Tag: midwife

What Happened at the National Maternity Review Team Listening Event?

7 Comments

Yesterday was the first listening event of the National Maternity Review, held at London King’s College.

The invitation, from the Chair of the review herself, Baroness Julia Cumberledge promised that the event would “…be pooling ideas to improve maternity services.”

And that “We are most anxious to hear from all those who have an interest in maternity services; the public, users, commissioners, professionals, and organisations who would like to contribute to our initial thinking. We believe there is much that is exceptional, good, kind, and sensitive to the needs of women and their families. But we also know that there are services which could improve and some which are deeply disappointing with issues that need to be addressed. At this early stage in our work, we do not have any answers but wish to hear from you and your colleagues about your experiences, your thoughts, views and opinions and some possible solutions.”

I was invited because of my work with #HugosLegacy and #MatExp. Hugo was of course present via his handprint on my necklace:

And I was keen to share to promote the post What I Want the National Maternity Review Team to Know

How did the event perform against these objectives?

Overall, very well. The room was full of a range of interested parties including consultant obstetricians, midwives, members of the Royal Colleges of Midwives and Obstetricians; various NHS organisations, members of organisations that had been set up in response to personal tragedy (such as the MAMA Academy and the Campaign for Safer Births whom I was pleased to meet but did not have enough time to talk to).

Julia Cumberledge introduced the event by outlining the scope of the review, which is looking at the maternity experience from conception through to six weeks after birth. The timescale for the review raised a chuckle…

Workstreams include choice, continuity, diversity, professionalism, culture, accountability (mutual respect between professionals and teamwork), levers (triggers and incentives) – and barriers.

The comms plan for the review includes visiting centres across the country so as many voices as possible can be heard.

I loved the ethos for the event:

Be compassionate

Be a friend

Have fun

Assume it’s possible 

And so we began with the first round table discussion, looking at issues and solutions.

A few points from the discussion (facilitated by Cathy Warwick) on our table include:

  • Women need individualised care within a system that genuinely supports the range and variety of experiences and needs women will have
  • Polarisation – high risk/low risk and between obstetricians and midwives – is very unhelpful
  • Connected with the above point, for better collaboration and teamwork between midwives and obstetricians – no ‘them’ and ‘us’. There is evidence to prove that training and working together as a team provides positive results.
  • Dignified care and safe care need not be mutually exclusive (contrary to what some of the polarised debate about where is ‘best’ to give birth may suggest)
  • Time for training – health professionals want to do the best they can for their patients, but are constrained by lack of time for training. Training on things like team working (such as cross over training between midwives and obstetricians so each can better understand each others’ perspectives) and effective communication would be invaluable.
  • Targets – such as C-section rates – are a barrier to women receiving care that meets their own individual needs.
  • Policies, procedures and guidelines are important of course, but there needs to be more encouragement for health professionals to use their own judgement to respond to women’s individual needs without fear of punitive action. This connects to issues relating to training and teamwork – enabling staff to do their jobs and giving them confidence in their practise – in short, empowering them to do their best.

Feedback from the other tables was insightful, including this point that being part of #HugosLegacy was music to my ears…

twitter

There needs to be a seamless care pathway to better meet the needs of mums whose babies are in the neonatal unit, as described in my post about what I want the review team to know.

Other points of insight included:

  • Need to make sure good practice can be shared across hospitals
  • Need to find ways to make sure care is women-centred – this goes back to tick boxes and things like C-section targets.
  • Need for better postnatal care.
  • Need for commissioning that is better connected between CCGs, local authorities, and NHS England.
  • Need to look at culture – acceptance that innovative vision is the way forward to make the changes that need to happen.
  • We need to manage risk, risk should not manage us. Antenatal education needs to empower women to make the right choice for them.
  • We need to eradicate concept of ‘high risk/low risk’.
  • Women and their families need to be more involved in the creation of pathways
  • Evaluation methods need to be more useful for service users – and the feedback meaningful.
  • A woman needs to be seen as a whole person, not a womb with legs – her emotional and psychological needs, for example, need to be considered too.

