The Maynard Doctrine: A guide to the bollocksfest of NHS management jargon
Health economist Professor Alan Maynard turns his attention to the beautiful world of NHS management jargon
The ways in which NHS staff communicate with each other and the public are a wonder to behold! There is redundant use of adjectives to emphasise perfectly adequate nouns … and then there are phrases which are mis-speaking, misleading or just vacuous.
The latter are charitably collectively known as ‘jargon’. Less charitably, they are known as ‘bollocks’.
Following an appeal on Twitter, the following examples of this pathetic use of jargon are offered to stimulate debate and elaboration.
The underlined material is suggested translations for current jargon. My interpretations can be revised if you have better offerings. Many thanks to my initial Twitter responders.
Enlightened NHS organisations wishing to eradicate this abuse of language might adopt the following incentive: each abuser should contribute £10 to Oxfam for each “sin”!
Jargon / translation
Action plan = plan (intrigued to know if users of this term also think in terms of inaction plans? Many NHS plans appear to be inaction plans.)
Blue sky thinking = pious, un-evidence-based hopes
Burning platform = we are in the shit
Deep clean = clean
Deep dive = analyse
Doing a piece of work around = analysing, probably superficially, with vague completion date
Drill down = analyse
Effectiveness = not a synonym for efficiency, as commonly yet wrongly supposed. The former tells us us what works; efficiency tells us whether something works at what cost. NHS documents should ban this confusion and fine managers and clinicians for mis-use using the tools of derision and demotion!
Envelopes = money and time limits / budgets
Holding the ring = shutting up, being loyal and praying
Incentivise = making a vague effort to alter behaviour, usually in an un-evidenced way
Integrated commissioning = 2013’s favourite health policy unicorn; much talked about but rarely seen
Movable feast = the author / speaker is clueless about what’s happening; it’s time to pray
A marathon, not a sprint = this is difficult, don’t blame me if we fail
Need more granularity = yes, thank you, I am aware that my analysis is poor; please shut up while I sort out my deficiencies
Negative uplifts = funding cuts
Pump priming = allocating taxpayers’ resources; generally in poorly designed and un-evaluated ‘wheezes’
Slight discomfort = deficit ahoy - mind out for your job and / or worse patient care
This paper is not robust = this paper is crap and I don’t agree with it, but am trying to be unnecessarily polite to a clueless colleague
Talk offline = kindly shut up: you are embarrassing me. Let’s fix this quietly and discreetly
Transformational = pious, un-evidence-based hopes
Trust over-performance = a good old-fashioned overspend: these are always fun! We are screwing the CCG!
Please offer further additions to this initial stock via Twitter, on the hashtag #NHSjargon