Why do NHS managers love gobbledegook?


The language used by managers in the National Health Service (NHS) is often ‘gobbledegook’, according to a new report by the Plain English Campaign.
Steve Jenner, the Campaign's spokesman, said the NHS has become riddled with jargon when it comes to explaining many issues, such as the closure of hospital services or major incidents.
But what is even more worrying is that he believes the NHS may be doing this on purpose.
"If you use impenetrable language it means the public has no clue what is going on. This suits the NHS sometimes." He said. “What this jargon is describing is very important. It should be articulated very clearly. We expect doctors to clearly explain themselves. It should be the same for NHS management."

What the heck is a ‘Sticky Toffee Pudding’? 
‘Sticky toffee puddings’ (STPs) is a new management phrase being used in the NHS. In fact, these 'puddings' are among the most important developments in the health service in recent years.
But you would never guess what the phrase actually means. (Incidentally, it means ‘Sustainability and Transformation Plans’).
However, the jargon goes further than that, according to the Plain English Campaign. Look through most plans (there are 44 of them altogether) and you will find some strange phrases.
Cambridgeshire and Peterborough's documents, for example, talk about investing in "system-wide quality improvements" and developing a "shared understanding of all the interrelated issues", while being able to learn "what it means to us as individuals and as organisations".
Meanwhile, documents from North Central London NHS shared the experience of one patient's care that went wrong. It says that due to "hand-offs, inefficiencies and sub-optimal advice and information transfers" the "patient's pathway" went on for too long!!
Another popular "pathway" is the ambulatory patient pathway. What does that mean? It simply means that the patient can go home after being seen in hospital. Why can't they just say that then?!?!
‘Vanguards’ is another phrase often used to confuse the public. There are 50 'vanguards' that have been set up to test new ways of running services. They were created in 2015 and include schemes to get hospital doctors working in community clinics and to provide advice via video link-ups as well as the creation of super hubs in the community bringing together GPs, district nurses and council care teams.
You should not be surprised to hear evidence of what works best in the ‘vanguard’ programmes will then be fed into the ‘STP’ process. Aaaaggghhhhhh!!!!
And how about this for extreme gobbledegook? Northern Ireland's ten-year health strategy, published last autumn, promised to shift the focus from "treatment of periods of acute illness and reactive crisis approaches, towards a model underpinned by a more holistic approach to health and social care.” EH?!?!?
Why can’t they simply say “to get people to live more healthily and give them better support to stop them needing hospital care.” It makes far more sense to say this, and is easily understood by the public. So why do they insist on using such confusing terminology?
And has anyone heard of ‘Operational Pressures Escalation Level Four’?!?!?
That is the new name for a ‘black alert’ (when hospitals get so busy they have to cancel non-emergency operations, divert ambulances and call in extra staff).
And can you guess what ‘red alerts’ (the level below 'black alerts’ are now called? Yes, that's right, ‘Operational Pressures Escalation Level Three’.
Guidance issued by NHS England last year actually ordered hospitals to use this dreadful new terminology when communicating with the public. But thankfully not everyone obeyed this stupid new rule. Newspaper coverage this winter was littered with reports of ‘black alerts’ and ‘red alerts’ - terms that at least the public can understand.

Why is the National Health Service Littered with Gobbledegook?
The answer is obvious really. The NHS want to confuse their own customers (i.e. their patients) so that they don’t understand what is meant whenever any bad news is being conveyed.
More importantly, they want to keep a sense of power over us ‘little’ people. We are the mere users of their services. And what better way to keep power over service users than by using terminology that ordinary people don’t understand?
We see this technique frequently used throughout the public sector. For example many local councils and parts of the Civil Service are littered with management-speak, gobbledegook, jargon, acronyms and buzzwords that none of the customers actually understand.
The interesting thing is that in the private health sector, nearly all communications materials are extremely well-written so that the customers can easily understand what they are being told. I have been treated several times recently in private hospitals, and the communications has always been outstanding. 
In fact, my experiences of private healthcare in the last year has shown what a massive gap there is between the NHS and the private sector in terms of customer service generally. And this is not just down to the private health sector having more money, as I will explain in a future article.
It's high-time that management in the NHS started treating (excuse the pun) their customers with a bit more respect and dignity. After all, WE are the people that pay their wages.


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