UNDERSTANDING TRUST AND THE HSE Trust is a vital part of how we live our lives. We make trustbased decisions every day, and we give our trust when we believe that a person, an institution or even a process, is worthy of it.
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roviding health and care services that people can trust and have confidence in is part of the HSE’s core purpose. In the health service, if people feel they can trust us, they are more likely to seek our help at the right time. This includes reporting symptoms, following treatment plans and attending screenings. In February 2021, we started work to help us understand what trust means to the public, our staff and patients and service users. This involves a programme of research, consultation and action. We want to be able to measure public trust in the HSE on an ongoing basis and use the results to make service improvements. With this in mind, we took the following actions: • Commissioned a review of research on trust and healthcare internationally. We also analysed previous research conducted by the HSE • Undertook an online survey of 2,000 representative members of the public and held a series of workshops with staff • Gathered colleagues, patient reps, health leaders and subject matter experts to form a Trust Working Group. The Trust Working Group defined four leading drivers of trust and 25 behaviours and action statements to assess the HSE. RESEARCH FINDINGS We are broadly trusted as an institution, but many are uncertain one way or another. 39% said they had a high level of trust, 43% a medium level of trust, and 18% a low level of trust. The research found four leading drivers of trust in healthcare services and organisations: • Public good - we should put people first, treat everyone equally and provide good value for money • Respect – we should communicate better, listen more and be inclusive and responsive in our relationships • Integrity – we should be ethical, honest and more open; particularly in owning up to our mistakes • Competence – we should provide high-quality and safe patient care which is reliable and consistent and we should support our staff to fulfil this aim.
INSIGHTS FROM THE PUBLIC, STAFF AND PATIENT GROUPS The biggest drivers of trust for the HSE focus on public good. This includes HSE’s success in delivering on its core purpose of providing high-quality care for the people of Ireland. The greatest area of concern in this area is long waiting lists and access to care. Personal experience also has an impact on trust with negative or poor past experiences shared by those who have a low level of trust. The research highlighted the importance of respect of listening and involving people in a systematic way. Issues relating to integrity have a significant impact on whether people trust the HSE. There is a keen desire for transparency and a culture of openness in the HSE. The competence and commitment of frontline staff in providing a caring and effective service was seen to be an important generator of trust in the HSE. PROPOSED ACTIONS FOR 2022 Here are some examples of the actions we have already agreed to implement as part of this programme. •
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Earning trust through supporting Public Good Communicate with the media openly, building trust with the media and the public. Earning trust through Respect Improve visibility and leadership for patient and public involvement within the HSE. Earning trust through Integrity Evaluate and improve openness and disclosure policies. Earning trust through Competence Acknowledge and celebrate everyday successes. This will include the development of a new peer to peer staff recognition programme.
The work we’ve done and the evidence we’ve gathered suggests that to improve levels of trust, the public must have confidence that the HSE will stay true to its values, can fulfil its vision and that all objectives, values and actions are pointed towards the common good. We know that this work will be challenging and will take time and we’ve started to take action on our programme of work already. We look forward to working together to protect the public’s trust and confidence in the services we provide. HEALTH MATTERS SPRING 2022 | 67
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