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A couple of weeks ago I went to the door to collect the post, there was the usual mixture of junk mail and bills, but was there was something that looked like a card.

My internal thought processes went into overdrive trying to figure why in the middle of lockdown I would get a card? it wasn’t my birthday ?, there was no other celebration, I hadn’t been anywhere or done anything so it couldn’t be a thank you card and it was lockdown so no one would be sending an invitation as there was nothing going on. The internal questions seemed to last for the longest time but then I bent down and picked up the post.

In my work role I support the Heads of Patient Experience  who work in healthcare across the country. At the start of the pandemic the sudden lockdown and the preparations to protect the NHS, things changed for heads of patient experience; many felt like their day to day job had disappeared, the friends and family test was suspended, many of the national surveys were paused and complaints were suspended. Everyone’s focus was on the response to the pandemic.

Heads of patient experience soon refocused and started getting new processes in place to support people being admitted with the virus and all of the efforts were focused on supporting people in hospital who were no longer able to have visits. Quickly the network in the spirit of reciprocity shared their newly developed standard operating procedures, for messages to loved ones, connected hearts, virtual visiting, infection control, family liaison services, and bereavement services.  They all worked together to design, refine and implement new and innovative ways to put the person and their family at the centre of the patient experience work.

We often talk about what matters to me and what mattered to people was keeping touch with loved ones given the visiting restrictions. This was especially important for people who were approaching the end of their life, that where the connected hearts, pebbles and other symbols were used to create a connection across the distance.

That’s where the messages and letters to loved one came in, families would send a message via e mail along with photos, and the onsite team would transpose that message and photos onto a headed sheet of paper with logos and motifs. It would be laminated and then delivered to the patient. Everyone involved, the person sending the message, the person laminating it, the person delivering it and the patient all got a warm and fuzzy feeling of comfort and security from the process.


There was one particular day when reflecting on the changes the pandemic had bought to the world of experience of care; I was questioning the letters to loved ones.  There was part of me which got the reasons  why messages to loved ones were important, but then there was the process side of me thinking why would you bother to send an email, let someone transpose and laminate it and get it delivered to the ward, when its seems should a retrograde process. Especially when most people have a smart phone and/or tablet and surely it would make more sense to just send the message and photos by e mail, text, messenger functions or just have a video call. It all felt like it was labour intensive, backwards and a lot of effort.

But then I got the card through the letterbox, the one where I couldn’t figure out where it had come from.

When I finally opened the card, the front cover was awash with beautiful purple flowers and the words inside were written in purple pen; it was a feast of purpleness. Purple is an important colour for me.

I read the card and tears welled in my eyes.

The card was from my friend Maria, who I had spoken to on the phone a few days before. I had explained how this time of year was difficult for me because it was the period six years ago when Seth got his terminal late stage pancreatic diagnosis. I explained how because of taking the time to write down our 33 day journey and the subsequent letters that formed the basis of the play, the film and the educational resource that became Seth’s Story, the memories at this time of year were particularly acute, crystal clear, extremely painful and so hard to remove from the forefront of my mind.

Maria had reflected on our conversation and written the most beautiful and thoughtful card that summarized our phone conversation. The act of kindness and connection was in the reflections she bought to the card and it was very touching.

That was the moment that the messages to loved ones became clear. As a process it was a backwards step but its effect was transformational.

I know from experience that the person who is ill will often during phone calls, via text and video calls, say that they are ok when they really aren’t, they just don’t want to worry their loved ones. The loved ones contacting the patient, often on calls and texts are focused on finding out how their loved one feels, what procedures will be happening today, are the test results in? The use of technology makes the contact transactional not relational.

We know that what matters to people is the very human emotion of connection and love. What the letters to loved ones do is give the recipient time and space to reflect on what matters to them, the personal messages fill the gap that the no visiting policy leaves so gapingly open.

It got me to think of applying a new test to everything we do in patient experience and it’s called the Maria Test.

Maybe if the work we are doing doesn’t hit the relational aspects that are fundamental to us all as human beings …. Maybe we shouldn’t do it…. It’s just a thought that maybe we should explore more as we emerge into a new normal. Who is up for exploring the Maria Test with me?