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About the Sweeney Programme

  1. What is the Sweeney Programme?
  2. Why ‘Sweeney’: the story of Kieran Sweeney
  3. Differences between Sweeney and other improvement programmes
  4. Who is the Sweeney Programme for?

What is the Sweeney Programme?

The Sweeney Programme enables staff to step into patients’ shoes and see care through their eyes. Using tried, tested and effective tools and experiential techniques, the programme helps staff get as close to experiencing the patient’s journey as possible.

No one can imagine the unimaginable except those, like me, who are experiencing it.”

Kieran Sweeney

The programme is born out of the belief that relational aspects of care are as important as the technical clinical aspects, but that these aspects often get neglected. Whilst healthcare staff are motivated to care, it takes conscious and sustained effort to understand the patient’s experience and consider their fears, vulnerabilities and needs as an individual. Staff can only consider what matters most to the patient, and then change their actions accordingly, if they are given the space, time, and resources to understand the patient’s perspective.

The programme is grounded in three core beliefs:

  • That staff are highly motivated by the desire to provide good care
  • That patients are the people who know what good care feels like
  • That staff need a structured process and effective tools to improve patients’ experience

The training changes mind-sets and leaves staff and patients equipped to continue to adapt and improve their services.

The programme builds the capacity of staff in frontline teams to drive sustainable, bottom-up change in their services using insights into patients’ experience of care and uses techniques such as patient shadowing and filmed patient interviews to help staff to question their own routines and practices and see them in a new light.

What participants gain from the programme:

  • Structured training in patient-centred service design techniques that staff will come back to again and again
  • Collaborative learning events to create space for teams to work together and learn from others
  • Tailored teaching from our expert faculty of clinical leaders and experts in QI, including service users
  • On-site and off-site training and distance learning
  • Written, video and audio materials to support learning
  • Ongoing coaching and mentoring from accredited personal development coaches

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Why ‘Sweeney’: the story of Kieran Sweeney

The programme is named in honour of Kieran Sweeney (1951-2009). As a mesothelioma patient, Kieran wrote about his experiences, urgently calling for healthcare staff to improve the relational aspects of their care by considering the patient’s perspective and making changes accordingly.

Kieran was a General Practitioner and medical scholar who wrote in depth about the need for a compassion-based understanding of medicine. Having degrees in both medicine and the arts, he endorsed a holistic approach which embraced the full range of human needs, recognising that patients need relational care as well as clinical care.

In his 2009 BMJ article ‘Mesothelioma’, Kieran wrote about the care that he received. He did not fault the clinical care – ‘the transactions have been timely and technically impeccable’ – but he felt that staff fell short when it came to ‘relational aspects’, displaying a ‘hesitation to be brave’. Kieran described his fears, anxieties, and the confusion that he felt, and how the actions of staff often, perhaps inadvertently, only worsened this.

I think there may have been something about me being a doctor, and being in my late fifties, most of the consultants were in their late fifties or fifties, our kids would be the same age… they weren’t brave enough to say “this is really bad news for you”. Maybe they hid behind the science…to avoid confronting [that] I am a man devoid of hope.”

Kieran Sweeney

Yet Kieran believed that it was possible for staff to change the way in which they interact with patients if they consciously consider the patient’s experience: “one’s journey to this bleak place can be rendered more bearable if everyone who shares a professional role at the various staging posts bears the bleakness of the terminus in mind.” He called for staff to be braver; to be bold enough to question their own actions by considering how they might be seen through the patient’s eyes.

The Sweeney Programme does exactly this, enabling staff to step back and consider the care pathway from a whole other perspective – that of the patient and their family – and make changes based on this understanding. We believe, like Kieran, that staff can act differently if they only ‘bear in mind’ what the patient is experiencing, but we recognise that staff must be given support if this perspective is to remain fresh. This programme gives staff the time and the tools to make Kieran’s vision for healthcare a reality.

Differences between Sweeney and other improvement programmes

Traditional improvement programmes often begin with goals established by professionals who have a clear sense of what needs to be improved. The Sweeney programme supports teams to take a step back, view care from patients’ eyes, and ask the right questions to seek insight into how care is experienced by patients and families.  The improvement goals relate to the expressed needs of patients.
Traditional improvement programmes often draw on techniques from manufacturing or industry. These approaches can be very useful in streamlining processes and eliminating waste.…. The Sweeney programme recognises that all patients are vulnerable and that care is at its best when staff acknowledge their patients’ individuality and the importance of relational aspects of care.
Traditional improvement programmes are often directed from the top down and focus primarily on achieving organisational goals The Sweeney programme recognises the intrinsic motivation of front line staff to deliver excellent care, and understands the unique perspective of staff to know how to tackle the issues they see
Traditional approaches to improvement such as clinical audits are often applied by staff from single disciplines. The Sweeney programme works with multi-disciplinary teams, recognising the impact of team-working on both staff and patients’ experience. It builds strong bonds between team members. It recognises the impact every member of the team on the patients’ experience. For staff who don’t work directly with patients, it adds greater meaning to their work.
Traditional improvement programmes often assume problems and often apply standard processes widely without understanding the local context. The Sweeney programme recognises that there are important social and contextual aspects of care that also need to be paid attention to. This means solutions are determined locally, by staff working closely with patients.


Who is the Sweeney Programme for?

We have worked with teams from a broad range of settings in the past, including end of life care, paediatrics, mental health, learning disabilities, A&E, and maternity.

The project leaders that we have worked with in the past have also come from a wide range of clinical and professional backgrounds; we advocate bottom-up change and therefore welcome applications from staff at all levels of the system, from junior doctors to ward sisters. Our experience has shown that the most successful teams are those who are committed to the programme rather than those who have had it imposed from above.

The approach is team-based and so can be valuable and add meaning to a range of staff, even for those whose role is not patient-facing.

To see a full list of organisations who have done the programme see this interactive map.