1. ‘Right-touch trust’: thoughts on trust in healthcare Peters and Bilton (Forthcoming)
Samantha Peters Chief Executive and Registrar
General Optical Council

2. Picture yourself here:
Who or what do you trust?
"Harry Potter and the Deathly Hallows 27 – Death in the Forest" by Jared If only I remembered…. is licensed under CC BY 2.0

3. Trust dimensions in healthcare
Trust is shaped by perceptions of ability, benevolence or integrity (Mayer et al. 1995, Schoorman et al. 2007).
In healthcare trust is located in individual professionals or organisations; teams, groups or types of individuals; wider institutions or systems (Hall et al. 2001, Rose et al. 2004).
Patient trust in individual professionals is strong (Kao et al. 1998, Hall et al. 2001, Calnan and Sanford 2004, Calnan and Rowe 2004, Zhao et al. 2016).
Personal relationships are rooted in impersonal contexts which also promulgate trusting behaviour.
General Optical Council

4. So, why trust Snape? Trust can be transferred
"Harry Potter and the Deathly Hallows 25 – The Death of Severus Snape" by Jared If only I remembered…. is licensed under CC BY 2.0

5. How trust helps or hinders care
Increases access and continuity
Encourages acceptance of diagnosis, and adherence to treatment
Builds effective relationships
Enhances patient efficacy
Decreases monitoring
Encourages passivity and discourages verification
Evidence of untrustworthiness is discounted
Exploitation is perceived more slowly
20/07/2018
General Optical Council

6. How distrust helps or hinders
Increases monitoring
Encourages healthy scepticism and verification
Evidence of untrustworthiness is taken account of
Exploitation is perceived more quickly
Decreases access and continuity
Discourages acceptance and adherence
Undermines effectiveness of relationship
Impairs patients’ personal efficacy
20/07/2018
General Optical Council

7. What about risks to care?
“What’s life without a little risk?” Sirius Black
20/07/2018
General Optical Council

8. What about risks to care?
Right-touch regulation doesn’t suggest all risk can be removed, but a proportionate approach to risk.
Healthcare contexts inspire high levels of trust and low levels of distrust.
Both can be founded or unfounded, creating risk.
Appropriate levels of trust must be balanced with appropriate levels of distrust.
Must protect people from a (too-high) propensity to trust or a (too low) propensity to distrust.
20/07/2018
General Optical Council

9. What might we think about this?
Trust is a critical component for effective healthcare.
Professionals’ capacity to build trust is as (if not more) important than technical skill?
Trusted professionals could be much wider health enablers.
Does that change our role; do we see it as building trust, ensuring trustworthiness, or both?
20/07/2018
General Optical Council