BMJ 2014;349:g6613 doi: 10.1136/bmj.g6613 (Published 4 November 2014)
Page 1 of 2
News
NEWS Attitudes need to change for patients to be more involved in care, says think tank Nigel Hawkes London
Involving patients in their own care is widely supported until it comes to doing something about it, a new report from the King’s Fund concludes.1 Although evidence exists that it improves outcomes, and there are good examples of implementation at a local level and a policy commitment at national level, not much has actually happened, it says.
Putting patients first remains more of an aspiration than a programme of action, admitted Jeremy Taylor, chief executive of National Voices, the coalition of health and social care charities in England, in his introduction to the report. He blamed a lack of clarity in objectives and a confusing diversity of approaches, as well as the more traditional obstacles of entrenched ideas and structures. To do it properly meant challenging cultural and behavioural attitudes among patients and among providers of care, he said. To achieve this, he argued, requires national leadership that abandons its preoccupations with activity, capacity, professions, and organisations and sets the system free. But he acknowledged that, when things went wrong, it was tempting to reinforce regulation rather than to liberate and empower. The report lists eight priorities: engaging people in keeping healthy; shared decision making; supported self management; personal health and social care budgets; involving families and
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carers; providing choice of providers; participating in research; and evaluating services through feedback.
The only one of these in which real progress was being made, the report said, was involvement in research, in which the United Kingdom boasted the highest involvement in the developed world and where recruitment to clinical trials has risen fivefold in the past decade. Personal budgets are slowly spreading, but the advance is patchy, and the number of eligible patients is still quite small. The report suggests that NHS England’s Integrated Personal Commissioning Programme, which will begin in April 2015, may help accelerate the pace. But the overall message of the report is downbeat, and its recommendations are offered more in hope than expectation. Professional education must be reframed, access to tools and support improved, organisations held to account if they fail to deliver, and strong leadership and clarity of goals provided, it says. 1
King’s Fund. People in control of their own health and care. 4 Nov 2014. www.kingsfund. org.uk/publications.
Cite this as: BMJ 2014;349:g6613 © BMJ Publishing Group Ltd 2014
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BMJ 2014;349:g6613 doi: 10.1136/bmj.g6613 (Published 4 November 2014)
Page 2 of 2
NEWS
Figure
For personal use only: See rights and reprints http://www.bmj.com/permissions
Subscribe: http://www.bmj.com/subscribe
Page 1 of 2
News
NEWS Attitudes need to change for patients to be more involved in care, says think tank Nigel Hawkes London
Involving patients in their own care is widely supported until it comes to doing something about it, a new report from the King’s Fund concludes.1 Although evidence exists that it improves outcomes, and there are good examples of implementation at a local level and a policy commitment at national level, not much has actually happened, it says.
Putting patients first remains more of an aspiration than a programme of action, admitted Jeremy Taylor, chief executive of National Voices, the coalition of health and social care charities in England, in his introduction to the report. He blamed a lack of clarity in objectives and a confusing diversity of approaches, as well as the more traditional obstacles of entrenched ideas and structures. To do it properly meant challenging cultural and behavioural attitudes among patients and among providers of care, he said. To achieve this, he argued, requires national leadership that abandons its preoccupations with activity, capacity, professions, and organisations and sets the system free. But he acknowledged that, when things went wrong, it was tempting to reinforce regulation rather than to liberate and empower. The report lists eight priorities: engaging people in keeping healthy; shared decision making; supported self management; personal health and social care budgets; involving families and
For personal use only: See rights and reprints http://www.bmj.com/permissions
carers; providing choice of providers; participating in research; and evaluating services through feedback.
The only one of these in which real progress was being made, the report said, was involvement in research, in which the United Kingdom boasted the highest involvement in the developed world and where recruitment to clinical trials has risen fivefold in the past decade. Personal budgets are slowly spreading, but the advance is patchy, and the number of eligible patients is still quite small. The report suggests that NHS England’s Integrated Personal Commissioning Programme, which will begin in April 2015, may help accelerate the pace. But the overall message of the report is downbeat, and its recommendations are offered more in hope than expectation. Professional education must be reframed, access to tools and support improved, organisations held to account if they fail to deliver, and strong leadership and clarity of goals provided, it says. 1
King’s Fund. People in control of their own health and care. 4 Nov 2014. www.kingsfund. org.uk/publications.
Cite this as: BMJ 2014;349:g6613 © BMJ Publishing Group Ltd 2014
Subscribe: http://www.bmj.com/subscribe
BMJ 2014;349:g6613 doi: 10.1136/bmj.g6613 (Published 4 November 2014)
Page 2 of 2
NEWS
Figure
For personal use only: See rights and reprints http://www.bmj.com/permissions
Subscribe: http://www.bmj.com/subscribe
