- Evidence
- Evaluation
- Urgent and emergency care
An SBRI Healthcare-funded independent evaluation of CardMedic in emergency and urgent care
Findings from a large NHS acute trust – one of a growing number of independently evaluated CardMedic deployments across NHS care.
By CardMedic · · 5 min read
At a glance
- 7,503 patient interactions supported during the evaluation period, by 854 staff: 6,199 using clinically assured content, 1,049 using Live Translate (our machine-translation feature), and 255 escalations to professional interpreters placed through the app, on top of the trust’s existing booked interpreting
- More than 50% lower blended cost per interaction, with improved and faster communication maintained over the same period – in-year value alongside much wider access to support
- Around 90 seconds for one emergency department consultant to go from the bedside to speaking with a professional interpreter through CardMedic, compared with considerably longer through previous routes
- Every clinician surveyed said communication with patients had improved, and in urgent care all but one said consultations were faster
- A clear picture of unmet need: around 90 interpreter bookings a month in these departments, against an evaluator estimate of closer to 850 patients who may have needed language support
- Independently evaluated, not self-reported – by an external research organisation, funded through SBRI Healthcare, building on earlier development supported by Innovate UK
The setting
A large NHS acute trust, with emergency and urgent care departments serving a diverse local population and many patients who speak little or no English.
The trust already had well-established professional interpreting in place, and staff knew how to use it. Its aim was to make the right communication support even easier to reach in the moment, in departments where decisions are made in minutes and where many conversations are short, frequent and unplanned.
Those everyday conversations are where support is hardest to provide. When arranging help takes longer than the clinical moment allows, staff do their best with whatever is to hand – a relative, a consumer translation app or gestures. That challenge is shared across the NHS, and it is the gap CardMedic was built to close.
What the trust did
The trust introduced CardMedic across its emergency and urgent care departments as a single approved route to communication support, available at the bedside on whatever device staff had with them, online or offline. Clinicians could choose the right support for the person in front of them and the conversation:
- Clinically assured content – prepared, translated cards for short, everyday exchanges
- Live Translate – a machine-translation feature, with stated limits, for appropriate conversations that need to go back and forth
- Professional interpreter access – one-tap access, by phone or video, to the trust’s own approved interpreting provider
Easy Read, Read Aloud and British Sign Language video sit alongside them for patients facing other barriers to understanding.
CardMedic is provider-neutral: the trust chooses its interpreting providers, keeps control of the pathway, and has a fixed organisational licence that does not rise with interpreter minutes.
What the evaluation found
The evaluators assessed real-world use through system usage data, a staff survey, interviews with frontline clinicians and senior managers, and exploratory cost modelling. The findings are theirs.
Staff feedback was consistently positive. Every clinician surveyed said communication with patients had improved compared with previous methods, and all rated the effect on how well patients could communicate back as valuable or really valuable. Most said consultations were faster, and almost all found the app straightforward to use.
One advanced clinical practitioner described a consultation with a woman who spoke no English and had been relying on her son to translate, until the explanations became too fragmented to be useful:
“As soon as we accessed CardMedic, you visibly saw her shoulders relax, you saw her smile. You could see that her questions were absolutely getting answered.”
In urgent care, staff used prepared content for short exchanges, Live Translate for appropriate open conversations, and escalated to a professional interpreter for longer or more complex ones, all from the same device. One staff nurse described moving between them:
“Child needed urgent triaging and treating but both the child and family were unable to speak English. I started the conversation with cards and then moved to live chat, before going to an interpreter. It saved so much time and stress and made my life much easier and the child and their family were so grateful they could communicate with us.”
Meeting unmet need, affordably
In the month before CardMedic was available in these departments, staff made around 90 interpreter bookings. Based on attendances and local language data, the evaluators estimated that closer to 850 patients might have needed language support. They are clear this is an estimate that needs further testing, but it reflects a challenge every trust recognises: the support formally booked is only part of the support patients need.
With trusts under growing pressure to save money, meeting that need affordably matters. CardMedic offers a fixed-cost licence with unlimited access, so staff can support far more everyday conversations, while professional interpreters remain easy to reach for the conversations that need them.
The evaluation found a blended cost per interaction more than 50% lower, with improved and faster communication maintained over the same period. That average reflects the full mix of support – prepared content for short exchanges, Live Translate for appropriate open conversations, and professional interpreters for those that need them, with interpreter calls placed through the app counted in. The evaluators note the figures are indicative rather than definitive.
Because we work agnostically, the trust stays in control. Staff choose the right support for each conversation and use the trust’s own interpreting providers, and the trust can see the full picture of need and use. The result is better access, quality support and lower cost, together.
What people said
A senior clinical leader at the trust said:
“Effective communication is fundamental to safe and compassionate care. When a patient can understand what is happening to them straight away, everything changes. They feel calmer, they are able to take part in decisions about their care, and our teams can get on with delivering the care that person needs. This evaluation suggests CardMedic has made it easier for our staff to access approved communication support at the bedside in a busy urgent care environment.”
Tim Grimaldi, Co-founder and Managing Director of CardMedic, said:
“Behind every interaction is a patient who could be understood, and a clinician who could do their job with confidence. I founded CardMedic with my co-founder Dr Rachael Grimaldi, an NHS consultant anaesthetist, from what she saw at the bedside, and our mission is simple: every patient understood. As budgets tighten, trusts need a way to meet more of their patients’ needs affordably. We want to help the NHS move towards communication support that is faster, fairer and built around the patient, with professional interpreters easier to reach whenever they’re needed.”
Next steps
Professional interpreters remain essential, and the evaluation found that digital support and professional interpreting work best together. Professional interpreting remains the right route for conversations such as consent, safeguarding, mental capacity assessments, breaking bad news, complaints, and complex or open-ended discussions, and wherever local policy, clinical risk or professional judgement calls for it.
As an early study of implementation, the evaluation recommends further work on longer-term patient outcomes, service impact and health economics, and we look forward to supporting it. For any trust, a useful starting question is how many patients needed communication support last month, as well as how many interpreter bookings were made.
You can read the full case study and methodology or see more on our evidence page. To talk about what this could look like in your organisation, get in touch.
SBRI Healthcare is funded by NHS England with the Health Innovation Network. This funding does not imply NHS England endorsement of CardMedic.