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Call for patients to take more responsibility

  • 32 Comments

Individuals’ responsibility for their own health and use of the NHS has been underemphasised and should be made more visible by NHS England, the organisation’s patient experience director has said.

In an interview with Nursing Times’ sister title HSJ, Neil Churchill said the health service had largely avoided the focus on responsibility, which has been seen in recent years in other public services such as welfare where entitlement has been cut. However, he said the NHS should not limit entitlement to free services or extend charges, for example by fining patients for missed appointments, and that such moves were unlikely to be effective.

Instead, Mr Churchill said the NHS should experiment with “nudge techniques”, such as encouraging healthy behaviour and making the best use of services. He highlighted the large proportion of medicines wasted and said patients should be more involved in discussions about the value of services.

One possibility is for them to be told how much their medicines and wider care cost the NHS. Mr Churchill called for experimentation and ideas to be suggested for possible inclusion in a strategy being developed by NHS England.

“We’ve been pretty timid about talking the language of responsibility with patients,” he said, adding: “As commissioners we have to… make sure both rights and the responsibilities we expect of people are more visible than they have been.”

Mr Churchill also said people were becoming more aware of their rights under the NHS constitution but they needed more “teeth”. He said: “The constitution doesn’t have a great deal of traction.”

  • 32 Comments

Readers' comments (32)

  • Does this also mean that adult patients in hospital will behave like adults then?

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  • michael stone

    Anonymous | 26-Oct-2013 11:58 am

    Depends what you mean by 'behave like adults' - empirically, however adults are behaving, is 'the behaviour of adults'.

    More widely, this piece seems a bit 'conflicted' - “The constitution doesn’t have a great deal of traction.” is spot-on, though.

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  • A young woman I knew suffered asthma but was totally non-complaint in her treatment.

    A frequent A/E attender this woman would not listen to advise and was abusive to staff if the issue/importance of compliance was raised.

    The coroner ruled her death as being the result of "natural causes" He was wrong she killed herself.

    Many patients fall into the same category.

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  • Jenny Jones | 27-Oct-2013 7:39 am

    unless she was bought to A&E in emergencies one wonders why she was a frequent attender if she refused to take any advice.

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  • Anonymous | 27-Oct-2013 8:54 am

    This is quite a common issue. Non-compliance followed by a visit to A&E when it all goes pear shaped and the symptoms become distressing/painful/etc.

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  • Anonymous | 26-Oct-2013 11:58 am

    I know exactly what you mean!

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  • michael stone

    Jenny Jones | 27-Oct-2013 7:39 am

    I could get involved in this one, but I'm reluctant to.

    The coroner was right - asthma is 'a natural cause' and refusing treatment for something which might/will then kill you, isn't the same as suicide legally.

    However, it is clearly complicated, if patients 'make [apparently] bad choices' - the issue hinges on delving into the combination of that 'apparently' and patient self-determination. The asthma one is, after all, merely an 'in extremis' variation on 'anyone who smokes is committing suicide', when analysed logically as opposed to emotionally.

    But I do see the 'issues' here.

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  • Anonymous | 27-Oct-2013 9:51 am

    it really isn't surprising when one considers the lack of confidence in the NHS and the professions. you are at the mercy of whoever happens be thrown at you without any idea of the competencies, level of knowledge or skills and expected to blindly follow their advice? In an emergency sadly patients have little other choice.

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  • Anonymous | 27-Oct-2013 3:33 pm
    from
    Anonymous | 27-Oct-2013 9:51 am

    I rather take exception to that.

    It is becoming rather too easy to make wholly inaccurate, blanket claims about a service and the majority of highly skilled and dedicated staff by writing them off in such a manner.

    The type of patients to which I was referring, generally have been given very good advice and appropriate treatment but have chosen themselves to disregard and/or lapse the treatment. Typical that the health professionals are lined up for the blame whereas the patients seem to be absolved of any responsibility. A problem indeed.

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  • "...have chosen themselves to disregard and/or lapse the treatment..."

    their right so to do!

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