‘How will this affect Esther?’ A person-centred approach for Wales

I recently heard nurse lecturer Austin Thomas speak about his experience of 30 operations after barely surviving a near-fatal road accident. His verdict was that many people working in the NHS say that the patient is the most important person. But when you are a patient it doesn’t feel that way.

How can we change the way we deliver services to ensure they genuinely meet the needs of the people who use them? Listening to patients is one way that seems so obvious, but we don’t always have a good track record of doing this. Maybe it’s the fear of only hearing one point of view, which may not be enough to build a service on – but hearing one voice has to better than hearing none at all.

One model that has proved how well involving patients in the design of services can work is the Esther Network in Jonkoping, Sweden. ‘Esther’ is based on a case study of an older woman called Esther who had a less than ideal experience of accessing healthcare. Now, when planning to introduce new services or change existing ones, those in charge are encouraged to ask ‘How will this affect Esther?’

The Esther Network was a key theme in Person Driven Care, a white paper produced by 1000 Lives Plus and supported by the Health Foundation. Similar person-centred thinking has been adopted in Wales as a result – Freda in North Wales, and Megan in South-East Wales. Using a ‘person’ to frame the conversations moves the discussion away from what is right for ‘us’ – the clinical staff and the managers responsible for services – and over to the people who depend on the services.

The white paper recommended a network approach, including relevant people from across healthcare, the public sector and the third sector. It also advocated staff empowerment within the NHS, so that frontline staff know that they are allowed – and even expected – to institute change to benefit patients.

It is in all our interests to move the focus of our services to the people we serve. None of us want to use incomprehensible or ineffective services if we are ill, or when we get older. We need to recognise that, one day, we are likely to be an Esther, or Freda, or Megan, and we need to start getting it right, right now.

Jan Davies is a director of 1000 Lives Plus, Wales’ national healthcare improvement programme. www.twitter.com/1000LivesPlus