20 YEARS IN PAT I ENT CAR E
document to actually be adhered to. Finally, the chronic staff shortage in health and social care has been building over the last two decades and yet little has been achieved to reverse the trend.
Is healthcare getting better at involving patients? The simple answer is ‘yes and no’. Shared decision making is part of health policy and guidance in England. In 2021, NICE published a clinical guideline on shared decision making that included recommendations on embedding shared decision making at an organisational level, and putting it into practice The NHS Choice Framework, published in 2016 and updated in January 2021 set out what choices patients should have over their own healthcare, including choosing their GP and GP practice, asking to change hospital if maximum waiting times are exceeded, and choosing services provided in the community, among other things. The NHS Long Term Plan published in 2019 (and due for an update) committed “to make personalised care business as usual across the health and care system” and included specific targets around shared decision making. However, despite these commitments and the maturity of ideas around shared
decision, our evidence suggests patient partnership it is still not embedded in practice. That’s one of the reasons our five- year strategy is to embed patient partnership across health and social care.
Are we doing enough to ensure the patient’s voice is heard when shaping services? Not yet, which is why our five-year strategy is patient partnership that results in services designed and delivered through equal partnership with patients. We’re hopeful; we have worked with NHS England to provide the framework for how the new Integrated Care Systems will work with patients, people and communities.
In Scotland the Government is consulting the public on how NHS Boards, Health and Social Care Partnerships and Local Authorities listen to the views of people who use them. We’re watching with interest how all this will play out in terms of greater patient involvement in their own care and in the design and development of services.
What needs to happen next? We believe the ongoing debate around the resourcing of the health and social care system needs to be re-framed from the patient perspective. Our research shows there are substantial resource barriers to
patients being able to participate fully in decisions about their care, and, therefore, to reaching the best decision for each patient. This extends to partnership between communities and the system in the development of services.
The consequences of the current pressures must be understood in terms of patient involvement and experience, as well as the delivery or non-delivery of treatment. Involving patients in the care and in the development of services cannot be delivered consistently while the NHS is under its current resource constraints.
About the author
Rachel Power has over 20 years’ experience of working in health and social care within the voluntary sector. She joined the Patients Association as its chief executive in June 2017 and has overseen a significant period of change, establishing a new senior leadership team and a new five-year strategy focused on patient partnership. She is passionate about empowering patients and speaking on their behalf to ensure the patient voice is heard and acted on.
CSJ
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