Improving English language skills in the NHS

Rashid works as a hospital porter. When he first started, it took him a while to figure out where everything was because he cannot read well. To get round this, he used to ask for directions all the time. Now he just knows his way around.

Irena is a cleaner in a nursing home. Her English isn't great, but she gets by. Most of the residents just want her to listen anyway. She has a nice way with them and they all like her. Her main problem is with reading instructions on the cleaning materials she uses. As a result, she sometimes uses the wrong ones.

Deepa works in the kitchen at a community hospital. Her spoken English is pretty good, but she cannot read cooking instructions. She gets away with it by asking people instead. However, the other day she was making custard and there was nobody with sufficient understanding of English to ask. She used salt instead of caster sugar by mistake.

Key skills

While each of the above scenarios is fictitious, they could really happen. Of the general working population, 8 per cent do not have the level of spoken or written English they need to perform well in their job, because English is not their first language. The current percentage of people working in the healthcare sector whose first language is not English is significantly higher than this.

Regardless of how experienced or well qualified people are, poor communication skills and difficulties with reading are not uncommon, particularly among those whose first language is not English.

These problems are not restricted to entry level jobs - they relate to all levels and bands across the healthcare sector. Doctors and consultants from other cultures may have high-level qualifications from their home country, but this does not mean they can make themselves easily understood in English.

Valued staff

However, without migrant workers, the skills gaps and shortages in some areas of the healthcare sector would be significant. Migrant workers are valuable employees who enhance the equality and diversity of the sector and offer skills that are of great benefit to our healthcare services.

All workers need good communication skills to unlock their full potential. Once they have learned English or enhanced their English, they are typically more motivated and better placed to take advantage of other learning and development opportunities.

In the meantime, poor English language skills are a health and safety issue, particularly in the healthcare sector, where people are coming into direct contact with patients. We need to raise awareness of this issue with employers throughout the sector and find ways to ensure those already working in healthcare have the necessary skills to do their jobs effectively.

Myriad benefits

Adequate communication skills are critical in the healthcare sector to:

• ensure patient safety;
• improve service delivery;
• enable staff to carry out their roles more effectively;
• reduce the risk of mistakes;
• improve the way people relate to one another;
• underpin participation in learning opportunities;
• ensure greater compliance with health and safety regulations;
• support career development;
• create a flexible and adaptable workforce;
• raise confidence levels;
• increase motivation;
• reduce absenteeism;
• help improve recruitment and retention;
• help people engage in their communities and contribute to society.

Work under way

Over the last six years, there has been significant investment of public funds in English for speakers of other languages provision. In the 2004-05 academic year alone, the Learning and Skills Council spent£279m on ESOL - providing 538,700 learning opportunities.

A major project is currently under way to develop ESOL materials for migrant workers. The Department for Innovation, Universities and Skills has commissioned the Quality Improvement Agency to deliver on the project and the National Institute of Adult Continuing Education is taking the work forward.

The project is due to finish in January 2009. It covers sectors where the employment of migrant workers is increasing, including health and social care.

Representatives from each industry's sector skills council are actively involved to help ensure their sector's requirements are reflected.

A range of materials for learning providers is currently under development, influenced by a new suite of "ESOL for work" qualifications. There are three stages. For phase 1, reading materials have been produced that are currently being piloted with around 18 ESOL providers. Phase 2 will focus on speaking and listening skills, and phase 3 will concentrate on writing.

In many instances, learning may need to take place in the workplace, so it is important that it is available in easily accessible "bite-sized" chunks. Online learning has a part to play, but not everyone will have computer access, so other technologies are being considered, such as the potential use of mobile phone technology.

The future vision

It is crucial that everyone working in the sector has the requisite skills. Our vision is of a workforce that is competent, safe, flexible and adaptable - a workforce where all members of staff can do their jobs effectively and make best use of opportunities available to them.

To help achieve this, healthcare employers and learning providers such as further education colleges will need to work in partnership. There is funding available to supplement the investment being made by employers themselves, but greater understanding of how to access this support is required.

In the meantime, we must continue to think creatively about how to reach out to and engage with those working in healthcare who are currently struggling with English as a second language. By working together, we can help to enhance their quality of life as well as the lives and well-being of those they come into contact with.