Breaking Down Barriers: What People Are Telling Us About Language and Communication in GP Care

Why this matters

Everyone should be able to understand their healthcare, communicate their needs, and book an appointment in a way that works for them. But for people with limited English, sensory loss, or communication needs, this isn’t happening often enough.

Despite the Accessible Information Standard and new national frameworks around interpreting and translation, people are still struggling to:

• Book appointments
• Access interpreters
• Use digital tools and online forms
• Receive information in a way they can understand

These barriers mean people delay care, feel frustrated, or rely on family members to communicate on their behalf.

Language barriers are stopping people from seeing their GP

Many older Nepalese residents—especially Gurkha veterans—told us they find it increasingly difficult to access primary care. Limited English, combined with a reduction in face‑to‑face appointments, leaves people unsure how to explain their concerns or navigate online systems.

“The GP will only do a telephone appointment with me and that is creating a huge problem because my English is not good. There should be an interpreter.”
— Nepalese veteran

Digital‑first care is widening inequalities

Across Kent and Medway, Nepalese residents told us that:

• They struggle with digital forms, especially e‑consult systems
• Face‑to‑face appointments feel more accessible
• Booking by phone is difficult without an interpreter
• The cost‑of‑living crisis and isolation make healthcare access even harder

In some communities, more than 60% of people said they find it “hard” or “very hard” to access NHS services.

GPs remain inaccessible for many D/deaf patients

Feedback from D/deaf residents across the county shows the same recurring theme: making and attending GP appointments remains an uphill battle.

• 70% said their GP was not accessible
• 75% found booking appointments difficult
• Only 17.5% felt comfortable booking online
• Young Deaf adults (18–25) reported feeling “frustrated, confused and reliant on hearing family or friends”

“There should be someone who can translate face‑to‑face and is easy to access.”
— Deaf resident

Interpreter delays and mismatched support

Even when BSL interpreters are booked, people told us they still face problems such as:

• Long waits for appointments
• Interpreters with unfamiliar regional signs
• Mistranslation by trainee interpreters
• Feeling uncomfortable discussing sensitive issues with certain interpreters

One in four people said their appointment was delayed because an interpreter was not available.

Digital systems are leaving D/deaf people behind

Some practices require people to book online or call by phone—neither of which are accessible for many Deaf patients.

One profoundly deaf patient told us they were advised to “ask a neighbour to phone up” for them when they couldn’t use e‑consult or the phone.

Why the system isn’t working well

Translation and interpreting support in Kent and Medway is funded by the ICB and delivered by The Big Word.
But for interpreting to work, lots of things need to happen at the right time:

• The patient must be able to communicate their need
• Staff must record it correctly
• Extra time must be booked
• Interpreters must be available
• The appointment must be booked far enough in advance

People told us this process often breaks down.

Digital systems are adding further pressure. At present, commonly used GP platforms such as ANIMA, e‑Consult and AccuRx do not include translation features, and neither does the NHS App.

What’s happening next?

In 2026, the Kent and Medway Integrated Care Board will begin a full review of translation and interpreting services. This will include:

• Assessing what’s currently available
• Learning from good practice in other areas
• Exploring whether a more joined‑up system is possible

Healthwatch will continue listening to people and making sure their experiences shape this work.