News and Comment

Patients produce tangible reforms

Thursday 27 March 2014

Well, not always, but they have the potential to. This was one of the strongest messages to emerge from our patient engagement seminar this morning at Body and Soul.

Meaningful patient engagement, according to the consensus, is less something done to patients and more something that’s done with them. Indeed even the phrase ‘patient engagement’ was challenged on the grounds that it originated from the old paternalistic mind-set where health professionals engage and patients are engaged. Informed patient collaboration – both with clinicians and with leaders and managers in the health service – should be the real aspiration.


But the old question still remains: how do we bring this about? Fortunately we welcomed a panel brimming with ideas, innovations and even inventions.

Olivia Butterworth, Head of Public Voice at NHS England spoke about the potential of NHS Citizen, an initiative designed to put citizen voices at the heart of NHS decision making. Even in its fledgling state NHS Citizen has gathered some 20 million Twitter interactions and had already caught the attentions of almost everyone in the room.

As its name suggests conceiving of and treating patients as ‘citizens’ – with all the agency and rights that word connotes – is integral to its vision. Its goal is not to create or do good participation, this Olivia made clear is something which only communities can do for themselves. Instead, NHS Citizen is intended to develop citizen voice within the decision making process and hold the NHS England Board to account

Drawing from his experience of trying to implement Shared Decision Making in his surgery in Collingwood over many years, Dr David Thomson stressed the importance of designing multiple ways to increase the chances of collaborative practice between patients and clinicians.


David was adamant that in encouraging collaboration to take place in GP consultations, the onus cannot just be on patients to behave differently, clinicians too must be willing to stray from the conventions which they are used to.

Mark Webb, the non-clinical Chair of North East Lincolnshire CCG, picked up on this theme presenting the collaborative governance model adopted by his commissioning group, which gives equal weighting to its community forum as it does its council of members, who are local GP practices.


Finally, Tim Williams a former doctor and co-founder of My Clinical Outcomes demonstrated software that helps to improve the care of patients with long term conditions. Tim spoke of the importance of making it easy for patients to collect data and of ensuring this data is made easily accessible and clinically-useful to time pressured doctors.


As one would expect from any event on patient and public involvement, there was a lively Q and A covering everything from whether we can afford the cost of increased patient participation in the health service (answer: we can’t afford not to); to how do we go about changing the cultures of patients, professionals and clinicians to interact with each differently (answer: with a lot of hard work).

In the coming weeks we will be circulating an OPM policy paper which picks up on these issues and others and includes best practice examples for engaging, sorry collaborating, with patients at all levels in the NHS. In the meantime, you can follow developments and contribute to discussions using the #PatientEngagement hashtag on Twitter, or by getting in contact with us directly.

You can download speakers’ presentation slides from the seminar here.