Importance of professionals’ English language proficiency on patient experience and safety

We’ve been working with the Health and Care Professions Council (HCPC) to understand the impact the English language proficiency of health and care professionals has on patient and carer experiences. 

The HCPC is the UK-wide regulator of 15 health and care professions including paramedics, chiropodists, occupational therapists, psychologists, dieticians and radiographers.  Regulators exist to ensure that health and care professionals deliver safe and high-quality care to patients and the public. 

The HCPC sets out the English language proficiency requirements for applicants to ensure they practise safely and effectively.  As part of its work to update the requirements, the HCPC held a public consultation on the following proposed changes to its policy: 

  • Remove and replace the option to self-declare English as a first language 

  • Introduce a list of qualifying countries based on majority English-speaking populations 

  • Accept previous registration in a majority English-speaking country or supervised work experience in the UK 

  • Create an exhaustive list of approved test providers. 

We ran an online focus group with 10 patients and carers from across the UK to ask their views on the proposed changes.   

Themes from the focus group 

The impact of English language proficiency on patient experience: Participants in the focus group told us that the ability of health and care professionals to communicate in English is important for positive patient experience, patient partnership and shared decision making. 

“If the [health and care] professional doesn’t have a good command of the English language then they are unable to translate the medical jargon into lay person’s language to explain what the issue is. Patients will suffer without this.” 

However, they discussed that professional competence, and the ability to communicate effectively to patients and carers, are not determined by having a “perfect” or a native-level of the English language.  So, it is important to take a fair and balanced approach to requirements. 

Creating a fair system: The participants agreed that it is important the HCPC has a policy in place to set a standard of English language proficiency for professionals that register with it.  However, the participants agreed that it is important not to disadvantage or deter international applicants who do not come from a majority English-speaking country from working and registering in the UK.   

Ways that an applicant could be disadvantaged include cost of the test, accessibility of the test centre and a lack of feedback or option to retake the test.  Some applicants such as people with disabilities or childcare responsibilities may be more likely to face disadvantages in the process. 

“The system needs to be open, transparent and fair. If the health professionals are disadvantaged, in turn the patient is disadvantaged.” 

Partnering with patients and carers: The participants discussed the importance of gathering and listening to patient and carer’s experiences the policy is reviewed and implemented.  They also discussed the importance of regularly monitoring and reviewing the policy to understand if the changes are having a positive impact on patient experience and the safety of patients, carers and health and care professionals 

What happens next 

Overall, focus group participants agreed that the HCPC’s proposed changes would create a more robust and clear system that would instil greater confidence in the process for the registering professionals, and patients and carers.   

We summarised the focus group discussion in a short report with recommendations for the HCPC, which will use the report, alongside the feedback from the public consultation and its wider stakeholder engagement activities to update the policy.  The HCPC will publish the updated policy on its website later in the year. 

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