Why innovations like ours are needed
A short article on the facts and figures as to why innovations like those we are working on are needed.
2 min read
The World Health Organisation published a paper in 2022 revealing that refugees and migrants have worse healthcare outcomes than host populations, calling for solutions for what they referred to as a ‘global health priority’.
An important cause for this disparity were language barriers. Language barriers cause inequity in care and worse outcomes for patients as well as healthcare professionals (HCP) (Shamsi et al, 2022). In England and Wales alone, 5.1 million (8.9% of population) do not consider English their first language (Consensus, 2021). Ideally such patients would be offered professional interpreters (GMC, 2023). Unfortunately, interpreters are expensive (Inbox Translation, 2022) and underused (Whitaker et al, 2022). Despite this, the NHS spent an estimated £65.9 million on language services including interpreters in 2021, almost 10% of total NHS spend (Language Services Report, 2021). Supplementing the use of expensive professional services is an over-reliance on family members which can be dangerous and detrimental to patient outcomes (Rimmer, 2020).
Consenting for a medical/surgical procedure, for example, is an important part of many patients’ healthcare journey. Valid consent requires the patient to have capacity and their decision to be informed and voluntary (NHS, 2022). A patient is entitled to prosecute for battery if these stipulations are not met (UK CEN, 2022). In 2021 medical negligence cases cost the NHS £2.2B (Department of Health, 2022) of which 19% were due to communication failures (NHS, 2022).
Public Health England recognise the importance of clear and accurate communication between a HCP and patient, advising against the use of untrained interpreters. Since a fluent HCP is unlikely to be trained in medical vernacular, although able to assess capacity they cannot guarantee the provision of accurate information. The use of family members increases the additional risk of coercion or omitted information (Rimmer, 2020). Both can lead to patients who are unaware of what is being discussed and agreed upon with regards to their healthcare including potentially dangerous procedures or medications.
Inequity of healthcare is not limited to consultations and the consenting for procedures. Medical trials recruiting patients need to be able to communicate effectively to enrol patients and follow the same vigorous process when consenting as do HCP when consenting for a medical procedure.
The future of medicine has been so-called dubbed ‘precision medicine’ with drug development and investigations targeted to the individual rather than the masses (Johnson, 2021). With a disproportionate recruitment of English-speaking Caucasian people however, medicine has remained biased towards advancing research to suit Caucasian physiology (Adigbli, 2021). In the UK only 12% of research recruits non-fluent English patients despite 19% of the population having low English proficiency (LEP), (NICE, 2022; Census, 2021), a proportion that is worse in the USA where these figures are 3.95% and 42.2% respectively (Ma et al.,2021; US Census, 2021).
By not addressing these issues, healthcare systems are being complicit in providing a significant proportion of society substandard healthcare. Those who suffer are people with LEP, often disproportionately represented by the lowest socioeconomic groups already suffering from several healthcare barriers (King’s Fund, 2022). Such barriers lead to 3.6x more deaths from avoidable causes in this vulnerable group (King’s Fund, 2022).