Staff are already able to effectively communicate at all levels with patients, carers, relatives and colleagues. 

This section concentrates on competencies related to communication and collaboration. It highlights the need for staff and patient autonomy when it comes to delivering or receiving care, and the importance of trust when building the foundations of a therapeutic relationship with patients.

We Can Talk recognises that these existing core skills already are embedded in practice:

• Interpersonal Communication – NHS staff are trained and expected to communicate clearly and compassionately, enabling them to engage patients, families, and colleagues in meaningful conversations that support patient well-being (1).
• Teamwork and Collaboration –  Effective communication within the multidisciplinary team (MDT) is a fundamental skill, ensuring that care is coordinated and that patients receive consistent, safe care (1, 2).
• Building Trust – Building trusting, respectful relationships with patients is an essential part of all acute healthcare workers’ jobs, helping patients feel understood and supported in their care journey (3, 4).
• Cultural Sensitivity and Adaptability – Healthcare staff are expected to adapt communication to meet the needs of patients from different cultural backgrounds and those with learning or communication difficulties (1, 4).

The following We Can Talk competencies build on these existing core skills:

• Explore the importance of effective communication when supporting individuals who experience a mental health problem. Be able to effectively communicate with the wider Multidisciplinary Team (MDT), family, friends and carers (3, 4, 5).
• Examine the importance of cooperation and maintaining good relationships with everyone involved in the patient’s care. Encourage teamwork within the wider MDT, ensuring that staff respect each other’s roles and contributions to patient care (6).
• Summarise the difference between engagement and assessment and understand your role when supporting individuals with a mental health problem.
• Explore the impact of professional mannerisms and attitudes when discussing mental health and understand how they could impact patient care (5, 6).
• Demonstrate the ability to communicate at a level appropriate to the individual, considering any cultural, learning, or communication difficulties and any potential barriers this may present (1, 6).
• Outline how to build honest, respectful, trusting, and non-judgemental relationships by actively listening and avoiding assumptions (1, 2, 5, 7).
• Develop the confidence to ask direct questions about suicidal ideation and behaviour, by understanding that asking direct questions does not increase risk(13).
• Recognise the role acute hospitals have in supporting the mental health needs of their patients (3, 4).
• Recognise how the provision of high quality care reduces risk and promotes well-being (3, 4, 7)

Staff are already used to the dynamic application of risk assessments to ensure staff,  patient and visitor safety, by recognising risks and reacting accordingly.

We Can Talk recognises that these existing core skills already are embedded in practice:

• Risk Assessment and Management – NHS staff are skilled in assessing and managing risk, regularly making informed decisions to ensure the safety of both patients and staff (1, 8).
• Crisis Management – Managing distress and stressful situations is a core competency. Acute healthcare staff frequently manage crises in different areas of healthcare, and these skills can be applied to mental health crises (4, 5).
• Ethical Practice and Accountability – NHS staff are trained to act with accountability and integrity, ensuring that their actions are respectful and uphold ethical principles, even in high-pressure environments (1).

The following We Can Talk competencies build on these existing core skills:

• Explore how to support patients in distress due to their mental health, using compassionate care to ensure individualised emotional and psychological support during challenging situations (1, 5).
• Examine how to apply risk awareness and risk assessment skills in the context of mental health, to improve patient safety and well-being (1, 5, 8).
• Explore concepts of mental health vs mental illness (1, 5, 7).
• Recognise the early warning signs of mental health concerns (1, 5, 7).
• Define the concept of mental health crisis, including signs and symptoms, and its impact on people’s behaviour, feelings, and perceptions during a crisis (1).
• Understand the need to be respectful, accountable, responsible, and adhering to ethical principles (1, 2, 5).
• Explore why good quality care is vital to reduce risk (9).
• Understand how to see patients as resources, supporting them to identify their coping mechanisms and involve them transparently in their care (2, 5, 7).
• Examine system pressures across hospitals and the community, and why acute settings are challenging (1, 4).
• Explain the impact of social triggers and how they can create mental distress (1, 2, 4, 7). 
• Explore how stereotyping and judgements can change the experience for both the patient and the staff (1, 2, 4, 7).

