'We have not found an area where improvement has not been possible'

One of the great privileges of my job is to meet patients, carers, families and staff to discuss with them how Nottingham University Hospitals Trust can meet their needs even better.

Abundant opportunities exist every day to gather these rich perspectives. These include chance encounters in hospital corridors and car parks and more formal meetings with groups of patients. These opportunities can be described as a cubic centimetre of chance.

I can think of no decision or service development that has not been enriched and improved by patient engagement. There are, of course, challenges. Not least being humble enough to recognise that for all our training and experience, we rarely possess the intimate knowledge of what and how it feels to be a patient until you are in that situation yourself.

I have written before about the many examples of engagement in particular service areas, or with particular patient groups that support our enduring passion to improve patient care. In Nottingham, we are dedicated to creating more opportunities for patients and carers to both fulfil a more active role in their own care and also to share with us their ideas as to how we can improve our services.

When we were planning to embark on the most comprehensive transformation programme we have ever undertaken, authentic patient engagement, along with that of colleagues, was the basis on which we built Better for You, our whole hospitals change programme.

Now in the second year of the programme, Better for You is our concerted approach to improve what we do often with fewer resources by asking the question: “if the services we provide didn’t exist, how would we create them?” By taking this approach, we have not found a single area where improvement has not been possible.

One of the most powerful messages about the importance of patient and staff involvement is summed up by one of the patients working with us to improve care for people with diabetes: “We’re the experts on our diabetes. I’d like to retain control of my glucose tests myself when I come into hospital… giving me my insulin is as natural as eating or getting myself dressed.

“It’s wonderful to be able to have the opportunity to give our opinion… it’s a real boost to have the opportunity to have a say in our care.”

What Better for You demonstrates over and over again is that our patients and our colleagues already have the answers to the apparently conflicting questions of how to simultaneously improve quality, safety and cost. However, the question is not whether the opportunities for improvement exist but whether we choose to take them. In other words, if we seize some of the abundant cubic centimetre of chance.

The essence of sustainable and meaningful transformation is the preparedness to seek to see what patients, carers and staff view and experience every day. It is also vital that we learn from projects that do not achieve the desired results. It is essential to have mechanisms to capture, codify and share such valuable learning so this improves the rate of progress in other areas. This also sets the right cultural tone.

Through Better for You, we are expanding our own knowledge and skills in involving and understanding what service quality and value mean for our patients. Some of the most revealing and refreshing insights have also come from when our staff put themselves in the position of patients and begin to truly appreciate what it feels like.

This takes courage on both sides. But without this depth of authentic understanding and appreciation we might make changes that fall short of what our patients expect.

Better for You spans the full extent of everything we do in our trust, with more than 200 active projects, each one transforming services by working alongside our patients. Our patient partnership group provides governance and oversight of our progress including patients’ unique insight and challenge.

We have recently presented to our local overview and scrutiny committee on patient engagement, which provides a valuable opportunity to review with our local authority leaders the progress we are making and benefit from listening to their reflections.

Transforming our services is a major undertaking and one that we would not have embarked upon without the support, involvement and encouragement of patients and staff. Patients and staff deserve nothing less. What cubic centimetre of chance to improve patient care have come your way today?