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The spotlight has recently been placed on managers’ responsibility for patient-centred care as a result of Mid Staffordshire NHS Foundation Trust failings. In previous research, clinicians reported that managers do not have an adequate structured plan for implementing patient-centred care. The purpose of this paper is to assess the perceptions of European hospital management with respect to factors affecting the implementation of a patient-centred approach.

In total, 15 semi-structured interviews were conducted with hospital managers (n=10), expert country informants (n=2), patient organisations (n=2) and a user representative (n=1) from around Europe. Participants were purposively and snowball sampled. Interviews were analysed using framework analysis.

Most participants felt that current levels of patient-centred care are inadequate, but accounted that there were a number of macro, meso and micro challenges they faced in implementing this approach. These included budget constraints, political and historical factors, the resistance of clinicians and other frontline staff. Organisational culture emerged as a central theme, shaped by these multi-level factors and influencing the way in which patient-centred care was borne out in the hospital. Participants proposed that the needs of patients might be better met through increasing advocacy by patient organisations and greater staff contact with patients.

This study is the first of its kind to obtain management views from around Europe. It offers an insight into different models of how patient-centred care is realised by management. It indicates that managers see the value of a patient-centred approach but that they feel restricted by a number of factors at multiple levels.

Research on patient-centred professionalism in pharmacy is scarce compared with other health professions and in particular with pharmacists early in their careers. The purpose of this paper is to explore patient-centred professionalism in early career pharmacists and to describe reported behaviours.

This study explored patient-centred professional values and reported behaviours, taking a qualitative approach. In all, 53 early-career pharmacists, pharmacy tutors and pharmacy support staff, practising in community and hospital pharmacy in England took part; the concept of patient-centred professionalism was explored through focus group interviews and the critical incident technique was used to elicit real-life examples of professionalism in practice.

Triangulation of the data revealed three constructs of pharmacy patient-centred professionalism: being professionally competent, having ethical values and being a good communicator.

It is not known whether our participants’ perspectives reflect those of all pharmacists in the early stages of their careers. The data provide meaning for the concept of patient-centred professionalism. The work could be extended by developing a framework for wider application. Patient-centred professionalism in pharmacy needs further investigation from the patient perspective.

The findings have implications for pharmacy practice and education, particularly around increased interaction with patients.

The data contribute to a topic of importance to patients and in relation to UK health policy, which allocates more directly clinical roles to pharmacists, which go beyond the dispensing and supply of medicines.

The methods included a novel application of the critical incident technique, which generated empirical evidence on a previously under-researched topic.

Patient-centred care and patient involvement are increasingly central concepts in health policy in the UK and elsewhere. However, there is little consensus regarding their definition or how to achieve “patient-centred” care in everyday practice or how to involve patients in service redesign initiatives. The purpose of this paper is to explore these issues from the perspective of key stakeholders within National Health Service (NHS) hospitals in the UK.

Semi-structured interviews, covering a range of topics related to service redesign, were conducted with 77 key stakeholders across three NHS Trusts in the West Midlands. In total, 20 of these stakeholders were re-interviewed 18 months later. Data were managed and analysed using the Framework Method.

While patient-centred care and patient involvement were regularly cited as important to the stakeholders, a gap persisted between values and reported practice. This gap is explained through close examination of the ways in which the concepts were used by stakeholders, and identifying the way in which they were adapted to fit other organisational priorities. The value placed on positive subjective experience changed to concerns about objective measurement of the patients as they move through the system.

Increased awareness and reflection on the conceptual tensions between objective processes and subjective experiences could highlight reasons why patient-centred values fail to translate into improved practice.

The paper describes and explains a previously unarticulated tension in health organisations between values and practice in patient centred care and patient involvement in service redesign.

The purpose of this paper is to examine how strategic, patient-centred communication plays a part in the discursive management of expectations posed to patients and healthcare organizations.

The paper provides an analysis of four documents collected as part of an ethnographic case study regarding “The Perspective of the Patient” – a Danish Hospital’s patient-centred communication programme. Mapping methods inspired by Grounded Theory are used to qualify the analysis.

The paper shows that strategic patient-centred communication addresses both a care-oriented approach to the patient and deploys market perceptions of patients. Market and care is seen as co-existing organizing modes that entail expectations to the patient. In the communication programme the patient is constructed in six information-seeking patient figures: affective patient; target group patient; citizen with rights; patient as a competent resource; user as active partner; and consumer. As a result, the patient-centred communication programme renders the patient as a flexible figure able to fit organizational demands of both care orientation and market concerns.

This study contributes to qualitative research in organizational health communication by combining two subfields – patient-centredness and health communication – in an empirical study of how market and care are intertwined in a patient-centred communication programme. The argument goes beyond the prevalent prescriptive approaches to patient-centredness and healthcare communication, instead providing a critical analytical perspective on strategic communication and patient-centredness and showing how expectations are posed to both patient and organization.