In order to ensure that patients are empowered and involved in their care planning, staff are already working to promote active participation in care, self-management strategies, and fostering a sense of autonomy.

We Can Talk recognises that these existing core skills already are embedded in practice:

• Empathy and Compassion – Demonstrating empathy and compassion is a key skill for healthcare staff, fostering an environment where patients feel respected and empowered to participate in their care (1, 4).
• Patient-Centred Care – Staff are trained to put patients at the centre of their care, providing information and support to help them make informed decisions (1).
• Promoting Autonomy – Encouraging patients to take responsibility for their health and supporting self-management strategies is central to NHS care, as laid out in the NHS Constitution and Health Education England (1, 5).

The following We Can Talk competencies build on these existing core skills:

• Understand how to empower patients to participate actively in decisions about their care and recovery throughout their journey(5).
• Examine the importance of validation and understand that saying something is better than saying nothing.
• Explore the use of basic coaching techniques to help patients manage mental distress (5).
• Examine the benefits of using  empathy, respect, and a non-judgemental attitude when working with others (1).
• Identify ways in which you can give patients time to talk by finding ways to communicate sensitively (5).
• Identify the need to promote dignity and autonomy for patients, ensuring they feel like active participants in their care, not passive recipients (6).
• Explore the needs of individual care, recognising that there is no one-size-fits-all approach (1, 2, 5, 7).
• Explain the stigma and discrimination that patients may face in their journey (1, 2).
• Recognise that attitude, not just expertise, is key in managing mental health challenges (4).

1. Professional Standards (multiple)
   
   Health and Care Professions Council (HCPC) Standards of Proficiency (2023) https://www.hcpc-uk.org/standards/standards-of-proficiency/Standards for Proficiency for Registered Nurses (NMC) (2018)

   https://www.nmc.org.uk/standards/standards-for-nurses/standards-of-proficiency-for-registered-nurses/

   Care Certificate Standards (2015) https://www.skillsforcare.org.uk/Learning-development/Care-Certificate/Care-Certificate.aspxGeneral Medical Council (GMC) Good Medical Practice (2023) https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/good-medical-practice

   Security Industry Authority (SIA) Licensing Standards – Knowledge and Skills Specification (2021) https://www.gov.uk/government/organisations/security-industry-authority

   General Pharmaceutical Council (GPhC) Standards for Pharmacy Professionals (2017) https://www.pharmacyregulation.org/standards 

2. NHS Constitution for England (2023) https://www.gov.uk/government/publications/the-nhs-constitution-for-england
3. NHS Values-Based Recruitment (2016) https://www.hee.nhs.uk/our-work/values-based-recruitment
4. National Confidential Enquiry into Patient Outcome and Death – Treat as One (2017) https://www.ncepod.org.uk/2017report1/downloads/TreatAsOne_Summary.pdf
5. Mental Health Core Skills Education and Training Framework (2016) https://www.skillsforhealth.org.uk/services/item/525-mental-health-download
6. National Curriculum and Competency Framework for Emergency Nursing (RCN) (2017) https://www.rcn.org.uk/professional-development/publications/pub-005923
7. Self-harm and Suicide Prevention Competence Framework (2018) https://www.ucl.ac.uk/pals/research/clinical-educational-and-health-psychology/research-groups/competence-frameworks/self-harm
8. Care Quality Commission (CQC) Report – How are People’s Mental Health Needs Met in an Acute Hospital (2020) https://www.cqc.org.uk/sites/default/files/20201016b_AMSAT_report.pdf
9. Francis Report (2013) https://www.gov.uk/government/publications/report-of-the-mid-staffordshire-nhs-foundation-trust-public-inquiry
10. Dazzi T, Gribble R, Wessely S, Fear NT (2014). Does asking about suicide and related behaviours induce suicidal ideation? What is the evidence? Psychol Med. Dec; 44(16):3361-3. doi: 10.1017/S0033291714001299. Epub 2014 Jul 7. PMID: 24998511. https://pubmed.ncbi.nlm.nih.gov/24998511/