The National Health Service (NHS) was founded by Aneurin Bevan in July 1948 (Nuffield trust, 2019). It has been developing and regularly changing in an attempt to improve its services and patient experience. From being free, to developing lifesaving treatments, and creating the organ donor register, the NHS had, and still has, the experience of its service users at the heart of all developments and changes, which is also known as person-centred care (NHS England, 2013).
The NHS has a set of 6 core values that all staff working in health and care should follow and adhere to; these were introduced in December 2012 (Skills for care, 2019).
These core values are known widely as the 6Cs. All of the 6Cs are of equal importance in ensuring a high quality of care is delivered to patients. The core values focus on putting the patient at the centre of the care that they receive (RCNi, 2015). Since the 6Cs were implemented it has helped health care professionals to ensure that the job is done effectively and efficiently and that patients are given the best care possible, including staying safe and keeping them as well as they can be (NHS England, 2016).
The 6Cs are care, compassion, competence, commitment, courage and communication (Barber, 2016). They are all important in their own way and all should be at the heart of all tasks carried out by staff working within health care settings. Care is at the centre of the NHS and is its main role and purpose. It is imperative that this is provided by staff that are compassionate and competent in all that they do. They must have courage to implement changes and to whistle blow if necessary. Healthcare professionals must have a commitment to the profession, that also extends to the experience of all service users as well as their relatives and friends (Barber, 2016). Most importantly is exemplary communication skills, and this is a large part of providing a positive patient experience resulting in the delivery of quality care (Barber, 2016).
Communication is important because it helps patients to feel at ease, in control and valued (Baird, 2016). It is normal for NHS service users to feel scared and worried about their condition and what will happen both while they are in hospital and after they leave. If the professionals that they come in to contact with have good communication, then this can help them to feel more confident and settled with what is going to happen (Baird, 2016). It can make the patients feel like they have people that they can confide in about their worries and therefore make them feel more secure, compliant and happy (Baird, 2016).
When people enter a care setting, they can quite often feel as though they have lost control of when and how simple daily tasks are carried out, and this can also then have a negative impact on a patients recovery speed or level (Peckham and Hann, 2010, p. 9). By using positive communication methods to give patients choices about if or when things take place this can allow them to feel back in control of some aspects of their lives and daily care and therefore increase their level of mental well-being and positivity and in turn increase their chances of a full and speedy recovery (Peckham and Hann, 2010, p. 9).
There is much more to communication than just the words that we say. There are five main factors to consider when thinking about communication, these are: listening and attention, verbal, non-verbal, questioning, and written communication, whilst some of these are related to or used alongside the spoken word, written communication is not.
Listening and attention is vitally important when working within the health care sector and in close proximity with patients and their relatives (RCNi, 2016). People often only talk to someone that appears to be showing an interest in what they have to say and remember what they have told you, also known as active listening. Frequently in health care settings, it is care workers or receptionists that are a services users first point of contact and they will often express their concerns or feelings with these people rather than with the doctors, nurses or staff carrying out procedures. Workers can encourage service users to continue to talk to them without interrupting them by using techniques of non-verbal communication such as head nodding (RCNi, 2016).
Sparing time to listen to what patients want to share with you gives you the opportunity to better understand the emotions that they are experiencing, and will also give you the opportunity to offer further help. This will allow and help the patient to feel more valued as appose to feeling like they are just another patient (RCNi, 2016).
Questioning is an important technique that can be used to help healthcare workers understand patients needs and wants. Questions can be either opened of closed, with closed questions often requiring just a yes or no answer and open questions leaving the opportunity open for more of a response (Argyle, 1994). Open questions offer the opportunity for patients to discuss how they are coping/feeling. These often receive a much more in depth answer when paired with good non-verbal communication such as nodding (Argyle, 1994). Answers to open questions often also lead to opportunities to ask further questions.
Non-verbal communication is most commonly referred to as body language. This is because it is the way in which your body communicates with people. There are 4 components of body language that should be considered when communicating with patients and their families. These are body posture, eye contact, touch and facial expression.
Positive body posture should show a persons openness (Basavanthappa, 2004). Healthcare workers should not stand over a service user that is seated or on a bed as this could intimidate them (Timby, 2009). It is important that a service user feels as though who they are talking to somebody who wants to be talking to them too, and this means that their body language and stance should be open (Basavanthappa, 2004). An open person should be stood within nearby with unfolded arms and not fidgeting. Staff within health care settings should always be extremely aware of what their facial expressions are doing and showing about their current mood and emotions such as showing if a person is interested, sympathetic or happy (Argyle, 1994). Good eye contact should always be maintained, whilst being mindful not to stare. However, it is important to know the service user, where possible, as in some cultures eye contact can be considered rude. This is also the case for the touch aspect of body language and workers should always seek personal permission before touching any service users.
Verbal communication, much like the other features of good communication, can give off the wrong impression if not executed properly. It is greatly important that care givers are clear, accurate and honest when talking to service users to ensure they fully understand what they have been told (Timby, 2009). It is also vital that when communicating, people working in healthcare settings are respectful, and courteous and this is generally helped by asking patients how they wish to be addressed. It is also key that workers ensure that they are using the appropriate tone of voice and to be careful not to appear impatient or to be rushing the patient as this could lead to the patient not feeling that they can approach you with any further issues (White, 2005).
It is extremely important in health care that excellent written communication is always maintained. Written communication is used in patients personal medical records and is used to keep a good and accurate record of a patients illnesses, treatments and progress. Staff caring for a patient can often change between shifts or between patient appointments and therefore it is imperative that all medical records are clear, accurate, legible and factual (RCNi, 2016). Medical records should not contain personal opinions and to do so would show poor written communication skills in a healthcare setting (RCNi, 2016). Having positive written communication in a patients medical records makes for a smoother process and more positive experience for the patient during a possible change in personnel caring for them.
All of the 6cs contribute to ensuring a positive experience for all service users and with the use of excellent communications skills service users can be given an even high standard of care (RCNi, 2015). The use of excellent communication skills allows for clear communication and for patients to share their stresses and concerns with the staff providing their care. This enables the health care professionals caring for a patient to better understand their patient and tailor their care more uniquely. With the patient feeling more comfortable to communicate to their care team this makes them much more relaxed in the environment and in turn it increases the speed and level of their recovery. Therefore, it is evident that communication is the most vital of the 6Cs (Barber, 2016).