‘First do no harm’ should be the golden thread that is woven throughout all healthcare systems. Sadly, the reality is that despite the implementation of significant initiatives designed to improve systems and processes, many instances of avoidable harm still occur on a regular basis.
Navigating the patient’s journey is becoming increasingly complex, particularly for the frail, the elderly, and those with multiple morbidities. Unrelenting pressures upon the NHS, insufficient capacity, major workforce shortages and poor morale all increase the potential for mistakes to occur. However, these challenges serve to underline the importance of the role of patient partnerships, both in terms of self-care but also as advocates for the wider community, especially those most disadvantaged.
Engaging patients as true partners in their health and wellbeing offers a way forward and has a particular poignancy for me. I spent most of my career as a NHS Chief Executive and my late wife was a ward sister, so we both had extensive knowledge and experience of how the healthcare system works – or so we thought.
My wife had a very rare, and ultimately fatal, auto-immune disease. Together, we spent eight years undertaking the patient’s journey at all levels of the healthcare system before her death. There were many examples of excellent, compassionate care, but there were also times when services were disjointed, leading to poor patient experience and sometimes greater risk of harm. This was not because staff were uncaring, but rather because assumptions were being made which were simply wrong.
Patient safety has as much to do with mindset as it has with systems and processes. Those organisations that embrace the concept of patients as partners will be in a stronger position to challenge assumptions about the patient’s journey. Creating a positive safety culture is a huge challenge, but it is more likely to be achieved if those who offer the greatest insight into the day-to-day realities of the healthcare system are regarded as a precious resource.
Patients and their families can bring valuable expertise to the patient safety agenda, acting as ‘knowledge brokers’ and providing helpful reality checks. Safe, effective, and responsive care is based upon effective teamwork. Patients and their families should be regarded as an important part of the team. Let me finish with a simple maxim: ‘If you want to know if a pair of shoes fits, you should ask the person wearing them, not the person who made them’.
Chair, Royal College of Physicians Patient and Carer Network