Abstract
Stood in the operating theatre, in the middle of a laparotomy, the surgeon asked his young assistant, just embarking on her surgical house job, whether she had managed to get to theatre much as a medical student. ‘Well,’ came the reply, ‘I did manage to see quite a few performances at the National …’. Her considered reply was to include an account of some memorable plays and some incisive lines, but she was cut off by the surgeon delivering his own punch line: ‘Monica, we’re in an operating theatre!’ She wasn’t ever called Monica except by this particular surgeon, because her name was and still is, Barbara. Such is the nature of miscommunication. Needless to say, Barbara still gets to the theatre a lot, sometimes the National; as a consultant psychiatrist useful lessons on communication have been learnt from time spent in the theatre. Little of use was learnt in the operating theatre, although this particular house job confirmed a resolve to pursue her chosen career and an interest in drama.
A report published by Demos, described as Britain’s leading cross-party think tank, in November 2023 has highlighted the urgent need to improve communication within the NHS. More than half of patients have experienced poor communications from the NHS in the past 5 years and one in ten say their care was affected as a result. The report calls for more care coordinators, more care navigators in GP surgeries and more use of the NHS app. Whatever the verdict on the proposed solutions, the diagnosis won’t come as a surprise to those of us working in the NHS. The majority of patient complaints have their root cause in poor communication or miscommunication. This is disappointing when so much of our training and so much effort is spent on ensuring that our communications are well directed, accurate and in tune with the needs of patients.
It is no surprise that as with most issues of InnovAiT, we include articles with advice on communication. So many consultations primarily require time for explanations and the accurate communication of advice and guidance. Helen Leach et al. give a useful account and practical tips for effective use of video consulting. This warns of pitfalls and the potential for miscommunication. Anna Podlasek provides a thorough and thoughtful account of the management of obesity, again with lessons on the importance of good communication. Hussain Al-Zubaidi considers ankle sprains in sport. These present very often to GPs and this article helps to inform better assessment and management, not least from a good history and appropriate advice. Recurrent pregnancy loss is very distressing for all concerned and medical management should incorporate accurate and empathic advice within effective consultations providing enough time for patients to express themselves. The article by Hana Baig and colleagues will help us to better meet the needs of patients. Renal and ureteric colic can cause quite a stir when affected patients present, often in some distress to primary care. Aleksandra Berezowska and Panagiotis Nikolinakos provide facts, information and advice to guide us and our patients presenting for help.
A general election will be closer when this issue reaches publication, and I don’t doubt that communications about health care will feature large. Let’s hope they are well-directed, accurate and in tune with the needs of patients! Perhaps we should remind our politicians of the political strategist, James Carville’s three messages for the focus of campaign workers in Bill Clinton’s successful 1992 US presidential election campaign: ‘Don’t forget health care’, ‘Change versus more of the same’ and the third? ‘It’s the economy, stupid’.
The green shoots of Spring should be in evidence by the time of this issue’s publication. I am sure this will bring us hope and the resolve to continue worthy efforts for improvements in the lives of patients. Should we have a Spring clean and review where there are opportunities to improve communication, not least from a review of complaints? Let us also hope that upcoming political campaigns can enlighten and inform about the economy and health care. Hope springs eternal. When making decisions we need to weigh our choices carefully with the benefit of good information and evidence. Change or more of the same? Political campaigns, like consultations, need that important human ingredient. It’s communication, stupid! Let’s hope for accuracy in communication, unlike that from one ageing rock legend trying to warn us of the greatest threat to mankind: ‘Artificial insemination’.
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