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Annex A: Welsh language services for vulnerable groups

Availability of Welsh language services to ensure best outcomes

Primary care services seek to meet the needs of individuals with holistic and personalised approaches. A clinicians’ ability to understand and clarify a patient’s history, to empathise and to discuss diagnostic tests and results are critical factors for achieving the best outcomes and patient satisfaction.

Language barriers can result in miscommunication which may impact a patient’s understanding of their condition or treatment and may reduce their engagement with therapeutic interventions. Effective communication is particularly important for vulnerable and marginalised individuals and where the sensitive nature of discussions requires confidence to build a therapeutic relationship.

The Welsh Language Act places particular duties on health and social care organisations to ensure that the Welsh and English languages are treated equally in the conduct of public business in Wales. Clinicians should also consider the implications of language for the quality of care provided and work to ensure that access to care in the Welsh language is considered in this context.

Cluster needs assessment

Professional collaboratives should reflect on the local need for services in the Welsh language and in particular the impact on vulnerable local groups, for whom the quality of care may be affected if care in the Welsh language is not available. Collaboratives should be informed of the availability of the ‘Dignity in care’ Welsh Language Toolkit that can be used to structure the local analysis.

The Collaborative should share their professional analysis of Welsh language needs for the local needs assessment.


Mold F, Fitzpatrick J & Roberts J (2005) Minority ethnic elders in care homes: a review of the literature. Age and Ageing 34 107-113:

  • A review of studies from the US, UK, Taiwan, China, Canada and Australia concerning minority ethnic elders in care homes.
  • This identified the need for greater cultural awareness in care homes, including improvements in communication, in order to enhance individualised care.
  • Further research by Heikkila and Ekman (2000) and Heikkila et al (2007) explored the experiences of older Finnish immigrants in care homes in Sweden and identified the significance of language and cultural congruency for enhancing communication and understanding that led to feelings of solidarity, belonging and shared identity.

Welsh Language Board Guidance 6(iv); 1996 cited in Dignity in care:

  • ‘… in circumstances where stress, vulnerability, illness or disability are key factors, not being able to communicate in their first language may place those concerned at a personal disadvantage. Given the sensitive nature of many of these discussions, it is important to offer language choice wherever possible.’