https://www.bbc.co.uk/news/uk-england-bristol-66605536
21st November 2023
NHS interpreting service
problems contributed to patient deaths
The BBC has found interpreting issues
were a contributing factor in at least 80 babies dying or suffering serious
brain injuries in England between 2018 and 2022.
Some staff have resorted to online
translation tools to deliver serious news to non-English speaking patients.
NHS England said it was reviewing if
and how it could make improvements.
Rana Abdelkarim and her husband Modar
Mohammednour arrived in England after fleeing conflict in Sudan, both speaking
little English.
It was supposed to be a fresh start
but they soon suffered a devastating experience after Ms Abdelkarim was called
to attend a maternity unit for what she thought was a check-up.
In fact, she was going to be induced, something Mr Mohammednour said he
was completely unaware of.
"I heard this 'induce', but I don't know what it means. I don't
understand exactly," he said.
Mr Mohammednour said he was promised a phone call from the hospital to
let him know when his wife was ready to give birth so that he could be there
with her but that call never came.
His wife suffered a catastrophic bleed which doctors were unable to stem
and she died after giving birth to her daughter at
Gloucestershire Royal Hospital in March 2021.
"They called me and said to me, 'you have to come hospital very
quick' and then he said 'we tried to keep her alive but she's passed
away'," the father-of-two said.
Mr Mohammednour now looks after his
two daughters alone, the youngest of which is named after her mother, Rana.
He said better interpreting services
would have helped him and his wife understand what was happening.
"It would have helped me and her
to take the right decision for how she's going to deliver the baby and she can
know what is going to happen to her," he added.
The Healthcare Safety Investigation
Branch (HSIB) found there were delays in calling for specialist help, there was
no effective communication with Ms Abdelkarim, and the incident had traumatised
staff.
Gloucestershire Royal Hospitals NHS
Foundation Trust has apologised and said it had acted on the coroner's
recommendations to ensure lessons have been learned to prevent similar
tragedies.
It added it was committed to
delivering the safest possible service.
Serious interpretation
failures
Under the 2010 Equalities Act, people who don't speak English have the
right to be provided with an interpreter when they are dealing with public
sector organisations in instances such as asylum applications and social
services.
The National Register of Public Service Interpreters said "poorly
managed" language services were "leading to abuse, misdiagnosis and
in the worst cases, deaths of patients".
It was Ms Abdelkarim's death which led the BBC to write a Freedom of
Information (FoI) request to HSIB which revealed serious interpretation
failures are linked to about 80 babies coming to harm.
The BBC's File on 4 programme asked HSIB to review
all investigations from 2018-2022 that involved cases of babies dying or being
diagnosed with a severe brain injury in the first seven days of life.
The FoI found that of the total 2,607 reviewed cases, 80 included
references to interpretation or communication problems due to language
difficulties in the recommendation section of the report, which it therefore
considered to be a contributing factor to death or brain injury.
The data came as no surprise to Prof
Hassan Shehata from the Royal College of Obstetricians and Gynaecologists who
said there is a disproportionate risk of poor birth outcomes in women of
colour.
He said the service was "failing
some of the most vulnerable people in society".
"Add to that the language
barriers, which will further exacerbate the risk with women struggling to
access, engage with maternity services and communicate their concerns to
healthcare professionals," added Prof Shehata.
When Rula (not her real name) woke in
hospital the day after giving birth to her first child, she was shocked to
learn her womb had been removed.
She had suffered a life-threatening
bleed shortly after labour at the Princess Royal Maternity Hospital in Glasgow
in April 2022.
Staff could not initially contact a
telephone interpreter for Rula, who is from Syria, and spent 15 minutes using
Google Translate to try to make her understand she was going back to theatre
for the emergency operation, before a phone interpreter was found.
She said: "Sometimes I could
understand them, sometimes I couldn't. But I begged them, please don't remove
my uterus."
When Rula woke the next day an
interpreter had been summoned to deliver the devastating news in person.
"Because most interpreting services was provided over the phone, I
couldn't understand them. They couldn't understand me," she added.
NHS Greater Glasgow and Clyde said a
telephone interpreter had been made available throughout her labour but it
appreciated this had been "extremely challenging" and it would like
to apologise for any concerns she experienced.
It said it was "not routine to
use face-to-face interpreters due to Covid", adding her claims were
investigated but not upheld.
Rula, who had wanted more children,
now wishes she had been sent an interpreter the day before. She has been left
wondering if it could have made all the difference.
Mike Orlov, told the BBC the level of
qualifications in the profession varied hugely, making standards
"extremely patchy".
Mr Orlov has likened the NHS to the
"wild west", where all trusts are encouraged to operate their
language service needs independently and there are many instances where family
members or friends are deployed in hospitals.
NHS England said the service was vital
for patient safety and a review would identify if and how it can support
improvements in the commissioning and delivery of services.
BBC Radio 4 - File on 4, Lost in Translation
