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About This Book
Used properly jargon can be effective, but used incorrectly it can damage communications, waste time and money, and harm public, patient and staff relations. This book will enable and encourage readers to use language that the intended audience will understand. It provides practical advice based on the author's experience of producing National Health Service documents and contains explanations of common NHS jargon, with alternatives. Plain speaking and writing techniques are included, and there are numerous examples from real NHS management communications. This is an invaluable book for Health Service managers, clinicians with management responsibilities and all those responsible for communicating information about healthcare.
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PART ONE
NHS JARGON
CHAPTER 1
RECOGNISING AND CATEGORISING NHS JARGON
âManagement-speak and gobbledegook are still rife in NHS documents. Poor communications still baffle patients and waste huge amounts of taxpayersâ money.â1
Chrissie Maher, Founder-Director, Plain English Campaign
âConsult any National Health Service document nowadays and you will read of how âGovernment-wide agencies will provide effective services for all who benefitâ and where âchanges will need ownership of the guiding values ⌠a shared understanding within and across agencies and stakeholdersâ.
âŚLittle wonder, that with their [public sector managersâ] eyes fixed firmly on creating their âcross-agency, cross-sector umbrellas", their projects should flounder in incompetence.â2
James Le Fanu, general practitioner and medical columnist
âWe held public meetings fronted by GPs⌠At each meeting, three major problems were identified: communication, communication and communication. âYou donât use our language.â âYou donât answer our questions.â âYou donât give us information in the right way.â These same criticisms are made time and again in other surveys, in reviews and in public and internal inquiries. They were made after Hillsborough, after Dunblane, after the Piper Alpha disaster. They have been made in dozens of inquiries into shortcomings in systems, from health to education to sport.â3
Hilary Spiers, Head of Communications, Cambridgeshire Health Authority
No one has anything good to say about NHS jargon. Members of the public complain it makes NHS communications hard to understand. NHS workers not involved in management find it confusing and alienating. Managers in partner organisations struggle to understand it. And those new to NHS management (such as management trainees, clinicians gaining management responsibility and new non-executive members) take time to learn it.
But what exactly is jargon? Is it just one thing, or several? And is it always such a bad thing?
TYPES OF JARGON
The word âjargonâ comes from an old French word meaning âthe twittering and chattering of birdsâ. It came into English in the fourteenth century, when its meaning was extended to include âmeaningless talkâ or âgibberishâ.
The Longman Dictionary of Business English defines jargon as:
â(1) language, written or spoken, that is difficult or impossible for an ordinary person to understand because it is full of words known only to specialists
(2) language that uses words that are unnecessarily long and is badly put together.â4
Many linguists believe that the word âjargonâ would be best reserved for the first of the two definitions above. Some people also refer to this as âtechnical jargonâ or âshop talkâ.
There have been many suggestions for words to describe the second type of jargon. The most popular today is probably âgobbledegookâ, originally an American word thought to echo the sound of turkeys. Alternatives used over the years include âbafflegabâ, âbureaucrateseâ, âofficialeseâ, âdoublespeakâ, âstripetrouserâ (a lovely term invented by George Orwell) and âFOGâ (frequency of gobbledegook).
A third type of jargon â buzz words and phrases â is also rife in the NHS. This fashionable jargon varies between areas of work, but is similar across public and private sector management.
This book uses the terms âtechnical jargonâ, âgobbledegookâ and buzz wordsâ to differentiate these three main types of jargon â and âjargonâ as a generic word to cover all of them. (If you read other work on jargon, remember that other writers may use these terms with slightly different meanings.)
CATEGORISING JARGON
It is important for NHS communicators to be able to:
- recognise jargon (so you can be aware when you or others are using it)
- understand how each of the three types of jargon â technical jargon, gobbledegook and buzz words â behaves (so you will know when to be watchful for each)
- differentiate between the three types of jargon (since there are different ways of tackling each).
TECHNICAL JARGON
Technical jargon is equally common in writing and in speech (both planned and spontaneous). In NHS management, it usually falls into one of the categories shown in Box 1.1.
