At the King’s Fund, we have spoken a lot about the benefits of collective leadership lately. 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 care. Leadership needs to be distributed throughout organisations, working alongside patients, rather than concentrated in a few individuals.
Our Patient and Family Centred Care (PFCC) programme, run in partnership with the Health Foundation, aligns extremely well with this vision. It involves working with a number of clinically led, multi-disciplinary teams to achieve patient centred care, showing how teams 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 throughout their care—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 explained how boards have been affected by hearing from 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 has a knock on effect on safety and efficiency too. For example, we have seen teams achieve great improvements in the management of pain, which has led to smoother processes, and less time spent in the hospital for patients.
Earlier this week, the King’s Fund and the Health Foundation launched an online Patient and Family Centred Care toolkit, which aims to help clinical leaders and frontline teams 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, when they are given the authority to act, and when they have 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 the approach is well structured and organised, and allows staff from across the organisation to get involved and engage with patients. The key enabling feature is that it is leadership at the point of delivery—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 Fitzsimons joined the King’s Fund in September 2009 as a programme manager on The Point of Care programme. She has previously worked at the Audit Commission and the Healthcare Commission, as well as working with the Commission for Health Improvement.
Competing interests: The author has no further interests to declare.
This blog first appeared on the King’s Fund website here