The Government is relying heavily on AI to transform health and social care but improved outcomes may lie in better communication rather than better technology. 

The impact of poor patient communication on health outcomes, for example, has been well-documented with one recent study reported in The BMJ showing four in 10 patients receive incomprehensible letters concerning their health. It's noted ‘NHS communication failures erode trust'. 

And when it comes to changing organisations, more than two-thirds of transformation programmes fail in part because of poor communication. 

In fairness, the Government recognises the importance of communication in its 10-Year Health Plan, Fit for the future. It openly acknowledges poor communication is the most common reason for complaints. Yet surprisingly there are only three references to it in the entire 168 pages. 

But changing the way health and social care organisations communicate will need a big investment in time and a change in attitude. Five barriers stand in the way. 

First, there is the will and this starts at the top. Leaders need to publicly acknowledge the importance of both talking to and listening to patients and service users. All too often their views are ignored, or merely given lip service. 

It surely says something about medical culture, for example, that even getting access to a second medical opinion required Government intervention through Martha's Rule. One suspects the desire for a second opinion is driven as much by the feeling of being ignored or shut out as much as getting access to confirmation or otherwise. 

The second barrier is the skills gap. Advanced communication skills depend more on listening than speaking. The current obsession is on channels that allow leaders to push messages out. But less time and energy is set aside to ensure that staff are able to develop powerful listening and empathy-building skills. Both matter. 

But staff not only need training – they need time, particularly face-time. Organisations that rely upon online only interactions may be missing critical information that can only be gleaned from face-to-face exchanges. And when staff feel too time-pressured, they don't have the mental space to build empathy. 

Understanding what patients and service users want is a third obstacle to transformation. Three key questions should inform interactions with them. Who is this person? What do they want? And how can I work with them to help them get it while improving health and social care outcomes? 

The key to unlocking personal motivation – a key driver for preventative healthcare – is in understanding patients and service users as people first, who have their own hopes and fears. How many leaders know the answers to these questions of their own staff, never mind their service users? 

The fourth barrier is whether leaders themselves are able to embrace communication as a tool for change. This means shifting from using communication as a means of ensuring service users and patients know things to affecting how they feel about things. 

Feelings matter – they can drive actions. But unless leaders are interested in how staff, in particular, feel about their situation and prospects, they're unlikely to achieve full organisational transformation. How many leaders would know how staff in their own office feel today? 

And finally, the Government needs to signal a change in attitude. As it stands, it is acting as a barrier to change by repeatedly failing to properly engage the public sector in it. All too often, by announcing in advance massive changes through the media (such as the closure of Health Education England) and by failing to consider the emotional impact on staff, they trigger anxiety and depress motivation. 

But more than that, the Government is not positioning itself to listen to staff ideas. The people who know how to unleash efficiency and productivity gains are probably already doing the job. They just need a signal from ministers that their views matter and will not only be listened to but acted on. 

The thing about communication is that since we all do it, we know when it's working well. 

We can easily spot when people are nodding but not listening. Maybe that's why AI is so attractive to ministers – it takes instructions, never answers back and it doesn't feel anything.