The patient care crisis

from the Health Service Journal, 9 January 2008

We are proud of the NHS and its values. It is rooted in a philosophy of care for all. It aspires to mend and heal. It inspires great public service from energetic practitioners.

However, there is a crisis deep within our culture. It is a crisis of care -the way we treat people andhow we engage and listen to our service users.

Sometimes, going into hospital as a patient feels like travelling through a foreign country where no-one speaks your language and you do not speak theirs.

Managers, who are charged with overseeing the culture of healthcare organisations, should ask how responsive and people-centred our systems and structures really are. Is feedback from patients as important as the financial results or the latest set of targets?

Managers should take a lead in asking not about what is going well, but what is wrong. It seems to me that too few NHS leaders are angry about not getting it right for enough people.

Encouraging compassion

Unless we create 'communities of compassion', where patients are the beating heart of our work, there can be no real improvement in the quality of care. We must make the jump to seeing things from others' perspectives.

Here are some actions that might help you put compassionate care firmly on your organisational agenda.

  • Find time and places where you can observe your organisation at work. Take note of things that would be unacceptable if they happened to anyone you care about.
  • Invest in listening to the patient experience. Respond to complaints as opportunities to deepen care.
  • Ask others how they would describe your place of work with one adjective. Be energised by the gaps between how we describe our aspirations and what the actual practice is. Let us address the minimalist functionality of much of the space where we deliver care. What about more imaginative use of colour, light and texture?
  • How much power and control do we give to the patient? Are they partners in decision-making? Let them decide what is appropriate- we do not always know what is best. In Birmingham, Sandwell, Solihull and South Staffordshire, our palliative care network has launched a campaign to ensure that choice is given back to people at the end of their life. What shape would your campaign take?
  • Discover what makes your staff tired and demotivated. Invest in programmes of staff support to enable them to deliver care differently.