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Integration within the NHS has historically been structural – but from the patient's perspective it has lacked co-ordination Many people have placed great faith in the idea that integrated care can solve some of the most pernicious health issues of our time. With an ageing population and a dramatic increase in long-term conditions, it's easy to see why co-ordinated care for patients could provide better health, care and value. However, it's easy to confuse structural integration with what patients really want – personalised, high-quality, seamless care focused on their needs. Of course...

The Care Quality Commission's annual inpatient survey suggests that the negative press is by no means all justified Judging by recent media coverage, you might be forgiven for thinking that the NHS has become a patient's nightmare, with doctors and nurses routinely mistreating or ignoring those in their care, leading to thousands of unnecessary deaths in hospitals across the country. What does the evidence say? The Care Quality Commission's annual inpatient survey – looking at the experiences of more than 64,500 people admitted to NHS hospitals in England in 2012 – got precious little...

People Powered Health is an approach that can improve quality of life and save the NHS money The health system is going through significant upheaval and crisis provoked by the combined impact of the NHS reforms and the Francis Inquiry. The result is a sense of unease and uncertainty despite the NHS ranking excellently in international terms . At a recent Lord Darzi discussion on primary care, the mood was summed up as: 'Why does it feel so bad, if we're actually doing so well?' Part of the answer is that the NHS is good at dealing with acute and infectious disease, but is still finding...

The intervention shows that NHS boards are expected to suspend staff or services as soon as they have suspicions The suspension of children's heart surgery at Leeds general infirmary and the subsequent battle to restart operations is a foretaste of what will become a familiar chain of events in the NHS post Mid-Staffordshire. In his final report , Robert Francis QC is unequivocal on the requirement for services to meet fundamental standards to be set out in the NHS constitution. Expressions such as "no tolerance of non-compliance" and "rigorous policing" make clear that...

The health service needs a new mindset of personalised care so hospital patients and staff alike feel that they really matter as people Last year my 78-year-old mother was injured in a car accident. It was upsetting to discover that she did not feel cared for in hospital. Her care was so impersonal that she felt like "the broken leg in the far corner". Mum's experience shook me. It made me want to explore what patient-centred care could look like and how her experience could have been different. My area of expertise is person-centred practices, an approach that focuses on understanding...

We must put the integrity of the whistle-blowing system beyond question, for the benefit of both patients and staff The NHS is under pressure over whistleblowing and gagging. We in the NHS leadership community need to make it crystal clear that we regard attempts to prevent staff from raising concerns about patient care as utterly wrong and self-defeating. Responsibility for quality of care rightly rests with the boards of NHS trusts and the frontline clinical teams they employ. Boards of directors therefore need to build an open culture where the concerns of staff are freely discussed. Effective...

Debbie Jordan began her healthcare career after losing her father to cancer. She explains the challenges of working as an acute oncology nurse Describe your role in one sentence I work in a team providing rapid assessment and triage for people attending hospital with emergencies related to cancer so we can make sure they get the cancer care they need. How did you get into it? I was a staff nurse on the haematology and gastroenterology ward at Doncaster Royal Infirmary, before starting a master's degree in oncology and palliative care. Why did you want to work in healthcare? My dad died from...