Abstract
Background
Communication difficulties due to unmet language needs are a driver of inequality in healthcare access. The provision of professional interpreting services should mitigate these, and their use is associated with improved patient outcomes. However, interpreting uptake in England is suboptimal and there has been limited research focused on understanding patient experiences and the potential impact on uptake. This multilingual study explored patient perspectives of access to and experience of language support in general practice (primary care) in England, including the use of professional interpreting services and informal language support (i.e. family/friends).
Method
This is a qualitative study based on face-to-face semi-structured interviews with 30 participants from South Asian backgrounds (Pakistani, Indian, Bangladeshi), with no/limited proficiency, living in England. Interviews were analysed with inductive thematic analysis. Patient advisors were involved in all aspects of the research and interpretation of the findings was supported by public engagement focus groups.
Results
Three main themes described participants challenges related to uptake of professional interpreting services including 1) the burden of articulating need, 2) prioritisation of different types of language support (professional/informal), and 3) perceptions of professional interpreting services. Participants described an onus on them to arrange interpreting themselves, whilst regular use of informal language support could inhibit offers of professional language support. Online/digital booking systems perpetuated these challenges. Patient illness appraisal impacted decision making, with informal language support prioritised for less serious matters. Patients highlighted the importance of having confidence in these services, and face-to-face interpreting was preferred to remote interpreting.
Conclusions
No/low English proficiency patients need additional support when booking interpreted-assisted appointments. Increasing patient awareness of and confidence in professional language support is vital to uptake of services. Emphasising the benefits of professional support over informal options is important, with links to patient safety. We provide recommendations for general practice in how to support the uptake of professional interpreting services.