Health managers are very keen on “pathways”. They also have a fondness for “frameworks” and “taskforces”.
But above all they love acronyms and abbreviations - CSRs, ACADs, CQUINs, SCCRs, and WRAPs, to name but a handful.
That much is clear from the language used in many of the Sustainability and Transformation Plans (STPs - yes, another NHS abbreviation).
While a handful of these blueprints for change to the structures of the health service are commendably clear, others are shrouded in a fog of jargon.
Last month, members of the Healthier Lancashire and Cumbria umbrella group complained that one of the major problems they faced when assessing their local STPs was simply their inability to understand it in the first place.
They highlighted the following example: “Implement short-term high-impact secondary prevention measures to reduce demands on services.”
Councillor Steve Holgate, a member of the panel, said: “You can’t have a proper conversation about an issue if nobody understands what it says.”
Other STPs are littered with similar examples of gobbledygook: “We must drive a system vision that leverages community assets”; “Self-care happens when patients are ‘activated’”; “affordability challenge”.
Clinicians have made the point that the use of such unwieldy language, perhaps handed on by highly-paid management consultancies involved in drawing up the STPs, is ultimately counter-productive.
Dr Taj Hassan, president of the Royal College of Emergency Medicine, said: “We would urge STP leaders to be more robust and forthcoming with details as to how they hope to achieve change. Obscuring facts with impenetrable language helps no-one, especially our patients.”
Below is Johnston Press Investigations attempt to unravel some of the linguistic red tape:
• “Affordability challenge” - savings target
• “Abatement growth” - savings target
• “Point of care testing” - bedside blood test
• “Frailty friendly hubs” - clinics for elderly patients
• “Dr First triage” - patients will be assessed by a clinician, not someone called Dr First
• “Ambulatory care pathway” - patient can go home once seen
• “Right size” - as in “to right size a service”, unlikely to mean considerably expand.
‘We’re just following the rules’
Reacting to criticisms that the STP plans are vague and full of jargon, Dr Amanda Doyle, the lead for Lancashire & Cumbria STP, said: “The draft Sustainability and Transformation Plan document, which was published in November 2016, is a document which was created based on technical guidelines set by NHS England and NHS Improvement, in which we were required to demonstrate how we would close the health and care, health and wellbeing and finance and efficiency gaps (known as the triple aims).
“The intention of the document was to assess and outline the challenges faced across the Lancashire and South Cumbria health and care system, in order to accelerate further thinking in developing potential solutions to overcome some of the challenges we are facing.
“The document that we have created does not make any specific proposals for how services may change as there has not been the level of engagement and involvement with staff, clinicians or members of the public that this would require.
“We are committed however, to make sure that widespread involvement with stakeholders takes place over the coming weeks and months to help shape our thinking.
“We are currently working to develop an easy read version of the Sustainability and Transformation Plan and a suite of materials, which has been tested with members of the public to make sure these are easy to understand and free from jargon and technical information.”