Interpreters and language support for your appointment

Why language matters in a consultation

A consultation depends on being understood in both directions, and people who speak good everyday English can still find a medical conversation hard in it. UK government guidance on interpreting in health care notes that conversational fluency does not always extend to understanding, discussing or reading health information [1].

The same guidance points to the GMC’s expectation that every possible effort is made to communicate well with patients, including in languages other than English, and records that working with interpreters improves safety in diagnosis and prescribing [1].

What the evidence shows about professional interpreters

Trained interpreters make fewer errors that matter. In a study of 57 recorded visits to two children’s emergency departments, 18% of 1,884 interpreting errors had potential clinical consequences, and the share was 12% with professional interpreters against 22% with ad hoc interpreters such as relatives or untrained staff [2]. Interpreters with at least 100 hours of training made fewer of these errors than those with less [2].

A systematic review of 28 studies found professional interpreters associated with better communication, use of services, clinical outcomes and satisfaction than ad hoc interpreters, bringing care close to or level with that of patients who face no language barrier [3]. The studies differ in setting and design, so they show the direction of the effect more surely than its size in any one clinic.

Family members and children as interpreters

A relative is most useful beside you as support, with a professional doing the interpreting. The government guidance says a professional interpreter should always be offered in place of family or friends, so that interpreting is accurate and impartial and the people with you can help you decide without the pressure of translating [1].

The guidance calls it inappropriate to use children as interpreters, because they rarely have the language or health knowledge for a complicated conversation and can be distressed by what they hear [1]. If you still prefer someone you know to interpret, tell the doctor, who records your choice [1].

How to prepare for an interpreted appointment

Tell us what the interpreter needs to know when you request the appointment, and plan the time around it.

• Give your preferred language and dialect, such as Mandarin or Cantonese, or Farsi or Dari [1]
• Say whether you would prefer an interpreter of a particular gender
• Allow extra time, because an interpreted consultation takes around twice as long [1]
• Bring your medicines and any letters, translated where you can
• Speak a sentence or two at a time, so the interpreter can keep pace [1]
• Say at once if you know the interpreter personally, so that another can be found [1]
• Before you finish, repeat the plan in your own words so the doctor can check it was understood

Consent and translated documents

Decisions that are hard to reverse deserve the most care with language. Principles agreed by UK healthcare regulators ask professionals to obtain informed consent and to explain every option, including declining treatment, in a way the patient can understand [4]. Abroad, the FCDO advises thinking about translation help particularly when you are asked to make important and long-term decisions [5].

For records you carry between countries, copies in English help a new doctor most, and the CDC advises asking for records in English after treatment abroad [6]. Use a professional translator for written documents, and keep the original with the translation.

Who should ask for an interpreter

Ask for one whenever you would think more clearly in another language, whatever your level of English. It matters most for a new diagnosis, a decision about treatment, a conversation about mental health, and care for a child or an older parent. For mental health and other sensitive subjects, the guidance notes that keeping the same interpreter across appointments can help [1].

In an emergency, never wait for an interpreter. Call 999 in the UK or the local emergency number, and say which language you speak [7].

How The Wellness can help

We consult in English and in Arabic, and Dr Adel Elalfy consults in both [7]. For any other language we bring an interpreter, at our standard fee, onto the call before the doctor arrives, and when a doctor comes to your home or hotel in London the interpreter joins by telephone before the visit begins [7] [8].

Our clinics are on Baker Street in Marylebone and Eccleston Street in Belgravia, open from seven in the morning to nine at night every day. Every doctor is GMC registered, every result and letter goes into one record you open from any country, and appointments can be arranged with partners in 12 more cities.