Posted by: ayrshirehealth | November 20, 2013

Person Centred Care by @audreybirt

Mother, daughter and wife

Even before I started my career proper, as a nurse, the blend of personal experience and professional life enabled my learning. I was volunteering while still at school to see if indeed nursing was for me. You should go to university I was told, not go into nursing. My solution  was to do both but it nearly faltered at that early stage. Confidentiality had been drummed into me so when I was asked to join the sister bed bathing a critically ill patient I did- without telling her that she was neighbour. My naive understanding of confidentiality was to say nothing. But no one had to tell me the need for dignity, kindness, deep listening and empathy. I knew her to be a mother, daughter, wife and person who had type 1 diabetes who was now dying of its complications. I shared my sadness about her situation with no one, until after she had died.

breast cancer awarenessA few years later our other neighbour, my friends mother, was diagnosed with breast cancer. Seeing her distress, her disability with lymphoedema, her slow and sad decline and early death taught me the the impact of breast cancer on all in the family. I therefore chose to study it as part of my thesis in my final year at university. I interviewed women in the then Longmore Unit, heard what mattered to them, learned the power of shared decision making, saw the pain on their faces. All shades of that experience taught me the how to fine tune my experience as a nurse. It led me to improve my counselling skills, to learn the power of listening.

Self management is power

But it wasn’t until I experienced serious illness myself that I honed my advocacy skills. I learned why people might DNA appointments when the focus of the consultation isn’t theirs but instead the clinicians. I understood that knowledge to self manage is power in the right hands, I knew that psychological healing is as crucial to recovery as physical healing. I recognised the importance of early diagnosis and why that was key and subsequently campaigned for that-that was the focus of my Masters thesis.

breast cancer breakthroughMy lived experience led me to work in health service redesign and then in the third sector. It’s no coincidence the charities I led in Scotland were those serving the communities of diabetes and breast cancer, my old neighbours having taught me there was much still to be done. Those professional journeys also helped me see the power of involving those with experience of conditions or of the service. Suddenly the blinkers come off and everyone can see the impact of ill thought out or insensitive care and also get ideas on how to change it. The collaborative redesign experience opened my eyes to it. The Diabetes UK diabetes voices training and Breakthrough Breast Cancer service pledge I found to be valuable tools ( and there are many more) in enabling patient involvement and advocacy to coproduce improved services.

The patient advocate

My recent journey back into treatment for breast cancer and the start of my blog confirmed for me the absolutely key role the patient advocate has. But I’m not only a patient, I’m a third sector leader, a former nurse, a mum, a daughter, a wife, an aunt, a friend. So really I’m a people advocate, a champion of us all having a voice, especially when we are our most vulnerable, whoever we are and whatever our own cause, be it professional or personal.

PCC progI brought all of that experience to my role recently leading a piece of work for the person-centred team to develop a set of principles for person-centred care and support. They were co-produced with all sectors and those with lived experience to give us a shared language and a touch point for quality-for all. This symbol represents the shared priorities and the overwhelming message of it being about all of us in relationship. PCC prog 2Not as patient or professional but connected through our humanity in mutual respect-not only in direct care but in service improvement too. We have an opportunity in Scotland to lead the way in true person-centred care at all levels, at one to one, at service and at community level, using all of our expertise. Our main lever for change is ourselves and our commitment to real partnership and collaboration at all levels. That might feel like a scary journey at times but its time has come, I truly believe that we can do this together and I know how transformational and deeply rewarding that will be. I’m up for that-are you?

If you are keen to know more, here are some links to help you start your journey – click on the graphs to open the link in a new window.

Quality Improvement Hub


 This week’s blogger was @audreybirt Independent coach and consultant in health and social care (

Comments are welcomed on any of our blogs – please click the comment link to leave a comment or question.



  1. […] Person Centred Care by Audrey Birt on the Ayrshirehealth blog. […]

  2. […] Birt’s post, Person Centred Care on the Ayrshirehealth blog, was inspiring and moving. She told of her own experiences as a […]

  3. […] by Audrey Birt and colleagues emphasising the importance of ‘People in relationship’ (see I have listed these principles below as headings; with some ideas about the sort of questions […]

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