Sussex Interpreting Services (SIS) has undertaken two pieces of research, with Service Users and NHS departments, into why patients who require support with communicating in English miss some of their NHS appointments, and how that could be reduced.
The first piece focussed on gathering insight from SIS Service Users who had missed NHS appointments. The primary reasons for not attending were communication issues, with patients saying that clearer information in an accessible format, consistent use of SMS reminders, an easy rebooking system and improved communication channels would help them overcome barriers to attending.
Following on from this, we used SIS data to identify NHS Sussex departments with high incidents of missed appointments by people with language needs and invited them to meet with us to explore more effective communication with these patients.
Project Activities:
SIS Bilingual Community Researchers (BCRs) conducted research through 1:1 phone conversations with Service Users (SUs) who had missed NHS appointments in the previous 6 months. 28 SUs speaking the following languages were invited to take part: Farsi, Polish, Portuguese, Russian, Sorani, Spanish, and Italian. The SUs were asked about when and how the appointments they missed had been made, why they hadn’t attended, if they were able to contact the service to reschedule or cancel, and what recommendations they would make to services to help them overcome barriers to attending.
We then spoke to staff from the following departments: Antenatal at Royal Sussex County Hospital, Orthoptics at Sussex Eye Hospital, Diabetes Care For You (DCFY) Service, and Brighton & Sussex Diabetic Eye Screening Programme (DES).
We explored how communication currently takes place between healthcare teams and patients, and invited reflections on whether current approaches are effective and what improvements could be made and communication enhanced. These conversations aimed to identify practical, low-cost solutions that could improve appointment access and overall patient experience. We emphasized that recommendations should be realistic and mindful of existing resource constraints and instead focus on small, actionable steps that could make a meaningful difference.
Key themes and recommendations:
Key themes discussed included referrals for new patients, appointment letters, appointment reminders, rebooking or cancellation, use of translations, use of interpreters.
Recommendations generated and discussed with departments included:
- use of translated appointment letters
- commissioning of a short translation of key information
- staff making use of the free additional support SIS offers (Bilingual Social Prescribers, translated resource libraries, translated self-referral cards, bilingual appointment letters)
- using telephone interpreting to support communication around amending bookings
- using an SMS service that supports translated information
- empowering patients to self-refer for interpreting support
SIS can also provide a Health Promotion service using an SMS system to translate and disseminate resources to thousands of Sussex residents or create videos in other languages to facilitate equity and inclusion.
It was encouraging to hear how some departments are trying to improve their communication with patients with language needs. However, budgets, staff capacity, and knowledge of tools/methods are a barrier to consistent implementation. Departments shared their concerns regarding adaption or modification of current systems: adding to workload of staff, trust rules about what must be included in patient communications and the need for permission to add anything extra, and which languages to choose for translations.
Full versions of the reports with more details on the themes and recommendations can be found here:
Why do people with language needs miss their NHS appointments?
Both pieces of research were funded by the NHS Sussex Health Inequalities Grant.
You can read more about other SIS Community Research projects here and contact us if you would like to know more about future research projects.
