How much does the NHS spend on translation services? The NHS spends approximately £60–65 million per year on translation and interpreting services. Recent data shows total expenditure of around £240 million over five years, with costs rising due to increased demand from a linguistically diverse population across NHS trusts in England.
Translation and interpreting services are a critical, yet often under-examined, component of the UK’s National Health Service (NHS). With a linguistically diverse population, ensuring effective communication between healthcare providers and patients who do not speak English fluently is essential for safe, equitable, and high-quality care. At the same time, the costs associated with these services have become a subject of scrutiny, debate, and policy interest.
In this comprehensive article we examine how much the NHS spends on translation and interpreting services, what the figures suggest about trends in expenditure, and why these services matter. Weights are given to available data sources and contextual factors, acknowledging limitations in the completeness of published figures.
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Understanding NHS Translation and Interpreting Services
When we talk about “translation services” in the context of the NHS, we refer to a wide range of language support mechanisms. These include:
- Interpreting services — real-time language support during consultations, face-to-face or by phone/video;
- Document translations — converting written materials such as consent forms, patient information leaflets, letters, and clinical documents into other languages;
- Other accessibility services for patients with communication barriers.
These services are provided free at the point of need because the NHS has a statutory obligation to ensure safe, accessible healthcare for all residents, irrespective of language proficiency.
How Much Does the NHS Spend on Translation Services? By Setranslations.uk?
The NHS provides translation and interpreting services to ensure patients with limited English proficiency can access safe and effective healthcare. With the UK’s growing linguistic diversity, these services play a vital role in clear communication between patients and healthcare professionals, helping to reduce misunderstandings and improve clinical outcomes.
Recent data shows that the NHS spends around £60–65 million each year on translation and interpreting services across England. This includes spoken-language interpreters, document translation, and British Sign Language support. Over recent years, total spending has reached hundreds of millions of pounds, reflecting rising demand and wider accessibility obligations.
While the cost attracts public attention, translation services remain essential for patient safety, equality, and quality of care. At setranslations, we understand the importance of accurate translation and focus solely on delivering professional translation services, while responsibility for document authenticity remains with the applicant.
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Key Figures on NHS Expenditure
Recent NHS-Wide Data
Publicly available data on NHS translation and interpreting services vary in scope and coverage, largely because there is no single central reporting system that aggregates all trust-level expenditures. However, analysis from multiple sources provides a clear indication that the NHS spends tens of millions of pounds each year on translation and interpreting services, and that spending has increased over time.
A recent analysis based on Freedom of Information (FOI) data from NHS trusts and Integrated Care Boards (ICBs) showed that:
- In the 2020/21 financial year, NHS providers spent approximately £31 million on translation and interpreting services;
- By 2024/25, this figure had more than doubled to around £64 million.
- Over the five financial years between 2020/21 and 2024/25, total reported spending was approximately £243 million.
- On an average daily basis, this corresponds to more than £130,000 per day being spent on translation and interpretation.
These figures illustrate both the scale of expenditure and the trend of rising costs, reflecting increased demand for language support as the UK’s population becomes more linguistically diverse.
Longer-Term Estimates and Trust Variations
Other estimates, based on a broader span of financial years and partial trust responses, suggest considerable cumulative spending:
- Between 2019/20 and 2021/22, NHS trusts that responded to data requests spent at least £113.9 million on interpreters and translation services. When estimating for all trusts, the total could be substantially higher, potentially exceeding £174 million over that three-year period.
Looking at individual trusts, there is wide variation in spending levels. Some trusts spend only tens of thousands of pounds annually, while others spend hundreds of thousands or even low millions, depending on local demographics and demand patterns. For example, a single trust’s spend over five years in one FOI disclosure amounted to almost £1.4 million.
Separate FOI disclosures from individual NHS organisations also show:
- A trust that spent £460,187 on translation and interpreting over five years (2020/21–2024/25).
- Another trust reporting an annual spend of around £263,502 in the 2024/25 financial year alone.
e-Referral System Translation Costs
Parliamentary data on translation costs associated with the national e-Referral Service (e-RS) is a notable outlier. Over the last five years, England’s e-RS incurred a total translation cost of only £4,213, because the system uses standard templates and pays for translation only when templates change or languages are added.
This highlights that different parts of the NHS operate under very different cost structures for translation services.
Why Translation and Interpretation Services Are Essential?
