Since the publication in 1991 of the Patient’s Charter, patient rights, perspectives, and the notion of patient partnership within the NHS have grown in importance.
The Charter set out some basic standards that users of the NHS could expect to receive. Some services were set out as rights.
To us at the Patients Association it is obvious that patients should play an active role in their care. But putting shared decision-making and patient partnership into practice has proved challenging over the years.
There has been cautious progress with examples of good practice. Our 2020 report, ‘Being a Patient’, found that one in five patients had had a positive patient experience. In July 2021 our report, ‘Shared decision making: shared reality or insider jargon?’, showed patients were not clear what was by meant by shared decision-making and many hadn’t experienced it. A subsequent survey of clinicians and healthcare professionals’ perspectives fund serious barriers to shared decision-making, including:
- The crisis in the NHS – lack of resources in the NHS leading to time constraints, staff shortages, and high workloads
- IT system barriers
- A need for improved patient information and tools was seen as essential to support shared decision-making.
Despite these significant barriers, the survey respondents were optimistic that shared decision-making could become easier in the future. And our Patient Experience Winter Survey in 2023 conducted less than a year later, showed evidence of patient partnership and shared decision-making common among the nearly, 2,000 respondents:
- Two thirds of respondents who had a medical appointment felt listened to and taken seriously
- Two thirds said heath staff were understanding and compassionate.
More than half of respondents said they had participated in decisions and about their care, and more than half had been given the information they needed to be able to look after themselves.
Together these reports highlight progress in patient partnership within the NHS.
But we’re not complacent. We have a long way to go before patients and services fully reap the benefits of patient partnership. The benefits include:
- Improved quality and outcomes: working in partnership with patients ensures services meet patients’ needs and, so, achieve better results for patients
- Cost-effectiveness: when services meet patients’ needs it is less likely that money is wasted on unsuccessful services, or on services needed to fix problems caused by ineffective actions
- Improved safety: a health system that partners with patients will value their involvement and listen to their concerns about any safety problems.
So what needs to happen next? The health system must:
- Enhance provision of information to facilitate patient/professional conversations
- Support patients to ask questions and participate in decisions
- Support patients to understand treatment options and consequences
- Promote consistency of care across different patient groups
- Strengthen accountability for treatment decisions and complaints
- Improve accessibility of medical records
- Provide resources to help patients understand medical language
- Provide comprehensive training in shared decision-making
- Support consistent shared decision-making practices among clinicians
- Create a culture of shared learning among healthcare staff.
- We believe that if these are implemented consistently across the system, patient partnership will be greatly improved as will patient safety, leading to improvements in outcomes.