Clean Language in the NHS South West End of Life Network

In a league table of taboo subjects, your own death is probably close to the winning spot. You probably don’t want to think about it, let alone talk about it.

But death will come to us all. What kind of death would you like to have?

Colleagues working in palliative care want to support people to have the kind of end-of-life that they’d prefer, as far as possible. That means they need to find ways to talk about it.

What if, instead of being scary, those conversations could be invigorating and energising, like a breath of fresh air?

Surprising? Maybe. But that’s what happened when we introduced Clean Language at a meeting of end-of-life workers recently.

What is Clean Language?

Clean Language is deceptively simple and very powerful. In essence it’s a set of open questions framed in a way to enable people to explore things that matter to them.

“It opens a door to a new way of thinking about how people’s minds actually work. Clean Language questions help other people to explore their thinking and the metaphors which underpin it.” Wendy Sullivan and Judy Rees in “Clean Language: Revealing Metaphors and Opening Minds”

An introduction to Clean Language for End of Life

Saskie Dorman and Kath Rooksby, both of the South West End of Life Network hosted by NHS South West, had heard about Clean Language and were curious to find out more about how it could work in understanding and improving end of life.

They invited Judy Rees to give an introductory 90-minute session at the South West End of Life Network online learning event in November 2022. Over 50 people took part in an engaging and interactive co-designed session.

Inspired by her Clean Language friend and colleague Caitlin Walker’s work on Living With Your End In Mind, Judy asked the group to consider their individual answers to the question, “Your ideal death will be like… what?”

Answers to this deceptively-simple starting question were then explored in small groups using the Clean “Lazy Jedi” questions. Powerful metaphors were revealed, as well as interesting differences between individuals’ needs and preferences.

The activity enabled members of the group to understand and talk about what matters to them about their own death, often in new and expressive ways.

The group went on to explore how members viewed a valuable end-of-life system, again using Clean Language questions.

And what happened next?

The session ended with participants feeling energised and curious to learn more. One participant commented that “Clean Language training should be obligatory for all health and social care staff”!

A more in-depth Clean Language training programme is now being scheduled for Network members. A Phase 1 training programme was quickly oversubscribed, and further sessions are being planned for 2023 and beyond.

Saskie commented: “Over the years I’ve thought a lot about death and dying. But Clean Language questions have opened up fresh ways of thinking about it, sparked new connections and conversations. A wonderful way to see, feel and understand what really matters to each of us… and how that could be possible to achieve.”

• The introductory session and training programme are funded by the South West End of Life Network, South West Integrated Personalised Care, NHS South West.