As we look to the future, the healthcare industry is at a critical juncture. The rapid development of theories on how to deliver safe, person-centred care means that we can no longer rely on the excuse that “healthcare is different” from other industries and cannot be reliable and safe. People are now demanding safety and reliability in the care they receive, and they want to be treated as people who happen to be ill rather than as a number or a disease.

Currently, it is by chance rather than by design that one receives highly reliable person-centred and safe care.  Yet we continue to build the same type of hospitals, educate future nurses and clinicians as we have always done and operate in a hierarchical system that disempowers people, rather than enables people to be healthy.

Although the provision of healthcare is complex, it is possible to overcome the complexity and provide care that is of the highest standard in all the domains of quality. 

To achieve this, I suggest six steps to be considered:

• Power: Hospitals as a concept gained their power in the last century and should now integrate that power and share funding with the community. We need to address the power imbalance in the system and recognise that the design of the system with the hospital at the centre should change to the hospital as the facilitator of health within a system of care delivery which is closer to the home. This will require a reallocation of resources to primary care and a change from healthcare to health.
• Quality: Standards of care in the past have focused on the processes of care and now need to be redesigned by people who receive care. This will change their focus from measurement of the process to a refined assessment of peoples experience and the desired outcomes.
• The Providers of care: The healthcare workforce will require re-education to be able to deliver health as well as manage disease. An understanding of the theories of Complexity Science, Systems Theory, Patient Safety Science and Human Factors is required. Medical curricula will need to be challenged and changed to educate the clinicians that we require in the future.
• The well-being of all: The well-being of providers of care within a framework of psychological safety is a core part of the change that is needed to ensure we have a system filled with compassion, kindness, dignity and respect. We need to prevent burnout and stress proactively, and this implies a recalibration of the way we support each other,
• Leadership: Change will require leaders who understand what quality and safe person-centred care is, with a deep understanding of Systems Theory and Human Factors as well as knowing how to realign the budget to facilitate change.
• Politics: The wider implication of a total redesign will require political will to allow the realignment and re-engineering of the healthcare system to one in which all policy is aimed at the long term health of the community. Politicians need to invest in health while funding healthcare.

All of this change will require courage and imagination, vision and hope. But more importantly, it will require co-production with all the people involved, particularly people who will be receiving care.

We must address these key issues and make difficult decisions but I am optimistic that we can make the change. 

This article was originally published in French in the December version of the PAQS magazine - all teach, all learn - https://fr.calameo.com/read/0044173487cb09c9ade5e