A quantitative analysis of the impact of Limited English Proficiency (LEP) on time to dispatch for individuals calling 999 to access emergency care from a regional NHS ambulance service in England.


  • Sandra Igbodo


NHS, Health Care, Telecommunication, Language Barriers, Limited English Proficiency, Translation, Ambulance Service, Emergency Care, Pre-hospital Care


Background: Telecommunication is the established method that the ambulance service is accessed by the public in emergency circumstances.  By using verbal means alone, an Emergency Medical Dispatcher (EMD) must gain critical information from a caller to assess the severity of a patient’s injury or condition to ensure that resource to life-threatening incidents as a priority.  Language barriers between the caller and the EMD during a 999 call have the potential to delay dispatching an emergency response vehicle due to miscommunication or the need to access a third-party translation service. This study explores the impact of Limited English Proficiency (LEP) on emergency response vehicle dispatch times for individuals calling 999 to access emergency care from a regional NHS ambulance service in England

 Methods: Analysis of secondary data from a single, regional NHS ambulance service in England was undertaken to assess whether there was a statistically significant difference between time to dispatch for 999 callers with reported LEP and those who do not report LEP.  Data were collected for 999 calls received between 01 January 2021 and 31 December 2021.

Results: For call categories 1 to 5, the mean to time to dispatch was statistically higher for 999 callers with LEP compared to time to dispatch for callers that did not report LEP (Call Categories 1 – 3, p = <.001; Category 4, p = .001; Category 5, p= .003). 

 Conclusion: This research suggests that when individuals with LEP call 999 to access emergency care from the ambulance service, there is a statistically significant increase to time to dispatch compared to those that do not experience language barriers during a 999 call. This research contributes directly to public health action at the participating NHS organisation by providing a foundation to its equality, diversity, and inclusion agenda, as one of the key areas for improvement is the impact of English as a second language on access to the 999-emergency service and the NHS 111 urgent care service.  This research could support the recommendation to introduce standardised LEP reporting to allow for consistent recording of LEP cases on 999 calls to support robust monitoring that would allow for further investigation of the impact of language barriers to dispatch times.