Sometimes, the NHS needs to measure patients’ weight and height. The NHS records their weight and height internally in metric units but often tells the patients their weight and height in imperial units, which is preferred by the vast majority of Britons. This requires conversions. During the pandemic, the Government used metres exclusively for social distancing information. We use grams and kilograms for recipes, food purchases and the gym. We are all familiar with these units. So why does the NHS convert from metres to feet and inches and from kilograms to stones and pounds for its patients?
I few weeks ago, I went to my local surgery for a general health check-up. At the surgery, I noticed a height ruler with metres and centimetres on one side and feet and inches on the other side. I also saw a weighing machine with a switch that converts from kilograms to stones and pounds. The doctor asked me to take off my shoes and stand straight on the scale to measure my height. She told me that I am 1 metre 80½ centimetres tall. After telling me my height in metric units, the doctor immediately converted it to feet and inches. She told me that I was 5 feet 11 inches. I understood the height measurement in metric units and did not ask for any conversion, but the doctor gave me one anyway. She also weighed me and told me that I weigh 95.5 kilograms. Interestingly, she gave me no conversion in stones and pounds. I didn’t need one in any case and have no complaints about that. I am pleased that she felt no need to give a conversion. I understood the weight measurement perfectly well.
It is enough to know your weight and height in one measurement system. There is no need to know this in two measurement systems. What do we often use two measurement systems to measure the same thing?
One problem with unit conversions is rounding errors. Heights expressed in feet and inches tend to be rounded to the nearest inch. Given that there are approximately 2½ centimetres to an inch, an imperial height conversion could be over 1 cm out. Weights expressed in stones and pounds tend to be rounded to the nearest pound. Given that there are 454 grams to a pound, an imperial weight conversion could be over 0.2 kg out. When you convert the imperial units back to metric, you may not get the original values in metric units. Therefore, the imperial figures given to a patient may not correspond to the NHS official records. Stick to metric and the rounding problem disappears.
It is worth asking the question that forms the title of this blog article again: Should the NHS do more to encourage patients to use metric? Metric Views is interested to hear readers’ measurement experiences in the NHS.
Metric Views 
Cannot comment on the NHS since I live in the USA (with our disastrous non-healthcare privatized system) but I am surprised you were told your height as “1 metre 80½ centimetres”, which mimics the Imperial breakdown separately into “feet” and “inches”.
I would assume the “native metric” number would be either 1.85 meters or 185 centimeters. Still some education needed there as well, it seems, when it comes to thinking fully in metric.
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Of course they shouldn’t be converting at all and people should just know it in metric. The reason why imperial has lingered on for so long in the UK is because there is a tendency to stick with what people know, rather than getting them use to the new system. Voluntary gradualism if you like. As opposed to other countries that managed to get it largely done and dusted within a timeframe of about ten years.
It is a self-fulfilling prophecy and ultimately creates an unnecessary distinction between professional and public life. With road signs being the most egregious example of it. As long as road signs are in miles people aren’t going to get use to kilometres and so you claim that is what people are use to and continue to perpetuate it. It is a similar story with the media and things such as the medical profession. Hence why it is taken so long for this stone unit to finally die, despite it not being used anywhere else or for anything else for that matter.
If the media and medical profession conversed in metres and kg. People would be more likely to quickly get use to it rather than persisting with reverting it back into inefficient old fashioned units.
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Ezra,
1 m 80.5 cm is not the same as 185 cm, it is the same as 1805 mm. If the nurse meant 185 cm and read it as 180.5 cm, then this nurse shouldn’t be allowed to practice medicine.
But, what is even more surprising, if this so-called nurse was supposedly educated in metric units in both elementary school and nursing school, I would have thought she would have learned to read a metre scale correctly. Either as 180 cm or 1.80 m. The extra 0,5 is just nonsense, as one’s height can vary by a centimetre or so throughout the day.
It’s amazing this type of ignorance is allowed to fester in such a way it can result in errors that can result in compromise to ones health.
