Title: Interpreting safety netting: does it translate? Healthcare interpreters’ perspectives on safety netting strategies in GP Consultations

Talk Code: 
P1.2A.4
Presenter: 
Eleanor Southgate
Co-authors: 
Stephanie Taylor
Author institutions: 
Queen Mary University of London

Problem

With increasing use of remote consultation, it is crucial that GPs are able to effectively triage serious disease from non-serious disease. “Safety-netting” is a well-recognised consultation strategy in primary care. It is generally understood to describe the advice given to a patient in the context of clinical uncertainty, which specifies actions that a patient should take if symptoms persist or new symptoms arise that are suggestive of a worsening clinical course or a more serious diagnosis.Safety-netting may have an important role in achieving early diagnosis of serious disease (for example cancer) where patients present initially with symptoms that do not meet the threshold for immediate referral, but nonetheless need monitoring or investigation. Use of safety-netting is also well established in the context of childhood illness to help parents understand how and when they should seek medical care if their child’s condition does not improve. Studies examining safety-netting from the patient’s perspective describe how it is ineffectual when it is not recognised or understood. In Tower Hamlets, East London, around 35% of adults use a main language other than English and use of interpreters for medical consultation is common. Interpreters’ perceptions of safety netting strategies are poorly understood, yet their role is instrumental to the success of safety netting advice in language discordant consultation. This qualitative study aims to explore the perspectives of professional interpreters on the use of safety netting in primary care consultations. What do interpreters understand by the concept of “safety netting” and how do they perceive their own contributions to safety strategies used by GPs?

Approach

Focus group discussions will be conducted with 8 to 12 purposively sampled healthcare interpreters who are currently working in primary care. Data from focus group discussions will be used to inform interview guides for subsequent semi-structured interviews Focus groups and interviews will be audio-recorded and transcribed verbatim for inductive thematic analysis. This phenomenological approach will explore the subjective experiences of healthcare interpreters and their perceived contribution to safety netting in primary care.

Findings

This work is currently in progress. By inviting interpreters to share their perspectives on safety netting I will explore how they relate to a communication strategy that is widely relied on in primary care for risk management and patient safety.

Consequences

Insights into interpreters’ role in safety netting in cross cultural consultation may influence future work into promoting patient safety in language discordant consultation in primary care.

Submitted by: 
Eleanor Southgate
Funding acknowledgement: 
NIHR School for Primary Care Research