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Wednesday 6 June is international ‘What matters to you?’ Day and Jonathan Berry explains why personalised care that takes account of the things that matter most to people improves patients’ outcomes and experiences – and is good for the taxpayer.
For the past two years the campaign has been taken up in Scotland, with over 600 organisations taking part. This year we’re flying the flag for ‘What matters to you?’ day in England, with activities happening across the country.
I was recently challenged by a well-meaning colleague who had heard that I’m involved in ‘What matters to you?’ day. I told her that it is an important opportunity for clinical and non-clinical frontline staff to change the types of conversations they have with patients, service users and carers, from “what’s wrong with you?” to, yes you have guessed it, to “What matters to you?” The reply was only partly tongue in cheek: “So we are only going to ask this on one day a year then?”
Fair point you might think and of course this is not the intention. I’m usually behind the scenes at NHS England, where I’m the policy lead for Shared Decision Making. But I’m supporting ‘What matters to you?’ Day because I passionately believe it shines a spotlight on the relationship between people and their health practitioners so that decisions are truly shared. And I also believe that this is better for all of us, whether clinicians, patients or taxpayers. It’s worth remembering that a shared decision making conversation consists of patients and clinician working together to decide what tests and treatments are most suitable: it takes account of the individual’s own circumstances and what is important to them alongside the practitioner’s clinical knowledge of the benefits and risks of available options.
None of this can happen if it isn’t a conversation between equals. The clinical and medical knowledge of the health professional is absolutely fundamental. But the person they’re supporting has their own expertise and experience which are equally essential in ensuring that the decision reached achieves the best outcomes based on what matters to them. So of course, this definitely isn’t something to do on just one day. But for all of us who care passionately about patient care and quality it is a reminder of the importance of getting those conversations right. And finally, a couple of real life examples:
Some time ago when I was a patient advocate, I was supporting a woman who had been given an injection to help counteract the effects of hay fever. She was distressed because although it had helped with her hay fever symptoms she had a red, unsightly patch on her arm on the weekend she was to be a bridesmaid at her sister’s wedding, wearing a sleeveless dress. Nobody had asked her what mattered to her and if they had she might have been able to make a more considered judgement about what to do.
Maybe this example seems trivial in terms of human and system cost. But my second example definitely isn’t. This concerns a man whose main form of social contact was chatting in the front garden with his neighbours. This became increasingly difficult due to severe knee pain. The upshot was that he had a knee replacement. Afterwards he fed back that it had been a lot more painful and difficult to recover from than he expected and that, anyway, what he really wanted was a hand rail. As well as his regret over the decision it is worth reflecting on how much more expensive a knee replacement is compared to fitting a handrail.
What this man’s story also does is remind us that although people contact services because of a change in their health, the solutions to their needs might not lie within the health service.
There is more about ‘What matters to you?’ day on our website at www.england.nhs.uk/what-matters-to-you, and a link to the bigger picture of shared decision making at www.england.nhs.uk/shared-decision-making.