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We’ve recognised for some time that language is a significant barrier to Black and Minority Ethnic communities accessing cancer services. The relationship between the patient and the professional can come under strain when there is no common first language, and the many myths about cancer can lead to difficult and uncertain communication.
The obvious and most effective way to overcome these barriers is to use an interpreter, but this brings its own difficulties and requires a new skill set for both the professional and the interpreter. Not only must the professional know how to manage the relationship with the interpreter, but the interpreter must try to overcome their own cultural barriers regarding cancer, or the communication could be made worse.
In North West England, Macmillan is working with East Lancashire Hospitals NHS Trust and Applied Language Solutions (ALS) to try to provide solutions to these issues.
The Trust has a high south Asian population and the use of interpreters is well-established.
To improve the effectiveness of this relationship, Nazir Makda, the Trust’s Equality and Diversity Manager, produced a policy outlining the management of interpreters with ALS. The Trust has allowed Macmillan to use this document and we will be producing a short toolkit which will be available at Learn Zone|.
It will cover all aspects of using interpreters. For example, it’s advisable not to use family members as interpreters in a clinical situation due to considerations of quality and patient confidentiality. Yet they may be appropriate in a general discussion about menu choices or a patient’s comfort. The document will also consider the role of volunteers, bilingual professionals and other people who may get involved.
- Allow time for introductions, sharing important information and completing paperwork. Check your interpreter understands any technical phrases you may need to use.
- The meeting must be conducted by the professional, not the interpreter.
- Talk to the patient and look at the patient, not the interpreter.
- Keep your language clear and simple, allowing as little room for ambiguity as possible.
The other side of this relationship is, of course, the interpreter. Macmillan has identified that however well-trained and prepared the professional is, if the interpreter is constrained by cultural taboos and inhibited by the language of cancer, then the barriers to communication remain. They may even be compounded as the interpreter struggles to translate crucial information in a sensitive way such that vital meaning is lost.
We therefore approached ALS, the main provider of interpreting services to the NHS in the North West to help them develop better interpretation services for people affected by cancer. ALS recognised our concerns and is keen to use the online ‘Introduction to Cancer’ course to help their interpreters gain a wider understanding of cancer and the issues people face.
With Lesley McGuire’s assistance as Macmillan Learning Technology Manager, we have identified several ways that we can roll this out we look forward to extending the learning out to improve the access to care for people for whom language is a real barrier.
Email Paul Maskell|.
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© Macmillan Cancer Support 2013
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