The Francis report (The Mid Staffordshire NHS Foundation Trust Public Inquiry, 2013) published earlier this year emphasised the need for a cultural change within the NHS. Highlighting the failure of the Mid Stafforshire NHS Foundation Trust to detect poor quality care and to ensure that its services met the standards that the public expects, the 3-volume, 1782-page report called for a patient-centred culture, which has a commitment to serve and protect patients.
Though the Francis report focused on a single NHS Trust, its recommendation for the need of a structure of fundamental standards, which identify the basic principles of care a patient can expect, and stronger healthcare leadership, are applicable to the NHS as a whole.
The provision of safe and effective care often starts with the paramedic, and so it is imperative that the highest quality services possible are delivered. As a profession that is rapidly taking on increasing responsibilities within the NHS, the paramedic profession has to ensure it is able to keep up with its broadening demands. One of the ways it can ensure this is done is by getting the simple things right. The importance of thorough patient assessment and accurate history taking cannot be undervalued, as it is this that informs the clinician of the appropriate action and treatment to carry out. This issue of the Journal of Paramedic Practice goes back to basics by exploring the fundamentals of paramedicine that are often overlooked, with articles on integrated care, patient assessment and history taking.
In response to the Francis report, Health Secretary Jeremy Hunt has announced a new £260 million fund for hospitals (Department of Health, 2013) that will be put towards increasing the use of technology for patient records. Outdated paper-based systems for patient notes will be replaced by computer systems, making history taking and prescribing easier. This marks a critical step in the NHS' plan to go digital by 2018. Organisations such as St Helens and Knowlsley NHS Trust have had their patient records accessible online for health professionals to access when needed, while at New Queen Elizabeth Hospital in Birmingham, an online ‘portal’ allows patients to view and update their own medical records so that health professionals can get instant real-time updates should they need them.
History taking forms a notable part of the paramedic's overall patient assessment, and so the ability to have more accurate details on a patient as a result of up-to-date technology systems means that better and faster care can be delivered. Not only this, but it will mean transferal to specialist departments will also be easier due to the ability to send patient records electronically.
If a truly patient-centred culture within the NHS is to be made a reality, the needs of the patient have to be properly understood and assessed. Getting the basics right is surely a step in the right direction.