Natalie Liu explains dental professionals’ legal obligations around language barriers and shares some strategies for communication with patients who do not speak English.
The UK is one of the most diverse countries in Europe, with people from different ethnical background contributing to its rich tapestry of languages. According to the 2021 Office for National Statics Census, there are more than 300 languages spoken across the UK. This linguistic diversity reflects the multicultural makeup of the population, with immigration playing a significant role in shaping the country’s demographic profile.
Language diversity in the UK
In the census data, 92% of the UK population reported speaking English as their main language. Other commonly spoken languages include Polish, Punjabi, Urdu, Arabic, Bengali, Somali and Turkish.
English proficiency varies for the remaining 8% of the UK population, with 2.5% of the population who cannot speak English at all. This equates to approximately 1.7 million people in the UK.
The data also showed that the proportion of people who cannot speak English varies significantly across different regions and demographic groups. In some areas with high levels of immigration, such as London, Birmingham and Manchester, the percentage of people with limited English proficiency may be higher.
Given the presence of a significant number of people with limited or no English skills, dental practices in the UK, especially in multicultural cities, need to be prepared to address language barriers to ensure clear communication and effective care.
The impact of language barriers in dentistry
Effective communication is fundamental to providing quality care, and any breakdown in communication can lead to misdiagnosis, misinformation about treatment plans and reduced patient experience. A language barrier is also a barrier to healthcare access, resulting in poorer health.
Overcoming language barriers can foster trust, improve patient outcomes, and ensure every patient receives the best care possible – regardless of their linguistic background.
Legal requirements
The General Dental Council Standards for the Dental Team 2.3.35 states that ‘it is your responsibility to recognise patients’ communication difficulties and you should try to meet each patient’s communication needs where possible’.
What language support are you obligated to provide?
In NHS England’s guidance for commissioners, it stipulates the following:
- Professional interpreters should always be offered
- Children should not be used as interpreter
- An interpreter should be present where there are concerns about child safety or gender-based violence
- Automated online translating systems or services such as Google Translate should be avoided in healthcare settings.
The Equality Act 20107 also stresses:
- All service providers to take steps to make ‘reasonable adjustments’ to avoid putting a disabled person at a substantial disadvantage
- Information must be provided in ‘an accessible format’
- In the exercise of its functions, must have regard to the need to reduce inequalities between patients with respect to
- Their ability to access health services
- The outcomes achieved for them by the provision of health services.
NHS service providers, including partial private dental providers, must also comply with the Accessible Information Standard (AIS). The AIS ensures people who have a disability, impairment or sensory loss are supported with their communication needs.
Strategies for overcoming language barriers
To ensure that language differences do not impede the delivery of quality dental care, dental practices must adopt strategies and tools that foster effective communication. These strategies include the use of professional interpreters, leveraging technology, and cultivating a culture of inclusivity.
1. Professional interpreters
Interpreters are trained to ensure accuracy and avoid misunderstandings. Professional language interpreters should hold relevant qualifications, have appropriate insurance and have an enhanced disclosure from the Disclosure and Barring Service.
British sign language (BSL) and English interpreters should be registered with the National Registers of Communication Professionals working with Dead and Deafblind people. Apart from face-to-face interpreting, many dental practices access on-demand telephone or video interpreting services.
It’s important to note that while family members or friends might offer to translate, this practice can sometimes lead to inaccuracies, misinterpretations, or omissions. Particularly when it comes to complex medical terminology. However, in emergency situations, family members or friends, or bilingual staff may interpret for a patient if an interpreter cannot be arranged.
2. Preparing information in languages aside from English
Many dental practices now offer websites or patient portals that provide information in multiple languages. This can be especially useful for new patients who need to understand office policies, treatment options, and payment processes before even stepping into the office. By providing written materials in various languages, practices can ensure that non-English-speaking patients are better prepared and informed.
The NHS website, as well as many professional dental organisations, provide health resources in other languages. For example, the Oral Health Foundation website contains a variety of oral health information for patients in 10 different languages. The British Society of Paediatric Dentistry also has patient information leaflets in multiple languages available to download.
3. Using visual aids and demonstrations
Visual aids can be employed to allow patients to better understand procedures and instructions. Pictures, diagrams, 3D models, or even videos can help explain the procedure. They can be used to communicate treatment plans, post-operative care, and preventive instructions. Videos may be available in multiple languages but there needs to be quality assurance process to ensure information is accurate.
4. Cultural competency training
Cultural competency refers to the ability to understand, communicate with, and effectively interact with people across different cultures. This includes understanding the importance of cultural norms, values, and beliefs that may impact a patient’s approach to healthcare.
Cultural competency training also includes educating staff on potential health disparities that specific groups may face. A culturally sensitive approach can help build trust and encourage these patients to seek regular care.
Conclusion
In this increasingly globalised world, embracing diversity and communication accessibility is essential in ensuring all patients receive high-quality care. Overcoming language barriers can foster trust, improve patient outcomes, and ultimately minimise health inequalities and their long term impacts on oral health.
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