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What does bad look like?


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Friday, 12 July 2013

What does bad look like?

The NHS is a world leader in the use of hackneyed phrases, gobbledygook and jargon. Where plain English words are not up to the job – and let’s face it, they rarely are - we invent brilliant new ones.

The NHS is particularly adept at producing euphemisms, because as we know, the main point of communication is to avoid causing offence. Meaning and clarity are at best secondary considerations.

NHS organisations make the shortlist of The Plain English Campaign’s “Golden Bull” award scheme every year. Four NHS organisations were among the last ten entries for the “worst written nonsense” in 2012. Well done to you all.

Cheshire Warrington and Wirral Commissioning Support Service was nominated for a passage containing this example: “Building in equality and risk impact assessments the options are taken through a process to arrive at the content for an output based specification and benefits foreseen as a result of the implementation.”

NHS Norfolk and Waveney’s nomination is down to this little beauty: “[We] apply a negative financial uplift to the out-turn value of all our supplier contracts” – a poignant reminder of the negative uplift to the out-turn value of the English language caused by the passing of PCTs.

To celebrate the NHS’s sixty-fifth birthday NHS Networks has compiled a list of the top terms found in reports, policy documents and overarching strategic plans.

Send us your examples of world-class NHS guff (or just paste them into the comment box below). The sender of the best entry will get a copy of Lynne Truss’s disgracefully jargon-free bestseller Eats, Shoots and Leaves.

Let us know if we’ve left any of your favourites off our list.


What does good look like? – a useful warm-up question for anyone preparing to think out of the box

Overarching – never rely on a mere strategy or try to muddle through with something as basic as a plan

Hard to reach – remote or disadvantaged members of society lurking at the back of cupboard or left on a high shelf

Tick-box exercise – survey your team regularly to make sure they are not wasting their time on these

In the driving seat – where everyone needs to be, however crowded and dangerous it becomes

Taking ownership of problems – a chance to get to know your problems before (or instead of) tackling them

Patient-centred care – useful reminder of what we do for anyone prone to lapses of concentration on the ward or in the operating theatre

Going forward – adds a sense of purpose to the idea of getting around to something at some point

Direction of travel – replaces the outmoded concept of a destination: it’s where you’re heading that counts

Transformational change – when ordinary change simply won’t cut it

Evidence-based – no sentence containing the word “decision” is complete without it

Clinical leadership – the special leadership only a fellow doctor can provide

Lifted and shifted – what most industries do with cargo, the NHS does with humans

Joined-up thinking – something to aspire to when you’ve mastered joined-up writing and joined-up shoelaces

Reinvent the wheel – thanks to this phrase you won’t ever need to

Editor: NHS Networks

Chris Collison
Chris Collison says:
Jul 12, 2013 02:02 PM
Well done Julian, you have written a beacon of best practice in world class thought leadership.
Martin Rathfelder
Martin Rathfelder says:
Jul 12, 2013 02:16 PM
Scale and Pace - new rivals to Ant and Dec
Janine Reynolds
Janine Reynolds says:
Jul 12, 2013 02:25 PM
Low hanging fruit (we'll do the easy bits first), Belt and Braces approach (we'll do it properly, for once), Combining Synergies (I can't think of another phrase so I'll chuck this in).
Janine Reynolds
Janine Reynolds says:
Jul 12, 2013 02:27 PM
Oh and "Let's take this off line"... (I can't be bothered to ask politely if we can talk about this later on when the meeting has finished)
Mat Jordan
Mat Jordan says:
Jul 12, 2013 02:35 PM
Given that we've been doing so much of it lately, my vote is for the verb 'to transition'. I transition, we transition, they transition, we all transition together. It's what you do in between leveraging synergies.
Kevin Willis
Kevin Willis says:
Jul 12, 2013 02:39 PM
A raft of ideas....probably destined to sink without trace.
Laura Lopez-Bueno
Laura Lopez-Bueno says:
Jul 12, 2013 02:47 PM
Community Interest Company (CIC): A highly profitable business with a bulging PR growth in its moral fibres.
Anonymous says:
Jul 12, 2013 02:47 PM
Making Every Contact Count (MECC). Forcing all new friends to demonstrate how many fingers (and maybe toes) they have. "The solution is in the room" - The cocktails are on me. "Let me land on this one" Runway for a new idea.
julie upton
julie upton says:
Jul 12, 2013 02:47 PM
I can't worry about all this jargon, I'm too busy trying to operate within my financial envelope to recover my financial position
Anonymous says:
Jul 12, 2013 02:51 PM
Ball park .... where you park your ..er ..maybe not
Rich Anderson
Rich Anderson says:
Jul 12, 2013 02:54 PM
Proforma - Someone somewhere in our trust called a form a proforma and as everyone with an ordinary form must be less important than those with a proforma it has spread to all areas. Lets misuse a latin term - it's got Pro in it and it contains the word form so it must mean the same but better! (even if the original latin term means that you don't actually have to fill it in as it's treated as already complete...)
Eg. Could you send me a copy of the transformation plan proforma?

