In this mood and moment of national partying, I looked back to see if we could invoke an excuse to celebrate the MAC blog history but the fact that it is 8 years and 9 months since our first blog does not give us a date that can be easily labelled – “Almost 9 Years of Blogging” sounds eminently unremarkable beside Diamond Jubilee or whatever. What we can celebrate is the continuity and also the consistency of the content of what we write. Here is an extract from that first blog authored by Andrew Craig:
My local experience suggests that user participation groups in primary care practices offer learning opportunities about mutual trust, responsibility and partnership which can help avoid such barriers and will stick when applied on the wider PCT canvas.
and then try this from the Series Introduction to the Smart Guides to Engagement:
High quality PPE (Patient and Public Engagement – ed.) is the key to unlocking many benefits for good patient experiences, better value for healthcare resources and trusted relationships in the community
Building trust has come to the fore because at a time of organisational change and less money, who to trust becomes a key question when thinking about building new networks and relationships. The SMART Guide on Working with Lay Members and Patient Representatives makes the point that
It is not always comfortable for professionals to work with patient representatives or lay members…This is shared decision-making at strategic level and not all professionals are used to doing it.
The context is made even more explicit in the Guide on Building Public Support for Change
Making changes to health services can be risky
The Swiss say No
You can see that again in our blog about Swiss politicians and healthcare insurers trying to persuade voters of the joys of Managed Healthcare . This is the phrase used by the insurance companies when they take charge of deciding whom a patient should see and how they are treated. To citizens accustomed to choosing their own doctors, this is anathema even if they are promised lower premiums. So the betting is that this proposal will join the seven previous attempts in the dustbin of failed initiatives for change. A SMART way to do things better is offered in the Public Support Guide. (page 6).
Information Linked to Change and Action
Amy Bowen Director of Service Development at the MS Trust made the point very strongly at the recent Patient Information Forum (PIF) event in Birmingham that we need to evaluate very much better than we do now the information that is out there on the web or on an advice line and yes people are still turning out leaflets. Has it changed behaviour? Has it achieved what you hoped for? Evaluation she reminded us is not to be confused with monitoring. The data from monitoring is all too often just a comfort blanket – if we are receiving so many calls and sending out so many leaflets, we must be achieving something. No – understanding achievement calls for courage and honesty – do not be afraid to ask the more difficult question about what has changed as a result of what we publish and say and then act. Lots of good feedback from the SMART guides – let us see what happens.
PIF World – where Strategy (future) lagged behind Action (now)
At the same Birmingham event, we were especially impressed with the Patient Knows Best story because it evidenced the workability and impact of a state of affairs we thought was still in the future – the patient being in charge. Actually says Dr Al-Ubaydli, the CEO of the company, the patient runs the show now because for one thing, the patient is the only one who has been to all the appointments. If the patient can aggregate and allocate all their records and so orchestrate their own care, they can indeed be said to be running the show. With this sort of radical stuff already happening, the long promised Information Strategy discussed in our blog under the effortlessly precious headline – Information Strategy – Le Noble Oblige (thanks Earl H) – seems a bit unnecessary and off the pace. People are self-training to use and experiment with the new networks, channels, devices – the big battalions lag behind. Here as in other sectors, patients are the leaders. Lynn Young a leader in the nursing profession wants patients and carers to be part of the 4 at the top – joining chief executives and directors of nursing and medical. If they need a little help , we know where they can get it.
In the meantime, we will just keep banging on about much the same things for much the same reasons – and if you need a reminder why, read Val Moore’s blog – I, the Patient.