This paper seeks to explore the challenges and transformations in healthcare resulting from building information infrastructures for patient‐centred care.

Four types of information infrastructures are analysed with special attention given to the efforts and controversies related to their mobilization and to their consequences for patient‐centred care. Data are gathered through a literature review and by empirical research.

The development of information infrastructures for patient‐centred care requires mobilization of technical, legal, clinical and ethical standards as well as a change in organizational and professional boundaries. Furthermore, the mobilization of information infrastructures entails unexpected transformation in the nature of patients, professionals, health records and consultations.

Patient‐centred information infrastructures call for institutional innovation and decision making regarding basic structures and relationships in healthcare. At the same time, the ambitions of patient‐centred care should be broad enough to learn from the consequences of emerging infrastructures for the patient and professional identities and for the quality of care.

The paper contributes to the understanding of healthcare governance by conceptualizing and empirically exploring the role of information infrastructure as a formative part of patient‐centred care.

Watson and Gallois have argued that “at the very core of health communication is the interaction between health professionals and their patients”, and thus effective and quality communication between doctor and patient is imperative.

Medical and nursing students are often anxious about communicating with patients with mental health problems, even when they have received general communication skills training. Communication is particularly challenging when patients are compulsorily admitted to hospital. The study reported here sought to explore medical and nursing students' attitudes to this challenge, stimulated by watching a DVD illustrating professional‐patient communications in this situation. Facilitated discussions of the DVD were recorded and the transcripts were thematically analysed. A strong commitment to three underlying principles of patient‐centred care emerged.1. A preference for egalitarian over authoritarian relationships between patients and professionals.2. A preference for empathetic over bureaucratic approaches to patients.3. Respect for patients as autonomous beings.Students seemed less aware of the need for clear and effective communication of information, and some appear confused about patient‐professional boundaries.

The prupose of this paper is to present the development of the Verona Patient‐Centred Communication Evaluation (VR‐COPE) scale, together with its psychometric properties. The nine item rating scale assesses the content and relational aspects of patient‐centred communication during medical consultations on the basis of a multidimensional evaluation as suggested by the more recent literature in the field. Each item is defined by operational definitions.

A sample of 246 transcribed primary care consultations was rated with the VR‐COPE. Explorative factor analysis, Pearson correlation coefficients and internal consistency using Cronbach's alpha were calculated. Convergent validity with the Verona Medical Interview Classification System (VR‐MICS) was also tested. A sub sample of 32 consultations was used to assess inter‐rater reliability.

Interrater reliability and internal consistency were good (overall Cronbach alpha=0.75). Four factors (explaining 74 per cent of the variance) were extracted by exploratory factor analysis. Six items of the VR‐COPE correlated significantly with specific communication skills evidenced by the VR‐MICS and pertained to the physician's ability to explore medical or psychosocial issues. The VR‐COPE items on interview structure and shared decision, more related to process than to specific skills, had no equivalent in the VR‐MICS.

The new rating scale responds to the need in communication research for a multidimensional scale that combines the evaluation of specific skills and process aspects.

This paper aims to explore how healthcare organizations in Denmark transform modern ideas of patient‐centred preventive care into organizational practice. Specific attention is given to the influence of existing organizational practices.

A qualitative multiple case study design is used to explore “motivational interviewing”, a health behaviour concept that was introduced in preventive consultations in ten Danish clinics. From an institutional perspective, the concept may be understood as an “organizational recipe” that translates into organizational activities. Data are generated by observations, interviews and document reviews. Theory and data provide the framework for an analytical phase model.

The paper reveals how abstract ideas on preventive care translate into specific activities in organizations following pre‐existing, general rules of medical practice. Disparities between clinics are related to distinctive local practices, such as clinics' conditions and preventive treatment practices that form local sets of editing rules. Differences in clinic performances result in variations in achieving the ideal of patient‐centred, preventive care prescribed by motivational interviewing.

It is acknowledged in medical practice that there are different conceptions of the ideal of preventive care. The paper points to the value of promoting transparency in clinical practice and of paying attention to the mismatch between external expectations and organizational capabilities.

The paper adds to the understanding of organizational dynamics at the micro‐level.

Developing ‘patient‐centred’ health services has become a goal in many countries but little work has been done to identify what research is needed to support the development of such services within mental health. The aim of this study was to consult all relevant stakeholder groups to establish research priorities for developing ‘patient‐centred’ mental health services in the UK. More than 1,000 stakeholders were consulted, including service users, carers and mental health professionals. The consultation identified 12 thematic areas requiring further research. These should be prioritised if services are to become more centred on the needs and aspirations of the people who use them.