These expenditures are not an optional administrative add-on; they are a core requirement of safe and equitable healthcare. Effective communication between healthcare providers and patients is integral to accurate diagnosis, informed consent, medication safety, continuity of care, and patient satisfaction.
Language barriers in healthcare can lead to:
- Misdiagnoses and clinical errors;
- Delayed presentations and higher-cost treatments later on;
- Increased missed appointments and use of emergency services;
- Inequities in access to preventative care and health outcomes.
While the precise quantification of “costs avoided” through effective language services is complex, healthcare research suggests that poor communication can incur substantial additional costs due to inefficiencies and adverse outcomes.
Language services also contribute to compliance with equality and discrimination law, ensuring that non-English speakers and patients with communication needs receive care on the same basis as other patients.
Drivers of Rising Costs
Several factors contribute to increasing NHS expenditure on translation and interpreting services:
1. Demographic Change
The UK’s population has become more linguistically diverse over the past decade, with large communities speaking South Asian languages and Arabic. This has driven demand for both interpreting in clinical interactions and written translations.
Certain trusts in diverse metropolitan areas naturally incur higher demand — and therefore higher costs — than rural areas.
2. Service Models and Procurement
NHS trusts may procure language services from external agencies, pay per session for interpreters, or manage in-house provisions. The absence of a unified national procurement framework means separate trusts may pay different rates for similar services, with some suppliers charging premium rates for rare languages or emergency availability.
3. Inclusion of BSL and Accessibility Services
Language support is not limited to spoken languages. BSL interpreting and other accessibility provisions (such as support for visually impaired patients) are often requisites under disability law and can add to overall service costs.
4. Broader Scope of Services
Interpretation is needed not only for clinical consultations but also for administrative interactions, consent discussions, discharge planning, and public health communications. As the NHS strives to improve patient engagement, demand for comprehensive communication support has grown.
Challenges in Data and Transparency
Despite the importance of these services, a lack of centralised reporting complicates accurate national accounting. The Department of Health and Social Care does not maintain a consolidated dataset on translation and interpreting expenditure across all NHS trusts and ICBs. Most data come from FOI disclosures and independent analyses, which may under- or over-represent total spending.
Furthermore, different trusts classify “translation” and “interpretation” differently in financial systems, making direct comparisons challenging.
Policy and Efficiency Considerations
The rising cost of translator services has prompted debate about efficiency and best practices. Some analysts have suggested that pooled translation resources, shared central libraries of pre-translated documents, and greater adoption of technology could reduce spending without compromising patient care.
However, these proposals must balance cost considerations with quality and safety. Automated or poorly vetted translation tools are widely regarded as unsafe for clinical use, given the risk of misinterpretation. High-quality, human translation and interpreting remain the standard in healthcare settings.
Moreover, effective language services are intertwined with broader policy goals, including reducing health inequalities, improving access to care, and meeting legal obligations under equality and human rights legislation.
Looking Ahead: Trends and Forecasts
Experts and published assessments suggest that spending on translation and interpreting is likely to continue to grow in line with demographic trends. An NHS South Central and West analysis estimated that the current spend on these services (circa £75.5 million per year in one estimate) is below what would be needed to fully cover population needs, projected at £250–£300 million based on demographic data.
These figures are not official NHS aggregate statistics, but they indicate the potential scale of unmet need and the implications for future health service planning.
Conclusion Of How Much Does the NHS Spend on Translation Services?
The NHS’s expenditure on translation and interpreting services is substantial and growing. Available evidence shows that:
- Spending has more than doubled in recent years, with roughly £64 million spent in 2024/25 alone on translation and interpretation services, and total expenditure over five years reaching around £243 million.
- Individual trusts vary significantly in their expenditure, reflecting local population needs and service models. (CLCH NHS)
- Broader estimates suggest that the actual total spending over recent multi-year periods may exceed £174 million.
Conclusions
These investments are not optional; they are foundational to delivering safe, equitable, and legally compliant healthcare to a linguistically diverse population. Understanding and optimising how the NHS provides these services remains a key challenge for policymakers and healthcare leaders.
At Setranslations.uk, we recognise the importance of accurate language support in healthcare and beyond. Our focus remains on delivering high-quality translation services, while emphasising the responsibility of clients to ensure document authenticity and compliance with all applicable standards.
If you need professional translation support for NHS or healthcare-related documents, feel free to contact us at Setranslations.uk.
