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10 November 2011
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Let’s cut the cliché: Why plain speaking is always best in the NHS

The language of leadership permeates the NHS and often contains cliché and jargon. In June 2011 David Cameron gave a speech on the NHS reforms which was highly figurative and peppered with metaphor and simile. Here are some examples of the language he used – ‘frontline’; ‘in the driving seat’; ‘level playing field’; ‘cherry picking’; ‘sticking with the status quo is not an option’; ‘a National Health Service not a National Sickness Service’; ‘one size fits all’; ‘reinvent the wheel’; ‘let me be absolutely clear’. 

It is not just political leaders who can defer to the use of figures of speech and jargon; have you ever attended a meeting or a presentation and heard colleagues talk of ‘strategic thinking’, ‘best practice’ ‘streamlining’, ‘value-added’, ‘taking ownership’ or ‘going back to basics’? 

The use of stock phrases and jargon can leave audiences feeling bored, disconnected or worse still repelled. Important messages or opportunities to influence and engage may be lost. Overused expressions are often perceived as being markers of poor quality and confused thinking and can imply that the speaker has little of substance to say even when this is not the case. Technical or fashionable jargon may appeal to an in-crowd but signal to others that the speaker is a member of a medical or leadership elite. 

At a time of widespread and rapid change in the NHS it is vital that clinical and non-clinical leaders and managers communicate clearly and to the point. This is likely to engender respect and overcome the differences in language that exist between professional groups and individuals. Ideas, big and small, will appear more impressive and meaningful if plainly addressed. We might do well to follow the advice of George Orwell who, in 1946, published six rules for the effective use of English:-

  1. Never use a metaphor, simile, or other figure of speech which you are used to seeing in print.
  2. Never use a long word where a short one will do.
  3. If it is possible to cut a word out, always cut it out.
  4. Never use the passive where you can use the active.
  5. Never use a foreign phrase, a scientific word, or a jargon word if you can think of an everyday English equivalent.
  6. Break any of these rules sooner than say anything outright barbarous.

 

Which words and phrases would you like to see used less in the NHS? 

 

References

Cameron D (2011) Speech delivered to an audience of NHS staff.  The speech can be accessed at: http://www.politics.co.uk/comment-analysis/2011/6/14/david-cameron-nhs-speech-in-fulls

Orwell G (1946) Politics and the English Language. Horizon. London.  The article can be accessed at: http://www.orwell.ru/library/essays/politics/english/e_polit

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About the author

Michael Hobkirk's picture

Michael Hobkirk

Michael Hobkirk is the Lead Consultant for Chichester Child and Adolescent Mental Health Service and the Specialist Advisor for Leadership Development, Royal College of Psychiatrists. As a Fellow in Clinical Leadership at NHS West Midlands, Michael collaborated with national and regional GP leaders to foster GP-led innovation and commissioning and supported the development of high quality and cost-effective outpatient and community services.

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Comments

12 years 4 months ago

Cutting the cliches

I'm with James on this one. Metaphors and similies are an important way of communicating ideas both consciously and unconsciously, and are part of the "story telling" dimension of leadership. If leaders are indeed "managers of meaning" , then yes, we do need to get our meanings across clearly and in ways that are not boring or worn out....but we also need to recognise that sometimes we can connect to ideas others have used before us to get a greater resonance than we otherwise could.
I like this quote....which is full of long words!!

"Leadership is about the 'management of meaning,' and that leaders emerge because of their role in framing experience in a way that provides the basis for action; that is, by mobilizing meaning, articulating and defining what has previously remained implicit or unsaid, by inventing images and meanings that provide a focus for new attention and by consolidating, confronting or changing prevailing wisdom."

Smirich , Morgan , Robert Birnbaum
How Colleges Work
1998

But having said all this, am I going to take on George Orwell? Clearly not! We do need to keep inventing new ways to communicate what are often the same leadership messages, and we do need to make them easy and fresh for people to hear.

12 years 4 months ago

Lets cut the cliche

My pet hates:

Overarching
A big ask - "ask" is not a noun either! "request" may be a longer word, but this is one instance where George Orwell would not have required a shorter word
Cross-cutting

12 years 4 months ago

For want of a better word...

It often appears to me that ‘better’ is a conceit in healthcare management, leadership and provision. I have rarely heard it used in a ‘plain’ way, but that it frequently reflects a shortcut to some sense of hope. I am not sure if this is even a shared reality of hope. If we accept that ‘better’ is not the end, then maybe we can begin to have a ‘plain speaking’ conversations about what the end is and find the means to reach it. Of course this maybe more difficult, painful even, and perhaps we require the odd metaphor to relieve the pain of plain, so to speak.

12 years 4 months ago

Cliches

Peter - isn't "pet hate" a cliche...:)

12 years 4 months ago

Cut the cliche

I have so many pet hates. The more recent include:
Granular
Post instead of after
Refresh as a noun

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