Harrogate and District NHS Foundation Trust was recently rated as excellent in a surprise inspection by the Care Quality Commission, but faces growing challenges to cut costs without impacting patient services.

The foundation trust status means it has 17,000 members of the community involved in running services and helping to maintain those excellent standards, while also working to find improvements and efficiencies.


The Challenge

Finding cost-effective ways to provide interpreting support for medics and patients was a priority for Harrogate and District NHS Foundation Trust as it worked to find savings at every level of the organisation.

Medical procedures are daunting and are made all the harder if your doctor can’t explain how they plan to help you. As a result all NHS Trusts need to hire in interpreters – but this can be a major burden on budgets as well as create additional time pressures in already busy departments.

For example, in the day surgery unit, interpreters were needed to help patients ahead of an operation but would then have to wait for several hours to support them following the procedure.

With patient experience and quality at the top of the agenda, the Trust turned to thebigword for help.

The Solution

On average, across the NHS, up to 20 per cent of patients miss appointments. Couple this with the lengthy waits between key moments in patient care, and the time interpreters spend in hospitals can quickly add up.

By using their world-leading technology systems, thebigword has helped Harrogate and District NHS Foundation Trust to access on-demand interpreting services over the phone that are delivering huge savings – in one month alone the Trust made a 92% saving.

By working closely with the Trust, thebigword was able to drive through cost efficiencies in a responsible manner while ensuring there was zero impact on the patient experience.

Under thebigword’s Interpreting Management System (IMS), health workers can instantly access expert interpreters in more than 250 languages over the phone. The service is fully automated and guides users to the most suitable linguist, ensuring patients always receive the support they need.

The average NHS call lasts 12 minutes with an average £6 charge, compared to face-to-face appointments which are a minimum of an hour and average £35 outside of London, presenting real savings. The Trust is also only charged when they connect to an interpreter, so missed appointments and lengthy waits are no longer a burden on the organisation.

The support of thebigword has helped to encourage behavioural change across the Trust, which says it is already considering how it can implement thebigword suite of translation technology and expertise across other areas of the organisation.


When a patient who speaks another language walks through the door, we know we can get an interpreter who speaks one of 257 different languages on the phone in 30 seconds, thanks to thebigword. We can now make substantial savings, without having any negative impact on a quality patient experience, and receive a more flexible service.


John Williams – Switchboard Manager, Harrogate and District NHS Foundation Trust