Box 1.1 Categories of NHS technical jargon
- Bodies â names of specific bodies (e.g. âCommission for Health Improvementâ, âHealth Development Agencyâ); or types of body (such as âclinical directorateâ, âprimary care trustâ)
- Staff groups (for example ânurse consultantsâ, âprofessionals allied to medicineâ, âgeneral dental practitionersâ)
- Posts (e.g. âCaldicott guardianâ, âcomplaints convenorâ)
- Care types and services (such as âoutpatientâ, âdaycaseâ, âcommunity pharmacyâ, âgeneral medical servicesâ)
- Documents â names of specific documents (for example Our Healthier Nation: a contract for healthâ, and âThe New NHS: modern, dependableâ); or types of document (such as âWhite Paperâ, âGreen Paperâ, âexecutive letterâ, âhealth service circularâ)
- Acts of Parliament (e.g. âthe Mental Health Act 1983â, âthe Disability Discrimination Act 1995â)
- Clinical specialties, conditions and treatments referred to in management communications (for example âophthalmologyâ, âmyocardial infarctionâ, ânicotine replacement therapyâ)
- Initiatives, programmes and approaches (such as âSure Startâ, Investors in Peopleâ, Integrated care pathwaysâ)
- Concepts (e.g. âbed blockingâ, âcase-mixâ, âclinical governanceâ, âearned autonomyâ)
- Processes and activities (such as âbenchmarkingâ, âcommissioningâ, âpersonal development planningâ)
- Measures and standards (for example âstandardised mortality ratioâ, âchartermarkâ, âfinished consultant episodeâ, âexternal financing limitâ)
- Funds and budgets â specific funds (e.g. âthe New Opportunities Fundâ); or types of budget (such as ânon cash-limitedâ)
In other words, words and phrases that fall into the category of technical jargon are official names for things. Although plain English experts recommend being sparing with capital letters at the beginning of words, technical jargon terms are the sort of words that many people feel should start with capitals. You would not find them in an ordinary dictionary. You can see more examples of this type of jargon in Part Four (in âExamples of NHS technical jargon, with plain English explanationsâ).
Technical jargon sometimes uses words that are in themselves ordinary, but which are used in a certain profession to mean something much more specific. For example, the word âbedâ is an everyday word, with an apparently straightforward and obvious meaning. But the Value-for-Money Unit of the NHS Directorate at the Welsh Office defines it specifically as:
âa device or arrangement that may be used to permit a patient to lie down when the need to do so is a consequence of the patientâs condition rather than a need for active intervention such as examination, diagnostic investigation, manipulative treatment, obstetric delivery or transport.â1
Many pieces of technical jargon are often shortened to acronyms or abbreviations, particularly in speech. This makes it doubly difficult for the uninitiated audience to work out what is meant. (Acronyms are abbreviations that are pronounced as a word, for example âNICEâ [National Institute for Clinical Excellence]; abbreviations are pronounced as a series of letters, for example âFCEâ [finished consultant episode].)
GOBBLEDEGOOK
For most NHS communicators, true gobbledegook is a feature of written language only (or of spoken language that has been prepared in writing and then read out). It is perhaps the most common form of jargon, which may explain why plain language guidelines focus on written language.
Gobbledegook contains many:
- long and often unusual words, including foreign ones (especially Latin, for example âad hocâ, âInter aliaâ, âmodus operandiâ, âprima facieâ)
- abstract nouns (words describing intangible things as opposed to material objects), for example âactivityâ, âprocessâ, âassessmentâ, âapproachâ. These are often combined with other nouns and adjectives (words that describe nouns) into long ânoun phrasesâ, for example âan environment of an economy of scale service delivery, and interactive health-related scenariosâ.
You will find gobbledegook words and phrases in an ordinary dictionary. In fact, people who use gobbledegook sound like they have swallowed one. You can see more examples of words that are common in gobbledegook in Part Four (see âExamples of NHS gobbledegook, with plain English translationsâ).
Unlike the other two types of jargon, however, gobbledegook does not just involve individual words. You can recognise it too by the overall style, which typically:
- includes many long sentences (of 25 words or more)
- has complex structures (both for ...
Table of contents
- Cover
- Title Page
- Copyright Page
- Table of Contents
- Preface
- User's guide
- Dedication Page
- Part One NHS Jargon
- Part Tow Jargon and the organisation
- Part Three Plain Language Guidelines
- Part Four Aids to NHS jargon busting