Week 12: I wrote 11,962 words on Southern Health’s crap communications so you don’t have to #107days

Ally has written a corker of a blog post for Week 12 that needs no more introduction:

Ally

Hi everyone! Just to give a bit of background to this blog, I’m Sara’s niece and I’ve just finished my linguistics degree in Leeds. During my final year at university, I had to write an 11,000-word dissertation. Or more specifically, I wrote about the transitivity and non-apologies in the communications from Southern Health to Sara, Monitor and the public, and how these structures were manipulated to assign responsibility for the positive and negative actions detailed in the texts.

The transitivity system deals with where participants are positioned in a sentence, and this can be changed to emphasise or hide these participants. For example, in an ‘active’ sentence like Sara wrote a blog, the ‘actor’ is Sara, and she writes the ‘goal’, which is the blog. Sara is positioned first in the sentence, so she is emphasised. In a ‘passive’ sentence like The blog was written by Sara, the blog is first and Sara is second. This hides Sara’s responsibility for the writing behind the blog itself, so the blog is emphasised. Passive sentences can also appear without an actor, e.g. The blog was written, where nobody is shown to be responsible. Active and passive sentences are very common and don’t always suggest deliberate manipulations of participant responsibility… but often they do, particularly in newspaper reportage.

Non-apologies are especially common in situations where public trust is at stake, such as from institutions and politicians. Non-apologies suggest that they are following social norms and expectations that they will apologise for what is perceived to be some kind of offensive act, but actually avoid performing a proper apology. Non-apologies come in several forms, but in general terms they can suggest that an apology will come or has already come, e.g. I want to apologise, or I have apologised, which doesn’t actually perform the act of apology. Non-apologies can also be selective about what they apologise for, such as I apologise for this distress, but not the act that causes the distress, or I apologise if this caused any confusion which dismisses the idea that anyone should have been confused.

The texts I analysed were the infamous Katrina Percy letter, the follow-up letter from Simon Waugh, the briefing note to Monitor (all on Sara’s blog), and the public statement that was issued after the Verita report was published. From these I chose the statements referring to positive events, such as improvements to services, previous good care etc., and the negative events such as LB’s death and the general failings of the unit.

My analysis compared the frequencies of features across positive and negative statements, including:

  • Who was emphasised as being responsible and who was hidden in positive and negative statements
  • If the participant responsible was hidden then which participant could be inferred from the surrounding context
  • How often participants were shown to be doing actions, and how often actions were done to them
  • The non-apology strategies present in the text

I won’t go into huge amounts of detail with the analysis, but there were pretty interesting findings (in my opinion!). In terms of transitivity:

  1. Passive sentences (backgrounding responsibility) were more common in statements regarding positive events such as ‘improvements’, and responsibility seemed to be suggested to fall on Southern Health as an organisation.
  2. When the responsible participant was removed, the responsibility could almost always be inferred from the surrounding context, and the participant suggested to be responsible was generally Southern Health as a whole in positive statements, but staff at the unit in negative ones. This seemed to create a divide between the ‘good’ organisation and the ‘bad’ staff.
  3. Southern Health was most frequently shown to be doing things to something else, such as improvements, whereas staff were always positioned behind something else which backgrounded their involvement in actions.
  4. Inanimate nouns such as ‘investigation’ were also often shown to be responsible for actions rather than explicitly naming who was driving these processes, further hiding personal responsibility.
  5. Inanimate nouns often ‘helped’ Southern Health in positive events, but ‘revealed’ information to Southern Health in negative events. This frames Southern Health as being dependent on these inanimate nouns, and reduces their responsibility for actions.
  6. Staff were often shown to be responsible for ‘failings’, whereas Southern Health was shown to be responsible for a greater variety of actions, again creating a divide between ‘good’ Southern Health and ‘bad’ staff.

