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Cut the crap: an alternative glossary of NHS jargon

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By Léa Legraien
Reporter
18 December 2017

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If you’ve ever felt perplexed by NHS parlance, we’re here to help. Léa Legraien unravels healthcare’s most hideous buzzwords

As if understanding the way our healthcare system works isn’t complicated and taxing enough, deciphering NHS jargon only makes things worse.

Person-centred care, driving efficiencies and resource-limited environment are just a few examples of the numerous health and social care terms that might make people lose their minds.

Here at Healthcare Leader, we’ve decided it’s time to stop jargonising the way we talk about health and start cutting the crap.

We took 10 NHS buzzword definitions and tried to squeeze some sense out of them.

Key to irritation

Useful idea, stupid name

Just annoying

Please stop using

1 Population health

DEFINITION Population health is not an easy term to define, as not everybody agrees on one definition.

In 2003, two retired professors involved in population health studies – David Kindig from the Madison School of Medicine, Wisconsin and Greg Stoddart from McMaster University Health Science Centre, Ontario – proposed the following definition: ‘Population health is the outcomes of a group of individuals, including the distribution of such outcomes within the group’.

So far, so mystifying.

Some believe that the two words should exclusively refer to geographic populations while others think they’re useful ‘to describe activities limited to clinical populations’ – another term that certainly needs more explanation too.

CUTTING THE CRAP ‘Population health’ literally means the health of the population.

Dawn Marie Jacobson, founder of the Abundant Living Wellness Centre in California and Steven Teutsch, an independent consultant in California, recommended that the term should be replaced by ‘total population health’. All clear now? No. Not at all. Can we please just use ‘health’?

IS IT USEFUL? No, even if well intentioned.

There’s a reason this particular term is top of our hitlist and that’s because in the absence of a single definition, the term doesn’t really mean anything.

IRRITATION LEVEL 3

2 Support chassis

DEFINITION No, it’s not a motor vehicle, although you might use it when driving efficiencies. The NHS uses the term ‘support chassis’ when talking about sustainability and transformation partnerships (STPs).

Here’s an example. ‘All STPs need a basic governance and implementation “support chassis” to enable effective working’.

CUTTING THE CRAP Essentially, this means that in order to succeed, STPs need management support, which is created by pooling expertise and people from across local trusts, clinical commissioning groups (CCGs), Commissioning Support Units (CSUs) and other partners. Surely there’s a less annoying name to give this?

IS IT USEFUL? On a car, yes. In NHS circles, though, it’s deeply irritating. Please refer to ‘support’ instead.

IRRITATION LEVEL 3

3 MEAT

DEFINITION In an NHS England context, contracts for healthcare services are awarded to companies by ‘selecting the MEAT’.

So what does the butcher have to do with healthcare services?

Actually, MEAT doesn’t refer to animal flesh but Most Economically Advantageous Tender.

Nicola Hall, managing director at NHS software provider Ingenica Solutions, says: ‘On every tender, there are hundreds of questions about the system, functionality and the company. But the only one that is really marked is the price, or it seems so based on highest marks to the MEAT response.

‘It would be more efficient to ask suppliers the price, score on this and then ask a second round of questions on functionality if the suppliers were in the ballpark. Taking this approach would be more cost-efficient for both the supplier and the procurement teams.’

So there you go. It isn’t just the term that’s unnecessary but the whole approach.

CUTTING THE CRAP In simpler terms, rather than accepting the lowest price when buying a service or a product, MEAT reminds us it’s important to consider value for money, based on factors such as quality and business risk.

IS IT USEFUL? Yes, with roast potatoes.

As an NHS term, no. Use ‘value for money’ instead, please, and thank you.

IRRITATION LEVEL 3

4 Leverage the opportunity

DEFINITION According to the Cambridge dictionary, ‘leverage’ means ‘to use something that someone already has in order to achieve something new or better’.

For example, the NHS ‘needs to leverage the potential of technology and innovation to allow patients to be more pro-active in managing their own health’. This is one management term we really wish the NHS had left to the sort of management-speak afficionados who think ‘thought leadership’ is a thing. Ugh.

