Think like a patient

There is currently a bit of a buzz around Outcomes Based Commissioning.

“Emperor’s new clothes” and “all smoke and mirrors” are just two of the responses I have received when I have sought to initiate a debate on the topic.

Some of the scepticism I suspect is generated from a perceived view that this is just another theory/strategy imported from across the pond which will flounder on the rocks of the UK National Health Service.

I tend to a different view.

If the NHS is serious about service transformation – and heaven knows the term gets banded around enough – then I believe it is incumbent upon us all to open our minds to innovative and creative thinking.

The more I read the work of Michael E. Porter and Thomas H. Lee[1] the more it resonates.

I accept that on occasion some of the language used suffers from what the cynics might decry as ‘management speak’, but for me what leaps out of the narrative is the primacy of the patient.

To my mind measuring outcomes that matter to patients is unarguable.

Re-designing care from a patient’s perspective is not only desirable, but when put as simply as that it is difficult to conceive that anyone ever thought there was another way of doing it.

When Simon Stevens says we need to “think like a patient”, surely this is part of what he means.

There is a huge amount of talk in commissioning circles about the importance of patient engagement and involvement. When anyone states we need to put the patient at the centre of the system we all nod sagely.

Well it occurs to me that Outcomes Based Commissioning speaks directly to this narrative, because here is a strategy where a patient centred system is definitively organised around patient needs, wants and desires.

Here is a theory that actually walks the talk.

My thirty years in healthcare means that I am not so naïve as not to understand that the forces of opposition will be large, organised and vocal. The vested interests here are established and powerful.

But no-one will convince me that a system that rewards outcomes that are not important to patients is one that is morally defensible.

When re-designing services our thinking should be guided by what we would want for ourselves, our children, our parents and our grandparents. We should look to our own value systems and use this as a template for action.

Of course it isn’t going to be easy but as some bloke once said…“We choose to go to the moon. We choose to go to the moon in this decade and do the other things, not because they are easy, but because they are hard”.

Think like a patient.

It’s not rocket science.

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