Table 5 Implications for practice based on existing commissioning guidance [33]
Principle | Summary of principle | Key recommendations | Insights/actions from current study |
|---|---|---|---|
1.Access to services | 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. | -Services are free at point of delivery -Services are high quality and accessible -Patients should not be asked to bring their own interpreter -Provide additional time (e.g. double appointments) -Record language/ communication preferences in patient’s records | -Patients to be provided with accessible information about the availability of professional services to raise awareness, alongside improving patient confidence in quality of professional services. -Emphasise the difference between professional services and other types of language support (e.g. family members). -Reassure patients that their family can come even when a professional interpreter is present. -Highlight challenges and risks associated with relying on informal language support. -Support practices to identify language needs and get this right from the first time a patient is registered. -National guidance to support consistent recording of interpreting use in electronic health records. |
2. Booking interpreters | Staff working in primary care provider services should be aware of how to book interpreters across all languages, including BSL, and book them when required. | -Primary care provider is responsible -Should provide name and gender of interpreter -Interpreters should be regulated -Staff training | -Staff to offer professional interpreters proactively and on a regular basis. -Practice to mitigate inaccessibility of online booking systems for patients with language needs. |
3. Timeliness of access | Patients requiring an interpreter should not be disadvantaged in terms of the timeliness of their access. | -Raise awareness (e.g. on registration and through advertising services) -Prioritise timeliness | -Support practices to raise awareness of professional interpreting services (e.g. through electronic screens in waiting rooms, community events). -Resource allocation formulas should take language need into account. |
4. Personalised approach | Patients should expect a personalised approach to their language and communication requirements recognising that “one size does not fit all.” | Account for: -Preferences (e.g. gender, cultural identity) -Choice of modality -Limits of other frontline staff skills to assist patients | -Where possible, patients should be given a choice in the type of language support they are offered (e.g. face-to-face/telephone). -Provide practical steps for clinicians/interpreters to improve communication within the encounter [34]. For example, use the teach-back method to check understanding. |
5. Opportunities to express views (i.e. compliments, comments, concerns and complaints) | Patients and clinicians should be able to express their views about the quality of the interpreting service they have received, in their first or preferred language and formats (written, spoken, signed etc.) | -Enable feedback opportunities -Produce service satisfaction reports -Ongoing monitoring | -Use existing survey tools to capture patient experience [10]. -Optimise mechanisms for patients/clinicians to provide feedback on the quality of interpreting services and in various formats (e.g. not relying on written feedback). |