Key points

  • Some interventions that seek to change relationships successfully improve the quality of care.
  • However, there is still much to learn about this and some of the evidence can be patchy and contradictory.
  • To improve understanding of why a given intervention may be appropriate for a particular setting, it is important to build knowledge about how each intervention changes relationships and outcomes, which will help identify the factors that could affect successful implementation.

Encouraging improvement through changing the relationships between healthcare service users and providers is a key area of work for the Health Foundation.

This report aims to contribute to the understanding of how changing relationships impacts on the quality of care. It does this by reviewing the conceptual and theoretical literature on relationships between service users and providers and then exploring the extent to which a chosen set of interventions correlate with the conceptual evidence, and their likely impacts on the quality of care.

In exploring the evidence around some innovative approaches to improving quality this report highlights exciting opportunities to transform healthcare. Equally, it points to the need for those designing, managing and commissioning health services to think carefully about how their favoured intervention mediates, or is mediated by, relationships and how it might lead to the change they want to see.

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