Exploring barriers to the use of trust translation services by pharmacy staff
Authors: Jones D , Woods O , Crawford C 
Published: November 2023

Abstract

Introduction
4.1 million people in England and Wales do not speak English as a first language.1 Whilst representing only 7.1% of the population, data suggests this cohort face greater barriers to effective healthcare than native English speakers. One study found they experience twice the rate of medication errors.2 One solution is the use of translation services in healthcare settings. However, national evidence shows service underutilisation.2 Research cites long waiting times, loss of phone connection and translator lack of familiarity with National Health Service (NHS) as contributors.3 Anecdotal data suggests underutilisation of services at Oxford Road Campus (ORC) of Manchester University Foundation Trust (MFT). 18% of ORC patients are not native English speakers, meaning there is a potential risk to patient outcomes if translation services are underutilised.

Aim
To explore the barriers pharmacy staff at ORC of MFT face when accessing the local translation service for patients; where its use would be appropriate and/or beneficial.

Methods
A literature search was conducted regarding use of translation services by healthcare staff and existing barriers to use. An interview proforma was formulated using the literature findings, existing questionnaires, discussions with a University of Manchester research Pharmacist and the group’s aims and objectives. The questions were formulated into the Qualtrics XMTM software. Data was collected using structured interviews to increase capture of qualitative data. The target audience was Trust pharmacy staff with patient contact. The sampling technique was opportunistic and captured 45 respondents. Quantitative data was analysed through Microsoft Excel, whilst qualitative data was analysed using thematic grouping. No ethical approval was required as this was a service evaluation.

Results
97.8% of respondents had encountered at least one patient without English as a first language. Of these, 100% were aware of trust translation services, despite only 7% of staff having received training. Only 25% of participants reported the trust translation service was their primary method for translation. Preferred methods of overcoming language barriers were use of relatives/next of kin or a multilingual staff member. The most reported barriers in order of frequency were time, ease of access and preferring alternative methods. Some participants who had never used the service reported concerns over the accuracy of translation and high costs of the service. 78% of respondents indicated that they would use the service if barriers were rectified. When asked about features of an ideal service, exact waiting times, use without a PIN and dedicated ward phones were the most popular responses.

Discussion/Conclusion
Results obtained show numerous barriers to service use and accessibility. Of note, several staff who reported barriers had never used the service. These perceived barriers often related to factually incorrect views of the service such as cost and accuracy of translation. Thus, training for staff in conjunction with improvements to the service would increase utilisation of the translation service and therefore patient safety. One imitation of our project was that no data exists on number of patient facing staff so it is not possible to quantify the percentage of staff captured.

References
1. Office for National Statistics. Census 2021. [Internet]. 2021 [cited 2023 Mar 14]. Available from: https://census.gov.uk/census-2021-results
2. Bajramovic Fejzic J, Tett SE, Medication management reviews for people from the former Yugoslavia now resident in Australia, Pharm World Sci, 2004 [cited 2023 Mar 14];26(5):271-6. Available from: https://pubmed.ncbi.nlm.nih.gov/15598068/
3. Lehane D, Campion P, Interpreters: why should the NHS provide them?, Br J Gen Pract, 2018 [cited 2023 Mar 14]. p. 564-5. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6255215/