I hear, almost daily, that the time has come for a public debate on the NHS: one that tackles the realities, for us all, of never-before-seen strains on the NHS purse and a never-before-experienced set of crisis-inducing challenges.
With the stakes higher than ever before, I’m game.
So too, it seems, is the public. Rarely can the fate of such a prized asset be decided with us – those with a vested interest in the health service – in absentia.
But many, though willing and eager, don’t feel equipped for such a conversation: just 40% of people believe they’re armed with the necessary knowledge to contribute to a dialogue of this nature.
How do we arm the remaining 60%? By matching the person-centred care mantra we hear so often with a person-centred language mandate. And by this I mean just one thing: leaving NHS-speak in the boardroom.
Meaningful dialogue needs all parties on the same page; any meaningful exchange needs all parties speaking the same language; and meaningful conversation needs a level linguistic playing field, free from jargon, sector-specific acronyms and opaque abbreviations. At such a critical juncture for the NHS, public debate must be as transparent in presentation as it is in content.We can’t afford for it not to be.
The NHS is so often seen as the guest rather than the gem in people’s lives; language, surely, must shoulder some of the blame.
Littering the public debate with industry terms such as “reconfiguration”, “bed-blocking”, “out-of-hours services” (out of whose hours?), only serves to exclude the great mass of people wishing to contribute their views on how health and care services can weather the tricky tide. If shared decision-making is what we’re after, a shared language is what we should utter.
Should not the challenge of a paperless NHS by 2018 be matched by an acronym-less one? If more patient and public engagement are what we seek, if more patient-centred ways of working are what we’re striving for and if more local community input is our aspiration through the foundation trust regime, isn’t language a pivotal point?
Sure, every industry, sector, business has its own terms, and I’m not saying that’s wrong. But the point I am making is that when that industry, sector, or business puts its customers first, it orients itself to accommodate all that this brings.
Opportunities for public engagement in decision-making, such as board meetings, consultation events, annual reports and performance reviews, can often lead even those who work in the health sector to reach for the NHS Acronym buster app. It’s a handy device, busting more than 700 NHSisms, but if we’re to reach and truly involve the underarmed 60%, we’ll need to banish any linguistics barriers to doing so.
Encouragingly, of those who wanted more information, 74% said they wanted more information about the NHS, particularly on how the service is funded and how funding is used. The appetite for shared decision-making is there.
As we head towards next year’s general election, in which health will no doubt be a battleground issue, let’s make sure that all those who have a stake in the health service can have their say.
Johnny Marshall is a GP and director of policy at the NHS Confederation
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