Dozens of babies have died or been harmed in England due to problems with the ‘wild west’ NHS translation service, it was revealed today.
Patients who don’t speak English are supposed to be provided with an interpreter when using public services.
However, problems accessing one within the NHS has contributed to the death or serious brain injury of 80 babies within the last five years, according to the patient safety watchdog.
In one case, a woman died during childbirth after neither she or her husband, who fled war in Sudan, were made aware that she was going to be induced or told how critical her condition was after giving birth due to poor communication.
Rana Abdelkarim (pictured), 38, and her husband Modar Mohammednour, originally from Sudan, believed she was going to hospital for a routine pregnancy appointment. As a result, her husband stayed at home to look after their three-year-old daughter. The couple, who spoke limited English, had not been provided with an interpreter so were unaware of the plan. It meant Rana gave birth without her husband present. She then began to bleed heavily and was taken for emergency surgery. However, she became unresponsive and died
Non-English speaking patients have also claimed NHS staff have resorted to using Google Translate to inform them about their care, including to tell one woman she needed an emergency operation.
Experts today warned that the interpreter service is ‘extremely patchy’.
The data, from the Healthcare Safety Investigation Branch (HSIB), was obtained by the BBC through a Freedom of Information request.
It asked for figures relating to incidents from 2018-2022 where a baby died or was diagnosed with a severe brain injury in their first week of life.
Of the 2,607 cases identified, 80 referenced interpretation or communication problems due to language difficulties as a contributing factor.
The BBC said it was prompted to ask for the data after a woman died during childbirth and was uninformed of how critical her condition was due to a lack of interpreter.
Rana Abdelkarim, 38, and her husband Modar Mohammednour, originally from Sudan, believed she was going to hospital for a routine appointment.
As a result, her husband stayed at home to look after their three-year-old daughter.
However, the appointment at Gloucestershire Royal Hospital on March 8, 2021 was actually to induce labour because she had gestational diabetes — which means it is safer to give birth sooner.
The couple, who spoke limited English, had not been provided with an interpreter so were unaware of the plan.
It meant Rana gave birth without her husband present. She then began to bleed heavily and was taken for emergency surgery.
However, she became unresponsive and died.
The hospital did not call Modar until after Rana’s death, meaning he had no idea that his child had been born or that his wife had been in a critical condition.
He told the BBC: ‘They called me and said to me, “you have to come hospital very quick’ and then he said ‘we tried to keep her alive but she’s passed away”.’
Modar said better access to an interpreter would have helped the couple understand what was happening.
‘It would have helped me and her to take the right decision for how she’s going to deliver the baby and she can know what is going to happen to her,’ he added.
The HSIB found that Rana was uninformed due to a lack of interpreter, there was a 30 minute delay in staff activating an emergency call bell after she began to bleed heavily and a further delay in transferring her blood.
Patients have the right to a professional interpreter throughout their care and the NHS is legally responsible for providing one.
Professor Mark Pietroni, medical director and deputy chief executive of the trust, said: ‘The death of Rana following the birth of her baby is devastating for her family and we would like to extend our heart-felt sympathies to her family members. We want to take this opportunity to apologise once again for the immeasurable distress that this loss has caused.
‘The Trust has acted on the recommendations from the coroner to ensure that all lessons identified have been learnt and embedded into our day-to-day practice.
‘The circumstances leading to Rana’s death were immediately and thoroughly investigated. An independent safety investigation was conducted by the HSIB. Alongside this, the Trust undertook further investigation to ensure clarity for Rana’s family regarding the cause of her death. The findings of these investigations were shared with Rana’s family and HM Coroner and we have implemented all 10 recommendations made in the HSIB report.
‘We are absolutely committed to delivering the safest possible service. To do this we will invite external reviews where appropriate, and build on our commitment to listen to women, their partners and staff to create a culture that enables excellent care.’
However, the appointment at Gloucestershire Royal Hospital (pictured) on March 8, 2021 was actually to induce labour because she had gestational diabetes — which means it is safer to give birth sooner
In a separate case at a hospital in Glasgow, an unidentified woman told the BBC that NHS staff used Google Translate to communicate with her.
The woman, from Syria, had suffered a life-threatening bleed shortly after labour and medics were initially unable to reach an interpreter over the phone.
This saw staff spend 15 minutes on the translation website to tell her she was being rushed into emergency surgery, during which her uterus had been removed — despite her pleading for it not to be removed, as she wanted to have more children.
Professor Hassan Shehata, vice president for global health at the Royal College of Obstetricians and Gynaecologists, told the BBC that language barriers in the NHS ‘exacerbate risk’ as it means women struggle to ‘engage with maternity services and communicate their concerns to healthcare professionals’.
The National Register of Public Service Interpreters, a voluntary regulator of professional interpreters, has likened the NHS to the ‘wild West’.
It said the provision of interpreters was ‘extremely patchy’.
Mike Orlov, its executive director, told the broadcaster that there are frequent cases of staff using family members or friends for language services.
An NHS spokesperson said: ‘Community language translation and interpretation services are vital for patient safety and local areas who commission these services are responsible for applying the highest quality standards possible.
‘NHS England is currently completing a review to identify if and how we can support improvements in the commissioning and delivery of translation services.’
It comes after data last week revealed that two in three maternity units in England are not safe enough, according to figures from the Care Quality Commission.
It ranked 67 per cent of services as either ‘inadequate’ or ‘requires improvement’, up from 55 per cent a year ago. The proportion of units deemed ‘inadequate’ — the lowest rating — has doubled, its figures show.
Such a ruling means there is a high risk of avoidable harm for mothers and babies, under the CQC’s criteria.
The regulator said the situation was ‘unacceptable’ and warned maternity safety ‘is still so far from where it needs to be’.
Health leaders have blamed a shortage of midwives. Inspectors have also warned of culture and leadership problems.
Timeline of the NHS maternity scandals
A swathe of scandals have hit NHS maternity care.
An inquiry into failings at Morecambe Bay NHS Trust – where 11 babies and one mother suffered avoidable deaths – found a group of midwives’ overzealous pursuit of natural childbirth had ‘led at times to inappropriate and unsafe care’.
The investigation report, published in March 2015, revealed 20 ‘serious and shocking’ major failures had occurred between 2004 and 2013.
An October 2021 report revealed that a third of stillborn babies may have survived if there were not serious mistakes at Llantrisant’s Royal Glamorgan and Merthyr Tydfil’s Prince Charles hospitals in south Wales.
The inquiry was launched in 2019 after the maternity services at Cwm Taf Morgannwg University Health Board were put into special measures.
Another probe into Shrewsbury and Telford NHS Trust, led by midwifery expert Donna Ockenden, found that 300 babies had died or been left brain-damaged due to ‘repeated errors in care’.
The two-year investigation, published in March 2022, highlighted staffing and training gaps as well as midwives being determined to keep caesarean section rates low as causes of some deaths.
Another report published in October 2022 exposed the failures of two hospitals which are part of East Kent Hospitals Trust.
It revealed there were 12 cases where a baby suffered brain damage due to getting insufficient oxygen, but there could have been a different outcome had the baby received better care.
An investigation at Nottingham University Hospitals NHS Trust, which started in September 2022, is looking into 1,700 similar cases. A final report is due in 2024.
Already reports claim there were dozens of deaths, stillbirths and babies left with brain damaged after mistakes. Nottinghamshire police announced in September 2023 that they are launched a criminal probe into failings.