AGENDA FOR CHANGE: THE NHS KNOWLEDGE AND SKILLS FRAMEWORK Crown Copyright 2004

CORE DIMENSION 1: COMMUNICATION OVERVIEW

Status Levels Core communication is a key aspect of all jobs in the NHS. This dimension underpins all the other dimensions in the KSF. 1 Communicate with a limited range of people on day-to-day matters 2 Communicate with a range of people on a range of matters 3 Develop and maintain communication with people about difficult matters and/or in difficult situations 4 Develop and maintain communication with people on complex matters, issues and ideas and/or in complex situations This dimension relates to effective communication in whatever form it takes place. Effective communication is a two way process. It involves identifying what others are communicating (eg through listening) as well as communicating oneself, and the development of effective relationships. Progression through the levels in this dimension is characterised by developments in: - the subject matter of the communication - the situation in which the communication takes place - the purpose of the communication - the numbers of people that are being communicated with, their diversity and the effect of these on the communication skills required. Communication might take a number of forms including: - oral communication - signing - written communication - electronic communication (eg email, databases, electronic results and reports) - the use of third parties (such as interpreters and translators) - the use of communication aids (eg charts, pictures, symbols, electronic output devices, specially adapted computers) - the use of total communication systems. The people with whom the individual is communicating might be: - users of services (such as patients and clients) - carers - groups (including families) - the public and their representatives - colleagues and co-workers - managers - workers from other agencies - visitors - the media. Barriers to communication may be: - environmental (eg noise, lack of privacy) - personal (eg the health and wellbeing of the people involved) - social (eg conflict, violent and abusive situations, ability to read and write in a particular language or style).
CORE DIMENSION 1: COMMUNICATION NHS KNOWLEDGE AND SKILLS FRAMEWORK August 2004 Page 64

Descripti on

Example s of applicati on
These may be relevant to all levels in this dimension

AGENDA FOR CHANGE: THE NHS KNOWLEDGE AND SKILLS FRAMEWORK Crown Copyright 2004 Legislation, policies and procedures may be international, national or local and may relate to: - complaints and issue resolution - confidentiality - data protection (including the specific provisions relating to access to health records) - disability - diversity - employment - equality and good relations - human rights (including those of children) - information and related technology - language. Links to other KSF dimensio ns Links to UK/natio nal policies This dimension is supported by: - Core 6 Equality and Diversity.

This dimension is related to: - Building on the Best: Choice, Responsiveness and Equity in the NHS, Department of Health, 2003 - Working together, learning together: a framework for lifelong learning for the NHS, Department of Health, 2001 - Confidentiality: NHS Code of Practice, Department of Health, July 2003 - Staff Governance Standard, Scottish Executive, 2002 - Protecting Patient Confidentiality: final report, Scottish Executive, 2002 - Codes of conduct and standards of different professional groups

CORE DIMENSION 1: COMMUNICATION NHS KNOWLEDGE AND SKILLS FRAMEWORK August 2004 Page 65

AGENDA FOR CHANGE: THE NHS KNOWLEDGE AND SKILLS FRAMEWORK Crown Copyright 2004

Core 1/Level 1 Communicate with a limited range of people on day-today matters

Indicators The worker: a) communicates with a limited range of people on day-to-day matters in a form that is appropriate to them and the situation b) reduces barriers to effective communication c) presents a positive image of her/himself and the service d) accurately reports and / or records work activities according to organisational procedures e) communicates information only to those people who have the right and need to know it consistent with legislation, policies and procedures. Examples of application People with whom communicating See overview Day-to-day matters might include: - asking questions - giving straightforward information - passing on simple messages - providing answers - taking simple messages. Forms of communication See overview Barriers to communication See overview Reducing barriers might relate to: - adapting communication - changing the environment - checking information received for accuracy and interpretation - using communication aids Legislation, policies and procedures See overview

CORE DIMENSION 1: COMMUNICATION NHS KNOWLEDGE AND SKILLS FRAMEWORK August 2004 Page 66

AGENDA FOR CHANGE: THE NHS KNOWLEDGE AND SKILLS FRAMEWORK Crown Copyright 2004

Core 1/Level 2 Communicate with a range of people on a range of matters

Indicators The worker: a) communicates with a range of people on a range of matters in a form that is appropriate to them and the situation b) improves the effectiveness of communication through the use of communication skills c) constructively manages barriers to effective communication d) keeps accurate and complete records consistent with legislation, policies and procedures e) communicates in a manner that is consistent with relevant legislation, policies and procedures Examples of application People with whom communicating See overview Matters might relate to: - establishing and maintaining contact with different people - explaining how to do something - making arrangements - reporting any changes that are needed - sharing information and opinions Forms of communication See overview Communication skills might include: - listening skills - non-verbal skills and body language - questioning skills Barriers to communication See overview Managing barriers might include: changing the environment or context changing the form of communication helping others communication modifying the style and/or form of communication monitoring the effectiveness of own communication presenting a positive image of her/himself and the service simplifying the content using communication aids. Legislation, policies and procedures See overview

