Today marks two years since the publication of the Francis Inquiry report into the causes of poor care at the Mid Staffordshire NHS Hospital Trust. The report highlighted incidents of severe neglect for many patients, including cancer patients.
The inquiry uncovered serious failures to treat patients with dignity and respect. It’s fair to say that the findings of the publication continue to reverberate today, prompting many organisations, like Macmillan, to work with the NHS to put ‘the patient’ at the centre of a new culture of care.
The voice and experience of the patient forms the backbone of the recommendations of the Francis Inquiry. This is natural territory for Macmillan, and so we facilitated a session which gave 200 patients and carers the opportunity to discuss directly with Department of Health officials what mattered to them most, and how this could translate into realising the vision of a new culture of care, defined and shaped by patient voices.
What are cancer patients saying about compassionate care two years after the Francis Inquiry?
It will come as no surprise that there was a fundamental agreement that ‘the basics’ matter: human kindness and respect are the foundations that allow a health service which is both compassionate and effective.
Giving NHS staff enough time to care for and listen to patients would bring about a much needed shift where patients are more than ‘just a number’, a ‘disease to be treated ‘ or ‘someone on a conveyor belt or on a production line’. In practice, this means that the ‘moments that matter’ to a patient (like making eye contact, like placing water within reach) become ‘always events’.
The patients at our event listed the following as working well in the NHS:
- Treatment and services. The treatment of cancer, the services and facilities have improved in the last few years. Developments in the effectiveness of cancer treatment, drugs, diagnostic tests and surgery have made them feel safer.
- Transparency. Efforts such as the national patient experience survey, individual trust surveys and the hospital inspection regime are progressive steps in hearing and acting on the voice of patients. The new models of accountability which represented patients’ views, such as Healthwatch, are also positive. However, there is a general feeling that more needs to, and can be, done.
The following were identified as working less well:
- Widespread variation in care. Experiences of care still seem to depend on the patient’s age (much older and much younger people did not get the best care), cancer type and location of the hospital.
- Unsupported staff. The low morale and frustration across the health service were cause of concern for patients. In their view, these issues led to overworked and stressed staff. Another obstacle NHS staff face is a lack of, or limited, training on delivering good user experience in hospitals.
- Uncoordinated care, disjoined transition points and loss of trust. The numerous services cancer patients can come into contact with do not feel integrated and joined up. Instances such as notes going missing affect the trust and faith patients have in practitioners.
- Acting on feedback. Questions were raised about listening to patients effectively and acting on feedback which led to tangible improvements.
What else needs to be done?
Significant steps have been taken by the Government and across the NHS to drive improvements.
However, there is still much more room for improvements to address the issues highlighted above. The NHS is not able to do this alone – and nor is it expected to deal with the size of the challenge alone. As its NHS Constitution so eloquently declares, ‘the NHS belongs to the people’, and there is a wealth of organisations, from large charities to small community networks to individual patients, who all have the collective expertise, commitment and will to support the NHS.
We at Macmillan are eager to play our part, by providing practical and effective solutions (such as the Macmillan Values Based Standard©) to bring about long term meaningful change to the way the NHS delivers care. We also believe that national leadership is needed to drive improvements on patient care. As the general election is only three months away, we are urging all political parties to take concrete action and commit in their general election manifestos to make compassionate care and patient experience a priority.
Alexandra Cardenas – Senior Public Affairs Officer @MacmillanPA
Jagtar Dhanda – London Lead and Head of Inclusion @JagtarSDhanda