Why listening is key.....

It’s been a shaky start for the new NHS phone line designed to replace NHS Direct. For a start not all of the forty plus services are up and running and already some have been suspended. There’s been criticism about long waiting times and poor advice and at least one media headline about a patient dying.

NHS England’s Chief Nursing officer, Jane Cummings, says improvements are being made but when asked by BBC Radio Four’s Today programme how callers could give their feedback the answer was revealingly confusing. It involved going to the website and looking for whichever GP consortium had commissioned the service where you live. Welcome to the world of multiple providers in the NHS. Nothing wrong with that except when nobody is clear about who’s doing what for who and when and, most importantly, who’s actually accountable for what’s going right or wrong. The figure that 100 thousand people used the service over the bank holiday weekend shows that there is a need for an advice line for non 999 cases which means the spotlight will continue to shine on the fledgling steps of 111. Whether clarity, accountability and improvement follow is another matter.

Regardless of who’s commissioned what and from whom what the caller really wants is fast and accurate advice. The other revealing bit of the information given so far is the answer about those people taking the calls. I am imagining that my call is being answered by nurses, paramedics, maybe even doctors and I could be right but the call answerers are described as advisors “with access to” nurses, etc. The “advisor” is reading from prompts on the screen and using algorithms to assess the information given. Both of these are useful tools in asking the right questions and assimilating the answers but the quality of the service depends almost entirely on the quality of those not just asking the questions but listening to the answers. Like all good communication it’s the listening that matters most and the ability of a specialist to pick up on something that could be key and get as much information from the caller as possible but also able to pick up on other things, sometimes unsaid. I hope there are enough of those kinds of specialist on the other end of the phone line.

Being apprehensive about new stuff and distrusting technology is human nature but ultimately the ability of this service to help people and save lives is not just about working effectively in a new way or about getting the computer technology right or about having the right people with the right skills at the end of the phone it’s about doing all three and so far the signs are not good.

Guest Blogger 

Lynne Wilson

Word of Mouth

Three things came together this week and as three is my lucky number that can only be a good thing.

Firstly, trudging up the muddy, snowy lawn I made a mental list of all the jobs that need doing in the garden. More chores? No, it wasn’t a feeling of burden, more a hopeful feeling; looking forward to Spring sunshine and new things growing.

It’s the same in gardens all around the world and my second thought was how important gardens are to the cycle of living …. and dying. Many health care professionals and anyone working in the caring sector will already know how important gardens are to a patient’s wellbeing and even recovery. Gardens in hospitals, care homes and hospices have a key role to play in not only how the patient feels but also the experience of family, friends and visitors. The gardens I’ve come across in these places are beautifully tended, often by volunteers, and well loved by children, adults, staff and visitors. They are not just places of peace and tranquillity but they signal that seasons come and go, plants die back in winter but there will be flowers again in Spring and Summer. They deeply connect with our sense of time passing but also our sense of hope and looking to the future. They are also places of fun and adventure, especially for children and siblings, they provide light relief from anything and everything to do with everyday life … and of course, death.  

And so to the third thing that made a lot of sense; the brilliant programme on Radio 4 by poet and author, Michael Rosen, exploring the language we use to discuss death. Just as the 2011 “Rev” Christmas special should be compulsory viewing for anyone contemplating becoming a vicar (see last month’s blog) so this episode of “Word of Mouth” should be on the syllabus for anyone planning to go into healthcare. Particularly insightful are Michael’s own observations about losing his son, who died suddenly from meningitis. The contributions from teachers and hospice workers also paint a picture of a scene very familiar in schools and hospices but one which shouldn’t be underestimated in terms of its power in allowing a person to find words for their feelings. Talking one to one with a child is important but often the real talking comes when you get a group of children, around a table, glue and paper and crayons everywhere and they are thoroughly and happily engaged in something that isn’t painful or incomprehensible. The power of that simple activity to free up the mind and allow a child to chat is a wonderful thing. Play specialists and trained counsellors already know that sitting side by side with a child, cutting out or colouring in, can result in some really positive conversations as part of the healing process. It’s funny how the simplest things can often have the most impact on our wellbeing, bit like waiting for the snowdrops to come up.   

More listening and learning

Guest Blogger

Lynne Wilson

BBC Radio 4, Word of Mouth. The language of bereavement and grief are explored by writer Michael Rosen, as 

he talks to psychologists, teachers, hospice workers and children’s charities.

Thrive –  a national charity that uses gardening to promote wellbeing for the disabled. Activities focus on the benefits of gardening to individuals and organisations