Trust relations in health care: developing a theoretical framework for the "new" NHS

Area of Science:

• Health Services Research
• Sociology of Health
• Health Policy Analysis

Background:

• Public and patient trust in healthcare institutions is influenced by policy and societal shifts.
• The National Health Service (NHS) in the U.K. is undergoing changes impacting trust dynamics.

Purpose of the Study:

• To explore the evolving nature of trust relations within the NHS.
• To present a theoretical framework for future empirical research on healthcare trust.

Main Methods:

• Conceptual analysis of policy initiatives and their impact on trust.
• Examination of factors shaping public and patient trust in U.K. healthcare.

Main Results:

• Policy changes (e.g., clinical governance, patient choice) have altered power dynamics and vulnerabilities between patients, clinicians, and managers.
• A theoretical framework indicates a shift from affect-based to cognition-based trust, with an emphasis on communication and evidence.

Conclusions:

• Policy and societal factors are key drivers of changing trust in healthcare.
• The proposed framework facilitates empirical investigation into new trust relations within the modernized NHS.