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Healthcare aims to be patient-centred but a large gap remains between the fine words and the reality. Care often feels designed for the convenience of the organisations that deliver it, and not enough around patients and their families, or even around the frontline staff who provide it. Why does this happen? What does it feel like? What can be done about it? This book stimulates reflection on these questions by listening closely to those at the frontline. It provides accounts from patients, carers and healthcare professionals who are patients about what it’s like when services get it right, and wrong, from birth up to the end of life. Quite simply, we want to draw upon the power of storytelling – which is increasingly valued as a tool for learning – to help policymakers and practitioners to understand how to deliver better care. We also hope to enlighten the general reader about how they might go about navigating “the system” while it remains imperfect. There is a growing literature of first-person accounts from patients and from healthcare professionals. This book differs by providing a collection of narratives of experiences of the NHS in England to paint a rich and varied picture. Alongside these narratives we provide some international context, and an overview of the history of moves towards a more patient-centred approach to care. We present the theory and practice of storytelling in the context of healthcare. We also seek to help the reader to draw out the practical learning from the individual accounts.
West African Ebola outbreak was considered a success for MSF; the response in Nord Kivu a failure for everyone involved. Yet even if the results in Nord Kivu would appear as good as in West Africa, if not better – fewer frontline staff infected, in fact, fewer cases overall and therefore fewer deaths – a comparison between the two epidemics is not helpful. Although actions of response actors in DRC were usually well intentioned, and the funds and resources provided were
, training, qualifications, working conditions and broader continuities between care in the community and the Poor Law.5 Even more interesting are the relationships that wardens had with the client groups who used their hostels, the experts whose research shaped the framework within which services were delivered and the policy-makers who constantly expected the impossible but who often also undervalued frontline staff. This chapter surveys studies of wardens in a range of settings and then focuses upon an archive of letters, running from the late 1940s to the early 1960s
, facilitators and technicians were first in the line to have their contracts terminated. Many larger institutions, faced with lockdowns and budget cuts, decided to make savings by laying off their frontline staff (Steinhauer 2020 ). In a feat of institutional hypocrisy, some institutions did not miss an opportunity to signal their own virtue by organising exhibitions lauding frontline workers of the pandemic – nurses, carers, doctors – while at the same time busily axing their own workforces. Hettie Judah commented on the exhibition Everyday Heroes that was opened in
feels as if it is designed for the convenience of the organisations that deliver it, and not enough around patients and their families, or even around the frontline staff who provide it. Why does this happen? What does it feel like? And, most importantly, what can be done about it? This book aims to stimulate reflection on these questions by listening closely to those at the frontline. It provides accounts from patients, carers and healthcare professionals who are patients about what it's like when services get it right and wrong, from birth up to
overcome is that of attitudes towards asylum seekers and refugees in general among state service providers. There are high levels of ignorance among those working in frontline services for refugee migrants in terms of the entitlements of their client group and where specialist services can be accessed. Much of this ignorance is fed by prejudice and results in discrimi- 175 Allwood 06 176 24/2/10 10:31 Page 176 Refugee women in Britain and France nation against asylum seekers and refugees. The tension between frontline staff working in health, education
monitoring and evaluation The foregoing discussion shows that, in its present form, the machinery cannot fully carry out monitoring and evaluation roles. It lacks strong frontline staff at the different policy and formulation and implementation levels, within the official structure. This is exacerbated by fragile lines of communication with vital Ministries such as Planning, Health, Agriculture and Education. Feedback about the performance of the Ministry or the needs of various connected institutions is received only when districts or ministries are approached. In
of the participants, as well as the structures and histories of the investigated fields. Hall (1997) focuses in particular on policy agents and how the actions of this group of people are affected by the awareness that their work impacts the work (lives) of welfare workers and citizens. In other words, welfare workers – the frontline staff – are affected not only by specific policy agendas but also by the fact that their actions and decisions can have many important consequences for the citizens whom they encounter. Furthermore, the actions of citizens reflect both
nurse education and research; a process that continues to date. In 2014 there are still signs of professional uncertainty, but nonetheless student nurses are still being prepared to be learning disability nurses and posts are still being advertised and filled. This apparently significant improvement in the position of learning disability nurses between 1970 and 1990 poses two important questions; what accounted for the change, and why didn’t frontline staff feel more secure as a result? The changing position of the learning disability nurse owed much, at a local level
often collected on personal devices, sent over hotel Wi-Fi, scrawled on scraps of paper then photographed and sent to headquarters via WhatsApp or simply emailed and widely shared with partner organizations’ (Loy, 2022 ). Organizational security and privacy policies on data storage and protection are viewed as irrelevant, impractical and frequently ignored. In addition, individual frontline staff take