Imagine a World…

By Laura Lennox

Elaine has dysarthria (motor speech disorder):

“I hate using the phone simply because I am so self-conscious of my speech.  And if they say “Pardon?” to me, it makes me more flustered because I automatically assume it’s my speech that’s the issue.  I would never think it could be that a noise distracted them at their end.  And the more flustered I get when trying to talk, the worse my speech becomes”.

“I love that some companies now have the ‘chat online’ service.  I will use that instead of the phone even though it takes longer”.

“The other day I saw some valuable looking equipment seemingly dumped under a bridge.  When I got home I went on to the Police Facebook page to message them, but they didn’t have messaging as an option.  I googled a contact email for them but to no avail. In the end I was forced to phone but it really is a last option for me”.

“I hate phoning for appointments, taxi’s, takeaways- all the things other people do without thinking about it – it’s a big issue for me and I often work myself up in to a state.  I try to remember the sound advice from my speech and language therapist to speak slowly and clearly but the minute I hear “Pardon?” I break out in a cold sweat

Last year I decided to get back into studying and registered for a three-year MSc in Advancing Healthcare Practice through the Open University.  I was asked to look at a small-scale innovation in a healthcare setting that could lead to a significant impact.  Straight away I knew what I was going to look at.  Listening to people’s stories time and time over – THE DREADED TELEPHONE!!

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William and Bob both had throat cancer.


“Speaking for myself, contact through email is the only way for me to go. I cannot carry a conversation by telephone due to the amount of Mucous and or phlegm talking generates.  I can listen on the phone to any conversation but can only give a limited response to any questions”. 


“I do not answer the phone as usually the valve needs cleaned for me to speak clearly.  If I need to make a phone call I need to clean the valve first and tend to just phone immediate family due to other people possibly not understanding me.  It’s embarrassing answering the phone and not being able to speak.  An email is so much easier to correspond with. No embarrassment.”

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Typically, the main or only method for contacting any public service is by telephone.  In the 21st century we have so many more ways of communicating:

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A Scottish Executive report published on communication support needs (Law et al, 2007) estimates there are between 1% and 2% of the population in Scotland who have complex communication needs.  Complex meaning to the degree that they cannot communicate effectively using speech, whether temporarily or permanently.  This is likely an underestimate given that the study is based only on people who were accessing speech and language therapy services.

If we consider the findings of this Scottish Executive report, having telephone contact as the only method of access within an organisation may be perceived as an inequality.

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(International Communication Project, 2016)

The Scottish Government (2011) recognises the requirement for public organisations to become more inclusive of people with communication support needs and has set guidance for public authorities on Principles of Inclusive Communication.  The legislative driver for this stemming from the Equality Act (2010) and the United Nations Convention on the Rights of Disabled People (2009), Articles 9 and 21, which set out a person’s right to have access to information and communication in different forms.

Individuals and the wider community benefit from all people being more independent and participating in public life.

Lorraine has Aphonia (loss of voice):

“I have difficulty with communication as my voice is a whisper and everyday there is a hurdle I have to try and jump.  One of these is appointments with NHS either hospital appointments or Dr Surgery appointments. I have lost appointments at the hospital as I can’t phone to cancel and rearrange. Also, when they send you a letter saying to phone up to arrange an appointment, I have to rely on other people to do this for me which is very hard as they work during the hours you have to phone, or they forget it’s also not very private. If you wanted to keep it private I can’t even have a phone consultation. I find it upsetting and frustrating that I have lost a lot of my independence having to rely on other people to make phone calls and appointments for me. There is a simple way to help people like me to give us part of our independence back and the answer is email. Most of us use it these days and I would have my privacy too. All they need to do is have on my records responds by email only, how hard is that? I don’t like to be one of those statistics that don’t turn up for appointments or when you don’t phone to make your appointment and think you do not need one. And that is just a small part of what I have to go through on a daily basis”.

Putting knowledge into action is what counts.  We could all work towards becoming more inclusive to people with complex communication needs by adding alternative options for contacting our services and departments.  It could be as simple as adding an email address to start with.

Now imagine if every service and department within health and social care did this then it would indeed be a giant leap towards a more inclusive communication world.

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Laura Lennox is a Speech and Language Therapist and AHPScot Social Media Champion for NHS Dumfries and Galloway

You can contact Laura at:

You can also follow on Facebook: @SpeechandLanguageTherapyAdultServiceNHSDG or on Twitter: @SLT_DG

This blog was first posted on DG Health in April 2018 – To see more from DG Health go to:


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