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Alex M,
This is the reason that in the better managed countries of the world, the metrication program was designed to change everything withing a sensible time period with no exceptions. So, now what happens when choices are given and half the businesses operate internally in metric and the other half in FFU? It harms the national economy when those companies using metric internally are forced to import both workers and materials from metric countries since those who insist on resisting metric are useless as employees in a metric company.
Raw material and finished goods produced in FFU are useless to a metric company so they import and the non-metric company eventually goes bankrupt as they continue to produce products that can’t be exported nor sold to metric businesses.
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I think the answer to the title of this article must be a resounding ‘Yes’. Perhaps the UKMA can promote that objective. The doctor or nurse does not rely on the height and weight information given by the patient, either in metric units or old-fashioned imperial. They weigh the patient and measure their height to make an accurate determination of those figures on the day the patients attends, if that information is needed. There is absolutely no necessity to convert the metric weight and height back into the old-fashioned units for the patient. If a patient who on their last visit weighed 70 kg has put on, say, 5 kg since their last visit, the increase is not going to be more meaningful in old-fashioned units. It is going to be 70 + 5 kg. Surely any patient can understand that? It was 70 and now it’s 75. And remember it. It is no more difficult to remember one’s weight in kilograms than it is in any other units. And it is the weight in kilograms that interests the NHS.
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Yes is the correct answer.
NHS is second to D(a)fT for being the worst offender in this respect. More life or death issues if misunderstandings go wrong.
Offending is the operative word when, as other comments above, they ‘correct’ my metric with some stupid units I have been trying to eradicate from my brain for over 50 years. It even sends my blood pressure up so it is irrelevant anyway.
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Ronnie, not only have I had the same experience as you, but my height and weight are very similar to yours giving both of us a BMI of about 30. Maybe we should both do something about our weights! B TW, the BMI is not a dimensionless number but has the units of kilograms per square metre.
What should the NHS be doing to encourage people to use the same units that they use internally? One way would be for the medical practitioner to always use metric units buy for conversion charts to be available for the taking at the receptionist’s desk (ie, no need to ask). People could take a copy as they leave and do their own conversion. I Am sure that within a few months. very few people would be taking copies.
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The problem is that weight (and height) as used by the NHS is a means to an end, namely to formulate the correct dosage of medicine to be prescribed and the usage is all metric. The metric weight is not the end in itself and medical staff rightly have other things on their mind rather than getting the patient to know his or her weight in kilograms. So the issue goes round and round and never escapes the vortex it is in. These conversions for patients back to imperial units rather reminds me of the time when the Celsius (then the Centigrade) temperature scale replaced Fahrenheit. Back then too weather forecasters would often convert to ‘old money’ for the viewer but I seem to think that they stopped doing that after a few years (though we still hear it creeping in again now, especially when it gets hot). Remove the prop and the individual will quickly adapt to the new units. This is why the voluntary process of changing to metric has not really worked. It has to be pushed through and the old units have to be taken out of circulation.
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What you say is entirely true, Ronnie, and it is a source of great frustration to people like myself who work in the NHS. As a GP I often have cause to weigh my patients, and of course I give them their weight in kilograms, and, where appropriate, their BMI. It is still the case that some people ask the question “what is that in real money?”. There is always the dilemma of whether you waste time doing conversions or risk offending the patient by inviting them to work it out for themselves if they really want to. My answer tends to be something on the lines of “you were 81 kg last time and you are now 79, so you have lost 2 kg”. Even some adults who are happy to use kg for their own weights still expect their babies to be weighed in pounds and ounces. I’m too polite to ask whether they actually know how many ounces there are in a pound and how many pounds in a stone. I can’t help thinking of the hapless minister, Lord Stephen Parkinson, who got it wrong while appearing on live television promoting the cause of imperial. And then there is the phenomenon of giving one’s weight in kg but one’s height in feet and inches. This is easily understood: heights tend to be fairly static and for many older adults there is a figure which they have fixed on many years ago and they continue to use. I think that apart from peer pressure there is an additional subconscious element, mainly a dislike of big words. Most imperial measures consist of only one syllable, e.g. inch, foot, yard, mile, pint, pound, stone, et cetera. Let us assume that the hundredweight, the gallon and the furlong are no longer in common use except in a few specialist areas. By their nature, metric units do not have single syllable names unless you abbreviate them. That, I suppose, is just one of those things we have to live with.
