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The Best Health Care Must Involve Kindness and Instil Trust

At a time of unprecedented financial challenge in health and social care, the NHS must never ever find solutions by doing things less well.

Kindness and trust.

These are hugely important words.

For me - they sum up the relationships that we, in the UK, each have with the people who work in healthcare - and especially the National Health Service.

Kindness and trust imply a relationship between people. They imply care, community, friendship.

Kindness and trust are the pillars supporting the whole structure of care - and yet they are so intangible.

It still surprises people to hear kindness and compassion being mentioned as key parts of great care, particularly from an organisation like NICE. That really bothers me. It implies that there are people who see these as being optional extras in the running of the health service. They're not. They are core, central, vital. Not just woolly soft and cuddly aspirations - they have a profound effect on outcomes.

I want to think about those words.

The word kind, the root of kindness, is very old,and is related to the word kin - meaning family.

Kindness is hugely important to us all - to our bonds to each other, to our mental and physical health, to our sense of belonging. It should also be potentially inexhaustible - provided we value and reinforce it.

However we also know when things go wrong in healthcare, it is often when kindness has evaporated.

At this moment in the NHS, there are millions of acts of kindness.

A nurse is comforting a small and bewildered child with cancer.

Another nurse is holding the hand of a shell-shocked mother who has delivered a very small and sick baby 13 weeks early.

A paramedic is talking quietly to an elderly man collapsed on his kitchen floor.

A homecare worker is listening to a pensioner's fears for her independence.

A family doctor is reassuring someone who has been frightened by a blood test result.

A porter shares a joke with a man he's pushing to theatre.

The list goes on. And on: not thousands of acts of kindness, not tens of thousands but millions each day, every day.

But what thrusts these people together?

We don't go to our doctor because we think they will be kind.

We don't call the paramedic because they will be kind. We go to them because we trust their competence.

I would argue we assume that most health and social care professionals will aim to be kind and caring. But without trust the relationship would soon break down.

Again, it's an old word. A gift from the Vikings, trust came into middle English from the Norse word for strong. And that's incredibly important. It is trust that keeps the NHS strong.

We trust that it will be there for us. It will be strong and it will care for us and those we love the most.

And the reason the NHS is so cherished is that it delivers. People's trust is earned.

The challenge of being trusted is huge. As the folks at Volkswagen well know, you spend decades building a reputation for it literally to go up in smoke overnight.

So what should we do to maintain trust?

In this, the NHS Constitution which enshrines the rights of patients in the UK is very helpful.

The role of the NHS is to bring "the highest levels of human knowledge and skill to save lives and improve health".

But this is a very tricky task for individuals working at the frontline of health and social care. And this is exactly where NICE fits in.

To produce our guidance, the best evidence on a topic is gathered and assessed, an independent committee of experts discusses the data, hears from other experts - including patients and service users - deliberates over the topic in hand and reaches a consensus view on their recommendations.

At this point, we seek views on the draft through consultation, and then the committee agrees the final guidance.

But to maintain trust, we have to make sure that we continue to provide the best service to people. We must strive to improve. There are real challenges in this. Not least because of constrained budgets.

And at a time of unprecedented financial challenge in health and social care, the NHS must never ever find solutions by doing things less well.

What will happen to trust if we do?

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