We used patients to design a patient centred medical centre at Hadfield, Derbyshire, in the late 1990's.
We trained patients to train other patients and to run the purpose built information room.
One of our patients was a professor at the University of Manchester Institute of Science and Technology. He recognized the changes were taking place and arranged for an MSc student to study, analyse and report on the practice.
The researcher titled her paper "Culture Change at Hadfield Medical Centre".
The paper described the cultural changes were in four areas:
1. Basic assumptions: Patients are intelligent and competent and can contribute helpfully to health care pathways.
2. Values: patients are valuable contributors to health care contributing over 95% of care to themselves or family who have long term conditions.
3. Norms: We changed the norms. Patients could have and hold a copy of the whole record. Patients could check the record and care pathways for errors or omissions. Patients could contribute to the dare pathway and records and audit.
4. Artefacts: Patients could use the same simple diagnostic equipment that doctors and nurses use. Patients could use the same guidelines that doctors and nurses use. Patients could have copies of the record.
The paper also discussed "emergent change" - different to top down managed change.
HIFA profile: Richard Fitton is a retired family doctor - GP. Professional interests: Health literacy, patient partnership of trust and implementation of healthcare with professionals, family and public involvement in the prevention of modern lifestyle diseases, patients using access to professional records to overcome confidentiality barriers to care, patients as part of the policing of the use of their patient data. Email address: richardpeterfitton7 AT gmail.com
