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By the Versus Team | April 2022 | Category: Organisational Leadership & Inclusion

Reading time: approximately 6 minutes | Audience: Healthcare Managers, HR Leaders, Public Sector Professionals

 

Here is a scenario that plays out in Italian healthcare and public sector organisations every single day. A patient arrives for an appointment. Nobody on the team speaks their language. A family member — perhaps a teenager, perhaps a spouse who barely speaks more Italian than the patient — steps in to interpret. The consultation proceeds. A form is signed. The appointment is marked as completed.

On paper, it looks fine. In reality, it may have been a clinical near-miss.

Language access — the ability of an organisation to communicate clearly and effectively with people regardless of the language they speak — is not a niche concern in modern Italy. With communities of Arabic, Romanian, Chinese, Tagalog, Bengali, Wolof, Tigrinya, Albanian, and Ukrainian speakers distributed across cities and regions from Lombardy to Sicily, no healthcare provider, local authority, or social services organisation can afford to treat multilingualism as an edge case.

And yet, most organisations have no formal strategy for it. They improvise. They rely on whoever happens to be available. They hope for the best.

This article identifies five clear signs that your organisation needs to stop improvising and start planning — and explains what a proper language access strategy actually looks like.

Sign 1: You Are Regularly Using Untrained People to Interpret

If your organisation routinely asks bilingual members of staff, family members, or volunteers to interpret during clinical consultations, legal appointments, or social care assessments, you have a language access problem — even if it has never been framed that way.

Untrained interpreters, however well-intentioned, are a significant liability. They lack the professional vocabulary to convey complex medical or legal information accurately. They may omit, soften, or inadvertently distort what is being said. They are not bound by confidentiality. And they can find themselves in deeply uncomfortable positions — a bilingual nurse asked to interpret during a psychiatric assessment of a colleague’s family member, for example, or a receptionist expected to convey a terminal diagnosis because no one else was available.

In Italy, using a child to interpret for a parent in a healthcare setting is still not uncommon in some communities. Beyond the obvious safeguarding concerns, it places an unfair and potentially damaging burden on the child, who may carry the weight of information no young person should have to process, let alone convey.

A language access strategy replaces these ad hoc arrangements with reliable, professional alternatives — qualified interpreters available on-site, by telephone, or via video remote interpreting (VRI) — matched to the situation and the language required.

Sign 2: Your Patient or Service User Feedback Reveals Communication Breakdowns

Look at your complaints data, your patient satisfaction surveys, and your incident reports. How many mention confusion about diagnosis or treatment? How many involve patients who did not understand what they were consenting to? How many reflect a broader sense of feeling unheard, dismissed, or unable to communicate their needs?

In organisations with a significant multilingual service user population, a disproportionate share of these complaints will involve patients or clients with limited Italian proficiency — even if the complaints themselves are not explicitly framed in those terms. Poor communication transcends language, but language barriers reliably compound every other form of communication failure.

If your organisation serves communities in Milan’s Porta Venezia neighbourhood, Rome’s Esquilino district, Turin’s San Salvario area, or any of the towns in the agricultural south where seasonal migrant workers settle — and you are not seeing language-related issues in your feedback data — this may not be because the problem does not exist. It may be because people with limited language access are less likely to make formal complaints, precisely because the system for doing so is also in a language they do not fully understand.

Silence in your complaints data is not always a sign that everything is fine. Sometimes it is a sign that people have stopped trying to be heard.

Sign 3: Your Staff Have No Training on Working With Interpreters

Even in organisations that have access to professional interpreters, the value of that resource is significantly diminished if clinical and frontline staff do not know how to use them effectively. Working with an interpreter is a skill. It requires understanding how to direct communication, how to structure information in segments, how to maintain the therapeutic relationship through a third party, and how to verify comprehension.

If your staff have never received any guidance on these techniques — if the default approach is simply to “speak to the interpreter” and hope things work out — then even the best-quality interpretation will not deliver the outcomes it should.

A language access strategy includes a training component. It equips staff at all levels — from consultants and senior nurses to receptionists and care coordinators — with the practical skills to make interpreted consultations genuinely effective. This is not a large investment of time. A two-hour workshop, properly designed, can transform the way a clinical team approaches language-mediated care.

Sign 4: Your Written Materials Are Only Available in Italian

Consider the documents your organisation produces: appointment letters, discharge summaries, consent forms, medication instruction sheets, service user charters, complaints procedures, safeguarding leaflets. Now ask: in how many languages are these available?

For most Italian organisations, the honest answer is one: Italian only. This is understandable as a starting point, but it is increasingly untenable as a permanent position. A patient who cannot read the letter explaining what to bring to their procedure may not bring it. A family who cannot read the discharge summary may not follow the care instructions correctly. A service user who cannot understand the complaints procedure has, in practice, no access to it.

Translation of key documents is a core pillar of any language access strategy. It does not mean translating everything into every language — that is neither practical nor necessary. It means identifying the highest-impact documents and the most-spoken languages among your service user population, and ensuring that critical information is accessible in those languages. In Italy’s current demographic context, Arabic, Romanian, Chinese (Simplified), Albanian, and Bengali are a sensible starting point for most urban healthcare providers.

Sign 5: You Have No Data on the Languages Your Service Users Speak

This is perhaps the most telling sign of all. If your organisation cannot answer the question — which languages does our service user population speak, and in what proportions? — then you are operating blind.

Without this data, language access planning is guesswork. You cannot make informed decisions about which interpreter services to contract, which documents to translate, or where to target staff training. You may be investing resources in languages that are rarely needed while completely neglecting the one that is causing significant daily problems.

Collecting language data is straightforward. It involves adding a language preference question to your registration or intake process and recording the information systematically. The NHS in England has done this for years under its Equality Monitoring framework — Italian healthcare and public sector organisations are increasingly moving in the same direction, and several ASL networks in northern Italy have begun implementing similar approaches.

What a Language Access Strategy Actually Looks Like

A language access strategy is not a bureaucratic document that sits in a drawer. It is a practical framework that answers four questions: Who are we serving? What languages do they speak? What are the critical communication touchpoints in our service? And what resources do we need to ensure those touchpoints are accessible?

At Versus, we work with healthcare providers, social care organisations, and public sector bodies to design and implement language access frameworks that are realistic, sustainable, and genuinely improve outcomes. The starting point is always the data — understanding the linguistic profile of the population served. From there, we help organisations build the right mix of professional interpretation, document translation, staff training, and technology.

The return on that investment is measured in fewer adverse incidents, higher patient satisfaction, reduced staff stress, and — most importantly — people who feel seen, heard, and treated with the dignity they deserve.

A language access strategy is not a bureaucratic exercise. It is a commitment to the principle that every person who uses your service deserves to understand what is happening to them.