GPs, dentists, pharmacists and hospitals in North Yorkshire are being urged to do more to help refugees break through the language barrier and access key health services.
Healthwatch North Yorkshire found some refugees seeking medical help were being denied access to interpreters or discouraged from using them, while health professionals often relied on Google Translate – which NHS guidelines say should be avoided due to its lack of accuracy.
With the NHS heavily promoting the Help Us Help You campaign to encourage people to use their local pharmacy as their first port of call for managing minor illness, Healthwatch North Yorkshire looked into whether services were fit for refugees – but found that many attempting to find help from pharmacists will be forced to take their ailments elsewhere.
Volunteers for the charity, which is the independent champion for people using health and social care services in North Yorkshire, carried out a “mystery shopper” investigation at 25 pharmacies across the county, seeking support for a friend whose first language is Arabic – and found only four willing to provide interpreter services. One of the 21 that did not provide services suggested to continue calling around pharmacies until they got a “Muslim pharmacist”.
Public services have an obligation to provide equal access to services as part of non-discriminatory provision, under the Equality Act 2010 and the Public Sector Equality Duty Act 2011. The 2018 “NHS Guidance for commissioners: Interpreting and Translation Services in Primary Care” says patients should be able to access primary care services in a way that ensures their language and communication requirements do not prevent them receiving the same quality of healthcare as others; that staff working in primary care provider services should be aware of how to book interpreters across all languages and that high-quality interpretation and translation should be provided free at the point of delivery. Patients should not be asked to pay for interpreting services or to provide their own interpreter and Google Translate should be avoided.
‘Interpretation’ refers to the spoken word, rather than ‘translation’ which is used for the written word.
Experiences
With many refugees lacking the knowledge or confidence to complain when their experience of services falls short, Healthwatch North Yorkshire is calling for healthcare providers and commissioners to act on a strategic level to ensure services follow NHS guidelines, staff are properly trained and the use of Google Translate is eradicated, among a list of recommendations.
Healthwatch North Yorkshire heard more than 40 refugees in North Yorkshire, conducting focus groups within Refugee Council drop-in services at locations including Ripon, Scarborough, Northallerton, Malton, Harrogate, Richmond and Selby.
People mostly shared their experiences accessing primary care such as GPs, dentists and pharmacists, although some offered stories of their experiences at A&E and at other secondary care services, usually at hospitals.
The report Policy Vs Reality: Interpreting In Health And Social Care Services outlines how some are being refused access to interpreters. Some are being refused access to services unless interpreters are present, yet they are not provided by the service.
Google Translate is often used, often without space for patients to type in their own language, despite its inaccuracy and the fact that guidelines state it should be avoided. Staff and patients alike are not sufficiently aware of interpreter provision, guidance and responsibilities.
‘Significant inequalities’
Where people were regularly provided with interpreters, they often had a better experience and a more positive view of services when they were provided with support they needed to communicate effectively. But people shared how lack of interpreter provision had affected their care throughout their treatment journey from registering at initial access to booking appointments, clinical interventions and written follow-up letters.
They also shared stories about dentists who do not provide interpreters, but will not conduct appointments without them. This leads to patients having to pay for interpreters themselves, having to take unqualified relatives to interpret or having to rely on services like the Refugee Council to provide support.
Nigel Ayre, Operations Manager for Healthwatch North Yorkshire, said: “Our findings show that refugees in North Yorkshire face significant inequalities when it comes to accessing healthcare. NHS guidelines state their communication needs should not prevent them receiving the same quality of healthcare as others, but this is not reflected in the experiences of those we’ve heard.
“The difficulties they can face in accessing interpreters create substantial barriers right through their treatment journey, and we’re hoping to work with service commissioners and providers to ensure changes are made to give them the same quality of care as English speakers.”
Alex Day 