CUTTING THE CRAP The NHS has to exploit opportunities in a way that delivers high-quality patient care and better performance. Common sense, really.

IS IT USEFUL? Nope. Couldn’t we just use ‘improve’ instead?

IRRITATION LEVEL 3

5 Holistic healthcare

DEFINITION Holistic healthcare is an ‘integrated approach to healthcare that treats the “whole” person and not simply symptoms and disease’. Sadly, for many people, the term ‘holistic’ conjures up images of healing crystals et al – in short, a wishy-washy term for a well-intentioned approach.

CUTTING THE CRAP Treating a ‘whole’ person means that healthcare services should not only focus on diseases or symptoms but also preferences, wellbeing and wider social and cultural factors.

IS IT USEFUL? At one time, the concept probably helped to broaden our thinking about ways to treat patients. Useful though that is, Healthcare Leader finds the term insufferable on a pedantic level: is there any situation where you would treat only ‘half’ a person?

IRRITATION LEVEL 1

6 Clinical pharmacist

DEFINITION Last year, the NHS published a 12-page document on the definition of a clinical pharmacist.

The ‘easy-read’ report, as it was called, describes a clinical pharmacist as ‘a health professional who trains for many years to become a specialist in medicines’. So: a pharmacist, then.

CUTTING THE CRAP Thorrun Govind, a locum pharmacist in the North West, argues that a clinical pharmacist is simply a pharmacist. And she’s not the only one.

The term has angered many community pharmacists in recent years, as officials at NHS England have an irritating habit of using it to describe only pharmacists in GP practices or hospitals. They point out that all pharmacists are clinically trained.

IS IT USEFUL? We’ve had pharmacists since the beginning of the 19th century. Why invent a new term and produce 12 pages to explain it?

IRRITATION LEVEL 2

7 Organisational silos

DEFINITION Silo is a widely overused word in the NHS, and it doesn’t refer to ‘a large and round tower on a farm for storing grain or winter food for cattle’. We’re no longer in the realm of MEAT. Interestingly, silo also refers to an underground missile chamber. Who knew?

CUTTING THE CRAP In primary care, organisational silos separate different groups of services, such as GP practices and community pharmacies. If health services interact poorly with each other, patient care and safety are at stake. Therefore, these ‘silos’ need to break open, as communication and collaboration are the keys to deliver the best outcomes.

IS IT USEFUL? Yes, as it conveys how services are separated out in the NHS. But its irritation level comes from its many other meanings.

IRRITATION LEVEL 1

8 Peer challenge

DEFINITION A peer challenge is a ‘proven tool for improvement. It is a process commissioned by a local council and involves a small team of local government officers and councillors spending time to provide challenge and share learning’.

CUTTING THE CRAP ‘Tool’ seems to be a misnomer. A peer challenge would be more accurately described as a ‘discussion’.

It refers to a council inviting senior people from other councils to look at its work and discuss what can be done differently.

IS IT USEFUL? To be fair, anything to improve communication in the NHS is to be welcomed. But we challenge you to come up with a snappier alternative.

IRRITATION LEVEL 2

9 Driving efficiencies

DEFINITION We hinted at our dislike for this term in our nomination of ‘support chassis’. It means finding ways to save money. Simple enough, right? Yes, but not when it is used in sentences such as ‘we need to drive efficiencies in a resource-limited environment’. What now?

CUTTING THE CRAP This unnecessary term seems to have migrated to the NHS from the management-speak of other sectors.

IS IT USEFUL? Not really. We prefer the plain terms ‘cost cutting’ and ‘saving’. ‘Driving efficiencies’ is one term we would like to send on a long journey to a far-off place.

IRRITATION LEVEL 3

10 ASCOF

DEFINITION ASCOF is the Adult Social Care Outcomes Framework, ‘a tool that the Department of Health (DH) uses to measure how well care and support services deliver outcomes that matter.

CUTTING THE CRAP To be fair, there isn’t really an alternative to ASCOF. Its irritation level lies in its sound and the fact that it’s just one of many, many confused NHS acronyms.

IS IT USEFUL? Yes, and the rationale is a good one. This is all well and good, but it’s hard to take seriously an acronym that sounds so expectorant.

IRRITATION LEVEL 1

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