In 2019, frontline healthcare staff and patients came together to develop the NHS Long Term Plan. It’s exactly what it sounds like; a ten-year plan detailing how the NHS will provide better healthcare for all. It addresses the need to improve the quality of care in all areas, from childbirth to autism, cancer to mental health, dementia to learning disabilities, and so much more.
When it comes to patient safety and the quality of care, there’s one thing that sits at the heart of it all, and that’s communication. It’s the only way we, as healthcare providers, can get information across to our patients and make them feel safe. And yet, failures in communication are the most frequent source of patient dissatisfaction.
Healthcare and allied healthcare professionals across the globe are doing a huge amount of wonderful work to put good communication at the heart of clinical practice. But we still have gaps in service provision, with room for improvement.
Healthcare isn’t equal
Creating a National Health Service that works for everyone means that all patients’ needs must be considered. That includes the nearly 20% of the UK population who have additional communication needs such as visual, hearing and cognitive impairment. It also includes the 9% of the UK population who speak English as a second language, and the 14.7% who have a reading age of 9 to 11 years.
Literacy and language needs affect access to quality healthcare and when you bring socioeconomic inequality and the social determinants of health into the equation, it’s easy to see how groups can be marginalised. There have always been barriers to good communication in healthcare, and the coronavirus pandemic has served to highlight the health inequalities suffered by those with communication challenges.
One thing is clear: reducing health inequalities should be everyone’s business.
We need digital solutions
The pandemic has shown us the importance of digital communication tools to our livelihoods and connection with others. The same has been true for the healthcare industry. We’ve seen many people check in with their loved ones in hospital using a mobile device, and we’ve also seen heartbreaking moments of people left with no choice but to say goodbye in the same way.
At the start of the pandemic in March 2020, I was on maternity leave in the United States where I was visiting family. I couldn’t travel back to the UK to support my colleagues on the frontline, but I was desperate to help.
I read a story about a patient who was severely ill with coronavirus and was terrified when they couldn’t understand what the doctors were saying through visors, masks and other PPE (Personal Protective Equipment). This story hit a nerve because myself and many colleagues have longstanding experience of struggling to communicate with patients across a variety of barriers, with the pandemic and PPE exacerbating the situation and creating a global disaster in healthcare communication.
Too often, healthcare workers rely on friends and family to communicate with patients because there just aren’t enough translators, or funding to hire more of them. It’s also not possible for translators, who are already overstretched, to be everywhere at once.
Providing in-person interpreters for D/deaf patients would cost the NHS £3 billion a year. Meanwhile, in-person translators for every patient who speaks limited English would cost £472 million each year.
That’s 20 times more than the estimated current spend on translators, which itself I believe to be an underestimate. This means many NHS Trusts aren’t able to meet the legislative requirements for patient safety set out by the Equality and Human Rights Commission or NHS England Accessible Information Standard.
If one nurse, one junior doctor and one consultant in every hospital each spent one hour less per day searching for a translator, the NHS would save £17 million annually.
Something needs to change, and that’s where CardMedic comes in.
Making healthcare one language
Seventy-two hours after reading the story about the coronavirus patient, I had created CardMedic – a website and mobile app to help healthcare workers communicate better with patients at the point-of-care. It is an A-Z collection of digital flashcards with ‘scripts’ pre-written by clinical experts, replicating conversations around common healthcare topics from allergies, nutrition, mental health and maternity, to heart, lung and kidney problems, dentistry, audiology and much more.
CardMedic improves communication across visual barriers, hearing or cognitive impairment, language barriers or PPE. It bridges the gap in service provision across the NHS, as healthcare staff can change the flashcards into different languages, sign language videos, easy read with pictures or read-aloud. It also hosts an integrated translation tool for conversations the expand beyond the cards.
Although we launched during the pandemic in response to a specific challenge, I like to think of CardMedic as a “one-stop communication shop” for all healthcare providers. It’s designed to overcome any communication barrier and it can be used by any healthcare or allied healthcare professional, in any healthcare setting, at any time. We are really proud to now partner with StepUp.One and Kakuma Refugee Camp in Kenya to translate CardMedic into languages indigenous to Africa.
Right now, I’m excited about the new version of the CardMedic app which has a speech to text feature. It creates a two-way conversation where patients can reply in one spoken language and have it translated on screen into text in another language for the healthcare provider. All CardMedic flashcards can now be translated into over 12 languages, with another 10 underway.
Communicating across barriers
At CardMedic, we believe that better communication will reduce health inequalities by improving patient safety, experience and the overall quality of care.
In May 2020, we commissioned an independent evaluation with the University of Brighton and Brighton and Sussex University Hospitals NHS Trust involving simulated patients. With CardMedic, patients reported feeling 95% confident in understanding NHS staff in PPE than without. This was an increase of 28%.
We’re proud of what we’ve achieved since we launched last year, but we couldn’t have done it all alone. We are working with an extraordinary group of enthusiastic, passionate and inspiring Speech and Language Therapists and Learning Disability Nurses to convert CardMedic into easy read with pictures. We’re also working with a variety of other healthcare and allied healthcare professionals to build on the content of CardMedic, including nurses, midwives, doctors, dentists, audiologists, radiotherapists and many more.
We’ve been lucky enough to partner with people and organisations who share our mission. Our charity partner, Include.org, has been an amazing support and source of knowledge over the last year. We also converted our flashcards into British Sign Language thanks to Inclusive Fruit, an incredible accessibility content agency.
What’s the next step?
The World Health Organization (WHO) predicts that by 2050, one person in ten will have disabling hearing loss. By then, the number of people living with sight loss in the UK will also have doubled from its current figure of 2 million.
As it stands, patients with additional communication needs are more likely to have medical issues. Sight loss and learning difficulties are strongly linked with conditions such as diabetes and epilepsy, making it even more essential that healthcare information is accessible.
Now is the time to break down all communication barriers in healthcare
With international migration on the rise, we must also consider the health needs of migrants who face language barriers. The WHO has called for health information to be accessible to migrants regardless of their cultural background.
By supporting healthcare and allied healthcare professionals to overcome any patient communication barrier in any healthcare setting, at any time, I hope CardMedic will get us closer to achieving the steps laid out in the NHS Long Term Plan. As of today, CardMedic has more than 50,000 users in 120 countries and over 16,000 app downloads, so we’re already on our way there.
We’ve just launched the new and improved CardMedic with more features than ever. Why not give it a go and download the app today? It’s free to sign up!