University Hospitals of Leicester NHS Trust and CardMedic

UHL is using CardMedic to help women and birthing people with additional communication needs through their pregnancy journey.

CardMedic is helping Saira feel less anxious about her maternity care at University Hospitals of Leicester NHS Trust

University Hospitals of Leicester NHS Trust (UHL), which serves the one million residents of Leicester, Leicestershire, and Rutland (LLR), conducted a short-term evaluation study of CardMedic in the Trust’s maternity department. Deployed across the Leicester
General Hospital and Leicester Royal Infirmary, the Trust has used CardMedic to help break down communication barriers for pregnant women and birthing people with additional communication needs to deliver more equitable care.

CardMedic is being used to bridge communication gaps and deliver more person-centred care

The evaluation study of CardMedic at UHL made maternal healthcare more accessible for the Trust’s diverse service user population. The multi-awarding winning app’s A-Z library of scripts guided maternity staff and service users through common clinical interactions and ensured that pregnant women, birthing people, and their families could play an active role in decision-making about their care. By working with CardMedic, UHL has achieved:

  • Rollout to over 150 users across the Trust
  • Reduced anxiety for service users
  • Improved experience for those with
    additional communication needs
  • Improved quality of care for individuals
    with limited English proficiency
  • Supported midwives with newborn and
    infant physical examination (NIPE) checks
The challenge

As one of the busiest NHS Trusts in the UK, UHL serves a high proportion of ethnic minority families. Leicester has the highest percentage of births to non-UK parents across the East Midlands (where one or both parents were born in a non-UK country), at 59.7%. This increases the likelihood of these families experiencing a language or other communication barrier. 

What’s more, expectant families who have recently arrived in the UK often lack a social support network which makes it more difficult for them to access the services they need. There are over 1,000 asylum seekers in Leicester and over 11% of the population speak a language other than English as their main language, with South Asian languages being the most common minority language group. UHL identified that language barriers were contributing to poorer outcomes for service users, as parts of the service were inaccessible and effective communication was not possible.

To overcome these language barriers, it was found that many individuals with limited English proficiency relied on friends, family, multilingual staff, or machine translation to communicate important information about a person’s care. Accessing communication support services such as interpreters can delay care in acute settings and frequently introduces uncomfortable and culturally inappropriate third-party players to sensitive and confidential dialogue, meaning the support is not always appropriate or available, especially in emergency and urgent settings.

The solution - how CardMedic is helping

By choosing to deploy CardMedic, the Trust has enabled maternity staff to communicate safely and effectively with limited English proficiency service users when an interpreter is unavailable. The app’s maternity scripts have helped staff explain procedures such as inserting a urinary catheter during labour and have consequently reduced the anxiety of service users. Since all of CardMedic’s content is translated and peer-reviewed by clinicians and speech and language therapists, the scripts are accurate and reflect real-life clinical practice.

To help with the rollout, the Trust nominated user champions to encourage uptake of CardMedic and support maternity staff with downloading, registering, and navigating the app. As a result, staff have been able to support a wider range of service users, including those with other communication needs as well as language barriers. CardMedic is also supporting service users with visual impairments, cognitive impairments, and literacy issues through the app’s Easy Read and Read Aloud formats. The platform has been designed to enable clinicians to communicate with service users across any barrier to deliver care, save time with instant, clinically certified content, and improve health outcomes.

In a survey evaluating the different scenarios in which CardMedic was deployed at UHL, 47% used the app to relay short and simple instructions, 29% used the app when they didn’t have time to access other translation services, and 24% used the app when they couldn’t obtain an interpreter. This demonstrates the variety of use cases for CardMedic and its ability to stand in for interpreters when they’re unavailable.

The result

CardMedic’s library of pre-scripted conversations is available in over 49 languages and has helped improve the safety of service users, enhance quality of care, and promote health equity. The implementation of CardMedic at UHL has enabled maternity staff deliver inclusive, person-centred care that considers the individual needs of a diverse service user population.

Midwives at UHL used CardMedic to perform NIPE checks. They found the app’s integrated translation tool helpful for delivering more personalised care. Other popular use cases of CardMedic in UHL’s maternity department included explaining to pregnant women and birthing people their baby’s movements and informing expectant families about breastfeeding.

Other benefits include:

  • Improved service users’ confidence – more effective communication between clinicians and service users has fostered a sense of trust and understanding, increasing service users’ confidence in their treatment.
  • Reduced health inequalities – all individuals receive equitable access to information and resources, irrespective of their communication needs, which has improved access to care for underserved populations.
  • Increased staff efficiency – improved understanding of service users’ needs enables staff to allocate resources more effectively and streamline workflows, increasing staff efficiency.
  • Improved service users’ safety – CardMedic enables staff to explain procedures to service users and ensure
    they understand and comply with their medication and treatment plan.
  • Reassured service users – conveying clear information in a manner that service users can understand has helped to ease their anxieties about their treatment.
  • Personalised care – the individual needs of service users with additional communication needs are being met through CardMedic’s language and format options.
Next steps

The short-term evaluation study of CardMedic at UHL has shown great potential in helping to bridge communication gaps and reduce health inequalities for maternity service users. The Trust is keen to work with CardMedic to help expand the app’s library by suggesting new topics for scripts to further support families and foster more equitable service
provision at the Trust.

“CardMedic has helped us fill gaps in service provision on the occasions when interpreters can’t be sourced. Maternity staff at UHL have embraced CardMedic with open arms, as the app has allowed us to quickly and easily communicate vital information to service users, improving their experience and reducing their anxiety, which is particularly important when we’re caring for pregnant women and birthing people.

“CardMedic has been an incredibly useful tool in our pocket that’s allowed us to instantly communicate with families across any barrier, in any healthcare setting. It’s also a safe and reliable solution, as the scripts are translated by clinicians who are on the frontline delivering care day in, day out, and are experts at what they do.”

Beverley Cowlishaw, Specialist Midwife in Public Health and Inclusion, University Hospitals of Leicester NHS Trust

See the impact of CardMedic in action