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Sign in or register for an accountFor those living in England, an inability to understand and communicate effectively in English can have several negative effects. Research conducted by the Office of National Statistics has linked poor English language skills to worse health and lower rates of employment. Those who speak little or no English have a greater likelihood of developing life-threatening conditions and have poorer access to and experience of healthcare services. Further research from Healthwatch has identified specific difficulties for people with limited or no English in accessing healthcare. For example, they may have difficulty registering with a GP, understanding appointment letters, navigating healthcare premises, explaining their condition, and understanding clinicians’ advice.
Data from the 2021 Census showed that over 1 million adults in England could either not speak English well (861,000), or not speak English at all (157,000), equivalent to 20% of all adults whose main language is not English. For households that did not have English as a main language, assistance in completing the census questionnaire was provided through interpretation services, and translation leaflets were made available in over 50 languages. In England, London, the North West and the West Midlands had the highest numbers of residents with poor English proficiency.
In the 2021 Census, 6,409 Salford residents whose main language is not English indicated that they cannot speak English well, or at all. This is equivalent to 2.4% of the total number of Salford residents, and 21.7% of Salford residents whose main language is not English, higher than the proportion for England.
Levels of poor English proficiency vary significantly within Salford. The map below shows the percentage of people who indicated they could not speak English well or at all in the 2021 Census by Salford ward.
The proportion of people in Salford who cannot speak English well or at all varies by ward from 0.5% in Boothstown and Ellenbrook to 8% in Broughton
[Download the cannot speak English well or at all Salford 2021 (cvs format, 2kb)]
As the map shows, with the exception of Little Hulton (2.5% with poor English proficiency), there are generally higher levels of poor English proficiency on the eastern side of the city. In several wards in the eastern half of Salford, including Weaste and Seedley, Ordsall, Pendleton and Charlestown and Kersal and Broughton Park, over 3% of residents indicated in the 2021 Census that they could not speak English well or at all. By far the highest levels of poor English proficiency were found in the Broughton ward, where over 8% of residents (equating to over 1,300 respondents to the 2021 Census) indicated that they could not speak English well, or at all.
Analysis on English language skills in England and Wales from the 2011 Census showed that in most ethnic groups, women were more likely than men to be unable to speak English, with the likelihood of this increasing by age. The same analysis showed that those from ‘White Other’ backgrounds were the least likely to speak English as a main language. Further challenges can also be faced by English as an additional language (EAL) learners with an additional need for support, for example, members of the D/deaf community.
There is a correlation between poor English proficiency and deprivation, with the consequence that those with poor English proficiency are also among the most likely to be digitally excluded. This should be taken into consideration when considering improvements to healthcare access that include a digital component.
There are two main ways to tackle the issue of poor English proficiency and its implications for healthcare: longer term educational efforts to improve levels of English, and practical assistance in the form of translating or interpreting services provided prior to or at the point of accessing healthcare.
In Salford, English for Speakers of Other Languages (ESOL) courses which help individuals develop their skills in speaking, listening, reading and writing are provided at a variety of levels and locations. After taking an initial assessment, ESOL applicants will be placed on a course which matches their current level of ability. There are also English learning cafes taking place across Salford on most days of the week to give residents opportunities to practice and improve their English speaking skills. Salford Ethnic Minority and Traveller Achievement Service (EMTAS) provides advice, support and training to primary and secondary schools with EAL learners attending.
NHS Greater Manchester Integrated Care Partnership’s guidance on interpretation and translation explains that, under the Health and Care Act and the Equality Act, anyone who requires it has the right to interpretation and translation services for NHS and social care services. These services may take the form of in-person interpretation, video interpreting, three-way telephone calls including an interpreter, or translation of key documents. Under the Accessible Information Standard, the NHS also has a legal responsibility to make sure that the services they provide are equally accessible to everyone. As many of the available interpretation or translation services rely on technology to some degree, the level of digital proficiency of patients or users should be taken into consideration.