Presentation by Emeritus Professor John Cox at the Institute of Health Visiting Regional Professional Conferences 2015. John Cox is Professor Emeritus, Keele University; Past President Marcé Society and former President Royal College of Psychiatrists and Secretary General World Psychiatric Association (2002 - 2008).

1. Quality standards for the provision
of humanistic health care and
Person Centred Medicine in the NHS
(England)
Perinatal Psychiatry may have the
key
John Cox

2. Institute of Health Visiting
professional conference
Reengagement of
Health Visitors

3. Personal

4. Second edition of the EPDS Manual
Cox Holden and Henshaw 2014 - and six
other publications.
Time to reflect on the Francis Enquiry and
the missing culture of care
Reengagement with the affairs of my
native country
Time to search for new models of health
care that will enable a true Medicine de la
Personne.

7. Prologue/Conclusions
• Three Titles for my talk!!!
• Marce Society is the place where we wish to present
our new ideas and research - to try them out . ( see my
interview with Kathy Wisner in 2009)
• That was so In California when I made the first
presentation on the EPDS in 1986. It remains so today.
• Perinatal Psychiatry shows the way in a health service
that is hungry for new integrative models of care.

8. The Health Visitors in my life
• Column in The Health Visitor Journal in which
answered the question
• ‘how can a man know about Postnatal
Depression’

9. Health Visitor Pioneers
• Some known to me:
• Eunice Sendagire (Uganda)
• Jeni Holden ( Scotland )
• Jane Hanley ( Wales)
• Cheryll Adams ( England )
• Asha Day

11. Francis report sequelae
• Total System failure.
• 290 recommendations
• Where is/ was Person centered Care?
• What are the roots of compassion?

12. Need for greater conceptual clarity to
respond adequately to Francis.
• What is a Person?
• What is caring?
• What is compassionate empathy?
• What can replace the worn out and inaccurate
splitting between Biomedical physicalism and
a Bio- psychosocial model of George Engel?

13. Philosophy
• Martin Buber: What is a tree? The dialogue
• Merlau- Ponty: human beings who are
embodied.
• Jaspers: subjective symptoms grasped by
empathy.
• van Staden: Person is primary in relation to its
constituent parts- biology, psychology and
sociology

14. Psychology
• Inter-subjectivity (Trevarthen)
• Bowlby-attachment.
• Rogers: Person Centered
• Balint: Joan Raphael Leff: Psycho-dynamic
insights

15. Theology and religious tradition of
Compassion
• The Good Samaritan ( Luke Chapter 10)
• The Desert Fathers .Spiritual Direction (Atwell
and Fulford). The journey.
• Relationship based healings: Mindfulness,
Koranic healing, corpotate prayer

16. Sociology
• Kin ( Campling)
• Neighbourliness ( Montgomery).
• Therapeutic Communities: the lost skills of the
Large and Small Group

17. The interpersonal dimension is missing
: what to do?
• Broaden our paradigms and models for research
and clinical work eg a Body Mind Spirit Paradigm
• Update Engel’s Bio –psychosocial model
• Implement the BPSI – the Bio – psychosocial
Interpersonal model for health care delivery

18. Practical Action
• Organise Schwartz Rounds
• Continue Balint Groups
• Teach Subjectivity (Yakeley et al)
• Advocate a Collaborative Economy
• Marshall interdisciplinary advocacy
• With parents and Carers change the culture
• Implement Music Therapy

19. Expect Commissioners to Implement
four core interpersonal Standards into
NHS contracts- AND into the Centre for
Quality Improvements Standards (CQI)
(Cox and Gray 2015.)
(1) State how you will cherish and support all
your staff to provide a humanistic Person Centred
Medicine and Person Centred Care.

20. 2) Indicate how you will provide regular
supervision from experienced mentors for
all your staff - including general managers.
3) Give details of the educational
curriculum and teaching methods you will
use to train staff in the principles and
practice of Person Centred Medicine and
People Centred Care (e.g. Balint Groups,
Listening Skills and Compassion focused
courses).

21. 4) Indicate how you will identify role models
for the provision of Compassionate Health
Care, and how you will implement a culture
of Intelligent Kindness.

22. Conclusions
Perinatal mental health services can
show the way.
We are fundamentally a relationship
based interpersonal mental health
service .
We hold the key for the whole of
medicine.
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