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Nurses concede NHS not 'patient-centred' enough

  • 18 Comments

Care in the health and social care sector is not person-centred, according to the outcome of a nursing debate organised at London South Bank University last night.

The debate, organised by the university’s principal lecturer in leadership Elaine Maxwell, invited four speakers to debate the idea and then invited questions from the audience.

In a vote following the discussion, 79% of the audience – comprising student nurses, nurse academics, researchers and nurses – voted against a motion that health and social care was person-centred.

Kath Evans, head of patient experience at NHS England and John Walsh, support manager at York Street Health Practice in Leeds, spoke in favour of the motion.

Speaking against it were Shaun Lintern, a journalist from Health Service Journal, and Andree Le May, a retired professor of nursing at the University of Southampton.

Ms Evans spoke about the popular Hellomynameis campaign, which was started by terminal cancer patient Dr Kate Granger.

“This focus on person-centred approaches is hard to achieve consistently in an environment of unprecedented financial pressures [and] competing priorities”

Kath Evans

She asked audience members to recall when they had connected with a patient or family member and provided care that “offered dignity, respect, compassion, co-ordinated, personalised, enabling care”.

Ms Evans cited patient experience statistics from the Care Quality Commission and Picker Institute that suggested 84% of respondents rated their overall experience as seven or above, while 81% felt they were always treated with dignity and respect.

She suggested person-centred care was not any single group or organisation’s precise responsibility, but was rather down to all health professionals to work towards.

“It is a culture that we must all nurture and this focus on person-centred approaches is hard to achieve consistently in an environment of unprecedented financial pressures [and] competing priorities,” she said.

“But it is happening day in day out across the NHS in GP practices, sexual health clinics, neonatal units, mental health units, A&Es at the beginning of life and at the end of our lives the NHS is full of people that connect with us,” she added.

“Stafford wasn’t just a story of appalling care for individual patients by individual nurses and doctors”

Shaun Lintern

Her co-speaker John Walsh drew parallels with the civil rights movement in the US, and said that the signs of shift and change were also in the NHS. “Person-centred care is present and spreading,” he said.

Speaking against the motion, Ms Le May blamed the overall healthcare system and said that some environments produced a culture that is not conducive to patient-centred care.

Meanwhile, Mr Lintern listed all the patients at Mid Staffordshire Foundation Trust that had not received patient-centred care and had suffered avoidable harm or died as a result.

He said: “Stafford wasn’t just a story of appalling care for individual patients by individual nurses and doctors. As we now know it was a story of a systemic failure from the hospital ward right to the door of number 10.”

He accused the NHS of being “preoccupied with cost savings, achieving targets and gaining foundation trust status”, warning that “quality of care and patient safety took a back seat”.

Mr Lintern also listed other high profile examples of poor care to demonstrate that he believed Mid Staffs was not an isolated incident.

“If we were to gather the families from Mid Staffs and Morecambe Bay and Winterbourne View and all those involved in the incidents, reports and avoidable deaths that I’ve mentioned, could you look them in the eye and with conviction say the NHS delivers patient-centred care?”, he asked.

  • 18 Comments

Readers' comments (18)

  • NO!!!!! sorry

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  • michael stone

    I don't even like the term 'patient-centred care': if care isn't centred on the patient, where the heck is it centred ?

    This is one of those terms clinicians 'attach a specialised meaning to' which isn't obvious from the 'label' - 'shared decision making' is another one:

    http://www.bmj.com/content/349/bmj.g4855/rr/761712

    See also:

    http://www.dignityincare.org.uk/Discuss_and_debate/Discussion_forum/?obj=viewThread&threadID=774&forumID=45

    But I think they probably got it right - even using a complicated definition of 'patient-centred', I suspect it doesn't happen as much as a lot of NHS staff suggest it does.

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  • The NHS lost it's Patient Centred Care as a result of it becoming Target Driven under the Blair Govt. The culture of bullying management started then.

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  • So-called patient-centred care still exists in many nursing homes but is increasingly threatened by miserable fees from social services and ever-increasing nonsense from CQC.

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  • Of course nursing isn't patient centred..it is paperwork and target centred.

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  • patient centred-care is the only type of nursing I know and was privileged to provide it in a centre with the highest standards of excellence in medicine and nursing outside the UK.

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  • michael stone

    Anonymous | 5-Jul-2015 4:24 pm

    I'm far from convinced that 'paperwork and target-centred' behaviour leads to good 'care' - that seemed to be the problem with something GP Practice Nurses (or perhaps Community Nurses) were reported to be doing, and which was being discussed by some of us on the BMJ:

    http://www.bmj.com/content/350/bmj.h2157/rr-3

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  • https://www.nursingtimes.net/michael-stone/1509869.publicprofile


    you are NOT one of us!

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  • Person centred care needs organisations to allow staff to give individualised care not standard pathways

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  • michael stone

    Anonymous | 6-Jul-2015 3:06 pm

    Not that it is relevant, who claimed 'that I am one of you' ? I claimed to be one of the people discussing something in that series of BMJ rapid responses, and I was.

    Anonymous | 6-Jul-2015 8:00 pm

    I agree 100%.

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