NHS the patient receives (Nursing and Midwifery council,


NHS constitution consists of rights of patients, public
and health professionals (Department of health, 2015). The principles within NHS
constitution was written based on the values of the NHS to improve health and
wellbeing. NHS constitution states that these principles were written to help
“ensure that the NHS operates fairly and effectively”. (DH, 2015). These
principles are there to enhance the care given to patients as well as improve
health and wellbeing (DH, 2015). One principle in the NHS constitution states
“patients will be at the heart of everything the NHS does”. This means that
patients will always come first. If any complaints from patients regarding NHS
services, these must be dealt with effectively for NHS services to develop
further which can improve the quality of care the patient receives (Nursing and
Midwifery council, 2015).  Furthermore, the
NMC code sees prioritising people very important. Ethics can be kept by giving
informed choices on their own healthcare decisions for example patients have
the right to either accept or refuse treatment or care. This would empower them
to have the freedom to choose. It is crucial that the patient’s choice is
respected (NMC, 2015). Overall, every individual is different and the NHS
constitution mainly will focus on meeting patients’ needs to provide with
person-centred care. Care would still be holistic and person centres when the
patient may lack capacity or is unconscious. In this case, decisions would be
done in their best interest (Mental capacity act, 2005). Example in MOOC
scenario (MOOC ethical principles in maternal care), where poor quality care
was delivered to pregnant women who wanted a home birth however due to high
BMI, her request was declined by the consultant. The pregnant women didn’t feel
cared for as their thoughts and feelings were ignored resulting in poor quality
care. A better way to approach this situation would be to discuss with the
patient about their needs, the option available to them and supporting their
choice give a better birth delivery.


care needs and choices of the patient must be focused on and religion, gender,
age, disability and culture must be taken into consideration (Royal College of
Nursing, 2015). Focusing on individuals can show good care because their
individual differences are respected (RCN, 2017). For example, Food preferences
will be different for every individual and this may be due to religion as some
religions don’t allow people to eat meat. Their preferences should be respected
and the care needs should be provided.

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One main challenges in the NHS is the ageing population (Garza,

population means more demand for care and it questions how care can be given to
an ageing population when there are not many young people to give that care. Staffing
levels is an issue within healthcare because it can lead to poor patient care
which has been noted down in the Francis report as one of the problems (Francis
report, 2013). Low staffing level can cause harm to patients as it can mean
care is left unfinished for example not being able to complete health records
or give medications on time. Uncompassionate care could result in health care
error (Geraghty, oliver and lauva, 2016). Francis report is an example of poor
quality care as a result of no compassion, dignity or respect for patient’s due
to low staffing levels. It reports the failure of helping patients to the toilet,
providing patients with nutrition, failed to keep patient’s hygiene by not
giving them baths and as a result, patients felt ignored and ashamed (Francis report,2013).
The 6C’s (Care, compassion, competence, communication, courage and commitment)
in nursing was published within the compassion in practice: our vision and
strategy to improve care provided to patients. It was published due to the
poor-quality care provided in mid Staffordshire NHS trust foundation (NHS
England, 2016). Cumming and Bennett (2012) states “compassion is how care is
given” (DH,2012). In this situation to give compassion, staffs need to feel
empathy and understand what it is like to be in their state (Nouewn et al
1982). It is emotion that the person feels when someone is suffering which can
urge them to want to help (Goetz et al, 2010). Help can be provided by giving
physical or emotional support for example helping feed patients or listening
and responding to the patient (Ramage et al, 2014). Example in scenario (MOOC)
where a 98 years old elderly with dementia believe they are 70 years old and
keeps searching for their mother. It is unethical to lie to a person because
trust is broken (Kitwood, 1997) and NMC, 2008 states nurses to “be open and
honest, act with integrity and uphold the reputation of your profession”.
However, by empathizing with others and understanding how the elderly might
feel, not telling the truth might be the right thing to do. Instead a
therapeutic lie can be used to avoid challenging behaviours but also decreases
their distress (James et al, 2006; Culley et al, 2013).


Communication involves 2 or more individuals
sharing information to each other and this can be by verbal communication as
well as non-verbal communication like facial expressions (DH, 2010). “Hello, my
name, is…” campaign encourages the importance of introduction which is help
provide compassionate care and build a relationship (Granger, 2014). Effective
communication about the patient’s needs and what treatment plan they want can
help to begin a trusting relationship. It will help patients gain a sense of
belonging and doesn’t make them feel helpless (Peplau, 1952).  Patient’s
experience is therefore increased by effective communication as patients feel
as though they are in control when making decisions and so feel valued when having
a discussion and having someone listen to them (NICE, 2012). A good body posture can help show that
staffs are listening (Egan 1982, cited in Burnard & Gill 2008). By
listening, Staffs are able to show that they care and are able to offer a
better treatment plain suitable for them in terms of holistic care. In the MOOC
scenario, where a woman was brought into A&E under mental health act
because she had tried to cut herself. Food and drinks (physical care) were
asked but not provided for her as staffs were too busy and the carer
responsible for her had to do an assessment with another patient. The woman
might have felt anxious. A better-quality care can be given by having good
communication which helps the staff to understand their psychological wellbeing
as well as providing her with food and drink can make her feel valued and at


Moreover, Health care profession should be aware of communication
barriers which may be due to the patient’s disability and physical health (Baillie, L. (2017). For example, hearing impairment can
affect the patient’s ability to communicate because information is not being
received by the patient and so communication impacts on care delivery. By
taking this to account, different types of communication should be used to
deliver information and better-quality care (NMC, 2015). This can help to make
patients feel respected, safe and less anxious (RCN, 2015). Moreover, communicating
information such as asking for consent can be difficult when the person lacks
capacity either due to learning disabilities or mental heal issues. In this
case, decisions would be done in their best interest (MCA,


Staffs must keep confidentiality and privacy. This means
protecting patient’s personal health information and ensuring that consent is
asked before information is shared to others (DH, 2003). Article 8 in the (Human rights act, 1998) states
“right to respect for private and family life” meaning patients have right to
privacy and confidentiality of their health information. It is important for
health care professions to protect information and respect patient’s privacy
because it maintains patient’s dignity (RCN 2008, p.8). Dignity can make individual’s feel
confident and in control (RCN, 2008). dignity can be kept by respecting
patient’s privacy for example knocking on door before entering their room or
closing curtains when assisting them with changing clothes (RCN (2008).  The confidentiality code of practice can help
to gain trust from patients which is crucial for safe and effective care (Health
and social care information centre, 2013). Protecting
information can support patients to feel more comfortable talking about their
health problems therefore, health care professions can provide with high
quality care by giving effective treatment to improve their health. Whereas, a
lack of confidentiality may prevent patients from conveying crucial information
(Slowther and Kleinman 2008). It is important for staffs to ask consent from
patients to either disclose information of not which is needed to give care
which helps to empower service users. Example in MOOC scenario, the child’s
thoughts and rights were not taken into account when decision making. There was
no respect for dignity for child as their feelings were neglected. In this
situation, using a child centred approach to understand the child’s needs. Everyone
has the right access to health services regardless of their race, gender,
religion, age or disability. These characteristics are protected under the
equality act. This influences good care because it safeguards individuals from
discrimination and every person is treated fairly for justice (Equality
act,2010). Also linking this to ethical principles the child must have the
right to autonomy. What the medication the child is taking and what the right amount
of dosage should be explained to the parents. In terms of beneficence and
non-maleficence, staffs can prevent harm and help the child by negotiating with
the parent. The parents had disagreed on decreasing dosage so there is concerns
for the child’s harm.