“We don’t all speak proper like, does us?”
There is much debate, in the media, and elsewhere at the current time, about immigration and the impact that curtailing this will have on the staff resourcing of the NHS. It is a fact that successive Governments have failed to allocate enough funding to the education and training budgets, in this Country, to ensure doctors and nurses are trained here. The Government recently announced plans to recruit an additional 1,500 doctors each year into training, and whilst this is a step in the right direction, it will do little to address the current situation.
It takes at least nine years to train a doctor to become a Consultant/Specialist and the need is now. Therefore, for the foreseeable future we have to accept that the staffing of the Health Service, if fully resourced, will be dependent on international doctors and nurses and we should welcome and support them when coming here to work. We at Crystal Clear Language Co. Ltd, believe that narrative is a vital part of the consultation process between doctor and patient. We are aware that despite the sterling work many of the staff do, there is significant carer and patient misgivings about doctors and nurses who are not proficient enough in English and whilst they may be able to pass tests they fail to be able to communicate in context.
Many of the Royal Colleges agree with us that there are concerns in this respect and that gaining more control would improve patient care and safety. We believe that improvements in this area would reduce costs to the Trusts dealing with complaints and litigation and allow this money to be re-deployed to other areas of patient care. We are aware that the need to address some of these communication concerns has been identified and addressed in recent legislative changes contained within the Medical Act 2014 and that these changes give the GMC more powers to check the language skills of licensed doctors and has also raised the required competency skills of the International Language Testing System.
We are also aware that changes are being made to the curriculum for doctor training. We believe, however, that there is a need to demystify the language and we at Crystal Clear Language Co. Ltd, have developed products, consisting of Reference Books, Smartphone Apps and an English E-learning Training Programme for doctors, to assist with these training needs.
Our product development has been supported by research, which has revealed the following five factors:
1. Doctors from overseas have a lower success rate in obtaining specialist posts primarily due to their poor communication skills, particularly contextual, colloquial and cultural English. There is evidence from some National Recruitment Panels for specialist doctors that approximately fifty percent of the applicants can be deemed not appointable due mainly to their poor communication skills. Many of these doctors are not in training programmes and, therefore, do not have educational supervisors and are unable to further develop their specialist skills and progress in their careers.
2. Research by Durham University, as reported to the GMC in December 2013, came to the conclusion that even after controlling for the effects of the available confounding factors, PLAB International Medical Graduates’ who passed the PLAB system demonstrate on average poorer performance on Annual Review of Competence Progression compared to UK graduates.
3. There is evidence that patients and carers have significant misgivings about communication with some doctors from overseas. The Medical Act 2014 highlights the issues with the standard of colloquial and contextual English for some professionals. It is known that the GMC and some of the Royal Colleges agree that the concerns exist and that doctors gaining more control would improve patient care and safety and possibly reduce mistakes caused by poor communication.
4. There is also evidence to suggest that overseas doctors are over represented in later stages of the GMC Fitness to Practice processes and one possible reason for this over representation is cultural differences (Durham University, 2013)
5. There is evidence that a lack of support for doctors and nurses from overseas is leading to seriously deteriorating morale and this needs to be addressed. (British Assn. of Physicians of Indian Origin Conference 2018),
We have confirmed, by gathering this evidence, the need to address this gap in the understanding of doctors from overseas, but have expanded our aims to include others, for example some nurses, carers and members of the general public who also suffer with difficulties between their learnt ‘Standard’ English knowledge and usage, and the colloquial language used by English Nationals.
Our aim is to demystify the language, providing comprehensive tools which by using our products should improve patient safety and the patient experience, as miscommunication should be lessened greatly. We also believe that our products could save time and money in respect of a reduction in complaints made against doctors and nurses by patients which might lead to fewer instances of litigation cases for Trusts.
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