2 min read

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