Sticky toffee pudding: decoding NHS jargon
The directive came to all staff: ‘The BME conference is a staff benefit and we expect you to support it and, if appropriate, attend.’ My friend’s mum, an NHS professional, scratched her head. “What can it mean, Sue?” Sue was stumped too. “British Medical… Employees?” Even the NHS’s own staff, well-practised in the art of decoding the health service’s communications, couldn’t decipher the internal jargon. They dutifully went along, lest they get in trouble for non-attendance.
Little did they know it stood for Black Minority Ethnic, the term widely used across business sectors and not, in fact, one of the service’s own, more obscure alternatives; the conference was predominantly for staff who identified within this group, which was visibly not Sue or said friend’s mum.
Jargon is ridiculous enough when your own staff can’t decipher it. But when weird internal terms end up in public facing communications, it’s time to refresh your PR and comms team. That’s what’s happened this week when the Plain English Campaign called out the NHS “gobbledygook” (a fine word itself, a delight to see it resurrected).
Initialisms are some of the worst NHS offenders, with a myriad of letters clustered together because staff can’t be bothered to write out the whole phrase, leading to situations like Sue gatecrashing the BME conference. Come on! Just write the whole thing out. It’ll take you less time than it’ll take your reader to decode it. The only initialism acceptable in the NHS is NHS. All others could confuse or humiliate.
There are even NHS jargon busters online – a whole series of them. Solihull has its own one, which is separate from NHS Southern’s one and this NHS Confederation one, which spells out BME for people like Sue. They’ve even made an app, so people can learn NHS jargon from the comfort of their own sofa, like Linguaphone.
Taxpayers’ money well spent, I’m sure you’d agree. Who needs an extra surgeon when you can employ a jargon buster, a coder and a copywriter? What’s your job? Me? Oh, I’m the jargon buster copywriter for the NHS – Solihull branch.
Some NHS branches are forcing their initialisms into acronyms, which are pronounceable initialisms forming new words either entirely unrelated, or tenuously related in a laboured way to the matter they represent. One of them in Solihull’s tailored jargon buster for the region is BADGER which sounds like someone shouting an animal at you in a game whose rules haven’t been explained. But it is actually Birmingham and District General Practitioner Emergency Room. Obviously.
There are acronyms, once decoded, which are still utter waffle. STP stands for sticky toffee pudding, naturally. And WTF is an STP? It’s a “sustainability and transformation plan”. When the plain English explanation is as jargon-heavy as the jargon itself, it feels like we’ve entered George Orwell’s 1984 universe where terrible atrocities are obfuscated by a massive organisation run by faceless bureaucrats through devastating euphemisms, puzzling initialisms and insidiously cute dessert-based metaphors. A sustainability and transformation plan surely never gets anything done because one definition counteracts the other in this paradoxical plan: one thing is attempting to maintain at length, while the other is attempting to change drastically.
Meanwhile, one patient in North London whose care went wrong was described thus: “Due to hand-offs, inefficiencies and suboptimal advice and information transfers the patient’s pathway went on for too long.” What a suboptimal expression. It’s a complex way of saying Janet’s hemorrhoid preparation got mixed up with morphine and now doctors have misdiagnosed her with early onset dementia because of her suddenly erratic behaviour. Poor Janet has been put in a home when all she came in with was piles.
Other jargon has been called-out, including self-important words like ‘vanguard’ and robotic, impersonal phrases like Operational Pressures Escalation Level Four, meaning ‘the hospital is really busy tonight.’ But there are times, it must be said, when the Plain English Campaign has got picky. It criticises ‘system-wide quality improvements’ and ‘what it means to us as individuals and as organisations’. These both seem relatively clear to me. There are far worse examples of corporatese (workplace jargon) than this.
Euphemisms or jargon can deliberately cloud. Any Londoner who has been on the tube when ‘Inspector Sands’ has been called to duty understands this code (or ‘cant’ to use the non-plain English term) is used with the best of intentions: not to panic tourists. But communicating with complete clarity to the public about matters of general health couldn’t be more crucial. Otherwise, they’ll smell a rat and become suspicious of what really is being said.
Either that, or publicly embarrass themselves by guessing the initialism incorrectly, like Sue.