Addressing Linguistic Needs
An MBBRACE report showed that from 2019 – 2021, 5% of maternal deaths were of women who did not speak or understand English.
The leading cause of death was Venous thromboembolism (VTE) followed by haemorrhage, suicide and sepsis.
The HSSIB Intrapartum Stillbirth Investigation from April 2020 to June 2020 reviewed 37 investigations into intrapartum stillbirth and found that 43% of women did not have English as their first language and that the availability of interpreters was a major issue.
Quick Guide for using Interpreter Services:
- Request same gender interpreter
- Introduce yourself and situation
- Ask the interpreter to introduce themselves and you
- Check dialect is correct for the patient
- Explain conversation is confidential, a professional interpreter at no cost
- Ask the interpreter to relay everything you say
- Check the patient consents
- Use simple English
- Speak directly to the patient
- Ensure there’s time to relay the conversation
Considerations for NHS Trusts:
- Accountability
- Training, guidelines and compliance, clear reporting mechanisms
- Suitable services with REGISTERED interpreters
- Support front line workers, allow enough time, consider extra time when calculating work load
- Access to PALS (in a meaningful way) and ALL other services
- Easy access to interpreter information and infrastructure (phones, ipads, video phones etc)
- Suitable alternative for times when interpreters are not available, consider CARDMEDIC?
- Simple English and translated documents, prescriptions, medication instructions, leaflets etc
- Engage with service users, community outreach, ensure accessible feedback, Maternity Voices Partnership, Local Healthwatch.
What can we do on the front line?
- Assess needs & offer interpreting services (open offer)
- Explain why you recommend interpreter services to patient & companions. (Clearer communication in certain complex situations, less pressure on the partner, mother able to attend appointments alone if they choose to, consent needs to come directly from the patient via an official interpreter, ensures partner can advocate for the mother and focus on providing support rather than having to concentrate on interpreting etc).
- Clear documentation of discussion, offer and communication plan. Document interpreter details and pin (if they have one).
- Record needs, so they are included in data and other professionals are aware.
- REPORT IT! Incident reporting. This IS a patient safety issue and can lead to claims of negligence.
- Ask: training, suitable equipment, information, support.
- Advocate for and empower families.
- Sign post to resources such as MAMA Academy and Tommy’s.
- Ask your Trust – who is ensuring the services we have are adequate? Who is responsible for training? Are they considering back ups, Face to Face is the GOLD standard, but telephone based is useful for unscheduled care, what about CARDMEDIC? Use offline in areas where phone reception or internet is poor.
- What about written and email communication? Is this being sent in appropriate language with simple English?
Other Resources:
- Google Lens App for parents to translate documents such as appointment letters and pregnancy leaflets
- Multilingual Pregnancy Resources for parents
- Inequities in Maternity Care: Insights from Amma’s “Birth Outcomes & Experiences Report”
With Thanks to:
Maria Rowntree
Dame Elizabeth Anionwu Fellow for inclusivity in the NHS