Doctors and nurses have been told to avoid using phrases such as “it’s raining cats and dogs” and “the early bird catches the worm,” over concerns they could confuse or offend foreign patients.
Lancashire Teaching Hospitals NHS Foundation Trust included this guidance in its diversity and inclusion training, stating that those common English idioms lack cultural sensitivity.
The guidance also recommends replacing terms like “chairman” with “chairperson” and “mankind” with “humankind,” as part of efforts to promote a more inclusive environment.
The UK has officially gone mad!
MSN reports: Critics said the guidance read like an April Fool’s joke and cautioned that the policing of language in the NHS was on the rise.
The 17-page document, first issued in November 2024 and reviewed every three years, says it is “crucial” for doctors and nurses to use “considerate, inclusive” language, claiming it will “lead to a healthier society”.
“By fostering an inclusive environment, the NHS can better meet the diverse needs of the populations it serves, ultimately leading to a healthier society overall,” the guidance reads.
The trust, which spent £100,723 last year on salaries for diversity and inclusion staff, has faced mounting financial pressure.
In 2025, it was placed in financial special measures after recording a £42.1m deficit since the previous November.
NHS England subsequently wanted that directors could be replaced if the financial situation did not improve.
The trust employed the equivalent of 2.3 full-time equality and diversity staff in the 2024-25 financial year.
The highest-paid earns £48,526, while newly advertised nursing roles offer salaries of £31,049.
The diversity training document was offered to staff at the trust, which runs Royal Preston Hospital and Chorley and South Ribble Hospital.
It adds: “English phrases or sayings like ‘it’s raining cats and dogs’ may need to be explained to international colleagues or patients.”
The guide recommends avoiding other worlds such as “guys”, suggesting “gender neutral terms” such as “colleagues”, “team” or “members” as alternatives.
It also instructs employees to use “they/them” instead of male and female pronouns if the gender of a patient is unclear.
Lord Young, founder of the Free Speech Union and Tory peer, said the NHS guidance could lead to witch hunts against staff members for using everyday terms.
He told The Telegraph: “This sounds like an April Fool, but the reality is that these busybodies are constantly churning out new language guides, banning an ever-increasing number of words and idioms.
He said guidance such as this will gradually result in more employees being investigated for being culturally insensitive.
He added: “The result is that more and more NHS employees, particularly older employees, are finding themselves under investigation for being ‘culturally insensitive’, which is code for ‘racism’. If you’re not fluent in ‘woke-ish’ – which is a constantly changing modern dialect – you will eventually be cancelled.
“Indeed, that may be the point of this language policing – to force older employees to take early retirement and make way for more pink-haired zealots.”
The Telegraph previously revealed that NHS staff were being told they could use the pronouns “Xey/Xem” at work.
King’s College Hospital NHS Foundation Trust also urged staff to apologise if they used the “wrong” pronouns for colleagues.
A training document entitled Pronouns and the LGBTQ+ Community lists several examples of pronouns, including I/me, She/her, He/him, They/them, Ze/Zir, Xey/Xem or It/Its.
A Lancashire Teaching Hospitals NHS Foundation Trust spokesman said: “As a large specialist Trust, we are proud to have a diverse workforce and to serve people from many different communities.
“It is well known that certain informal phrases or idioms are not always easily understood by everyone, including people with autism or whose first language is not English, so it makes sense to raise awareness of this.
“This helps ensure that within our busy hospitals, communications with our patients and colleagues are as clear and effective as possible.”