This report explores the experiences of accessing NHS health services in South West London for those who do not speak English as a first language. This work builds on insights from our 2025 spring engagement fund, where language barriers were identified as a key issue in accessing health and care services.
To explore this in more depth, we carried out targeted qualitative engagement with local communities across all six boroughs, working with voluntary, community and social enterprise (VCSE) organisations. A total of 32 people from a range of cultural backgrounds and across a number of languages shared their experiences through discussion groups and one-to-one conversations.
Key findings for consideration have been outlined below:
- Language barriers can delay care and lead to inappropriate service use at every stage of care with people putting off contacting their GP, relying on self-care and pharmacies, waiting until travelling abroad to see a clinician, or attending A&E when primary care felt too difficult to access. One person didn’t attend at all because they “didn’t understand how to register with a GP when they arrived in the United Kingdom”.
- Sufficient time and clear communication during appointments is key – we heard about difficulties in describing symptoms, understanding clinicians and next steps and that appointments were not long enough to take in to account the extra time it took when an interpreter was needed. Face-to-face and video consultations were often preferred over phone, as visual cues improved understanding. People valued when “GPs are kind, speaking slower and using simple English. It doesn’t guarantee I understand 100% but as long as I understand follow up actions and what I need to do next it’ll be ok.”
- Written communication and follow-up can be hard for people to understand – letters, prescriptions and aftercare information were sometimes unclear, particularly when only provided in English. “GPs talk and write letters in long sentences and need short sentences to be able to help understand.”
- Interpreter services, booking systems and digital tools present ongoing barriers – many were unaware that interpreters were available or found them difficult to access, particularly for urgent care. Where interpreters were available, they didn’t always speak the same dialect which caused significant additional difficulties “You get what you are given, and you just hope they speak your language”. Digital tools such as the NHS app and other booking systems were helpful for some, but others found them complicated to navigate in English “Having a translator would make me very independent.”
- Experiences with reception staff and hospital settings vary – we heard that the initial interaction with reception staff could make all the difference to the overall experience as it is “not easy to understand what is being asked of me.”
- Reliance on family members is common and can lead to difficulties with many relying on relatives to book appointments, interpret during consultations and translate information, raising concerns about confidentiality and appropriateness. “It would be helpful to book independently but that isn’t possible with only a few words of English.”
Overall, the aim is for this insight to:
- Help to inform service improvements across health and care services to better meet the needs of people who do not speak English as a first language.
- Be shared with providers, commissioners and partners to support future planning and service design.
- Support ongoing work to reduce health inequalities across South West London, particularly for Core20 and underserved communities.