Speaking the language of supported self care – Professor Jane Cummings
Chief Nursing Officer (CNO) for England, Professor Jane Cummings explains why it is so important to get the language right when it comes to supported self care.
“Language can educate and inform or confuse and mislead. Language can inspire or alienate, cherish or insult.” – Harry Cayton, Journal of the Royal Society of Medicine, October 2006
The language we use in health and care can have a profound impact on people – both those who give care, and those who receive it. As Harry Cayton highlights in the quote above, language goes far beyond just the words we use – the meaning of the words and the way they are interpreted can have a significant effect on the way people feel and behave.
We recently established NHS England’s Supported Self Care Programme, and have quickly worked to get to grips with this issue of language. As part of this programme we’ve been working closely with people with lived experience, who told us that some of the terms that are so often used to talk about self care are laden with problems.
We decided to look into this further. At some recent workshops we ran with our Sustainable Improvement Team, attended by both professionals and people with lived experience, we carried out an icebreaker called ‘The Language Challenge’. We asked people to identify terms used about self care that were misleading or inaccurate, and to offer more appropriate suggestions.
The term ‘self care’ came up. What is it? In one sense, it’s simply about looking after yourself – taking regular exercise, eating healthily and brushing your teeth, for example. Towards the other end of the spectrum, however, for many people it’s about having to manage multiple long term conditions (LTCs), sometimes with conflicting treatments and sub-optimal medication, and often suffering from social isolation.
People need support to care for themselves when they become ill, and in the case of people living with LTCs, this can be an ongoing struggle. The NHS spends 70% of its budget supporting people living with LTCs – a staggering statistic – and yet many people don’t feel that they have the knowledge, skills and confidence to manage their own health and wellbeing successfully.
The key word here is ‘support’. People with lived experience have told us that simply saying ‘self care’ creates a real sense of isolation – that they are being left on their own to look after themselves. Besides, they are already self caring!
This is why we have titled our programme ‘Supported Self Care’. Through this programme, we will be aiming to create a nation of supported self-managers, enabling people to be much more confident in managing their health and wellbeing.
A key way in which we’ll be working to increase the support available to people is through the Patient Activation Measure (PAM). We’re currently working with the 37 areas across England who will receive person-centred support to manage their own care that we announced earlier this year. Over time, PAM could help us to support over 1.5 million people with LTCs to live more independently.
‘Patient activation’, however, is another phrase that people identified as being problematic in our ‘Language Challenge’. Some people felt that the term implies that they are passive recipients of care who need to be ‘activated’. This is a very valid concern, but I can assure people that this is absolutely not the case with the initiative. Taking people’s feedback on board, we’re committing to using the terms ‘knowledge, skills and confidence’ rather than ‘patient activation’, aside from when using the official title of the PAM tool.
Over the next three years, we’ll work with other arm’s length bodies to provide support for local health and care systems to come together with the communities they serve and the voluntary sector. We’ll do this building on some principles developed by the Realising the Value programme and you can read about some practical resources for the implementation of supported self care that we’ve recently launched with our Realising the Value partners.
These are exciting times, with so much potential to improve people’s lives. As we get on with giving people the support they truly need to live more independently, let’s make sure we all speak the language of supported self care.
Professor Jane Cummings is the Chief Nursing Officer for England.
Before progressing into general management she was previously a nurse specialising in Emergency Care and has held a wide variety of clinical and managerial roles including Director of Commissioning, Director of Nursing and Deputy Chief Executive.
In February 2014, she became the National Lead for emergency care which involved working closely with clinical colleagues and NHS managers to agree and implement the 98% operational standard. She has also worked as the nursing advisor for emergency care, and with the Royal College of Nursing to develop the role of nurses and improve the experience and care of patients requiring urgent and emergency care.
Jane moved to NHS North West in November 2007 where she held executive responsibility for the professional leadership of nursing, quality, performance, QIPP and commissioning. In October 2011, she was appointed the role of Chief Nurse for the North of England SHA Cluster.
She began the fulltime position of Chief Nursing Officer for England in June 2012 and is the professional lead for all nurses and midwives in England (with the exception of public health) and published the ‘6Cs’ and ‘Compassion in Practice’ in December of that year.
Jane is the NHS England national director sponsor for the programme to transform care for people with learning disabilities and chairs the delivery board. She is also the lead national director for maternity.
Jane was awarded a Doctorate by Edge Hill University and is a visiting professor at Kingston University and St George’s University, London.
She is also a trustee for Macmillan Cancer Support and a clinical Ambassador for the Over the Wall Children’s Charity where she volunteers as a nurse providing care for children affected by serious illnesses
Latest News from
Simon Stevens challenges ambulance makers to help ‘blue lights go green’15/02/2019 09:15:00
NHS chief Simon Stevens yesterday challenged vehicle manufacturers to help “blue lights go green” and cut air pollution by developing more environmentally friendly ambulances.
Barbara Windsor’s husband issues Valentine’s Day call for people to check loved ones for dementia14/02/2019 13:15:00
Scott Mitchell, the husband of acting legend Barbara Windsor, has today issued a Valentine’s Day call for people to heed NHS advice and check loved ones for signs of dementia.
Hospital admissions for youths assaulted with sharp objects up almost 60%12/02/2019 09:15:00
Teenagers accounted for more than 1,000 admissions to hospital as a result of assaults with a knife or sharp object last year, NHS figures show.
NHS to rollout lung cancer scanning trucks across the country08/02/2019 16:43:00
Lung cancer scanning trucks that operate from supermarket car parks are being rolled out across the country in a drive to save lives by catching the condition early, NHS England announced today.
Older patients spared dementia and falls by NHS tech roll-out08/02/2019 13:43:00
Digital checks that can prevent dementia and falls in older people, and save lives through diagnosis of sepsis, are among a range of tools being made available in hospitals across the country, as part of the NHS Long Term Plan.
Top doctor calls for ban on ‘damaging and misleading’ celebrity social media ads04/02/2019 12:05:00
England’s top doctor has called on social media companies to protect young and vulnerable users by banning irresponsible and unsafe celebrity endorsements.
GPs create 100,000 extra patient appointments through Primary Care Network model04/02/2019 10:10:00
GP practices in Gloucestershire are working together to provide 100,000 more appointments for patients.
Clinical pharmacists vital to patient care in five-year GP deal01/02/2019 14:15:00
Pharmacists will take on an expanded role at the heart of local primary care networks across the country, NHS England has confirmed.
Five-year deal to expand GP services and kick start NHS Long Term Plan implementation31/01/2019 13:15:00
A new five-year contract for general practice across England will see billions of extra investment for improved access to family doctors, expanded services at local practices and longer appointments for patients who need them.