Three crucial concepts are: language, behaviour, and leadership.

(This is not an exhaustive list, and I may have missed things!)

There are a few issues that bear further exploration, for example: the remit of the review includes experiences up to six weeks after birth. This has the potential to miss two crucial issues: postnatal mental health, and the needs of mothers whose babies are in neonatal care, and/or who suffer a loss. The needs of these women extend well beyond the six week timeframe, and have long-lasting, serious consequences if those needs are not met.

I would be interested to see how the review incorporates these issues.

From a personal point of view, the event gave me a wonderful opportunity to catch up with and meet fantastic people whom I have got to know through social media. I won’t try to name everyone because I usually end up missing people out, but here are some photos…

Flo and I managed to stop talking long enough to take a photo

I loved seeing Alison Baum again (she’s CEO of Best Beginnings, creator of the DVDs for which people so generously donated money for Hugo’s first birthday) and meeting Heidi, founder of the MAMA Academy, of which I am proud to be an ambassador.

Meeting and having a chat with Jacque was fab

Gill and I enjoyed a lovely evening chatting. We forgot to get a selfie, but I have a picture of my pink shoe on my pink bag…

Flo took a JFDI #MatExp view to sharing the campaign, with one of the brilliant graphics and giving people an overview of the Whose Shoes game.

I may be biased, but the innovative, grassroots, no-hierarchy approach of #MatExp is key to the success of the review. It is heartening to see there is interest:

The event nearly ended in tears for me, however. Chatting about #MatExp to two ladies at the end of the event led to me sharing my own experience. Asking how long Hugo lived for (35 days), they commented that it was ‘quite a long time’. I disagreed, saying that it was not nearly long enough. Objectively, I know that as Hugo was born at just 24 weeks the fact I got any time with him at all was miraculous, and I am very grateful for every precious moment I had.

But a tip for others when talking to a bereaved mother: DO NOT try to tell the mother that they are in any way ‘lucky’, and especially DO NOT persist in your point of view once the mother has expressed upset.

The women did apologise, saying it’s difficult to know what to say to bereaved parents. Another tip: empathy is key. ASK the parent how they feel, and if you really don’t know what to say, STOP TALKING.

Considering the breadth of experience of women – and men – attending these events will have, taking a moment to consider sensitivity, as well as sensible things to say (and not say!) is crucial.

Fortunately, it did not mar the very constructive and productive day. I hope we can see our thinking translated into real action and change for women and the staff who care for them.

Next steps are…

and if you want to be involved…

 

 

Mums' Days

Language Matters: Health Communication and Baby Loss

8 Comments

Being in a healthcare environment – whether that be a GP’s surgery or a hospital – can be a hugely disempowering experience. You are likely to feel especially disempowered when you receive bad news – your head spinning, struggling to take in usually complex information. Then, more than ever healthcare professionals of all disciplines need to reflect that each patient is an individual, with their own experiences, values, hopes and fears.

Professionals need to be able to listen effectively, which includes reflecting back what a patient has said to check their understanding, and to make sure they understand a patient’s views.

My son Hugo was born 16 weeks prematurely because I had the life-threatening pregnancy conditions HELLP syndrome and pre-eclampsia. My beautiful boy fought so hard, but died in my arms at the age of 35 days.

Everything possible was done to save Hugo’s life. Sadly, he was too small, and too premature.

There were, however, areas of both mine and Hugo’s care that could have been better. These issues were around communication – there were occasions where stresses could have been avoided if there had been better interaction between staff, or if we had been provided with more suitable written information.

I’m proud to be the #MatExp language champion. Effective language and communication underpins so much, and even a few thoughtless words can cause enduring hurt.

A huge thank you is owed to everyone who shared this post asking parents to get in touch about their own communication experiences around baby loss. An even greater debt of gratitude is owed to those who got in touch to share their experiences – good and bad.