The non-apology findings were:

  1. 10/14 possible non-apology strategies were present in the texts, often with more than one example of each found.
  2. The most common strategy was to use words like ‘incident’ to avoid explicitly stating what the apology was for.
  3. The second most common strategy was to express a will to apologise or refer to a past apology.

I only looked at four texts so it’s not really possible to make sweeping statements about Southern Health based on these findings, but in these texts there is evidence suggesting some deliberate manipulation of Southern Health and its staff in assigning blame and taking credit for actions, as well as intentional avoidance of producing an actual apology and risking admitting responsibility for negative actions.

The division between ‘good’ Southern Health and ‘bad’ staff is interesting as it shows a lack of ‘duty of care to staff’, something that they emphasise throughout the communications. The findings also contradict the NHS Being Open policy that is designed to avoid shady communications, which suggests that this kind of communication isn’t widespread across the NHS and that Southern Health needs a reminder.

So, what now? As satisfying as it is to know that I managed to use my degree to give a giant middle finger to Katrina Percy et al, realistically I’m just an undergraduate with a long essay to wave at Southern Health. What would be ace is if someone who could use these findings for positive change (i.e. someone from Southern Health who reads this), actually had the balls to admit that their communications could do with a bit more openness.

Week 12: Sorry seems to be the hardest word #107days

This week, Week 12, we’re focusing on saying sorry. To kick us off a post from Sara sharing her thoughts and experience.

Saying sorry. A fairly straightforward concept with a handy NHS guide for those who might struggle. We’d planned a week on this topic as it’s fundamental to helping families deal with the unexpected and preventable death/serious harm of a family member. A swift, heartful and genuine apology probably is the most valuable tool the NHS has, in terms of heading off lengthy, painful and ultimately costly battles with families. Sadly, this doesn’t seem to be widely recognised.

This issue is particularly timely as the template response circulated by some Conservative MPs to constituents’ requests for support for the #LBBill includes a paragraph about Sloven and their unreserved apology for LB’s death. This is lifted from the statement by Katrina Percy, CEO of Sloven, on the day the independent review by Verita was published back in February 2014.

Deeplysorry

This apology was made seven months after LB died. Up to this point, I [not our family] received a ‘I was deeply saddened and sorry to hear of the death of your son, Connor’ from the Acting Chief Exec on July 11th 2013. An exemplar non apology. Her sadness comes first, followed by ‘sorry to hear’ and then a second line with ‘sincere condolences’ scattered like confetti. These words are words anyone can say to someone who has experienced bereavement. Not the words you say to someone who has died in your care.

Katrina Percy, the actual CEO, popped up in December 2013 ‘offering my personal and sincere condolences on the death of your son, Connor‘.

Again, a non-apology. Offering condolences is not saying sorry. We had to wait until there was evidence that LB shouldn’t have died before something approaching an apology was made, three months later. Sadly, despite this public statement, and an apparent acceptance of the Verita findings, nine months later Sloven stood in front of the coroner, arguing that LB died of natural causes. Maybe the NHS Being Open policy needs a footnote added to remind CEOs to remain consistent to their apologies.

In August 2014 we received a letter from Katrina Percy that is tooth enamel removing in its toxicity. On the subject of apologies, she has this to say:

Like every single organisation and individual in the world, we are not perfect and on a rare number of occasions we get things wrong, sometimes with deeply distressing consequences. On these rare occasions, my role as Leader is to do everything in mine and my organisation’s powerto offer our deep and sincere apologies, to work with everyone concerned – including relatives and regulators – in as positive and productive a way as possible to learn from what went wrong and to put in place arrangements to try to ensure nothing similar happens in future.

In this regard, I believe it was absolutely right for us to offer our profound and public apologies to you for the death in our care of your son, Connor.

Profound, sincere and deep are just words. Meaning remains absent, sadly. And without meaning you really ain’t sorry.

So this week we will be thinking about saying sorry and apologies. Please share any experiences in the comments section or drop us an email. As we say with tedious regularity, this really ain’t rocket science.

Tongue