Lost in translation
Pharmacies are breaking through the language barrier where English is not their patients' first language
With the number of patients not speaking English as a first language on the rise, Emma Weinbren discovers how pharmacies are breaking through the language barrier
C+D pharmacy pioneers | How to run a translation service | The industry view
In an increasingly multicultural country, it comes as no surprise that the NHS is now spending £23 million a year on translation services for UK residents who do not speak English. It's a trend that shows no sign of slowing – the government's latest education figures showed 17 per cent of primary school pupils do not speak English as a first language, and areas such as Hackney in London report more than 100 different languages are being spoken at home.
It's an issue that many pharmacies, especially those serving large ethnic populations, must address – if dosage instructions or health advice are lost in translation, the consequences are undeniably serious. So how can pharmacists ensure they get the right message across?
Crossing the language barrier
One pharmacy taking the lead is Green Light pharmacy in Euston, London, which serves a large Bengali-speaking population. After discovering many patients didn't understand health information, it decided to recruit Bengali speakers to provide a translation service.
The move yielded results almost immediately, as a questionnaire into the population's health beliefs yielded some "disturbing" results. "We got people who thought it was a good idea to detox from their medication for a few days, and many didn't take their medicines during Ramadan," explains Nihel Choudhury, a Bengali speaker who joined Green Light as a technician in 1999. "I've also seen people who think diabetes will go away and they don't understand that it's there for life."
After seeing the extent of the problem, the pharmacy decided to take action. It held a health talk translated into Bengali to address some of the area's most common health problems, which attracted a large response from the local community.
Word soon spread that there were Bengali speakers in the pharmacy, which prompted an increase in business. Staff acted as translators for the pharmacists and talks in Bengali became a regular event, fostering ties with the community, building a loyal customer base and making sure health needs were addressed.
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Building a customer base
Patients now see the pharmacy as a hub for health advice, says Josie Nakos, Green Light's health community project co-ordinator in the west Euston area. "It was extremely important to us that people could come in and talk to us about their issues, as the language barrier had created a lot of local health inequalities," she remembers. "We wanted to create a place for the community where people felt they were understood."
This has made Green Light an important point of contact for the local population – patients now come to the pharmacy to discuss health issues with the staff or even each other, helping to tackle local health needs.
Ms Nakos cites diabetes – a particularly common but misunderstood problem among the local population – as an example. An evaluation of the translation service revealed that the pharmacy had helped patients manage the condition.
"We give out questionnaires a couple of times a year and most people say they know a lot more about managing their diabetes. We ask them about what foods are appropriate and what to do if they are sick, for example, and a lot of the responses are now correct," Ms Nakos says.
And this understanding is proving the key to battling health inequalities in the area. "We try to make our talks patient-led, so we ask people what they want to know more about – it can be simple things like how a medication works or how the heart works," Ms Nakos explains.
"In the end, if you understand your health, you're more likely to take advice on board."
C+D pharmacy pioneers
Who Green Light Pharmacy, Euston, London
The problem Large population of non-English speakers, making communication difficult
The solution Recruited native Bengali speakers to translate for pharmacists
The result Improved ties with community and increase in patients visiting the pharmacy for advice; improved understanding of conditions such as diabetes
How to run a translation service
Green Light pharmacist Simon Harris gives his top tips for making a translation service work in your pharmacy Do...conduct research Before starting a translation service, Green Light looked into what the local population needed. "We did questionnaires to find out if there was a need for Bengali speakers, or whether anyone else was providing the same thing," Mr Harris explains. "We made sure we weren't duplicating anyone else's work – as a result, we've linked up with other schemes in the area and pooled our resources." Don't...assume you need a big budget News of the NHS's £23 million spend on translators may lead some pharmacies to believe they can't afford a translation service.
But Green Light started its service without splashing the cash – instead taking on pharmacy staff who already had language skills and holding talks in the pharmacy. "What's quite amazing is we had no money or funding," Mr Harris recalls. "We just used the top floor of the pharmacy to give talks, and employed staff who already spoke Bengali." Do...have a back-up plan While Green Light employs more than one staff member with language skills, there are still days when no one is available to translate. This can cause problems if you don't have a back-up plan, Mr Harris warns. "Some patients who come here only know how to say ‘hello' and ‘thank you', so it can be impossible to communicate," he tells C+D.
"When they don't understand what I'm saying, they will often just nod, and it's easy for us to think they understand. We've all learned how to say a few basic things in the language and we can also ask them ‘can you explain this?' to check whether they've understood." Don't...assume all healthcare providers offer the same service You may provide a comprehensive translation service, but that doesn't mean the patient gets the same treatment from their GP or hospital.
Mr Harris says Green Light employees often have to help patients with their other healthcare providers.
"People come in and ask us to book an appointment for them at their GP. We will then call the surgery and tell them they'll need a translator," he explains.
And the language barrier can create further problems. "Often there are dosing mistakes – one person was on an arthritis drug and we asked to see their dose monitoring book. The dose had been changed from 17.5mg weekly to 15mg, but the prescription hadn't been updated," Mr Harris remembers. "It turned out the woman hadn't understood her dose had been changed and if she'd carried on with the higher dose, she would have suffered more side effects."
The industry view
Leyla Hannbeck, head of information services at the NPA, gives her verdict on translation services "If a pharmacy is located in an area that serves large ethnic populations, it can be beneficial for the pharmacist to offer their patients the chance to speak in their first language.
"This can build up a good customer base and can be very important for medicines optimisation and health improvement interventions.
"When hiring a member of staff to act as a translator, the responsible pharmacist should make sure any advice given to patients is correct and within the staff member's ability, and that the team member is acting as a translator in conjunction with the pharmacist rather than providing independent advice."
Tips for your CPD entry on translation services Reflect What are the largest ethnic populations served by your pharmacy? Plan Make a list of the different languages used and how you can improve communication. Act Put your plan into action using advice from this article. Evaluate Have you improved pharmacy services to your area?
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What does your pharmacy do to assist patients of different ethnicities? Comment below or email us at [email protected] You can also find C+D on TwitterLinkedIn and Facebook |