It was interesting that the bad experiences reflected what I suspected – they are focused around failing to reflect that each patient is an individual, with their own hopes and dreams. The incidences of good communication are heartening.

I will take the poor first, so we can end on a positive note with the good.

One mother had a medical termination because her baby was diagnosed with a condition that meant they sadly would not live. I was appalled at what the mum had to say:

We were ushered in to see a male consultant. He obviously did not have adequate time to spend with us. Everything he said felt like one more thing he had to tick off his to do list. His comment: “at this point, I have to say that I’m sorry for your loss” was the least genuine and sympathetic expression I have ever heard in my life. He then followed this by referring to our baby, OUR BABY, as the “retained product of conception” and the loss of our baby, THE LOSS, as “the event”. He sickened me!

Another mum said:

…we had decided to have an amnio. We explained this to the Community Midwife (whose first words as we walked in was ‘oh this will be an easy appointment’….how little she knew!) Her response? ‘But how would you feel if you lost it and nothing was wrong’ said in a very judgemental way. As if we had not consider the risks…..I left the appointment gobsmacked she could be so insensitive and was so upset, I sobbed all the way home.

A woman who had a miscarriage said:

He then flippantly answered my questions in a nonsensical fashion. “It would hurt no more than a period” (I found labour easier, was offered pethidine for the pain all whilst being physically sick). “I wouldn’t need to stay the night” (ummm…I did…. “I wouldn’t bleed much” (not true). And my personal favourite: “no, you don’t need any medication now. Go home and just turn up at any point on Friday and we’ll deal with you.” (15 minutes later and in a taxi on our way home I noticed numerous missed calls. As we thought, I had needed to take the first of my tablets and was asked to return to the hospital as soon as possible.)

The two examples around my own experience include when discussing Hugo’s end of life, in my distress I cried how guilty I felt. The consultant said:

All mothers feel guilty.

That may be so – no mother of a premature baby, or a baby that dies for whatever reason is at fault. Knowing that does not diminish our sense of guilt, and that comment felt very dismissive. I wanted to talk about why I felt guilty, and be listened to.

The other example relates to a midwife from my local hospital phoning me the day after Hugo died. In a cheerful voice, she asked how I was. I replied that Hugo had died the previous evening. It was evident she had not heard me, because continuing in that cheerful voice she said “Oh ok, I understand you are at home now, would you like a visit?” Even if Hugo had not died, the tone and content of the call was inappropriate. Hugo would have been 29 weeks at that stage and while the unit that cared for him is excellent, there is no way he would have been home by that stage. It seemed to be a failure of checking the notes properly.

These are all examples of health care staff using jargon, and impersonal medical terminology. I am sure (and hope) these staff did not intend to be impersonal or insensitive. I am sure (and hope) these staff simply failed to put themselves in these women’s shoes, to consider how they were feeling at such a sad and difficult time, and to offer empathy. In the example of the midwife who phoned me, she needed to have used a different tone to the one she would commonly use with the happy events of mums at home with their healthy babies.

Effective communication is something I am passionate about, for the benefit of patients – I have worked in the profession within the NHS for several years.

Thankfully, we do have positive examples of communication to talk about.

The woman who had a miscarriage gave this emotional account:

The ward matron ushered us into her office and apologised profusely. She gave me my tablet and then offered to answer honestly any questions we had. We went over everything again but this time we received compassionate and truthful answers. “Yes, it would hurt lots but you will be offered pain relief”. “You will need to stay the night”. “It will be hard but we will be here to help you get through it”.

In the digital age, most of us will take to Google to explore our diagnosis and prognosis to find out more. Of course, while the internet has many useful, trustworthy sites, there are many that are complete rubbish (this is true of every condition, not just baby loss).

As one mum said about her baby’s diagnosis

Probably the worst thing I did was google the condition when I got home.

