Tuesday, November 24, 2020
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NHS communication? Give it the black spot!

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Nick is being treated for cancer and other issues.

FOR all its faults, the NHS has been brilliant to me, so I desperately want to pay it back.

I’m a comms journalist, so maybe I could help improve the flow of intelligence between all these brilliant individuals. Wait, that’s an impossible dream. No medical professional would listen to a lower order hack.

Perhaps I could help the NHS interact with patients more effectively. Maybe help departments talk to each other more readily, express themselves more clearly and cut the missed appointments and misunderstandings. 

Our most precious asset is our time – especially if you’ve been told you can expect three years to live – but you wouldn’t think so when dealing with the NHS. It has multiple channels of communication, some are instant, but mostly it moves at glacial speed. There are some terrible connections and some are deadly. 

As I identified about two decades ago, the ownership of multiple forms of communication creates an automated class system, with a concentrated form of discrimination against the elderly. 

The NHS is what comms experts call an ‘Omni channel’ organisation, using everything from a mobile phone to a medical secretary. They can talk, tweet and teleconsult with patients, and fax – yes, fax – the supply chain. 

Medical comms is at its most impressive when they hold multi-disciplinary meetings over Skype. I was less impressed when I couldn’t get an answer from my oncologist, but I saw him talking about an off-expertise topic on Newsnight! If the medium is the message, the message to me was: you’re not a priority.

I needed Doctor A to tell Doctor B that he was happy for me to have a particular drug that would have stopped the spread of an agonising necrotic ulcer. He might as well have put a message in a bottle and lobbed it into the Wandle. 

In the four weeks it took for that package of information to drift between neighbouring hospitals in the same clinical commissioning group, I was being eaten alive by that monstrous ulcer. 

That was the most psychologically demanding chapter of my cancer experience – although obviously there will be worse to come. 

It’s the feeling of powerlessness that really does you in. I have been in absolute physical agony, in both the Royal Marsden and Croydon University Hospital, but I could handle that. The crucial difference was the constant communication with nurses and doctors. Encouragement from a doctor is the best medicine.

I looked forward to the morning rounds by the surgeons like a kid at a Christmas tree. Which was an odd reversal because the surgeons are now half my age. 

Mr Hasan, Dr Shaw and Dr Alice at Mayday Hospital made a massive difference to my morale because they took time to explain everything. 

Information experts parrot the phrase that ‘content is king’, but they are missing the big story. Context is The Queen. And it’s Context that rules the house and makes all the buying decisions!

Dr Alice and Dr Shaw, for example, put things into context for me. Mr Hasan said get up and walk if you want to get better. So, despite the pain, I stalked the empty corridors of the hospital at night, with my herniated stoma dangling over my pyjama bottoms. The difference Hasan made was giving me a plan of action and a sense of power over my own destiny.

Meanwhile, getting pain relief from a GP is hopeless. But if you hit the right connection and get patched through to the Pain Management specialist: bingo. It makes the difference between sleeping and lying awake all night wanting to scream. Again, you have to speak to the right person at the right time, and say the right thing.

Talking of ‘empowerment’, I got a phone call out of the blue on Monday from a psychologist. It turns out an appointment had been made, but this was the first I’d heard about it. After we agreed to cancel the whole thing, that afternoon’s post brought a letter, sent several days ago with second-class stamp, announcing this appointment. I wonder how much that false economy cost.

I wonder how many missed appointments are created by the NHS’s black holes of communication: every letter goes second-class, in every phone call they withhold their number, they never leave messages, they rarely give you a direct dial number and these days you have to listen to a one-minute announcement about coronavirus every single time you call.

Still, the deadliest form of communication is the doctor’s letter. This dread goes back to my childhood when my dad, a GP, was an insistent letter writer. But like most doctors, his handwriting was illegible, each word resembling a randomly crushed spider. So his letters brought everything to a standstill because nobody could read them. 

To this day, the prospect of a doctor’s letter fills me with the same dread – it’s like being handed the black spot. 

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Nick Booth
Nicholas Booth is the editor of OhThisBloodyComputer and a freelance technology writer

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