Language and GP-patient communication: demonstrating the obvious

Unless you’ve been stranded on a desert island for the last decade, you might just have noticed that lots of health care types are interested in the idea of patient experience. Patient experience is all that stuff that goes on which isn’t directly about clinical effectiveness (is this the miracle cure?) or patient safety (have we got the correct leg?). It’s about how patients gain access to and navigate health care, whether they can find a clean toilet in their GP practice, and – of particular interest to me – how they experience the actual interactions that take place with NHS staff. How do doctors, nurses and other health care professionals actually communicate with patients? Are they concerned, interested, warm, human? Or are they sometimes distant, cold or downright rude?

So, the Government pays for loads of terribly rigorous surveys to be done asking patients about the the rat run of getting an appointment, if receptionists greeted them with icy hauteur, and whether they found any actual consultation a positive experience. Academics like myself and my colleagues take these survey findings and say things like….hang on guys, there’s some problems here! Look – people in minority ethnic groups are having a worse time with their GP (1). In fact, older female South Asian patients report a really bad time talking to their GP (2). What’s going on? And we scurry off and do lots more studies.

Our latest paper looks at one aspect of what might be going on with interactions between GPs and patients who come from ethnic groups who report worse experiences of communication (particularly South Asian groups). The thing is that language is a rather important part of communication, and language barriers might be having a large impact on patient experience of consultations (3). I know, I can hear you shouting – well that’s obvious! Honestly, who’d need to write an academic paper on that? To which I reply…there’s nothing like a good old empirical demonstration of the “obvious” to focus our attention. So, the headline is, if you don’t speak English at home, you have a worse time communicating with your GP. And to me, that rather shows that we have a lot more to do (at system, practice, practitioner and patient level) to improve the situation.

References
1.            Lyratzopoulos G, Elliott M, Barbiere JM, Henderson A, Staetsky L, Paddison C, et al. Understanding ethnic and other socio-demographic differences in patient experience of primary care: evidence from the English General Practice Patient Survey. BMJ Qual Saf. 2012 Jan;21(1):21–9.
2.            Burt J, Lloyd C, Campbell J, Roland M, Abel G. Variations in GP–patient communication by ethnicity, age, and gender: evidence from a national primary care patient survey. Br J Gen Pr. 2016;66(642):e47–e52.
3.            Brodie K, Abel G, Burt J. Language spoken at home and the association between ethnicity and doctor–patient communication in primary care: analysis of survey data for South Asian and White British patients. BMJ Open. 2016 Mar 1;6(3):e010042.
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  • The Cambridge Centre for Health Services Research (CCHSR) is a thriving collaboration between the University of Cambridge and RAND Europe. We aim to inform health policy and practice by conducting research and evaluation studies of organisation and delivery of healthcare, including safety, effectiveness, efficiency and patient experience.