Communication is the key

Last night I attended a talk provided by NHS Education for Scotland at the Western General Hospital in Edinburgh on adult literacy and how it impacts on the quality and provision of patient care. The talk and interactive session provided a unique insight into the challenges that some patients face in their daily livelihoods, particularly in this context when it comes to receiving and using healthcare services. The talk was very well attended with approximately 40 people from the world of pharmacy across the Lothians (including least one from outside the Lothians too, can you guess who?).

One of the first activities we did as a group was to discuss what literacies were specifically defined as - and we came up with a quite a few ideas. Ideas such as reading, writing, listening, interpreting information, speaking, numeracy and problem solving.

According to figures from the Scottish Survey of Adult Literacies, over one quarter of the Scottish population faces the occasional challenge and constrained opportunities with literacy skills, however will still manage with their day to day lives. But, within that figure, 3.6% will face serious challenges in their literacy skills.

In 2004, The Big Plus was launched where its main objective was, and still is, to provide support to residents in Scotland with reading, writing or numeracy skills. Run by Skills Development Scotland, it has reached out and helped many people improve their ability to carry out those relevant skills and hence improved their livelihoods in many different ways.

In the context of pharmacy and healthcare in general, we discussed many issues and in particular we spoke about the challenges some patients may face when it comes to, for instance, reading patient information leaflets for a certain medicine, reading health promotion posters, communicating to a pharmacist concerns regarding health and filling out forms.

To build on the last of the series of points, one particular example we discussed in deep detail was the form for signing up to the Chronic Medication Service. The form is very detailed and requires strong, clear guidance from the pharmacist leading the consultation as a result (take a look at this example here from Community Pharmacy Scotland). I suggested to one of the facilitators that it should be a bigger priority for the Scottish Government into looking to simplifying these forms and making them easier to fill in. Frankly, it is much too detailed and too complicated than it should be (even for me!).

We looked at a couple of scenarios later on and applied everything we discussed to addressing the problems presented by the scenarios. And finally, we were introduced to the 'teach-back technique' - it emphasises that simply asking, after an explanation, 'is that clear?' or 'do you understand?' is not enough. What it suggests is that asking an open-ended question like this:

"We have gone through a lot of issues today, can you sum up to me what you've gathered from our discussion today?"

That way, the patient will be given an opportunity to go through what they have appreciated from the consultation with the pharmacist and if any misunderstandings still exist then those can be clarified with ease.

Communication is such an important skill, that its relevance in the healthcare environment is not to be underestimated. And we pharmacists have a key role to play in ensuring that we are clear, unambiguous and a strong source of help for our patients in the NHS and in healthcare.