With the challenges currently facing the NHS, leaders at all levels across organisations need to learn to work together with a shared vision of providing continually improving, high-quality and compassionate care. Leadership needs to be distributed throughout organisations, working alongside patients, rather than concentrated in a few individuals.
The Patient and Family-Centred Care (PFCC) programme, run in partnership between the Health Foundation and The King's Fund, aligns extremely well with this vision: working with a number of clinically led multi-disciplinary teams to achieve patient-centred care, showing how small teams of committed, like-minded clinicians, managers and others can make small changes that make a big difference to patients. We have seen what a huge difference it makes to staff to feel that they have the tools at their disposal to put themselves in their patients’ shoes, and to make changes that improve their experience of care.
PFCC is a simple, low-technology approach to patient-centred service improvement. Central to it is putting the patient at the heart of what teams are doing, and visualising the ideal patient experience. A core part of the method involves improvement teams shadowing patients and families through their care experiences, to really see how patients experience care. This has been the most challenging thing for clinical staff, but also the most transforming and persuasive. Teams have described how boards have been affected by hearing clinical leaders who have used the PFCC approach describing what they had learned from listening to families, hearing what matters to them, and how care can be improved as a result of listening.
There is no lack of energy and enthusiasm for this work in the NHS. But sometimes there is a fear that engaging with patients and families in this way will open the floodgates to demands that cannot be met. Our teams have not had this fear realised. What is more, we have often found that the things that patients and service users want to be fixed are the very things that cause great frustration to staff too. We have found that positive changes in improving patients’ experiences often have a knock on effect on safety and efficiency too. For example, we have seen teams achieve great improvements in the management of pain which have led to smoother processes and less time spent in the hospital for patients, which is better all round.
Today The King’s Fund and the Health Foundation are launching an online Patient and Family-Centred Care toolkit, which aims to help clinical leaders and frontline teams to do this work. At a time when we often hear negative stories of the challenges facing the NHS, it is good to see how well staff can deliver service improvements when they are well supported, and when they are given the authority to act and make improvements, and the tools to help them put their ideas into practice.
Patient-centred service improvement is manageable and achievable. While it always takes time to do this work, it doesn’t need to be hugely time consuming if well-structured and organised, and the approach allows staff from across the organisation to get involved and engage with patients in different ways. The key enabling feature is that it is leadership at the point that care is delivered – not just at the top of organisations – that changes care for patients.
We have been proud to work with such committed professionals who have achieved such great things. We hope that these resources will help support others to do the same.
Bev is a Fellow on the Point of Care Programme at The King's Fund
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