I found the same about HELLP syndrome – it is so rare, there is little information about it, and much of what I read was terrifying – not helpful to my emotional recovery.

Patients need to be guided towards trustworthy sites. I was heartened to read that as the result of the involvement of a bereaved mum, one hospital’s website has “information specifically about fetal abnormalities as well as details of the team of people who will be looking after them. When they leave the hospital after diagnosis they are given the website address and the number of a counsellor so they can look at it when the shock has worn off”.  The website also has some links to recommended forums. 

Happily, I do have examples of better communication of my own to share: consultants (both obstetric and neonatal) listening to me, and patiently answering my questions without patronising being an important one. Vitally, I have found the majority willing to listen to and take on board my feedback, and seek to reflect on their practice and make changes were appropriate.

That is heartening progress, for the benefit of other women during the heartbreaking time of losing a precious baby.

Language matters, always.

When Is The Best Time To Try To Conceive After Loss?

30 Comments

My baby son Hugo died last year. We will always love Hugo, we will always miss him. He can never be replaced, but my partner and I would dearly love another baby, one we can take home. A question that has been troubling us is when the best time to start trying to conceive might be?

Put simply, there is no right time.

When I fell pregnant with Hugo I was full of joy, excitement, and a bit of anxiety – we both were – all pretty normal emotions. We were so looking forward to the arrival of our baby. However, at just 24 weeks I nearly died as a result of getting the rare pregnancy complications HELLP syndrome and pre-eclampsia. Hugo had to be born 16 weeks prematurely. He was growth restricted, weighing just 420 grams, and he died in my arms 35 days later.

That means if – when – I fall pregnant again I will be super high risk. I am especially high risk not only because I had the hat-trick of HELLP syndrome, pre-eclampsia, and intra-uterine growth restriction, but also because they struck me so severely, so quickly, and so early in pregnancy.

Me and Hugo

Me and Hugo

A frustrating thing about each of those three conditions is that we know what they are, and we know what the symptoms are. We sort of know what causes them (in very simple terms problems with the placenta, and the blood vessels force things back to the mother, which then causes her problems), but we don’t understand why it happens. If we don’t understand why something happens, we can’t prevent, or cure it (the only cure is for the baby to be born, which isn’t so bad if the mother is close to term, but catastrophic when it is so premature). We can only monitor.

And hope.

Pre-eclampsia and HELLP syndrome are relatively rare conditions. They most commonly appear later in pregnancy, and cases like mine are very rare. That means it is difficult for doctors to give a figure for the likelihood of it happening again. Doctors have given us different numbers which are educated guesses. Not to sound flippant for something so serious, but any figures we are given are about as meaningful as saying the chance of recurrence is eleventy-seven purple dinosaurs.

I might get to term without any complications. HELLP syndrome may appear again, but later in pregnancy and less severe. Or, it might appear as early as it did before.

No one can know.

Me at 20 weeks pregnant with Hugo.

Me at 20 weeks pregnant with Hugo.

Not knowing exactly what causes HELLP syndrome means it is impossible to do or not do anything to alter my chances of avoiding it in another pregnancy. There is no cause and effect, no ‘if this then that’. It is important for me to be as healthy as I can, physically, just as it is for anyone but there is no direct link, like there is with something like lung cancer and smoking.

One reassurance is I will have so many additional tests. Additional scans (including Doppler scans, which track the blood flow to and from the placenta) and blood tests will be able to track at an early stage whether things are starting to go awry. The difficulty with that, however, is there isn’t an awful lot they can do if things do start to go awry. I could only be monitored, and managed up to a point that is safe for me and the baby.

That means I am likely to be incredibly stressed and anxious prior to each appointment. I will probably have to have a bag packed at an early stage, and take it with me each time I go to the hospital in case I need to be admitted.

The stress isn’t helpful, of course. Increased stress leads to increased blood pressure, which is bad for me. Increased stress leads to an increase in the levels of a hormone called cortisol, which is bad for the baby.

