Language matters, image matters too – ‘The Ormskirk Model’

Dr May NgNHS England’s ‘Language Matters’ document highlights how language used by healthcare professionals can have a profound impact when caring for people living with diabetes.

Dr May Ng, Associate Professor at the University of Liverpool and Consultant Paediatric Endocrinologist at Southport and Ormskirk Hospital NHS Trust and her colleagues have built on this insight in creating ‘The Ormskirk Model’.

Dr May Ng tells us: “The Ormskirk Model has been developed to help healthcare professionals and people living with diabetes to identify resources, strengths and what is important to them. The new model approaches HbA1c and Time-In-Range (TIR) in a compassionate manner, utilising concepts from solution focused therapy and had gained over 80,000 impressions on social media!”

Language used in a positive, understanding and emphatic manner can lower anxiety, build confidence, improve relationships and enhance self-management. Conversely, when language is used poorly, it can be stigmatising, hurtful and have a negative effect on self-care.

However, accorded to Dr May Ng and The Ormskirk Model, not only does language matter, but image matters too. The current use of HbA1c models have revolved around the use of ‘scary’ images, traffic light systems and words such as ‘serious complications’, ‘very poor’ and ‘high risk’ which were not beneficial. The majority of these images and models are based on a pathological approach that makes an attempt to scare people with diabetes about risks of complications.

Dr May Ng continues: “The Ormskirk Model is a colour neutral model and image, taking a timely step away from previous traffic light systems of images which portray and categorises HbA1c into ‘good’ and ‘bad’ colours. The model also avoids negative language such as ‘complications’, ‘risks’ and ‘good/poor/very poor’. It asserts that it is time to move away from using the words ‘control’ or ‘complications’ when discussing goals within a clinic setting. With the use of neutral colours, there is a lack of immediate judgement of the person living with diabetes.

“The model also utilises language and images that facilitates people to identify what has worked well for them and what matters to them through the use of rhetorical questions. The model attempts to enquire how diabetes (no matter what the HbA1c or TIR reading) is managed and makes the assumption that people living with diabetes are doing the best they can at that point in time.