You'd etiketine sahip kayıtlar gösteriliyor. Tüm kayıtları göster
You'd etiketine sahip kayıtlar gösteriliyor. Tüm kayıtları göster

16 Ocak 2017 Pazartesi

"Can I speak to a serial killer?": there"s more to NHS comms than you"d think

“Can I speak to Peter Sutcliffe?”


The journalist was perfectly serious. I was working in communications at Broadmoor hospital and he saw me as a route to people he thought were patients there. He wanted Sutcliffe’s “take” on a series of recent “Ripper style” murders in the Ipswich area. I explained – while trying to not audibly gasp – that Broadmoor could not confirm who its patients were, let alone put them up for press interviews.


Every so often, an FOI request asks how much the NHS spends on “communications”. The easy headline is that the NHS needs real doctors, not spin doctors. But it is only when you look at the range of activities that communications cover that you wonder if the real spin doctors are those writing the story.


To some, communications is just shorthand for public relations and spin. In fact, responding to media queries (and FOI requests) – which the NHS is rightly expected to do as a public service – is a tiny proportion of our work.


Much of it is about making sure staff know what’s going on in their organisation, that information for patients is clear and easy to access and that MPs, local councils, regulators and community organisations are kept informed and involved in what the NHS is doing.


I have worked at a large trust where there was no system in place for briefing staff on the wards about things they needed to know. I’ve worked in places where every department was producing its own, homemade newsletter that was badly written, misspelt and missed out the information patients needed. I have had to advocate for people’s right to know about changes to local services and to develop plans to reach people who don’t read newspapers, rarely visit their GP and certainly don’t attend NHS meetings.


Part of the job is to manage press and public interest in the event of a major incident. This involves careful planning, working with other emergency services. How do you keep people informed, including your own staff, concerned members of the public and relatives of those impacted? Where do they all go in a busy working hospital? And major incidents come in different shapes and sizes. If a high-profile patient dies in your hospital, you need to be able to manage not just a potential media scrum disrupting your hospital, but the needs of the family too. I recall liaising with one very high-profile family after their son died, because they wanted to visit the hospital morgue without being accosted by the press.


Then there is the navigation issue. How does a person find their way around a hospital, let alone the whole NHS? Part of our job is to make sure that patients can get to the service they need as quickly as possible. How do we reach every potential patient to achieve this? How do we describe different services to the public? (spoiler: not always very helpfully).


I don’t deny that the odd Amateur Alistair surfaces, desperate to turn their job running comms for a cottage hospital into The Thick of It. But they are a rare breed. The majority of us see our job as helping the public, the media and a huge range of stakeholders to understand how the NHS works, the challenges it is facing and how they might be able to help. If you think about the huge numbers of services we provide, the many different communities we serve and the amount of information that implies, this is far from easy.


In recent years we have seen the beginnings of a sea change in the way the NHS talks to patients and the public. Expertise in consultation and community engagement is increasingly valued, not just because these things are required of the NHS, but because we know that involving patients in the development of services improves those services no end.


Some of the best conversations I have had about the NHS have been with the public. Most people understand the challenges presented by an ageing society, flat funding and increasingly expensive treatments. While they will not always agree with each other – or the NHS – on the best solutions, I am yet to attend an NHS public engagement event where I didn’t hear several good ideas. Of course, there is the odd moment – one man went around each person on a table, asked them their background and announced none of them were as qualified as him to talk about “his NHS” – but we should not underestimate the positive contribution patients and the public can make.


If you would like to write a blogpost for Views from the NHS frontline, read our guidelines and get in touch by emailing sarah.johnson@theguardian.com.


Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views.



"Can I speak to a serial killer?": there"s more to NHS comms than you"d think

29 Ocak 2014 Çarşamba

BPA Publicity Is "Too Reduced to Trigger Harm," In accordance To Regulators. But You"d In no way Know That From The Media Coverage.