Signposting - we can't tell people things anymore we have to signpost them.
Eg. Could you signpost me to the synergy meeting?

Anonymous says:
Jul 12, 2013 03:26 PM
We 'embed the values' and are constantly 'living the values'. As opposed to, well, just working with them in mind? (Do we get let off at weekends?)
Anonymous says:
Jul 12, 2013 04:55 PM
Lets not forget the Bruce Willis moments when we have 'drill down into the detail' or even take part in a 'deep dive' exercise, oh its hard work being an NHS manager.
Clare Hodgson
Clare Hodgson says:
Jul 12, 2013 07:53 PM
We are where we are - just to absolutely clear that we're not where we 're not. Does anyone know the way out of here?
Anonymous says:
Jul 13, 2013 07:25 AM
where the heck did 'fit and proper person' come from? I was broadsided by the one! Are these fit and proper persons instead of the aliens and cardboard cutouts we have been employing all these years.
Anonymous says:
Jul 15, 2013 09:19 AM
Let's not forget the 'boundary spanners', those nifty little tools for'change architects' to fix the plumbing, air con, staff morale etc. If only they worked on outmoded NHS bureaucratic processes too!
Anonymous says:
Jul 15, 2013 10:36 AM
Thanks for this wake-up call. I always said I wasn't going to go native and would try to resist speaking this language when I first started working at an SHA in 2008. It's terrifying to realise that I use these terms all the time and think I'm speaking normally. Think I need to implement a turnaround programme so I can model a return to my value abse.
Anonymous says:
Jul 15, 2013 10:37 AM
Mike Richardson
Mike Richardson says:
Jul 15, 2013 11:59 AM
There needs to be a series of conversations with stakeholders about this.
Mike Richardson
Mike Richardson says:
Jul 15, 2013 12:00 PM
There needs to be a series of conversations with stakeholders about this.
Mike Richardson
Mike Richardson says:
Jul 15, 2013 12:01 PM
Twice, apparently.
Bernard Horan
Bernard Horan says:
Jul 15, 2013 01:17 PM
Interview question from NHS England given to one of my team: "Can you give me an example of a time when you have valued someone's diversity?"
One time we received a long piece of guidance on how to write an Exec Summary. There were 3 main points listed. Number 2: Avoid jargon. Number 3: Meat to the bone
Sarah Carnwell
Sarah Carnwell says:
Jul 16, 2013 09:41 AM
Working in silos - to busy doing the job to be able to go and visit the farm!
Bernard Horan
Bernard Horan says:
Jul 16, 2013 09:57 AM
Swim Lane Diagram. Ring the bells and break down some of the walls. Flight path to success. Time Box Zero.
Anonymous says:
Jul 17, 2013 03:17 PM
When attending briefing meetings in the early days of PCTs, a fellow colleague and myself used to play bull**** bingo - each player chooses 6 (different) current "management speak buzzwords" before the start of the meeting, and wrote your chosen words / phrases down. As the meeting unfolds, strike out each word or phrase from your own list as it is spoken - as you would with a game of bingo. This certainly makes you listen to the presenter / speaker. (for extra impact, do not sit together with fellow players, and stand up / shout bingo when your card is completed)
Anonymous says:
Jul 18, 2013 11:47 AM
Horizon scanning - seeing who else is doing it, but better.
Andreas says:
Jul 23, 2013 10:02 AM
Check this out! 2 minutes of surrealism via the NHS #VMShortsVote Naughty http://shar.es/kcmhu via @VMShorts