In January 2019 the HFEA released its new code of contact in relation for patient support. The focus it puts on emotional support for patients is great development, and it ensures that clinics are prioritising patient centred care.
The HFEA have also released some guiding principles to help clinics. These provide really good guidance for clinics to help them think about what they need to do to improve their emotional support for patients.
This article covers the nine guiding principles and my thoughts on why they are important and my advice on implementing more emotional support.
1. Every member of staff is responsible for the provision of good emotional support
‘Staff at every level should take personal ownership for emotional support.’
I believe this is so important. Any contact the patient has with the clinic should reflect the supportive culture of the clinic and ensure that the patient feels important. When they call reception because they are really worried about something, they need to hear an empathic voice at the other end that they know will help however they can, and not add to their already anxious state.
Clinics need to create a culture of emotional support that starts with the hiring of staff and continues through frequent training.
2. Provide and participate in good training
‘Great patient care isn’t all common sense. Being able to convey empathy for others and sensitively deliver bad news, for example, are skills that can be learned.’
These are skills that are essential when dealing with vulnerable patients, and all staff should be given training to support them in the sensitive nature of the work they are doing on a daily basis.
Ensuring all your staff are regularly trained and supported will not only make them feel valued and important, but it will have a huge impact on your patient satisfaction.
3. Put patients at the centre of their care
‘Patient-centred care needs transparent information-sharing between the clinic and the patient. Create an environment where patients are part of the treatment decision-making.’
I often hear at support groups that patients aren’t fully aware of the process of treatment and why they are having certain procedures. There are also some who have had bad experiences of certain procedures (such as sedation) which is making them worry about treatment. By giving patients the time to talk through their concerns there may be alternative ways to do certain procedures that will make the patient feel more relaxed about treatment – meaning they are in a better frame of mind.
Clinic appointments can be very overwhelming and patients often leave wishing they’d asked more questions or feel like they’ve forgotten everything they heard. Give patients the opportunity to ask questions after their appointment and listen to their concerns.
4. Tailor care to the needs of different patient groups and to the individual
‘Every patient is different – they come to the clinic with many different life experiences and some may need a lot of support while others may not. Try to accommodate different values, preferences and needs.’
Be sensitive and tuned in to their emotions, if you believe someone is struggling ask if they’re ok and re-iterate the support available. Think about ways that you can make the treatment process easier for them.
Ask patients how they would like to be supported, consider their fertility journey so far and be mindful of how they need support and offer support services tailored to different needs (e.g support group for donor recipients).
5. Make every contact with the clinic as stress-free as possible
‘Make the experience in your clinic as easy as it can be with minimal waiting times and maximum comfort and dignity. Ensure that each patient’s privacy is respected, and that pain and discomfort is minimised.’
IVF is no-ones first choice way of getting pregnant, and if they had a choice most people wouldn’t want to spend their days in a fertility clinic.
Aim to make the time they are at the clinic as relaxed, easy and comfortable as possible.
Patients trying to conceive often view everything in months (their next opportunity to get pregnant) so long waiting times and postponed appointments can make people feel worried about time ticking on. It’s important to manage their expectations and allow flexibility in appointments.
6. Offer an outstanding fertility counselling service
‘Minimise barriers to accessing counselling, such as cost and appointment availability, and ensure that all offers of counselling to patients and their partners can be backed up with information on the potential benefits if this is needed.’
Emotional support is so important, and with research showing that patients with infertility display the same levels of stress as cancer sufferers, having access to a great fertility counsellor is essential.
I believe that it shouldn’t just be providing access, I think that clinics should be encouraging patients to speak to the counsellor, even if they just have one session, just to make sure they are aware of the emotional implications of IVF.
Patients I speak to feedback that the reasons they haven’t booked sessions is due to them being difficult to book when needed, inconvenient times of appointment and that they didn’t feel that they needed them.
Clinics need to make appointment readily available, and highlight the benefits that counsellors provide, highlighting that its not a sign of weakness.
7. Provide a variety of emotional support resources for patients
‘Remember that patients may benefit from different forms of support at different times.’
There are many forms of support that clinics could provide patients for outside of clinic hours, and I find that the peer support groups that I run have been really well received – especially online.
Infertility affects all aspects of day to day life, and patients are not just triggered emotionally during clinic hours. They need support in coping with their emotions and treatment at all hours of the day, so having access to support resources could make a big difference to their emotional health.
Patients also benefit from peer support, to validate their feelings, share stories and advice on coping. Offering a way to connect patients gives them an outlet to chat in a safe, non-judgemental space.
8. Staff wellbeing is patient wellbeing
‘There is a well-established link between physician burnout and bad patient care and safety. A recent report from the Royal College of Physicians stressed that staff mental and physical health ensures value-for-money, sustainable services with high-quality patient care.’
Patients expect their physicians to treat them with empathy and be on the ball with their treatment plan. They are vulnerable and feel out of control. They want to know that the people whose hands they are putting their future in are fully in control and know what they are doing.
By ensuring your staff are fully supported, maintaining their wellbeing and in a good place, you will ensure your patients get the care they need and that they feel like they are important.
9. Listen to complaints or feedback and act
‘Listen objectively to both colleagues and the patient. Check the validity of a patient complaint or feedback with empathy.’
Patients are very vulnerable and may be overly sensitive due to how important this is to them. They may over react to things that wouldn’t usual bother them or other people, but this is very real to them and any complaints must be handled with empathy.
It is difficult when staff are being targeted and your clinic criticised, but if you handle it delicately and show the patient that you are looking in to it, they will appreciate it. They want to feel important, and you don’t want to cause them any distress. Keep them updated on progress and any resolution and it will make a big difference to their view of you.
I think the new code of conduct is a really important development in the field of infertility. There have been so many medical developments, but I think it is great that such a big focus is being put on emotional support.
It is important that clinics start developing their new ‘Patient Support Policy’ in line with the code, and to develop an exceptional level of emotional support to patients.
If you would like advice in creating your Patient support policy and training your staff on emotional support, please email me on [email protected].
You can also download my complimentary Patient Support Audit to help you identify the key focus areas and I will feedback my thoughts on how you can enhance your patient support.