After Bristol: putting patients at the centre * Commentary: Patient centred care: timely, but is it practical?

Abstract

# After Bristol: putting patients at the centre {#article-title-2} Many of the 198 recommendations made by the Bristol inquiry urged doctors to include patients as active participants in their own care. Angela Coulter discusses how these recommendations can be turned into reality The public inquiry into failures in the performance of surgeons involved in heart surgery on children at the Bristol Royal Infirmary between 1984 and 1995 made 198 recommendations on how to prevent failures in the future. The pre-eminent recommendations urged doctors to: These recommendations are fine rhetoric, but how can they be turned into reality? Improving responsiveness to patients has been a goal of health policy in the United Kingdom for several decades. Until now, most initiatives in this area have failed to change noticeably the everyday experience of most patients in the NHS. The harsh realities of budgetary pressures, staff shortages, and other managerial imperatives tend to displace good intentions about informing and involving patients, responding quickly and effectively to patients' needs and wishes, and ensuring that patients are treated in a dignified and supportive manner. This is the essence of patient centred care, and most health professionals strive to achieve it. Many clinical staff, however, feel that demands for them to improve efficiency and productivity have restricted their ability to offer the time and empathy that patients need and hope for.2 #### Summary points The Bristol inquiry recommended that patients must be at the centre of the NHS and must be treated as partners by health professionals—as “equals with different expertise” The survival …