Demographic and financial demands mean the NHS has to change, and the way forward to improve care and save money is involving patients in their care. But by putting care in the hands of the patient, can you de-stress the patient and reduce readmission?
Healthcare can be done ‘to’ us or ‘with’ us. The goal is to change from ‘what’s the matter?’ to ‘what matters to you?’
“Empowered patients aren’t a nice to have, they are fundamental to the survival of the NHS” – Luke O’Shea, NHS England.
50% of inpatients are not involved in their care as much as they would like – a figure that has not changed for 10 years.
93% of patients are confident they can manage their health.
The upside of patient empowerment?
Better patient experience.
Better treatment and care.
Less dependence on services.
Less time in hospital.
A study of involuntary mental health inpatients suggests that, if coercive treatment to aid rather than disrupt recovery, services need to focus on rights and finding ways to foster a strong sense of agency and empowerment.
Areas for attention. What will benefit from patient empowerment?
Ageing and end of life care.
Care co-ordination in multiple complex conditions.
Barriers to empowerment for:
Conflict between patient autonomy and ethical duty to provide evidence-based care.
Fear of patients being unable to cope. However, access to children’s records gives parents a “sense of control”.
Patient decision aids allow people to balance risks against preferences, improve shared decision making and reduce procedures with no adverse effect.
Technology can help
IT services may especially contribute to empowerment by providing knowledge to cancer survivors.
Social media has been found to minimise length of hospital stay, reduce complications and improve patient satisfaction in paediatric diabetes care.
How? Integrated technologies helped the unit identify trends and tailor individual responses as well as supporting collaborative efforts to manage patients’ diabetes effectively.
81% of patients felt they had benefited from the technology.
The new normal
Taking over tasks previously carried out by providers is not new; online check-in is usual. Giving people more responsibility for their health may not be as difficult as some may expect.
Power to the patient
Student Joe Smith consults his GP, Dr Amy Black, over symptoms. Dr Black suggests several diagnostic methods. Using a patient decision aid, he opts for a test that may be less accurate but less invasive.
He receives his result on his smartphone, then returns to Dr Black. Again, they employ the patient decision aid to choose treatment.
Smith chooses a hospital near his family rather than his hall of residence. The appointment is booked at the GP surgery.
He is admitted to hospital; it’s rather unfamiliar. He uses his bedside terminal to find information on his condition and hospital routines, remind himself about recovery times and talk to his family about visiting. Feeling more in control, he chooses a meal then finds some music to listen to without disturbing others.
Back home, he rearranges a follow-up appointment and accesses online support from patient peers to help manage by himself and to remind himself of symptoms. Checking his record, he finds an inaccuracy about his hospital stay, and amends his record so everyone involved in his health is informed.
If patients take more responsibility for their healthcare, they will enjoy better wellbeing and depend less on services, saving the NHS money.
Most patients are confident they can manage their health and want to have some control.
The rise of multiple long-term conditions mean patients will need to be more involved in their care and its coordination.
Technology such as bedside tablets in hospital can help patients become involved in their health and improve their experience.
- Patient involvement can improve the doctor-patient relationship.