Lord Darzi published High Quality Care for All in 2008 which looked at workers and patients experience of the NHS. A key part of High Quality of Care is ensuring that patients are treated with compassion and respect and in a safe and well managed area. The NHS relies on its staff to deliver this. Staff need to be competent, to have the skills, knowledge they need to do the job, as well as sticking to the values of the NHS and patient centered care. A key skill for health workers is reliability which is very important in a patient centred care, particularly as much of the work in hospitals works on the basis of shifts.

So turning up late or not at all not only impacts on the patient who can not then be seen and then has a negative view of the service, but on other colleagues who are not able to finish their shift on time. Reliability means not only turning up on time, but carrying out the various tasks on time, so that patients do not have to wait longer than necessary because too much time has been spent with the previous patient, or do not feel as though they are being hurried along so the health care can get back on schedule and deal with other tasks.

Making patients wait means they become irritated, and feel that their time is not really appreciated, while hurrying them along means that they could forget to mention something that is relevant to their treatment or they feel that they are not being treated as an individual. Interpersonal skills are vital for a health care worker. They need to be able to communicate with a wide range of people and be aware of non verbal communication - a patients attitude, their stance to ensure that important things are not missed out that could be relevant to the patient's treatment.

They also need to be able to put the patient at ease, to get them to feel comfortable and confident in discussing their treatment, and raise any of their concerns and feel that they are being listened to and addressed. If this is not done than the patient may be worried, and may not fully participate in their treatment. They might fear side effects of the medicine that they have been prescribed or think that the exercises they have been told to do will make their injury worse and not do them.

At the same time as being empathetic health care workers need to maintain a professional distance so that they can properly asses the patient and not get drawn into a too intimate relationship which could mean that they miss things, or end up by causing problems to the health service, if the patient insists they will only talk to that healthcare worker. They will also need to be able to maintain that distance to ensure that they are able to convey difficult or uncomfortable messages to the patient, who might not want to take responsibility for their health and the need to follow through on exercises or medicines that have been prescribed.

Healthcare workers rarely work alone; they work as part of a team, and so must be able to work with a range of other people from doctors, to nurses and other specialist healthcare workers. They will also need to draw on their interpersonal skills and have to work with people that they might not personally like, or with a patient that they do not like. At times like that they need to remain professional, and look to the good of the patient, and what they as a team are trying to achieve.

Team work means that they need to be able to share what they know about a patient with others and make sure that the information is relevant and accurate, and not think that what they do is the only way to treat a patient and others work is less important. At times they will need to change what they do to fit in with other treatments like physiotherapy or particular medications. They might also need to step back and let others lead on treatment, but keep a close eye on the patient and ensure that the treatment is meeting their needs and helping them to live a better life.

So there might be times when they have to disagree about a treatment or push their view forward. Team work can be quite difficult and often needs to be carefully coordinated to ensure that the patient is not overwhelmed by the different people he/she has to see and to ensure that other members of the team are aware of what each member is doing in relation to the patient so that do not cut across each other. Taking responsibility for themselves and for others is also very important.

With patient centred care they need to realise that if they see something that is wrong or has not been done, they need to high light this and not just leave it for someone else to pick up. If left it might not get picked up and could result in an injury if a spillage is not cleaned up, or a patient receiving the wrong treatment. It also means that health workers need to take responsibility for keeping up their skills and ensuring that they are up to date.

Or asking if they do not know something even if they think it will make them look stupid, and of possibly having to do or say uncomfortable things such as reporting a colleague who has not done what they were supposed to do, or turned up late, or was unable to carry out their tasks competently. An anti discrimination approach is key to ensuring that patients get quality care.

Recognising that people have different beliefs and different preferences and honouring those where possible. So some women may feel more comfortable being dealt with by a female health worker if there are cultural sensitivities around talking to men. It is also important not to label or stereotype staff or patients and assume that just because they have blond hair for example that they are stupid, and talk to them very slowly and use simple words as this will offend them.

At times it will be hard as there could be patients who are awkward and bad tempered and the health care worker will need to be professional in how they deal with them, rather than retaliating by making them wait longer or trying to pass them off to another care worker. Also need to recognise that people bring different skills to a job and that just because they differ from theirs does not mean that they are not useful, and that there are different ways to approach things and another's way of approaching something may be just as valid as theirs.