Doctors told to avoid phrases such as ‘raining cats and dogs’ and ‘the early bird catches the worm’ to avoid offending foreign patients

Doctors and nurses were instructed not to say ‘The early bird catches the worm’ and ‘It’s raining cats and dogs’ to avoid disturbing foreign patients.

Lancashire Teaching Hospitals NHS Foundation Trust has demanded staff stop using the phrases in diversity and inclusion training, claiming they are not culturally sensitive.

He warns that these terms ‘may not translate well in other cultures’ and may need to be explained to international colleagues or patients.

The guideline, which was created to ‘promote an inclusive environment’, also bans the use of the words ‘president’ and ‘humanity’ and states that the expressions ‘president’ and ‘humanity’ should be used instead.

The 17-page document states that it is “vital” for doctors and nurses to use “thoughtful, inclusive” language and claims that this will “lead to a healthier society.”

‘By promoting an inclusive environment, the NHS can better meet the diverse needs of the population it serves, ultimately leading to a healthier society overall,’ he adds.

Critics said the training guidance, first published in November 2024 and reviewed every three years, read like an April Fool’s joke and warned that language policing was on the rise in the NHS.

The trust, which runs the Royal Preston Hospital and Chorley and South Ribble Hospital, spent £100,723 on salaries for diversity and inclusion staff last year and is facing increasing financial pressure.

It was placed under special fiscal measures last year after recording a deficit of £42.1 million since last November.

NHS England later warned administrators 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.

Newly advertised nursing positions offer salaries of £31,049, with the highest paid earning £48,526.

‘English expressions or idioms such as ‘It’s raining cats and dogs’ may need to be explained to international colleagues or patients,’ the document says.

The guidance recommends avoiding other worlds such as ‘men’, alternatively ‘gender-neutral terms’ such as ‘colleagues’, ‘team’ or ‘members’.

Staff are also instructed to use ‘they/them’ instead of male and female pronouns if the patient’s gender is unclear.

The early bird catches the worm – a robin in the grass early in the morning fights a mighty worm

Free Speech League founder and Tory peer Lord Young said the NHS guidance could lead to a witch hunt against staff using colloquial terms.

He told The Telegraph: ‘This seems like an April Fool’s joke, but the reality is that these busybodies are constantly publishing new language guides and banning an increasing number of words and phrases.’

Lord Young said guidance like this would lead to more and more employees being investigated for being culturally insensitive.

He added: ‘As a result, more and more NHS workers, particularly older workers, are finding themselves under investigation for being ‘culturally insensitive’, which is code for ‘racism’.

‘If you are not fluent in ‘woke’, an ever-changing modern dialect, you will eventually be cancelled.

‘In fact, this may be the purpose of this language control; ‘Forcing older workers into early retirement and making room for more pink-haired fanatics.’

A spokesperson for Lancashire Teaching Hospitals NHS Foundation Trust said: ‘As a large specialist Trust, we are proud to have a diverse workforce and serve people from many different communities.

‘It is well known that some informal expressions or idioms are not always easily understood by everyone, including people with autism or non-native English speakers, so it makes sense to raise awareness about this.

‘This helps ensure that communication with our patients and colleagues in our busy hospitals is as clear and effective as possible.’