Last week saw two important interventions that left me with a strong sense of déjà vu:
Firstly, our trustee Sir Robert Francis warned in an HSJ interview and on the Andrew Marr show that the conditions are ripe for more failures of care like those at Mid Staffordshire NHS Foundation Trust a few years ago. Secondly, the National Audit Office report on integrated care stated that promises of progress on reducing fragmentation and strengthening continuity of care for patients across the NHS and social care are fictional.
Is it all going wrong? Do the circumstances that led to the Mid Staffs scandal continue to present a threat? Are we in crisis and losing hope of future progress?
Certainly, there is cause for concern: just the other week we published a daughter’s story of her father’s admission to hospital, illustrating in a powerful way the human cost of systemic failures.
This story brings the national statistics alive, and there are many patient and staff stories warning that the system is overheating, worryingly close to collapse.
And yet there are things that have changed for the better since the Francis report, as well as developments that offer grounds for optimism. Our heads of patient experience (HOPE) network is flourishing: there are over 200 participants, which I take as a sign that more trusts see the need to invest in boosting improvements in patient experience.
Before Mid Staffs, a handful of patient activists campaigned nationally for cultural change in the NHS. Now, there are patient leaders working with the many parts of the NHS as collaborative partners driving changes in the system. People who call themselves patient leaders want the NHS to see patients as assets: they bring their own backgrounds, experience and expertise to the work, but as collaborative problem solvers, not mere tellers of stories. The narrative around patients and their value (as partners) is changing and we’re beginning to see more evidence on the ground that shows us what it takes to make these new kinds of partnership work in practice.
I am in no way saying that there is not much to worry about, but let’s not lose sight of the positives that have emerged in recent years.