This section introduces the patient focus theme. Resources to support this theme are:
- RCN products and services and RCN publications relevant to this theme
- agencies that provide further information and resources
- policy and reports which shape the current strategic and policy framework for this theme
- guidance and tools which help with understanding of and implementation of policy.
The NHS Constitution for England sets out, for the first time, the principles and values upon which the NHS operates and crucially, the rights, of everyone using the NHS. These rights cover “how patients access health services, the quality of care you’ll receive, the treatments and programmes available to you, confidentiality, information and your right to complain if things go wrong”.
The fourth principle states: “The NHS aspires to put the patients at the heart of everything it does”. It ascribes four ways in which this happens: (1) by supporting self-management (2) by designing services around the needs of patients, families and carers (3) shared decision-making and (4) by encouraging feedback about how to improve services (p3). It ascribes to six core values to its work: (1) working together for patients (2) respect and dignity (3) commitment to quality care (4) compassion (5) improving lives and (6) everyone counts (p5).
Recent actions in England designed to improve decision-making include (1) the introduction of the friends and family test (2) giving people access to information about health and care services to help informed choices (3) personal health budgets for people with long term conditions.
The policy page from the Department of Health on “treating patients and service users with respect, dignity and compassion” cites other key work relating to this agenda including: (1) safety strategy in the wake of Mid Staffordshire NHS Foundation Trust Inquiry Report and the investigation into the abuse at Winterbourne View (2) measuring user experience across the system (3) building a culture of compassionate care for nursing, midwifery and care staff through the “Compassion in Practice” three year strategy.
The “Transforming your care” (HSCNI 2011) review of Health and Social Care in Northern Ireland identified twelve principles for change including “placing the individual at the centre of any model by promoting a better outcome for the service user, carer and their family”. Key documents and actions following the review are available from the “Transforming Your Care” area of the Department of Health, Social Services and Public Safety web site.
Healthcare Improvement Scotland oversees a person-centred care programme which “seeks to improve healthcare services so that they focus on the needs and wishes of people, their families and their carers”. This work includes work to ensure that the “voice of the public plays a vital role in shaping care service in the NHS in Scotland” through the Scottish Health Council (SHC). The SHC site publishes “The Participation Toolkit” that supports staff to work with patients, carers and members of the public in the design and delivery of local services.
The strategy document “Together for Health” (NHS Wales 2011) and the delivery plan delivery plan “Achieving Excellence for Wales” (NHS Wales 2012) establish the key aims for the NHS in Wales between 2011 and 2016. Patient centredness remains one of the six dimensions of quality identified in annual reporting since 2011.
Since then a number of delivery plans addressing parts of the service in Wales have been published including “Together for Health: public information delivery plan” that addresses issues of access to reliable and easily understood information.
The Welsh Government has also published a “Declaration of Rights for Older People” (Welsh Government 2014) that spells out the rights of older people already underpinned by law and gives “older people and public bodies in Wales a key steer to where there is a risk that a breach of this legislation may occur”.
Department of Health (2013) NHS Constitution.
Department of Health (2013) Treating patients and service users with respect, dignity and compassion.
DHSSPSNI (2011) Transforming Your Care.
Health Improvement Scotland.
HSCNI (2011) Transforming your Care.
Scottish Health Council (2005).
Scottish Health Council (2014) The Participation Toolkit.
Welsh Government (2014) Declaration of Rights for Older People.
Welsh Government (2012) Together for Health. Public information delivery plan.
Welsh Government (2011) Together for Health.