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The survival of the NHS depends on the extent to which it can improve
responsiveness to patients' needs and wishes. Appropriateness and
outcome of care can be improved by engaging patients in treatment and
management decisions and this would also improve safety and reduce
complaints and litigation. Regular, systematic
feedback from patients is essential to improve care and accountability. Coulter (p 648) discusses how the recommendation of the Bristol inquiry
that "patients must be at the centre of the NHS and must be treated
as partners by health professionals" can be turned into reality.