Is the answer "yes" to all the questions?

Patients value a more patient-centred approach and more time in their consultations. Time is a fixed resource. How can healthcare professionals spend more time in value-added consultations. Two further questions that raises is “how do we do things differently?” and “what do we stop doing?”. Identyfing the low or no value activities and interventions is one way of unlocking resource. The right people, in the right place at the right time with the right information – it may seem like a slogan from the 90s - but remains as true today. If the information that’s needed isn’t there, if the environment isn’t conducive or if the right people, and that may be carers or relatives, aren’t in the room, the care planning meeting (because that’s what a consultation is), will not be of either high quality or be productive.

We need to gear our system so that patients answer “yes” to the following questions:

1. Have you had enough support from local services or organisations to help you to manage you health?
2. How confident are you that you can control or manage your health?
3. Did you discuss your goals in caring for your health?
4. Were you involved as much as you wanted to be in decisions about your health care and treatment?
5. When you think about your healthcare in general, how often do you receive the health care YOU need WHEN you need it?
6. Do you think support and care you receive is connected and working for you?

Easy to say, easy to agree with (I hope), less easy to do, even more difficult to measure? Well these questions or something similar could be used to assess patient engagement. Planning for people who need renal replacement therapy pays big dividends in terms of quality of care, the experience and the outcomes for patients. It also releases time – avoidable admissions, prolonged lengths of stay and low/no value outpatient consultations by getting it right at the planning stage