Patient empowerment

One principle of sustainable health care is patient empowerment. Empowering patients to manage their own mental health is a key factor in reducing burden on services and therefore reduced use of precious resources. The NHS however, has fostered a sense of dependency in patients. Sadly with the utopian principle of free care at the point of need, we have bred an attitude that health is not an individual’s responsibility but the state’s.

What can we do to change this unhelpful attitude? David Haslam, Chair of NICE, has recently commendably encouraged patients to be more assertive about their care. He said patients in the UK needed to learn from the Americans, who are far more confident about entering into dialogue with family doctors about their health, and taking an active role in managing their health. This view has received unfair media attention with some published articles suggesting it is doctors’ laziness that leads to patients having to be more assertive and that it is a doctor’s responsibility to ensure high standards of care.

A recent report from the King’s Fund entitled ‘Patient’s preferences matter’ states that while many doctors aspire to excellence in diagnosing disease but far fewer aspire to the same standards of excellence in diagnosing what patients want. The report demonstrates that preference misdiagnoses are commonplace and lead to patients receiving medication they would not choose were they better informed. It also states that patients tend to choose fewer treatments when fully informed, which could lead to the NHS saving billions of pounds.

So perhaps there needs to be movement on both sides of the clinic desk, (or maybe a removal of the clinic desk altogether!) One opportunity that could perhaps create the change required is that patients could own their own notes. Andy Burnham, the shadow health secretary, has said that patients having the right to see their medical records online would help rebuild the NHS to better provide integrated care which blends health, social care and mental health services.

While I agree that patients owning their online health records would reduce barriers between services and improve integration, the main benefit, which he does not mention, is the transformative power it would give patients over their own health. Patients who could read referrals made by their GP and opinions from specialists would feel, very rightly, at the center of their own care. I believe this would lead to the change David Haslam is keen to see; greater ownership of health and care from patients and more equal dialogue between doctors and patients.

Why stop there though? Why not use this online notes platform to empower patients further? An online platform that could support patient’s notes could also create links to trusted educational sites about medication and health conditions. In one swoop we could do away with all the problems we have with patients being misinformed about their conditions by irresponsible websites. We could go one step further again and have links to treatment options on this platform too, such as online CBT, community programs or peer support groups. In addition, there are currently multiple online symptom monitoring programs such as moodscope, or ones designed to be integrated into patient notes, such as True Colours.

In essence, we have the opportunity to provide patients with the ability not only to manage their own online notes, but also to learn more about their condition, monitor their own symptoms and look for appropriate support or treatment. In this age of advancing technology, doctors need to be more in-tune with changing patient expectations. I believe that a move towards not only patient owned notes, but an online, patient-owned, self-help platform is the way to fully achieve patient empowerment. This will, in turn, promote independence, less reliance on services and a more sustainable health care system.