So, I shall have to work on relaxation, meditation, positive thoughts. I will need all the support I can get to get me through that pregnancy. No additional stresses (as far as life can ever be controlled).

There is also the consideration that my pregnancy would not just be about me, but about the impact it may have on so many others, too. While the additional checks will reduce the chance of another pregnancy killing me, my other half, my family and friends will all be worried for me. My other half was just as devastated as I was when Hugo died. My family and friends were greatly upset, too.

Mummy, Daddy, Hugo.

Mummy, Daddy, Hugo.

Having my first pregnancy go so disastrously wrong does not give me protection from any other issues in another pregnancy, giving me more things to worry about. Miscarriage, stillbirth, other problems that mean the baby is unable to survive.

If another baby is born prematurely, we will have to go through the stress of neonatal care again, with an uncertain outcome.

One hope I hold on to is that another pregnancy without complications is possible. Another mum got in touch through my blog to say she had HELLP at 25 weeks and her baby also sadly died. Happily, she had another baby near term, with no complications.

It boils down to a couple of questions:

If I try and it goes wrong again, could I cope with losing another baby? I don’t know.

If I don’t try again, could I cope with never knowing whether I was able to take a baby home?

No.

With my history, another pregnancy will always be terrifying. I have to accept that there is no right time.

Anything can happen to anyone at any time, of course. The dilemma for us is that we know too much about things now. For all my talk about the value of information, I can see there are times when ignorance really is bliss.

Brilliant blog posts on HonestMum.com

Birth, Twitter, and Perception

8 Comments

Since Hugo died, I have been using Twitter to promote Hugo’s Legacy. I have been fortunate to engage and make friends with a range of people who share my passion for making a difference to other women’s maternity experience. Twitter has on many occasions been set alight with women talking openly about their own experiences, and healthcare professionals talking about how things can be done differently. It has been quite a wonder to behold.

However, some conversations are unhelpful, create confusion and generate further polarisation of opinion.

A significant part of #HugosLegacy is about the importance of language, and the impact it can have. I was proud to be asked to be asked to be the #MatExp language champion.

Language matters – it is at the centre of everything. Language is important not just in a healthcare setting, between professional and patient, but also between professionals too.

Discussions around birth naturally generate a lot of passionate debate. There has been much discussion about ‘normal’ birth, a ‘prevailing fear’ of birth in the delivery room (from mums and healthcare professionals alike), and where is the right place to give birth. I have previously outlined my thoughts about the debate in posts such as There is No Right Way or Place to Give Birth, and the Importance of Balanced Messages When Talking About Birth.

However, some number of conversations are unhelpful and contribute little to the issue. Some conversations have been uncomfortable to observe because of defensive responses, unkindness, ‘side-taking’, trading of insults – they go round and round in circles and achieve nothing.

We need to stop and consider the impact of these conversations on women. Stop and consider how many people observe on Twitter without contributing their own tuppence worth.

We need to stop and remember that many tend not to trouble to read the whole thread, or examine the context. That people often take things at face value, which can lead to a negative perception. Perception often becomes fact, leading to a reputational issue.

We need to stop and consider the impact of conversations on the perception of maternity services: respect, kindness, listening and empathy are key, but are sadly lacking in some conversations.

We need to stop and consider that the perception of the birth debate can be summed up (somewhat crudely) thus: “‘Natural birth is best, interventions are always bad, good luck to you if you have to go to hospital”.

Seeking to remove fear of one thing by replacing it with fear of something else just generates more fear. Not to mention a whole heap of confusion for women about what and whom to believe, what and whom to trust.

On the whole, my experiences on Twitter have been excellent. People have been kind, supportive, sensitive and empathetic. However, I have at times not felt listened to  during discussions about birth issues. I have been upset by the response I have received on a couple of occasions. I have also been frustrated when a helpful discussion about anxiety after birth trauma was derailed by a interjection that led to an unhelpful discussion about the whys and wherefores about normalising birth.

