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Commentary

Is Communication Important in the NHS?

Throughout the development of the NHS, since 1948, paramount structural alterations have proceeded, due to the absence of a the utmost important element: communication.

The concept of communication is not contemporary, instead its longevity diverges before the 7th century, according to Claude Simmon, who had developed the Communication Theory, “Information is the resolution of uncertainty”. However, when applying simplified theories, upon diverse sectors especially healthcare, the significance of communication may sometimes be blurred or perhaps become obscured. Frequently, the concept of communication is blurred into organisation structures, that the absence of communication leads to detrimental repercussions, regardless of the setting or situation. 

Throughout the development of the NHS, since 1948, paramount structural alterations have proceeded, due to the absence of a the utmost important element: communication. Both the clinical and moral failures, of the NHS was outlined first through the Ely report. The Ely report, followed the complaint of a nursing assistant employed at the Ely hospital, describing the “inhumane and threatening behaviour by six staff members towards four patients”, alongside the lack of care and indifference on the part of the senior staff to complaints (The Health Foundation). An inquiry committee had been established, after consideration upon the request of the Secretary of Social Services, to investigate the “ill-treatment of patients and of pilfering by staff” (UK Parliament). It is explicitly foreshadowed that, the rationale into filing the complaint, involved substantial lack of a combination of verbal and non-verbal communication between the staffing structures consisted with the NHS; further highlighting, the notorious consequences of underfunding inflicting upon the quality of care. The following allegations, were also implemented into the complaint:

  • Cruel ill-treatment of four particular patients by six named members of the staff;
  • Generally inhumane and threatening behaviour towards patients by one of the staff members already referred to ;
  • Pilfering of food, clothing and other items belonging to the hospital or the patients;
  • Indifference on the part of the Chief Male Nurse to complaints that were made to him;
  • Lack of care by the Physician Superintendent and other member of the medical staff.

(Socialist Health Association)

Principally focusing upon the allegation of “indifference on the part of the Chief Male Nurse to complaints that were made to him”, (Socialist Health Association) emphasises the culture of segregated communication due to the varying levels of responsibilities between members of the NHS. The mentioning of the term “indifference”, constructs the ignorance between members of the NHS, diverging due to a lack of communication and awareness of the importance of multi-disciplinary teams in any healthcare setting. In this case, effective communication between various roles within the disciplinary was essential to build a positive relationship between other NHS members and the patients, for better health outcomes from the perspective of the patients. Consequently, in this case due to consistent lacking of a combination of verbal communication skills, non-verbal communication skills, and listening, members of staff were unable to raise awareness of the issues encountered, instead they were dismissed as there was no framework to debrief situations, which may have significantly impacted staff, or a staff welfare trust. Having said, the failures of the Chief Male Nurse to address issues, primarily due to inadequate funding, further leading to failures in committing to the individual’s responsibilities, and being enforced to condemn the issues encountered by NHS subsidiary members.

Consequently, the predominant problem alerted centred around staff welfare, especially concerning “professional isolation” (UK Parliament) as there was a significant imbalance between “the skilled and devoted service given by the staff in long stay hospital, who have all too often been working for many years under heartbreaking difficulties” (UK Parliament), therefore upon the recommendations of Beatrice Serota, “a new system of regular visiting and inspection is needed” (UK Parliament) Beatrice Serota’s recommendation centred around effective communication, as regular visiting and inspection had significantly increased the wellbeing of staff members across the four departments investigated. Furthermore, regular visits allowed the four departments of the Ely Hospital to be constantly under the assistance of the government; therefore constantly developing plans to coherently improve the communication between staff members, to establish an attributional relationship between each other’s welfare.

On the other hand, some people may believe that throughout developing clinical skills, communication is sub-consciously and simultaneously developed, therefore there is no necessity into investing upon staff welfare and communication inspections by the government, instead they should be directly invested into allocating clinical equipments; specially in departments, where there is a significant shortage. According to Baroness Hylton-Foster, during a Parliamentary conference, supposedly the issue arisen is not professional isolation, instead “even with special training it needs superhuman patience to cope with some of the patients with whom they have to deal”. (UK Parliament) However some may question, in order to elaborate upon the patience to deal with complicated situations, in any healthcare setting, definitely communication is required in order to explicitly and assuringly address situations. 

In conclusion, communication whether it be in healthcare or any other professional or daily setting, is significant to continuously develop through organisation schemes, and avoid severe moral and legal failures. As portrayed through the case of Ely Hospital’s failings, in which professional isolation was deeply ingrained within the culture of Ely Hospital, members of staff had compensated the quality of healthcare through a paramount lack of motivation and inability to cope with mental and physical pressures. 

Sheza Dewan, Youth Medical Journal 2022

References

The Health Foundation. “Inquiry into Ely Hospital.” The Health Foundation, 1969, https://navigator.health.org.uk/theme/inquiry-ely-hospita. Accessed 27 June 2022.

Socialist Health Association. “Report on Ely Hospital.” Socialist Health Association, 1969, https://www.sochealth.co.uk/national-health-service/democracy-involvement-and-accountability-in-health/complaints-regulation-and-enquries/report-of-the-committee-of-inquiry-into-allegations-of-ill-treatment-of-patients-and-other-irregularities-at-the-ely-h. Accessed 28 June 2022.

UK Parliament. “Ely Hospital, Cardiff: Inquiry Findings.” UK Parliament, 1969, https://api.parliament.uk/historic-hansard/lords/1969/mar/27/ely-hospital-cardiff-inquiry-findings. Accessed 27 June 2020.

By Shanum Dewan

Hello, I am Shanum Dewan at Denbigh High School in the United Kingdom. I am interested in the field of medicine, especially gyneacology and neurology!

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