Abstract
Background: Language barriers in primary care contribute to health inequalities, limiting access to services and affecting patient outcomes. Professional interpreting services are emphasised in UK guidance, but evidence on how policymakers and commissioners deliver these services is lacking. This study aimed to explore the commissioning and implementation of interpreting services in UK primary care from the perspectives of commissioners, policymakers, interpreters and interpreting service providers.
Methods: Semi-structured interviews were conducted with 31 participants (12 national policymakers, 6 commissioners, 7 interpreters and 6 interpreting service providers). Thematic analysis was conducted to explore delivery and identify best practices and key challenges in delivery.
Results: The study found variation in commissioning models, with some areas favouring large national providers for widened scope and cost efficiency, while others prioritised local interpreting services for higher quality. The UK was seen as world-leading in interpreting provision, however fragmentation, lack of standardisation, accountability gaps, funding constraints within a publicly-funded healthcare system, and varied interpreter competencies and renumeration led to inconsistency in delivery. The healthcare sector was reported as having lower interpreting standards compared with other UK public sectors. Technological solutions were used in delivery and offered key advantages but sometimes failed to meet patient and provider needs.
Conclusion: Strengthening national regulation, funding allocation, and service integration is essential to addressing systemic issues and improving interpreting service delivery in UK primary care. Policy recommendations include promoting ‘what good looks like’, standardising interpreter qualifications and adopting approaches tailored to local population needs.