I understand no upset is intended. I understand it can be difficult to express completely what you mean within 140 characters on Twitter. I understand that passion can sometimes take over. I understand that brevity and multitasking can lead to misunderstandings.

There have been times that I have not contributed to a debate because I thought there was little point. I’m not shy about expressing my opinion, meaning we need to be cautious about inadvertently discouraging engagement.

We all need to be mindful of the words we use to engage and the impact they have, whether it is in a healthcare setting or on social media. This is particularly true when talking about birth, which is always an emotive issue and when people are talking about very personal experiences.

Whenever I contribute to birth discussions on Twitter, I try to see things from my personal perspective, as a bereaved mother whose last pregnancy nearly killed me too; and from a professional perspective, as an NHS communications professional.

I have an understanding of how Trusts work; I have been involved with investigations, and sat through inquests related to the deaths of children and babies. My heart always ached for the bereaved families. Since the death of Hugo I know all too well the pain of losing your baby. One reassuring thought I have amidst my heartbreak is I know that everything possible was done to save Hugo’s life. I cannot imagine the pain of the families who could have had their babies in their arms if only things had been done differently, such as with the Morecambe Bay scandal.

For all my knowledge and experience, however, I cannot help but feel frustrated and confused.

As Great North Mum observed in her recent post, “A large problem with the whole issue of maternity services in general is the fact that midwives and doctors are all lumped together as entirely separate professions and tarred with the brush used to paint the worst of them. I have good professional relationships with both midwives and obstetricians and have seen the collaboration and mutual respect that characterises the best of both careers – but the average woman without the benefit of this perspective could be forgiven for being perturbed.”

Let’s not exacerbate these unbalanced perspectives with unhelpful discussions on social media.

There are so many of us collaborating, trying to make a difference to women’s maternity experience. Let’s remember that we are all working towards the same aim – safe care for women and babies, however and wherever the babies are born.

Language Matters! My #MatExp NHS Change Day Action

11 Comments

Being in any healthcare environment for any reason can feel disempowering for a patient. Effective communication between healthcare professionals and patients can help build trusting relationships, improve patient outcomes and patients’ experiences.

Communication is at the centre of everything, and no more so than in a healthcare environment:

MatexpwebinarlanguageLeigh

That is why I have chosen my NHS Change Day action for the #MatExp campaign to centre around language.

As part of my action I will:

  • Continue to raise awareness of the importance and impact of effective communication – verbal and written – through all appropriate channels (including my blog, on social media, engagement workshops, for instance). While healthcare communication is important in any specialty, as a result of my personal experiences my focus is on maternity and neonatal unit environments.
  • Empower women to feed back about their experiences – positive and negative – to help health care professionals improve patient experience (part of this action includes discussing how to make the process of giving feedback easier, and meaningful).

I have been proud to be involved with the #MatExp campaign for the past few months. #MatExp is a campaign led by healthcare professionals and users alike, aimed at identifying and sharing best practice across the country’s maternity services. If you check out the hashtag on Twitter, you will see it has already been generating lively discussion about what needs to improve.

My passion for appropriate language and effective communication stems from my years of experience as a communications professional in the NHS. This passion was enhanced as a result of my personal experiences as a patient and as a parent in 2014.

For the benefit of those unfamiliar with my story, in February 2014 I was diagnosed with the rare, life-threatening pregnancy conditions HELLP syndrome and pre-eclampsia when I was just 24 weeks along. The only cure is for the baby to be born, and my son Hugo was born 16 weeks early. My beautiful son was too small, and premature and sadly died at the age of 35 days.

Raising awareness of HELLP syndrome was the inspiration for my pledge for last year’s NHS Change Day.

Me and Hugo

Me and Hugo

While nothing differently could have been done from a clinical perspective, there were several incidences where our experience could have been less stressful, and additional upset avoided if there had been better communication. That is why I set up Bright in Mind and Spirit (it is what Hugo’s name means), to raise awareness of these issues.

