Trust Matters in Health Care (State of Health)

Does trust still matter in health care and who does it matter to? Have trust relations changed in the 'New' NHS? What does trust mean to patients, clinicians and managers? In the NHS trust has traditionally played an important part in the relationships between its three key actors: the state, health care practitioners and patients. However, in recent years the environments in which these relationships operate have been subject to considerable change as the NHS has been modernised. Patients are now expected to play a more active role, both in self-managing their illness and in choice of care provider and clinicians are expected to work in teams and in partnership with managers. This unique book explores the importance of trust, how it is lost and won and the extent to which trust relationships in health care may have changed. The book combines theoretical and empirical analysis, while also examining the role of policy. Calnan and Rowe analyse data collected from interviews with patients, health care professionals and managers in primary care and acute care settings. Among the issues covered are: The importance of trust to their relationships What constitutes high and low trust behaviour The changing nature of trust relations between patients, clinicians and managers How trust can be built and sustained How interpersonal trust affects institutional trust Trust Matters in Health Care is key reading for policy makers, health care professionals and managers in the public and private sector, and a useful resource for educators and students within health and social care and management studies. FRONT COVER 1 HALF TITLE 2 STATE OF HEALTH SERIES 3 TITLE PAGE 4 COPYRIGHT PAGE 5 DEDICATION 6 CONTENTS 8 SERIES EDITOR’S INTRODUCTION 12 PREFACE 14 ACKNOWLEDGEMENTS 16 CHAPTER 1 TRUST IN THE CONTEXT OF HEALTHCARE 18 THE DECLINE IN TRUST: A DISCOURSE 18 THE SALIENCE OF TRUST IN HEALTHCARE 19 TRUST AND ITS CONSTRUCTION 23 DOES TRUST MATTER? 25 THE ‘DARK SIDE’ OF TRUST 29 RESEARCHING TRUST RELATIONS 30 FOCUS OF THE RESEARCH: STRUCTURE OF THE BOOK 41 CHAPTER 2 TRUST IN THE NHS: THEORETICAL PERSPECTIVES 46 INTRODUCTION 46 THE CONTEXT – THE ‘NEW NHS’ 46 THE EFFECTS OF DIFFERENT GOVERNANCE MODELS ON TRUST IN HEALTHCARE 47 TRUST, CLINICAL GOVERNANCE AND PERFORMANCE MANAGEMENT 52 TRUST AND PATIENT CHOICE 57 TRUST AND PATIENT PARTICIPATION IN DISEASE MANAGEMENT 59 PROFESSIONALISM, CLAIMS MAKING AND TRUST 61 THEORETICAL FRAMEWORK FOR TRUST RELATIONS IN THE ‘NEW NHS’ 65 METHODOLOGICAL IMPLICATIONS 69 CHAPTER 3 TRUST BETWEEN PATIENTS AND CLINICIANS 75 THE NATURE OF TRUST RELATIONS BETWEEN DIABETES PATIENTS AND CLINICIANS IN PRIMARY CARE 75 THE NATURE OF TRUST RELATIONS BETWEEN HIP REPLACEMENT PATIENTS AND CLINICIANS IN SECONDARY CARE 78 TYPES OF TRUST BETWEEN PATIENTS AND CLINICIANS 82 DIMENSIONS OF TRUST 85 HOW TRUST IS BUILT AND LOST 87 HIGH TRUST AND LOW TRUST BEHAVIOUR 91 BENEFITS AND DISADVANTAGES OF TRUST 96 CONCLUSIONS 98 CHAPTER 4 TRUST BETWEEN CLINICIANS 101 THE NATURE OF TRUST RELATIONS BETWEEN CLINICIANS IN PRIMARY CARE 101 THE NATURE OF TRUST RELATIONS BETWEEN CLINICIANS IN SECONDARY CARE 105 TYPES OF TRUST BETWEEN CLINICIANS 107 DIMENSIONS OF TRUST 112 HOW TRUST IS BUILT AND LOST BETWEEN CLINICIANS 117 TRUST LOSING 120 HIGH TRUST AND LOW TRUST BEHAVIOUR 123 BENEFITS AND DISADVANTAGES OF TRUST 130 CONCLUSIONS 134 CHAPTER 5 TRUST RELATIONS BETWEEN CLINICIANS, MANAGERS AND PATIENTS 137 THE NATURE OF TRUST RELATIONS WITH MANAGERS IN PRIMARY CARE 137 THE NATURE OF TRUST RELATIONS WITH MANAGERS IN SECONDARY CARE 141 TYPES OF TRUST 144 CONDITIONAL AND UNCONDITIONAL TRUST 145 DIMENSIONS OF TRUST 146 Acting in the Interests of Others 149 HOW TRUST IS BUILT AND LOST BETWEEN CLINICIANS, PATIENTS AND MANAGERS 150 TRUST LOSING 152 HIGH AND LOW TRUST BEHAVIOUR 156 BENEFITS AND DISADVANTAGES OF TRUST 160 CONCLUSIONS 162 CHAPTER 6 TRUST STILL MATTERS IN HEALTHCARE? 165 TRUST FROM THE PATIENT’S PERSPECTIVE 165 INTER-PRACTITIONER TRUST 169 TRUST IN HEALTHCARE MANAGERS 171 THE EXPLANATORY POWER OF THE THEORETICAL FRAMEWORK 172 IMPLICATIONS FOR POLICY: ACCOUNTABILITY, PERFORMANCE MANAGEMENT AND TRUST 177 IMPLICATIONS FOR POLICY: TRUST AND PATIENT CHOICE 180 TRUST AND QUALITY OF CARE 181 INSTITUTIONAL TRUST 183 AN AGENDA FOR FUTURE RESEARCH 186 CONCLUSIONS 193 APPENDIX: CASE STUDY SELECTION AND METHODS 194 CASE STUDY 1: DIABETES 194 CASE STUDY 2: HIP SURGERY 196 REFERENCES 200 INDEX 216 BACK COVER 223 Has Increasing Patient Self-management Changed Trust Relations With Health Professionals? This Book Provides A Detailed Theoretical, Empirical And Policy Analysis Of The Nature, Salience And Impact Of Trust On Relations Between Patients, Clinicians, And Health Service Managers. 1. Trust In The Context Of Healthcare -- 2. Trust In The Nhs: Theoretical Perspectives -- 3. Trust Between Patients And Clinicians -- 4. Trust Between Clinicians -- 5. Trust Relations Between Clinicians, Managers And Patients -- 6. Trust Still Matters In Healthcare? -- App. Case Study Selection And Methods -- Case Study 1: Diabetes -- Case Study 2: Hip Surgery. Michael Calnan And Rosemary Rowe. Includes Bibliographical References (p. [183]-197) And Index.