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pdbdoctorsorguk said:
“Most imperial measures consist of only one syllable, e.g. inch, foot, yard, mile, pint, pound, stone, et cetera.”
True, except you left out an important factor. You don’t measure height and mass in just one word, you use three words. You have Feet AND Inches and Stones AND Pounds.
Feet and inches are four syllables. Centimetres is also four syllables. Stones and pounds are three syllables. Kilograms are also three syllables. So, this is either just a weak excuse or ignorance on the part of the claimant.
The real truth is these people who hang on to older units do so out of loneliness. They want to draw attention to themselves and make themselves feel special. That’s all.
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I don’t know how many patients would be happy to keep copies their children’s records on the sheets at https://www.rcpch.ac.uk/resources/uk-who-growth-charts-0-4-years. These charts are almost entirely in metric units. I know that some people would go blank at the sight of these charts, but I don’t know if the numbers who would be unable to keep their own records [alongside the offical NHS records of course] constitute 5% of the population or 95%.
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Martin,
The reason those charts are in metric is because they are put out by the WHO which uses proper units used by the majority of people in the world. It’s not their problem if some people choose to be Luddites. Also, the WHO does its research in metric units, so why should they waste time and money doing conversions into units they don’t use and don’t understand? Pampering the Luddites is not the solution, forcing them to learn SI is.
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It is an attitude of mind really. From reaching adulthood onwards, height is virtually constant. Remembering one’s height in metres is no more difficult than remembering the route number of the bus to town. But some feel the need to align with their peers, who, they think, are reluctant to move with the times, instead of being ahead of the game.
Weight is slightly less simple because it can vary notably. However a target weight is a good idea, and one can measure one’s actual difference above or below that value. Easier in metric. Try subtracting ten stones ten from twelve stones six without becoming confused.
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Most British people younger than 40 only use metric, but are still sort of familiar with imperial measures. Usually using conversion apps.
Only NHS charts seems to be imperial only. We all appreciate that there are still a generation only familiar with imperial measures, but most of us are metric now and it would be great if charts etc could be metric for us under 50.
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Ideally all NHS charts should be metric-only with a metric-to-imperial conversion chart alongside the main chart. This will help people to familiarise themselves with metric units. I suspect that the imperial-only option is a sop from government ministers who are (IMO) more interested in votes from innumerate voters than they are in the health of the nation.
Whenever anybody tells me my weight in stones, I take great pleasure in informing them that I have never used stones – prior to the early 1970’s, when I lived in South Africa, weights were expressed in pounds rather than stones and pounds (much like the US) and wen SOuth Africa changed to the metric system, I made sure that I became familiar with that system. When I relocated to the UK in 1978, I did not see the point becoming familiar with stones and pounds as Britain was changing to the metric system anyway. I am still waiting.
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Thanks for the conversion apps, on the phone, anyone born after 1979, half familiar with imperial measures can easily and quickly convert to metric.
Maybe it should be the other way around, converting metric to imperial?
Metric is slightly more accurate, but who cares, cubic yards, furlongs, pounds, stones, it all keep our brains busy trying to convert.
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Last spring I had a diabetes type 2 consultation with a nurse at my local health centre. she asked me my height and weight in order to calculate my BMI, so I gave it in cm and kg. She then repeated the questions, adding that she wanted the measurements in feet and inches; and stones and pounds.
I asked what was the point of that when the NHS internally records everything in metric. After a minute of her trying to push me into capitulating, she finally accepted my measurements in metric.
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@Julian Skidmore
Looks like the NHS needs to be reformed to use only metric with the public. I do hope a Labour government will not only invest money and people into the NHS to restore it to health but will also encourage them to help propagate the use of metric for all things related to patients and their diagnosis and treatment.
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