Medical records. They’re a vital ingredient in the provision of medical care, but what happens when they’re provided in a foreign language?

This issue came to the fore for a Practice Index Forum contributor recently. They posted: “We have a new patient who has recently returned from overseas. They have a complex history and have kindly brought copies of their recent medical records – in French.”

While still rare, this scenario is one that’s likely to become more commonplace. Figures released by the United Nations suggest that the number of people leaving their country of birth to live overseas has risen by 14% in 15 years. And while the impact of Brexit on migration to the UK is debatable, it’s likely the UK will continue to see high levels of immigration, adding to the 8.3 million migrants already calling the UK home.

So, what can you do when faced with a patient and their foreign language medical record?

Care standards

For GP practices, the first priority has to be ensuring consistently high levels of care. And that means records need to be translated carefully. There’s no room for misinterpretation or incorrect translation as this puts diagnosis and treatment at risk – all records therefore need to be understood implicitly.

At this juncture it’s worth pointing out that in 2015 the NHS paid out £1.1bn in compensation for malpractice – and it’s highly unlikely that practitioners could defend themselves if they fail to misinterpret medical records. It’s also unlikely that medical indemnity would cover such an instance.

The above therefore rules out a quick and easy translation method for all but the simplest summaries – such as the popular Google Translate. Even with simple summaries, double check the results!

Check with your CCG 

The handy thread on this topic on the Practice Index Forum suggests that a number of CCGs offer translation services, so it’s worth asking if they’re available to you. In some cases (rare, of course) the service is offered free, elsewhere a subsidised rate has been negotiated.

Using a recommended service will likely satisfy insurers too, making this a good option. The patient engagement officer is the person to speak to at your CCG.

Turn to specialists

Another option is to turn to professional translators. A whole host of medical translation specialists exist for good reason – translating medical reports is a complicated business. We work in a field where jargon, terminology and acronyms are rife. Scientific terms are commonplace too – and some records from certain parts of the world are still written by hand (the notoriously bad GP handwriting could become even more of a problem!).

Good translators will have an academic or working background in medicine and, ideally should fully understand regional dialects – something that’s especially important with patients originally from Asia. Furthermore, rules state that the wording of the translated documents must be presented in standard level language – defined as language a schoolchild can understand – which translators should be trained to do.

Expense or cost-saving?

The downside is that professional translation doesn’t come cheap. But could it actually be worth it? If you get it free via a CCG, great. Even if it’s subsidised, it’s helpful. Even where no help is available, the cost versus time-saving benefits need to be considered.

What are the costs of additional tests and consultations versus translation? Is there an admin saving? Is it just easier and more reliable?

Where patients have a complex history, it could be quicker to employ a specialist than trying to do it yourself or utilising the language skills of friends and family. And with PMs and the wider practice staff pressed for time, that could be welcome.

Make the patient pay

Another, very valid option is to make the patient pay. Funding was once made available by the government for migrants to use translation forms to interpret legal and medical documents. However, this support has been withdrawn, making immigrants pay for professional translation services out of their own pocket.

If this policy is good enough for government, it’s good enough for practices. Try to position the proposition as being beneficial to the patient and in their best interest to get them to agree.

Summarise and prioritise

Other practice managers have told us that, in order to ease cost and time pressures, summary records should be requested which highlight key areas. Another option is to prioritise certain areas of the records – so that you’re clear about key diagnoses and procedures, with the rest made a lower priority. This hybrid approach may well be the best way forward.

The above should provide some pointers if you find yourself needing to have medical records translated. Balancing cost, efficiency and legal requirements, while continuing to deliver excellent care is a challenge – one of many faced by practice managers!

Have you come across this in your practice? How did you translate the records? Let us know by commenting below or join the debate in the Practice Index Forum here.

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