Final Report > Chapter 23: Respect and Honesty > Communication skills: overcoming the barriers to effective communication > Time

Time

28 Undoubtedly, pressures of time are a factor inhibiting good communication. This applies to all healthcare professionals whatever their skills. There is no escaping the reality that it takes time actively to listen, to assess a patient's need for information and to develop understanding of the patient's circumstances. We heard repeatedly that pressure of time means that patients often get a strictly limited amount of time to talk, particularly when seeing a consultant. This means that there is often no time for patients to ask questions or to take any real part in discussions about their care. The National Federation of Consumer Groups summed up the problem in a contribution to a Phase Two seminar:

`Lack of time is the problem that so often leads to thoughtlessness and lack of adequate information.' [23]

29 We were interested to note that in recent research into how hospital consultants in the Oxford region respond to patients' complaints, communication problems figured prominently in these complaints. `Circumstances and work conditions' were cited by some of the consultants as factors which prevented them from communicating effectively. One surgeon is quoted in the study as commenting:

`Communication is an expensive luxury. I have never yet had a complaint from one of my private patients because in my private practice I have the time to handle all aspects of a case ...' [24]

The point being made is clear: there is a relationship between the time to communicate and the resources available to the NHS. Time is a resource like any other resource. In the context of an NHS which has endured decades of constrained resources, the allocation of time to communicate with patients, though readily recognised by healthcare professionals as important, has been consistently squeezed. NHS trusts must ensure that the working arrangements of healthcare professionals allow them the necessary time to communicate with patients.

Footnotes

[23] Seminar 7. National Federation of Consumer Groups. Position Paper

[24] Mulcahy L. `Disputing Doctors; a socio-legal analysis of doctors' responses to being called to account by patients'. (just in press), Open University Press. Chapter 5. She also describes in the same chapter a consultant as saying `When you know that something has gone wrong, that's when you pull out all the stops and over compensate by listening to the patient and making them feel you really care'