Leadership in breast screening and the importance of appropriate communication during the early onset of the COVID-19 pandemic.

INTRODUCTION: In England, the NHS National Breast Screening Programme (NHSBSP) offers routine breast screening to all women, some trans men and non-bionary people, between the ages of 50 years and up to their 71 st birthday, every 3 years. The unfolding Covid-19 pandemic in early 2020 was understandably a time of great anxiety and concern. Culturally we were seeing strong behavioural shifts such as social distancing and a general change in all our daily life patterns. Conceptually, and as leaders, we understood the vulnerability we observed, but felt that we did not have the 'right language' and in fact lacked the relevant experience of how to address and communicate with staff and clients during this crisis.

METHODS: A semiotic, observational research project was utilised that aimed at providing insight how cultural behaviour was being shaped and expressed during the early onset of the Covid-19 pandemic in England. The recommendations of the project were then integrated and implemented into an action plan and subsequent practice.

RESULTS: Semiotic analysis revealed that several factors (positive and negative) impacted on peoples' confidence and had practical and emotional implications. Eleven main codes which are belief systems about oneself and others were identified and expressed in a multitude of different ways revealing three main themes or needs i.e. Reassurance, Trust and Clarity. An action plan was developed in response to the project findings and recommendation were implemented.

CONCLUSIONS: Effective leadership relies on situational awareness. Our semiotic project enabled us to find the 'right' language and communication style so that we could connect with staff at the time of crisis. Using our own expert staff, we empowered them by providing the correct, easily digestible resources to facilitate confidence across the service teams which in turn supported the delivery of high-quality breast screening at a time of great uncertainty.

IMPLICATION FOR PRACTICE: We must learn to be agile and adaptive, both in our operational delivery and our communication styles.