Suppose a new authoritative evaluation revised the estimate of your lifetime odds of being struck by a meteorite — from, say, a single in a hundred billion to a single in 10 billion.  Should that tenfold boost in the probability make you any more concerned?  No– since both values are someplace between negligible and infinitesimal.


A similar and much more pertinent query of that kind was posed by an announcement earlier this month by the European Foods Security Authority of a new “tolerable daily intake” (TDI) of a typical industrial chemical called bisphenol-A (BPA).  (BPA has been utilised for the past half century to make shatterproof polycarbonate plastics and is an ingredient in the epoxy safety liners of foods and beverage cans that shield shoppers from meals poisoning.)


At the exact same time that regulators reduced the TDI for BPA, they emphasized that human exposure comes nowhere close to the new, stricter restrict – a essential point missed by a lot of journalists and commentators.


TDI is an assessment of a person’s highest everyday consumption of a substance that can happen each and every day for a lifetime with out appreciable risks.  It is based on studies of relevant animal species and is intentionally set extremely conservatively.  In 2010, EFSA assessed BPA and set a TDI of 50 micrograms per kilogram of body weight per day.  In the current announcement, EFSA up to date that evaluation, proposing a lowered TDI of five micrograms per kilogram of body bodyweight per day.



Chemical structure of bisphenol A.

Chemical construction of bisphenol A. (Photo credit score: Wikipedia)




The updated, diminished TDI, which was proposed to reflect data from new studies that have become available given that 2010, represents a very conservative technique.


Taken at face worth, this TDI reduction might appear to be an indictment of BPA and to reflect a risk to human well being and, predictably, a lot of activists groups have touted the proposed modify as this kind of.  But EFSA’s most significant finding is buried deep in information reviews, if it is present at all: Even measured towards the proposed diminished TDI, “EFSA finds there is no overall health concern, as the highest estimates for mixed oral and non-oral publicity to BPA are three-five occasions lower than the proposed TDI, dependent on age group.”


Bolstering that conclusion is a related evaluation last 12 months by the U.S. Meals and Drug Administration, which concluded that “BPA is safe at the really reduced amounts that take place in some foods”–an evaluation “based on evaluation by FDA scientists of hundreds of scientific studies such as the most recent findings from new scientific studies initiated by the company.”


EFSA employed new data and details gleaned from more than 450 scientific research to propose the lower TDI, which is in essence a distinction without a difference: Even assuming the highest exposure estimates for any age group, from fetuses to the elderly, BPA consumption is well below the extremely conservative, up to date TDI.


Placing it another way, despite the fact that BPA’s TDI has been lowered, the sensible impact stays the exact same: No matter whether 50 or five micrograms per kilogram, the TDI is set at a degree to which people are not probably to be exposed.  Thus, reflecting a centuries-previous tenet of toxicology that “the dose tends to make the poison,” BPA is not harmful to human wellness simply because the dose is far as well lower.


One particular crucial takeaway from this revelation is the need to have to consider media reviews on chemical regulation with a big grain of sodium chloride.  The media like “if it bleeds, it leads” stories, specially if they involve particular activist-designated bogeymen, such as chemicals, nuclear electrical power and genetic engineering.  Often, the emphasis is on interest-grabbing headlines about shoddy research or created-up phenomena, this kind of as “BPA Exposure Linked to Prostate Cancer” or “Fukushima Radioactive Materials Washed Up on California Seashores.”  In this instance, even so, we have an exact, science-based mostly report that received uncritical, flawed media coverage.  One headline, for illustration, read, “EFSA Confirms the Hazards of BPA for Well being.”


EFSA’s tenfold decreasing of the TDI is analogous to  a tiny boost in thesa odds of being struck by a meteorite: There is no cause for heightened concern.  The actual story is that yet another mindful evaluation by a prominent regulatory agency has identified that BPA poses negligible danger to human well being.



BPA Publicity Is "Too Reduced to Trigger Harm," In accordance To Regulators. But You"d In no way Know That From The Media Coverage.