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Good morning. Yes, I know my title is supposed to be Supporting Patients, but I come from the awkward squad of patients - those who like to make up their own titles. And in fact we will learn how to support patients by listening to them.

[Muppet slide]

Here we have a kind of icon of primary care - the kindly doctor, the attentive patient, the concerned carer or friendly nurse. We know which is the patient; he has pyjamas. Very disempowering night-clothes especially when other people are fully dressed. We know who the doctor is. He has a stethoscope and a white coat. What is it about doctors and their stethoscopes? I know a psychiatrist - yes a psychiatrist - who will not leave home without one. We know who the carer is. He's the fluffy one and he's in charge of the patient.

There is some kind of dialogue going on in this picture. In fact everyone seems to be talking. But who is listening?

This picture presents us with a cosy image of healthcare that both patients and professionals like to believe in. It tells us however, what we believe in healthcare is good relationships, communication and that healthcare is about people and communities.

It is those relationships; between individual patients and care professionals; and between health services and the communities they serve that we need to transform.

For many users of the health service their journey through it is uncomfortable, inefficient and uncoordinated. The new structures for primary care and the new links that PCTs create between primary and secondary care and the communities they serve aim to build health services around their users. Listening to users, listening to communities, is essential if those changes are to be effective.

One example; in the South West Peninsula people with suspected heart failure were referred to a cardiologist at outpatients for their echocardiograph. They had to wait four to six months for this appointment. Now their GP is able directly to book an echo-test using a form jointly developed between GPs and cardiologists. The patient knows when their test will be instead of waiting for a distant date in the future. The majority of patients receive their test and have the results in 14 days. Patient experience is vastly improved and better health outcomes too.

Focussing on the patient's experience and the patient's journey and using the patient's experience can help us build new partnerships and improve services.

There are three messages I wish to share with you as we try to create a new patient-centred service.

Trust me I'm a patient

No one has greater interest in an effective health service than patients and the public. Use us as partners, trust our expertise and interest and let us work with you to transform healthcare.

Tell me the truth

Both at individual and community and national level we need more honest and open dialogue. Patients deserve to know and need to know the truth about their condition, about the options open to them. Communities need to know that health economises are acting in the interests of the community. At national level we need a more realistic debate about what the health service does well and what we can realistically ask of it.

And finally

Nothing about us without us

It's our health service. We pay for it. We use it - and sometimes abuse it. But we value it. Bring us inside so we can work together in the interests of all.

I believe that we are at an exciting moment of real change. We are recreating a publicly funded, monopolistic service so that it really serves its users. The values of equity and universality still hold true for patients and the public but in a more consumerist and deferential age we need new structures and new partnerships. This is what the NHS Alliance is working to achieve. I welcome your efforts and on behalf of patients, thank you for your work.