interpreting services and other equity-focused measures, ensuring cultural sensitivity and inclusivity, which has been recommended within the framework, alongside the need to ensure staff and patients are aware of patients’ rights to access services. 
2. Acknowledgement that those with limited English proficiency are more likely to live in the most overall deprived 10% of neighbourhoods in England and therefore face higher risks of being digitally excluded. Whilst we appreciate the shift from analogue to digital in the three-shifts, we must give careful consideration to those who are digitally excluded. We were pleased to see our concerns around the limitations of AI will be further interrogated through a national policy briefing in this area.  
3. The need for ensuring patients’ language needs, preferences about the gender of interpreters, and other communication preferences are accurately recorded in patient records.  

Whilst we have only dug into a handful of recommendations in the framework in the above, we are pleased to see that National Voices work has clearly made a huge impact. This was only possible thanks to the community organisations who supported us in our research, and their beneficiaries who so openly shared their experiences with us.  

Sharon Brennan, Director of Policy and External Affairs, National Voices, said:  

From an elderly patient in the Polish focus group who had relied on their 10-year-old grandchild to translate for them during diagnostic scans; to the mother in the Somali focus group unable to consent to her daughter’s care during a three-night hospital stay; and participants in the people seeking asylum focus group scared to advocate for their rights due to their migration status – each voice made a real difference to the impact of the work we produced.  

We are delighted that NHS England has worked hard and with commitment to develop an Improvement Framework that sets a pathway for addressing their basic access needs to health and care services.