When There Is No Interpreter: What NHS Language Access Failures Mean for Patients

When There Is No Interpreter: What NHS Language Access Failures Mean for Patients

A report published in late 2025 found that lack of adequate interpreter access contributed to the deaths of 16 children in the UK in the preceding year. The cases vary in detail, but a recurring element across patient safety findings of this kind is a breakdown in communication: a family unable to describe symptoms accurately, a clinician unable to explain a treatment, or a consent process carried out without the patient or their family genuinely understanding what was being agreed.

This is not a new problem. Healthcare providers, patient safety researchers, and professional interpreters have documented the consequences of inadequate language access in NHS settings for many years. What changes with each new report is that the evidence becomes harder to ignore.

Why Relying on Family Members as Interpreters Is a Recognised Risk

In NHS settings, it is common for patients who do not speak English as a first language to bring a family member or friend to help them communicate. In practice, this creates several difficulties.

A family member interpreting in a clinical setting may not know the medical terminology in either language. They may soften difficult news, withhold a diagnosis, or add their own interpretation of what the clinician has said. The patient may not speak openly about sensitive symptoms when a relative is in the room. And in cases where a child is asked to interpret for a parent, or a parent for a very young child, the dynamic adds further risk to what is already a high-stakes situation.

Professional healthcare interpreters are trained to interpret accurately and impartially, without filtering or editorialising. In specialist clinical contexts, they will have familiarity with medical vocabulary in both languages and will understand how to handle sensitive or difficult information.

What the Law Says About the Right to Interpretation

In legal and judicial settings, the right to interpretation and translation has been set out in UK legislation. The right to interpretation and translation in criminal proceedings is enshrined in retained EU law, and interpreter provision in courts is governed by specific rules, including the Welsh Courts (Interpreters) Rules for proceedings in Wales.

For specific rights and current standards applicable to NHS settings, we recommend consulting gov.uk and NHS England guidance directly, as healthcare-specific requirements are set out separately from the legislation covering courts and criminal proceedings.

What Healthcare Trusts and Practices Should Consider

When commissioning interpreter services for NHS or primary care settings, quality and reliability matter at least as much as cost. Several practical questions are worth asking when choosing a provider.

Language coverage. Does the provider cover the languages spoken in your patient population? For communities with significant numbers of speakers of Polish, Romanian, Somali, Tigrinya, Pashto, Kurdish, Amharic, or Dari, specialist coverage matters more than a general telephone line.

Healthcare-specific experience. An interpreter with clinical training or experience in healthcare settings is better placed to interpret accurately in a consultation involving specialist terminology. Ask whether interpreters have worked in the relevant specialty and how they handle clinical vocabulary.

Availability at short notice. For planned appointments, interpreters can be booked in advance. For urgent or same-day needs, ask about response times and whether cover is available outside standard hours.

A clear process when a booking falls through. If an interpreter does not arrive or cannot connect, what is the backup arrangement and how quickly can a replacement be found?

For patients, it is reasonable to request an interpreter when booking any appointment, confirm it has been arranged before attending, and ask to reschedule if no qualified interpreter is available and the appointment is not urgent.

Our team provides NHS interpreting services across more than 200 languages, including specialist cover for healthcare settings. To find out how we support NHS trusts and GP practices, visit our [services page](https://lingoservice.com/services).

Sources

• Lack of interpreters contributed to deaths of 16 children last year, Hyphen (December 2025): https://news.google.com/rss/articles/CBMiqAFBVV95cUxOTVJjQ2cxd09OeEl6b2wtM042T0RJajUtTzNBczNiVzZwSHVXV09rQVJRX05mZDMxYUZWaWtJUnZlX3J6el9DQlljSnhLWGlGbnJZa2tETko5TkRQdG5UNW5vUS1mY0tBT01FTDd2aWdiSFN3SlRKeU5QemYyUDF1OEFtSi1SN3V4SFpsc3pTU1BmZzB6bnJIZFh1cXdjSFd3RTh5UkVDdnI?oc=5
• UK legislation: interpreter and translation, legislation.gov.uk: https://www.legislation.gov.uk/all?title=interpreter