Kavita Parmar, chief commercial officer and co-founder at Word360, explains how Birmingham is leading the way in embedding language access into care.
Across the UK, language diversity is part of everyday life. Millions of people speak a language other than English as their main language, with hundreds of languages used across communities. In cities like Birmingham, this diversity is even more pronounced, with well over 150 languages and dialects spoken.
For the NHS, this presents both an opportunity and a challenge. Providing equitable care in a multilingual society requires more than access to interpreters. It requires systems that recognise and respond to communication needs as part of routine care. Yet in many organisations, language needs are still treated as an add-on rather than something embedded into clinical workflows.
When language needs are captured but not converted into action
In most NHS settings, language needs are already captured within the patient record. The issue is not visibility, but what happens next.
Too often, those needs are not operationalised. Booking an interpreter becomes a separate process, handled outside of the main clinical system, requiring staff to re-enter information and manage changes across multiple platforms.
This creates a familiar pattern. Appointments are rearranged but interpreter bookings are not updated, interpreters are booked but not required, or no interpreter is arranged at all. These challenges reflect disconnected systems that were never designed with language access in mind. The result is added administrative pressure, inefficiency and a risk that patients do not receive the support they need to engage with their care.
There is also a financial dimension. NHS organisations collectively spend significant sums on interpreting and translation services each year, with some Trusts spending hundreds of thousands of pounds and in some cases exceeding a million. While this investment is essential, inefficiencies such as late cancellations, missed bookings, or misaligned systems can lead to avoidable costs.
Addressing this is not about reducing access, but about ensuring resources are used effectively at a time when organisations are under pressure to do more with constrained budgets.
How Birmingham is leading the way in embedding language access into care
At Birmingham Community Healthcare NHS Foundation Trust, there was a clear recognition that this model was not sustainable.
Rather than continuing with disconnected processes, the Trust worked with its electronic patient record provider, Access, and language services partner, Word360, to embed language access directly into its Rio system.
The principle was simple. If language needs are recorded in the patient record, they should trigger action automatically.
With the integration in place, interpreter bookings are created as part of the appointment workflow. If an appointment is changed or cancelled, the interpreter booking is updated at the same time. What was previously a separate administrative task has become part of a single process.
This marks a shift from a reactive approach, where language support is arranged separately, to one where it is built into the care pathway itself.
Early indications suggest that this approach can deliver tangible benefits. Administrative time has reduced, with around 100 hours saved in the first three months. There has also been an increase in the proportion of patients having their communication needs met, rising by over 20%.
These gains translate into better use of staff time, fewer missed appointments and a more consistent patient experience.
There is also a clear impact on cost avoidance. By aligning interpreter bookings directly with clinical appointments, organisations can reduce unnecessary charges and wasted resources. In systems where appointments are frequently changed, even small improvements in coordination can scale quickly.
Importantly, this is not about reducing access to interpreters, but about ensuring support is available when it is needed and used effectively.
From add-on service to core system: a shift in how care is delivered
What makes this approach significant is not the technology itself, but what it represents.
For a long time, language access has been treated as a service that sits alongside care, rather than something embedded by design.
If the NHS is serious about addressing health inequalities, that model needs to change. National priorities such as Core20PLUS5 and the Patient and Carer Race Equality Framework highlight the importance of equitable access and experience, and language plays a central role in this.
Embedding language access into the EPR moves it into the centre of care delivery, making communication needs visible, actionable and consistent across teams.
The challenges seen in Birmingham are not unique. Many NHS organisations still rely on manual or semi-digital processes to manage language support, with systems that do not always align.
What Birmingham Community Healthcare demonstrates is that there is a practical alternative. By embedding language access into existing clinical systems, it is possible to reduce administrative burden, improve consistency and support more equitable care.
This approach is also replicable across other Trusts, creating the potential for a more joined-up, system-wide approach.
There is growing interest in how technology, including AI, can support communication. These tools have a role in routine interactions, but they are not a replacement for professional interpreters. Complex and sensitive conversations will always require human expertise.
Because ultimately, communication is not an add-on to care. It is a core part of it.
