Lack of interpreters can impact GP care

Dealing with patients who have limited English proficiency is now an issue for most GPs and this can present major challenges to the level of care provided, a recent study has highlighted.

According to figures from the Central Statistics Office (CSO), almost 14% of people living in Ireland in 2022 were non-Irish nationals. While the majority speak English well, the 2016 Census shows that over 86,000 people consider themselves to speak English “not well” or “not at all”.

The study carried out on behalf of the Irish College of General Practitioners (ICGP) aimed to evaluate the experience of GPs who are managing patients where there is a language barrier. It involved a survey carried out in 2021 and 2022 of 134 GPs and GP registrars currently working in Ireland.

The survey revealed that 19% of GPs felt that a language barrier impacted a consultation on a daily basis, while 37% felt that it impacted on a weekly basis.

When asked which methods of interpretation they used with patients with limited English, 20% said they used a formal interpreter, 90% used family members of the patient, 75% used friends of the patient, 61% used Google Translate and 5% used bilingual staff members.

Worryingly, 83% of respondents said they could recall an incident where a language barrier adversely affected patient care.

The survey also noted that just 33% of GPs knew how to arrange a formal interpreter and 84% would be interested in education around migrant health.

One GP said that the lack of access to translation services “is particularly dangerous for women”.

“We screen for domestic violence as policy in our practice. We have made it policy to pay for a translator for one antenatal consultation per pregnancy because otherwise it was almost always their husbands who translate,” they explained.

The researchers said that the findings demonstrate a dependence on informal and untrained interpreters, as well as online translation services. GPs believe this is having an adverse impact on patient care and this is therefore potentially a patient safety and medico-legal concern.

They pointed out that the provision of formal interpreters in primary care is variable, with some community health organisations (CHOs) funding them and others not.

The quality and availability of interpreting services can also be an issue as the interpreter may not be trained in healthcare interpreting.

The researchers suggested that the healthcare system needs to adapt to the needs of patients with limited English proficiency. GPs and their staff need practical and educational support to look after these patients as efficiently as possible, they added.

Details of this study are published in the ICGP journal, Forum.