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Making time to talk

Thursday, 14 June 2018

Making time to talk

NHS staff will be encouraged to talk to each other under radical new plans to be announced by the Department of Health and Social Care.

The department said the NHS had placed too much faith in action and underestimated the power of “just talking about things”.

“All the evidence is that action-based initiatives fail to produce results. Real change will only take root if we start sustainable conversations,” a spokesperson said.

Talks about talks

Royal colleges and professional bodies cautiously welcomed the plans but warned that clinical staff would want to see the details before agreeing to any proposals.

A spokesman for the RCGP said: “GPs are simply too busy to talk. Unless the government finds a way to ease workload pressures it’s difficult to see how they will be able to commit to any further conversations.”

The BMA said: “Many of our members are already at full vocal capacity and we see no sign that demand is slowing down. It’s not simply a case of finding time for a brief chat in the hope that things will get better.”

The BMA added that it wants to see compulsory training in oral skills for all doctors.

Saying more for less

Officials acknowledge that there will need to be fresh investment in those parts of the service under the greatest strain. Citing recent research showing that two in five GPs expected to shut up altogether within the next five years, NHS England promised changes to the GP contract which could make new money available for extended conversations and urgent chats. There could also be a performance-related expatiation indicator added to the QOF.

The Department of Health and Social Care said the government recognised the heroic efforts of NHS staff to keep talking in difficult conditions, but insisted that more could still be done to improve productivity.

NHS trusts are under pressure to deliver conversational efficiency gains of 4% a year, following a review by Lord Carter which recommended talking faster, not waiting for the other person to finish and using shorter sentences. The review found a “remarkable similarity” between the conversations held in acute trusts and urged them to work together to reduce duplication by agreeing a single conversation that could be held once. 

Conversational change

The government said it was considering calls from think tanks for a national fund for conversational change. Regional organisations known as sustainable conversation partnerships (SCPs) will be encouraged to apply for additional resources.

Critics said the new sustainable conversations fund (SCF) would benefit those areas that already talked a lot, such as Greater Manchester, putting quieter regions at a disadvantage. There are also suspicions that demand for integrated conversations across a bigger population footprint could open the door to privatisation of all health related dialogue.

NHS England said that too much of what was said in the NHS took place in silos, "making it difficult to hold a national conversation". It would be the responsibility of commissioners to bring all stakeholders together in a single recountable care contract under which at least 20% of conversations would need to be outcomes based.  

Under the plan, dubbed Making Time to Talk, patients are to be encouraged to have a chat with a family member, a friend or another patient as an alternative to seeking costly medical interventions – a move that could reduce waiting lists and ultimately patients.

An NHS England spokesman said: “If you look at the history of the NHS, huge sums have been wasted on generating more activity, providing additional services and seeing patients. Remarkably little has been invested in discussion and debate. From now on, talking will be part of everyone’s job.”

Editor: Julian Patterson