UK and US health care interpreting

UK and US health care interpreting

What are the main similarities and differences between these two systems

They both have very different healthcare systems. But both guarantee your right to an interpreter. 

England has the National Health Service (NHS). The US, even though it lacks universal health insurance coverage, has you covered thanks to the Affordable Care Act.

One has a universal health system, the other assures basic rights when it comes to being attended to. Why do both pay attention to languages?

set of focus groups took place in 2015 in England, and the output was a draft set of Principles for Interpreting and Translation Services. In 2016 and 2017 the draft principles were revised and incorporated into guidance for commissioners. And they all apply to primary care settings and hospital sites. 

We’re going to do a quick overview of how the systems work and how we got here, to analyze interpretation services in both. 

Photo by Artur Tumasjan on Unsplash


The United States is known for many things. One of them used to be how it could be illustrated as a “melting pot”. The US is multilingual from its very roots. And this multicultural landscape greatly influenced government policies that began in the early 1960s.

An important one that we have described more than once in our articles is the Title VI of the Civil Rights Act. It prohibited discrimination on the basis of race, color, and national origin in programs and activities receiving federal financial assistance, eventually setting the stage for language access rights for residents with limited-English proficiency (LEP). 

Even though universal healthcare never settled, there have been significant legislation such as Medicare and immigration reforms to try and make sure the system gave the same treatment to everyone. 

Under the ADA, health care providers must provide appropriate auxiliary aids and services to ensure communication with people with any type of disability or language impairment is as effective as communication with others. Today federal agencies are required to examine the services they provide, identify any need for services to those with limited English proficiency (LEP), and develop a system to provide those services. 


For those unfamiliar with the UK system, it offers universal coverage to all, regardless of social class or income. The National Health Service (or NHS), funded by general income tax, is the main player. The Prime Minister will receive the same level of healthcare as an average worker. And since the system is universal, it must also be able to attend to the needs of those who are not proficient in English. 


A 2012 study by the American College of Emergency Physicians found that the error rate was far lower for professional interpreters than ad hoc interpreters. Ad hoc interpreters are also more likely to make the type of mistakes that compromise patient care. These are defined as “errors of potential clinical consequence”. Not only that, but thanks to these kinds of studies, they also found out that 52% of these that were experienced by low English proficiency patients were due to communication errors. Some of them lead to physical harm. 

This is something both countries noticed, and in ways, they found more appropriate, integrated into their system. The lack of language access services can result in more frequent missed appointments, poor patient experience, and even mala praxis. Access to a medical interpreter is part of regulations in the US as in the UK. 

The NHS document Guidance for Commissioners: Interpreting and Translation Services in Primary Care states that “Patients should be able to access primary care services in a way that ensures their language and communication requirements do not prevent them from receiving the same quality of healthcare as others.” 

And these translation services should be high quality and free. For example, it may seem subtle, but American and British Medical Terms are not the same. So if it’s the remote interpretation you’re dealing with, via phone or video call, then that interpreter should know the term suitable for that region. Not any English term.

Interpreters ease the tension and frustration experienced by patients. They create a safe environment in what can be a very emotionally draining context. They reduce costs of patient care, since fewer people have to come back to the ER and when they do they stay for less time. 

That being said, wherever you are, you can call one of our language experts. We have specialized interpreters in the healthcare industry that could lend you an ear.


Scroll to Top