Obscure abbreviations and over-complicated policies keep the NHS from focusing on what is really important

Christmas and new year have come and gone, and NHS managers are back at work feeling bloated and broke.

Many NHS staff worked throughout the holiday period maintaining essential services. The latest research says work is good for your mental health - it pays the bills and occupies the mind.

And if you are helping people who are seriously ill, it makes you count your blessings. Maybe next year we could all save a lot of money and heartache and book in for a few shifts in our own services.

This can be a terrible time of year - suicides, self-harm, domestic violence and serious mental distress are all on the up. If mental health services were on payment by results, we would be quids in, but as it is, we have to flex just when staff are going off sick with various winter ailments that no amount of winter planning can avoid.

I once had a job as regional lead for winter planning, and everything bad that happened that year seemed a) to be caused by winter and b) to be my responsibility. I remember asking the national director whether they thought I could control what went into the Daily Mail - the answer, of course, was yes.

Keeping it simple

But now we are well into 2008. We have a lovely new operating framework to help build relationships between commissioners and providers, and Vital Signs is this year's local delivery plan. If the shorthand for the latter was LDP, will we be asked to call the former V-Signs?

Before the LDP, we had the service and financial framework (or SaFF), which became the service, workforce and financial framework (SWaFF). We should really have had the service, workforce and locality knowledge, but somebody had already used that one.

We are obsessed with TLAs (three-letter acronyms) in the NHS. You only have to mention something once and it immediately gets abbreviated - TMP, TPR, BCG, SoS, NFA, PCT, GDC, ABC, etc. As a student nurse at Great Ormond Street, I spent my first year wondering why, when a child used their potty, it was entered on the fluid chart as Box 1. I finally found out it meant bowels opened x 1.

The best communicators keep it simple, and only the bad ones add the word stupid and abbreviate it to KISS. So let us make two late resolutions. First, let's not abbreviate everything into acronyms, it only excludes people, and second, let's not take a nice ordinary word or phrase and use it to mean something it was never meant to. I call this B, short for bastardisation.

I am beginning to sound like a grumpy old woman, so it is time to sign off and wish a belated happy new year to you all.