NHS Trust Implements Language Guidelines to Foster Inclusivity
Doctors and nurses at a major NHS trust have been directed to refrain from using common English idioms such as 'the early bird catches the worm' and 'it's raining cats and dogs' in order to prevent potential offence to foreign patients. The guidance, issued by Lancashire Teaching Hospitals NHS Foundation Trust, forms part of its diversity and inclusion training programme, which aims to create a more culturally sensitive environment within healthcare settings.
Cultural Sensitivity at the Forefront
The trust's 17-page document explicitly states that these traditional phrases 'may not translate well across other cultures' and could require explanation when communicating with international colleagues or patients. It emphasises the importance of using 'considerate, inclusive' language, arguing that this approach will 'lead to a healthier society' by better meeting the diverse needs of the population.
The guidelines also extend to gender-neutral terminology, recommending that staff replace words like 'chairman' with 'chairperson' and 'mankind' with 'humankind'. Additionally, employees are advised to use 'they/them' pronouns when a patient's gender is unclear and to avoid terms like 'guys' in favour of alternatives such as 'colleagues', 'team', or 'members'.
Financial and Operational Context
This initiative comes at a time when the trust, which operates Royal Preston Hospital and Chorley and South Ribble Hospital, faces significant financial pressures. Last year, it recorded a deficit of £42.1 million, leading to its placement in financial special measures. NHS England has warned that directors could be replaced if the situation does not improve.
Despite these challenges, the trust allocated £100,723 last year to salaries for diversity and inclusion staff, employing the equivalent of 2.3 full-time positions in this area during the 2024/25 financial year. The highest-paid diversity role earns £48,526, while newly advertised nursing positions offer salaries starting at £31,049.
Criticism and Defence
The training manual, first issued in November 2024 and subject to review every three years, has drawn sharp criticism from some quarters. Lord Young, founder of the Free Speech Union and a Conservative peer, likened it to an April Fool's joke and expressed concern that it could lead to 'witch hunts' against staff for using everyday language.
'This sounds like an April Fool, but the reality is that these busybodies are constantly churning out new language guides, banning an ever-increasing number of words and idioms,' Lord Young told The Telegraph. He argued that such guidance risks forcing older employees into early retirement and could result in investigations for cultural insensitivity, which he equates with accusations of racism.
In response, a spokesman for Lancashire Teaching Hospitals NHS Foundation Trust defended the policy, stating: 'As a large specialist Trust, we are proud to have a diverse workforce and to serve people from many different communities. It is well known that certain informal phrases or idioms are not always easily understood by everyone, including people with autism or whose first language is not English, so it makes sense to raise awareness of this. This helps ensure that within our busy hospitals, communications with our patients and colleagues are as clear and effective as possible.'
The debate highlights ongoing tensions between promoting inclusivity and managing resources in the NHS, with critics warning that language policing may distract from core healthcare priorities while supporters argue it enhances patient care and workplace harmony.
