We must work together to put patients at the heart of care

by Dr Phil McCarvill Head of Policy and Public Affairs, England Phil-McCarvil_300x300


At the NHS Confederation’s annual conference earlier this month, I chaired a session entitled 'After Liverpool' – a reference to the Liverpool Care Pathway. The session included an introduction from Carol, a member of the Marie Curie Expert Voices group, talking about her experiences of supporting her terminally ill partner and about the importance of placing people at the centre of care and support.


This set the scene nicely for presentations by Andy Donald from Cannock Chase and Stafford and Surrounds Clinical Commissioning Groups about commissioning end of life care and Dr Fiona Hicks from Leeds about her work to raise awareness of community based end of life care services amongst doctors working in general wards within local hospitals. Andy spoke about the need to change the way we commission services – involving people in meaningful ways to ensure that services respond to local needs and plug gaps in services.


Challenging assumptions


Fiona demonstrated the power of building links between professionals and services which enable them to challenge their own assumptions. Most importantly, this had built the confidence of hospital doctors and consultants to discharge people into the care of community-based services, by raising awareness of what such services can offer. These three thought-provoking presentations sparked an important discussion about how we give people more of what they want and what the system undoubtedly needs. We covered a range of topics, including how we disseminate what works in hospice care to other care settings, shifting resources from acute to community services, the importance of real-time feedback, the work of children’s hospices and the need for greater availability of key data at CCG level – such as the Marie Curie mini-atlas of VOICES bereavement survey data.


Reshaping services together


The discussion involved commissioners, providers, health and social care professionals, regulators and those who use health and social care services. Together, these are the people who can help reshape services so that they genuinely put people at their centre and build care and support around them. Without such a dialogue, and without such change, as Carol said more terminally ill people will feel that they are stuck “in a cul de sac at the end of a one way street”. Our shared goal must be to make things easier by building services around what works best for terminally ill people and their families, not what works for those organisations and professionals providing services. After Liverpool (the conference that is) there is a lot for us to do together.