This slide explains more about why language matters, and why healthcare professionals should care about getting it right:

Slide3

Feedback from many other women on social media and through their own blogs reveals I am not alone in wishing for better communication in my maternity experience. These women had every kind of pregnancy and birth experience you can think of. The one thing we share in common is the impact poor communication and choice of vocabulary by healthcare professionals had on our maternity experience.

Language can have an enduring impact, with things that were said to women when they were giving birth to their babies staying with them many years later.

This slide describes the language we want to ban, and the kind of language we would like to see more of:Slide2

Medical jargon can be confusing and bewildering. In addition, some terms may impact a woman’s self-esteem.

Terms like ‘failure to progress’ and ‘incompetent cervix’ might be perfectly proper medical terms, not intended to be personal. But think about it for a moment: these terms describe a woman’s physiology. Women therefore cannot help but take personally such terms. In the context of pregnancy, where expectant mothers want to do everything possible to protect their babies, such words can inadvertently convey a sense of blame, leading the woman to feel she a failure or incompetent, rather than elements of her physiology that are beyond her control.

The words and terms in this column can make a woman feel like she is not in control of her body, her care, or decisions that are made. A bit of a walking womb. Doesn’t sound very nice, does it?

The examples given in the ‘language we want to see more of’ column outlines some simple ways to help a woman feel more in control of her body, an equal partner in her care, and involved in decisions. Sounds much better, doesn’t it?

Healthcare professionals of all disciplines need to reflect that each patient is an individual, with their own experiences, values, hopes and fears.

There is so much discussion around language in maternity services. For instance, women have raised points about choice (some women have little choice about how or where they give birth, for a variety of reasons); risk (which sounds scary – often it means only ‘possibility’); and ‘normal’ birth (the notion that there is a ‘right’ way or place to give birth). The vocabulary we use to describe birth is crucial for helping women feel equal and empowered. It could also help remove the polarisation of views between ‘normal’ birth always being best, interventions always being harmful, and take some of the fear out of the delivery room.

Empowering women to feed back about their experiences is the second part of my action. Healthcare professionals may not always be able to recognise that experience needs to be improved, unless they receive feedback. The problem is, the traditional feedback processes can often be onerous, stressful and result in unsatisfactory results for the complainant.

The NHS complaints process is complex, for many reasons, and can include cases of straightforward feedback to serious incident investigations and everything in between. The whys and wherefores of the complexity of the process is not a topic for this post. However, there are some simple considerations individual providers can implement to help the complainant feel like they have been listened to, been taken seriously and that they matter.

My personal experience of the complaints process from a hospital, a GP practice, and a mental health provider is the opposite. More stress and upset was caused by written responses that were impersonal, formulaic, and failed to acknowledge the impact the experiences had on me. The tone of the letters felt like board reports, and that the response had to be written so it could be added to a chart.

People composing these responses need to take a step back and appreciate that while there are statutory points to be made, facts to be stated, the recipient is a human being with feelings that do not fit into a chart. Think about the language of the letter and how things are phrased to help the complainant feel like they have been listened to, been taken seriously, and that they matter. Where appropriate, also advise the complainant of actions that are being taken as a result so they can be assured taking the effort to give feedback was worth it.

It is difficult to write this post without some reference to the Kirkup Report. There is so much I could write about it, but this post from Birthrights provides a useful insight into the impact that communication had on the care of women and babies at Morecambe Bay – with tragic results.

Improving language and communication will take time, and a shift in culture. In many cases there are no easy answers. However, recent social media discussions (with midwives, obstetricians, professionals from other specialties, as well as other users) about language have been heartening. It is heartening because the discussions between healthcare professionals and users have happened, and on such a public forum. It is heartening to see language being thought of, and the link between communication, outcomes, and patient experience being recognised.

The main point to remember about communication in healthcare is to consider how you would like to be treated yourself. You’re likely to want to be treated with compassion, empathy and respect, aren’t you?Slide4