CORE DIMENSION 1: COMMUNICATION NHS KNOWLEDGE AND SKILLS FRAMEWORK August 2004 Page 67

AGENDA FOR CHANGE: THE NHS KNOWLEDGE AND SKILLS FRAMEWORK Crown Copyright 2004

Core 1/Level 3 Develop and maintain communication with people about difficult matters and/or in difficult situations

CORE DIMENSION 1: COMMUNICATION NHS KNOWLEDGE AND SKILLS FRAMEWORK August 2004 Page 68

AGENDA FOR CHANGE: THE NHS KNOWLEDGE AND SKILLS FRAMEWORK Crown Copyright 2004 Indicators The worker: a) identifies the range of people likely to be involved in the communication, any potential communication differences and relevant contextual factors b) communicates with people in a form and manner that: - is consistent with their level of understanding, culture, background and preferred ways of communicating - is appropriate to the purpose of the communication and the context in which it is taking place - encourages the effective participation of all involved c) Examples of application People with whom communicating See overview Communication differences might be in relation to: - contexts and cultures of the different parties - degree of confusion or clarity - first/preferred language - levels of familiarity with the subject of the communication / context in which the communication is taking place - level of knowledge and skills - sense of reality. Forms of communication See overview

d)

e)

f)

Purpose of communication might include: - asserting a particular position or view recognises and reflects on barriers to - breaking bad news effective communication and modifies - encouraging and supporting people - explaining issues in formal situations communication in response (such as courts) - explaining outcomes of activities / provides feedback to other workers interventions on their communication at - exploring difficult issues appropriate times - facilitating meetings keeps accurate and complete records - helping people make difficult decisions - making scripted presentations of activities and communications - presenting and discussing ideas consistent with legislation, policies - providing technical advice to nonand procedures. technical specialists - representing views communicates in a manner that is - seeking consent consistent with relevant legislation, - sharing decision making with others policies and procedures. including users of services - sharing information - supporting people in difficult circumstances. Barriers to communication See overview Modifies communication through, for example: - deciding what information / advice to give / not give as the communication proceeds - modifying the content and structure of communication - modifying the environment

CORE DIMENSION 1: COMMUNICATION NHS KNOWLEDGE AND SKILLS FRAMEWORK August 2004 Page 69

AGENDA FOR CHANGE: THE NHS KNOWLEDGE AND SKILLS FRAMEWORK Crown Copyright 2004

CORE DIMENSION 1: COMMUNICATION NHS KNOWLEDGE AND SKILLS FRAMEWORK August 2004 Page 70

AGENDA FOR CHANGE: THE NHS KNOWLEDGE AND SKILLS FRAMEWORK Crown Copyright 2004

Core 1/Level 4 Develop and maintain communication with people on complex matters, issues and ideas and/or in complex situations

CORE DIMENSION 1: COMMUNICATION NHS KNOWLEDGE AND SKILLS FRAMEWORK August 2004 Page 71

AGENDA FOR CHANGE: THE NHS KNOWLEDGE AND SKILLS FRAMEWORK Crown Copyright 2004 Indicators The worker: a) identifies: - the range of people involved in the communication - potential communication differences - relevant contextual factors - broader situational factors, issues and risks b) communicates with people in a form and manner which: - is consistent with their level of understanding, culture, background and preferred ways of communicating - is appropriate to the purpose of the communication and its longer term importance - is appropriate to the complexity of the context - encourages effective communication between all involved - enables a constructive outcome to be achieved c) anticipates barriers to communication and takes action to improve communication d) is proactive in seeking out different styles and methods of communicating to assist longer term needs and aims e) takes a proactive role in producing accurate and complete records of the communication consistent with legislation, policies and procedures f) communicates in a manner that is consistent with legislation, policies and procedures. Examples of application People with whom communicating See overview Communication differences might be in relation to: - contexts and cultures of the different parties - degree of confusion or clarity - first/preferred language - levels of familiarity with the subject of the communication / context in which the communication is taking place - level of knowledge and skills - sense of reality. Situational factors, issues and risks might include: - changes affecting the people concerned which are outside their control - history of poor communication and misunderstandings - complexity of the issues and associated political issues and risks - clashes in personal and/or organisational styles and approach that cause difficulties in ongoing communication Forms of communication See overview Purpose of communication might include: - advocating on behalf of others - asserting a particular position or view and maintaining it in adversity - breaking bad news and supporting those receiving it - contributing to decision making balancing a number of different interests - delivering presentations without a script actively encouraging participation from the audience - explaining complex issues in formal situations (such as courts, expert witnesses) - explaining strategy and organisational decisions to everyone in an organisation - facilitating processes

CORE DIMENSION 1: COMMUNICATION NHS KNOWLEDGE AND SKILLS FRAMEWORK August 2004 Page 72

AGENDA FOR CHANGE: THE NHS KNOWLEDGE AND SKILLS FRAMEWORK Crown Copyright 2004

CORE DIMENSION 1: COMMUNICATION NHS KNOWLEDGE AND SKILLS FRAMEWORK August 2004 Page 73