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November 14, 2023

We can do better than 'no news is good news’

‘No news is good news’. This is a phrase I must have used countless times with many anxious families and parents, without question.

In Paediatrics we use this phrase very commonly when seeing children in Paediatric A&E. We often need to initiate investigations that are going to take some time to come back (for example, urine tests and throat swabs that need to be cultured to see if anything grows). 

For many of these investigations, children do not need to stay in hospital and we will start treatment directly from A&E or conservative management as we wait for results. We will tell parents that we’ll contact them if the results show anything unusual, but to assume that ‘no news is good news’ and if they don’t hear from us, everything is fine.

Why do healthcare staff say this? 

First, it’s important to acknowledge that the phrase is meant with good intention. It is supposed to be reassuring for parents while they wait for results, while also setting expectations that results may not be back for a while.

But the truth is, we often don’t have the means or capacity to contact every child who has a ‘normal’ test result by phone. We would love to do this, but when time and resources are stretched and we lack the tools for basic communication, we prioritise calling patients who have test results that require action or give us cause for concern.  

If I think back to the many times I have used this phrase, it seems a little unrealistic to expect a parent worried about their child's health to find an absence of information reassuring. Effectively, this expectation asks parents to place faith in the NHS as a well-oiled machine where all abnormal test results are promptly actioned and communicated.

Sadly, this just isn’t the case, and I’ve often seen abnormal results for a child not be communicated properly, because: 

  • Staff couldn’t get hold of the parent or guardian when they tried calling them. After calling multiple times, they didn’t feel comfortable leaving a voicemail about personal health information or in case the number was wrong.
  • Staff weren’t able to contact the GP or assumed the GP would receive the result and action it
  • The child was out of area and so staff didn’t have the relevant contact details or information
  • The child was a baby and hadn't yet been registered with their GP
  • There was incomplete or poor handover within clinical teams meaning results weren’t properly chased

When this occurs, clinical teams will make every possible effort to reach the child’s parents as soon as possible. In some A&Es where I have worked, going through the ‘chase’ list of outstanding results is the first thing we do every shift and multiple times during the shift. But it still begs the question: how could we do better than saying 'no news is good news'?

In 2023, it seems surprising that NHS staff just don’t have the means to communicate quickly and easily with patients and each other. When so much of our day to day is spent communicating to or about patients, why does it take 30 seconds to write an internal hospital referral, but 40 minutes before it gets to the right person within the right specialty (often in the same hospital)?

How to move beyond ‘no news is good news’

I've seen time and time again that good  communication practices can give patients and their next of kin timely information, reassurance and comfort that can improve their experience - and the patient's outcome. For example:

  • Up to date contact numbers through a PDS verified search
  • SMS messaging, to quickly communicate information to parents instead of calling them or sending letters  - how many paper versions of head injury leaflets & advice do  we give out that would be far more accessible via SMS?
  • Seamless communication between healthcare professionals via Accumail, to ensure safe transition and handover of care 
  • A child’s communication record moving with them, so that have every healthcare professional and guardian has visibility about that child’s care and needs

And it goes without saying that contacting parents via a quick SMS message to share the good news that results are normal, should also be the norm. 

No communication isn't a solution - but timely communication is

From regularly visiting and speaking to NHS trusts in my role at Accurx, I see how these instances of breakdown in communication not only cause parents to be left waiting in the dark about their children’s test results, but also lead to other large-scale challenges: poor patient flow, delayed discharge and long waiting times. If we gave NHS staff better tools to communicate with each other and their patients, I think we could start to make a significant step change in this and build better sustainability into the way we coordinate and deliver services. 

I believe that Accurx gives cause for hope here. Good tech does not need to be clunky or difficult to use to enable quick and reliable communication. I’m proud to see more trust staff using Accurx to message patients quickly and easily, collect data from them, view and resolve inbound, manage communication as a team, and collaborate with other clinicians involved in a patient’s care. 

Let’s sunset our use of the ‘no news is good news phrase’, so instead of asking patients to place faith in a lack of communication, we make timely communication the standard for all patients, because that’s what they deserve.

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