University Hospitals of Leicester NHS Trust
Interpreting and Translation report 2012.
1.0 Background
The interpreting and translation service remains the most important component of a
positive patient experience for those patients who need communication support. In all
engagement activities undertaken with Black and Minority Ethnic (BME), deaf and visually
impaired patients interpreting and translation services are always cited as the number one
factor in terms of a positive hospital experience. Given the demographic profile of
Leicestershire it’s therefore imperative that we get this right. We are also legally obligated
under the Public Sector Equality Duty 2010 to ensure that our hospitals are fully accessible
for all of our patients and the provision of a high quality communication service is an
essential element that demonstrates compliance with the Act.
Population data
The University Hospitals of Leicester (UHL) serves a diverse community. The 2011 census
data released in December 2012 by the Office of National Statistics (ONS) indicates that:

White British people now form less than half of the population of Leicester. Figures
for 2011 show that 45% of the city’s residents describe themselves as White British
compared with 61% in the 2001 Census.

In Leicestershire 89% of the population is White British. This is higher than the
national average which is 80%.
1.1 Country of birth
In addition to ethnicity, data was collected on respondent’s country of birth. This is a more
reliable predictor of the possible need for language support.

The data shows that 66% of the city’s residents are now recorded as being born in
the UK (compared with 84% nationally).

28% of the population are people born in other countries and is significantly higher
than the national average of 9%.

5% of the city’s population were born in other EU countries; 10% were born in Africa
(this includes East African Gujarati residents) and 17% are recorded as born in the
Middle East and Asia.
1.2 Household language
Data on is also a useful indicator when planning and resourcing interpreting and
translation services for the Trust.
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
The 2011 data shows that in the city, 18% of households currently have nobody who
speaks English as a main language. This compares with just 4% nationally. This
makes Leicester the eighth highest percentage in England and Wales.

In 70% of city households every occupant speaks English as their main language.
The national average is 91%.
Although many individuals become fluent in English it is very common at times of
personal crisis, such as ill health that people revert to their mother tongue and require
interpreting services to help them when they are at their most vulnerable.
In addition to spoken language support there are also many people who use our services
that have sensory disabilities who require communication support. It is estimated that
within Leicester, Leicestershire and Rutland:
 6,000 people are blind & partially sighted.

5790 people are registered as deaf or hard of hearing.
National evidence suggests that the actual figure of people who suffer with sensory loss is
much higher but individuals do not ask for support and therefore are not captured within
registered figures.
 Approximately 80% of people with learning disabilities will have difficulties
communicating.
This data clearly shows that if the Trust is to provide equitable access to all of its services
and allow individuals to be fully involved in discussions and decisions about their NHS
care a responsive and robust interpreting and translation service is essential.
2.0 Service provision
In 2009/10 the Trust joined a procurement process facilitated by NHS re:source
Collaborative Procurement Hub to procure interpreting and translation services on
behalf of twenty three East Midlands NHS Trusts. Problems with our existing
suppliers being able to meet increasing demand and inconsistency within the
provision prompted the change. We also hoped to achieve greater service
efficiency, higher quality, cost effectiveness and ease of access.
The contract was awarded to Pearl Linguistics and commenced in January 2011.
The contract will be re tendered in 2015.
2.1 Service Improvement
The service improvements already realised are:





A more responsive service with cover twenty-four hours a day, including bank
holidays and weekends.
Increased language coverage of up to 90 different languages/dialects
including all languages spoken in Leicester and Leicestershire.
A quicker turnaround time for patient information, medical record translation
and research materials.
Improved management reporting, evaluation and invoicing methods helping
the Trust to improve service planning and delivery and identify any areas for
improvement.
A mid contract cost saving.
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3.0 Headline Usage figures for 2012.
 The cost of interpreting and translation services in 2012 was £ 354,260; this represents
0.05% of the Trust overall yearly budget.
 The average cost is £29,521 per month
Figure 1. Monthly Expenditure by Service Jan - Dec 2012
Interpreting
£40,000
Translations
£35,000
£30,000
Telephone Interpreting
£34,206
£32,738
£27,202
£26,472
£31,361
£29,141
£27,434
£26,801
£29,179
£28,850
£25,340
£26,223
£25,000
£20,000.
£15,000
£10,000
£5,000
£0
£121
£276
Jan
6
£106
£490
Feb
£93
£263
3
March
£174
£635
April
£965
£63
£343
May
£534
£409
£396
June
£386
£517
July
Aug
£1,299
£361
Sept
£473
£391
Oct
£369
£270
Nov
Dec
* All totals have been rounded to the nearest pound.
Figure 2. Total expenditure by Division Jan – Dec 2012
£120,000
£100,000
£80,000
£60,000
£40,000
£20,000
£0
Acute Care
Clinical Support
Corporate
Planned Care
Womens &
Childrens
Total Interpreting and Translation costings for 2012

£380
In total the trust provided 5972 Interpreting sessions.
 of these sessions 92% were provided face to face.
 of these sessions 8% were conducted by telephone.
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Figure 3. The number of interpreting bookings both face to face (F2F) and telephone
(TI) that took place at UHL in 2012 per month.
Total No. of Bookings Jan - Dec 2012
600
517
512
500
432
447
460
409
476
463
440
402
514
394
400
F2F
300
TI
200
100
32
57
35
59
39
42
52
41
May
June
July
Aug
42
38
37
32
Oct
Nov
Dec
0
Jan
Feb
March
April
Sept
This represents an increase of 18% on 2011 data demonstrating greater use of the service.
The breakdown of figures demonstrates an increase in face to face sessions with a decline
in telephone usage.
 5% of patients which equates to 259 sessions did not attend (DNA) their appointment
Figure 4. Number of booked interpreter sessions when patients did not attend
appointments per month.
Patient Did Not Attend Jan - Dec 2012
45
40
35
30
25
39
30
28
21
20
15
20
21
19
16
15
16
18
16
10
5
0
Jan
Feb
March
April
May
June
July
Aug
Sept
Oct
Nov
Dec
 In addition to this a further 262 arranged interpreting sessions were cancelled by us with
less than 24 hours notice resulting in charges to the Trust
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Figure 5. Number of charged late cancellations by type in 2012.
40
35
30
25
20
15
10
5
0
Jan
Feb
March
April
Admin cancellation
May
June
July
Clinic cancellation
Aug
Sept
Oct
Patient cancellation
Nov
Dec
Patient DNA
NB: Breakdown of Late cancellations in January and February unavailable due to method of recording. Total
late cancellations in January are 23 and in February are 29.
The combination of patient DNA’s and late cancellations costs the Trust an average of
£1,500 per month in interpreter fees.

Fifty five languages were provided for during 2012. The top ten of which can be seen
in Figure 6. This represents a 16% increase in language coverage from 2011.
Figure 6. Top 10 languages interpreted during face to face sessions.
Top 10 Face to Face Languages Jan - Dec 2012
900
800
700
846
600
500
400
300
324
260
197
200
100
175
161
113
93
91
65
0
Gujarati
Punjabi
Polish
Slovak
Hindi
Somali
Russian
BSL
Chinese
Kurdish
(Mandarin) (All)
The top four interpreted languages remain unchanged from 2011 with Gujarati remaining
top. In 2012 Russian and Chinese (Mandarin) now appear in our top 10 interpreted
languages with Bengali and Farsi falling out.

Thirty-four documents were translated into an alternative format for patients
including, foreign language, Braille and large print, further increasing the number
already available within the Trust. The total cost for these was £4566.
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5.0 Service Evaluation
We have completed a patient evaluation of our current spoken language interpreting
provision and will shortly undertake a similar evaluation with patients that communicate
using British Sign Language (BSL).
5.1 Method
The Evaluation was carried out over a three month period, with evaluation forms translated
into the top 16 spoken languages identified within the Trust by our provider at no cost. All
patients who had utilised an interpreter were approached unless the nature of the meeting
was particularly sensitive or the patient was distressed.
A total of 118 responses were received, this equates to a 14% response rate (exact figures
of questionnaires given out are unavailable). Figure 7 demonstrate the preferred language
spoken of respondents.
Figure 7. Preferred language spoken by respondents
Language Returns
70
60
60
50
40
36
30
20
10
5
4
4
3
2
2
1
1
Latvian
English
0
Gujarati
Polish
Arabic
Chinese Lithuanian Slovak
Chinese Punjabi
(Mandarin)
(Cantonese)
The remaining demographical data shows that:


Respondents were spread across age groups with the highest (36%) between the
ages of 21-40 yrs.
Seventy-four respondents were female and thirty-two male the remaining chose not
to disclose their gender.
5.2 Summary of findings.



76% of respondents had been offered an interpreter on a previous hospital visit.
52% of patients felt they needed to contact the hospital prior to their appointment to
ensure an interpreter would be present.
Over 95% of respondents felt the interpreter was friendly, whilst being professional
and treating them with dignity and respect.
As we have seen from our usage data the use of telephone interpreting is rarely
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used despite being suitable in many instances. We used the evaluation to explore
patient’s experiences and feelings around the using of this method of interpreting.


24% had received interpreting services via a telephone.
Of these 87% stated they were satisfied with the service.
Despite the many benefits of using telephone interpreters; for example greater
privacy and confidentiality and guaranteed and immediate availability, only 18%
stated they would prefer to use it. The reasons for concerns are demonstrated in
Figure 7.
Figure 8. Patient concerns around telephone interpreting
50
40
30
20
10
0
Never used
Impersonal
Can't hear
properly
Patients concerns
Lack of
family/friend
involvement
Not completed
N/A
Patient comments
“Interpreter helped us very much. Thank you”
“Service was professional in the hospital and the help of the interpreter was amazing!”
“Many times we need interpreting, but no facility is available, that time we have to face
many difficulties”.
“I am really happy we had an interpreter during the visit. The issues we discussed were
very important we came once before and the hospital didn’t book us an interpreter even
though we needed one. This means we couldn’t communicate with the doctor because we
couldn’t understand him. We are very grateful to the interpreter.
“Thank you for providing this leaflet translated in Gujarati. I am sure that it will be of great
benefit to my parents as it is in a language that they both comprehend better than English.
Thank you for all your efforts in instigating and fulfilling my request. It is much appreciated!”
Staff feedback
“When I first started using this service there were problems but I feel that now it is very
efficient and well organised and the interpreters always arrive on time and are very helpful”
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“I chaired the meeting that the interpreter Mrs …. attended. I just wanted to let you know
how impressed I was by her professionalism and helpfulness. I would be very glad for her
to help with any of our meetings again”
6.0 Conclusion
Provision of these services clearly allows us to provide communication support to a number
of our patients enabling health care practitioners, patients and their families to effectively
communicate leading to a greater understanding for all in a wide variety of settings.
7.0 Future Plans

To conduct an interpreting evaluation for British Sign Users in conjunction
with our BSL service providers.

To conduct a cost benefit analysis of increasing telephone usage as opposed
to face to face provision. This should include the cost of appropriate
telephone equipment where required.

To explore the use of video relay interpreting services within our emergency
departments.

To continue to educate staff to ensure they utilise appropriate interpreting
services where required following the Trusts agreed guidelines.

Continual monitoring of management of the service to ensure appropriate
services are being provided and accessed.
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Glossary of terms
“Interpreting” is the oral transmission of meaning from one language to another, which is
easily understood by the listener. (This includes the conversion of spoken language into
British Sign Language (BSL) and other sign languages.
This can be delivered in by either:
“Face to face interpreting” involves a meeting at a prearranged place and time of the
patient/ client, interpreter and member of staff
“Telephone interpreting” involves having a telephone conversation with the patient/ client,
interpreter and member of staff all on the telephone line.
“Translation” is defined as the written transmission of meaning from one language to
another, which is easily understood by the reader. Translation refers to the conversion of
written documents into another language as text. In this context it includes transcription i.e.
the conversion of written documents into alternative formats such as Braille, large print,
audio, video or pictorial English.
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