Health Experiences of asylum seekers and refugees: how well are their interpretation needs met? (HEAR 2)
End of project summary
Background: The ability to receive health care in our own language is a requirement of all NHS organisations. A study into Health experiences of Asylum seekers and Refugees in Wales, 2019 (HEAR) revealed concerns around provision of interpretation services in health care. Lack of interpretation services can lead to significant problems with care, such as the wrong diagnosis being made, ineffective treatments being advised, missed appointments, and issues with consent and confidentiality.
Methods: We conducted the HEAR2 study which involved carrying out surveys and interviews with asylum seekers and refugees in Wales to understand their experiences of using interpretation services. We trained people seeking sanctuary in research methods as peer researchers. We also interviewed health professionals and professional interpreters in Wales and conducted a cross UK survey of commissioners of interpretation in the NHS.
Results: There were a number of important findings from this study. These included:
1. Some asylum seekers and refugees faced challenges in accessing interpretation services. The first point of contact can present a real challenge to people in need of interpretation. When received, patients were generally satisfied with professional interpretation during planned visits. There were some concerns around quality of interpretation, lack of choice of gender or dialect of the interpreter.
2. Users of NHS 111 were most likely to have reported they experienced delays due to attempts to access an interpreter.
3. Those with refugee status were more aware of their right to a professional interpreter (154, 79.8%) than those with asylum seeker status (97, 68.8%), particularly those with an unsuccessful asylum application (8, 44.4%).
4. For health professionals, more streamlined processes for accessing interpretation services, additional consultation time and training on working with interpreters would be beneficial.
5. Differences in characteristics of survey respondents, including demographic, language and self-reported quality of life measures, can occur when using different recruitment methods (NHS sites, community links and peer researcher approaches).
6. Coding of asylum status at NHS sites is inconsistent which presents a challenge for further research in this field.
7. Few commissioners sought feedback on NHS interpretation services from patients
8. Criteria for a future UK comprehensive evaluation of interpretation service provision in primary and emergency care were met.
Implications: This study has produced new evidence on meeting the interpretation needs of asylum seekers and refugees with potential benefits in healthcare quality, safety, and physical and mental health outcomes. Results are relevant to wider groups using interpretation. Recommendations have been made for policy makers, the NHS, interpretation service providers and others, with the aim of achieving this. These include the development of commissioning guidance and standards for interpretation in health and care for Wales, simplifying processes to access an interpreter especially for unplanned/urgent care and strengthening ways to feedback on interpretation services from patients and staff. The use of peer researchers in the administration of survey and interview elements of the programme enabled outreach to those who may have been otherwise excluded. The involvement of the third sector throughout the study also proved a strength. HEAR2 has added to the body of evidence in an under researched field.