toby@fr3domhealth.co.uk
Brighton
Having worked in Health Care related areas for over 20 years Toby is Director of Fr3dom Health, a specialist data capture and reporting business working in the NHS. Providing involvement and survey solutions for patients, staff and the communities they serve, Fr3dom Health is a private company.
Recent activity
Comments (10)
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Comment on: Nurses need freedom to do their jobs properly
Very valid concerns. There is a collective sense of responsibility at ward level for initiatives aimed at quality and service improvement, patient experience and so on. the problem we encounter sometimes is getting past that into personal accountability for outcome (rather than responsibility for action). this seems to me to be a pretty uniform inertia across much of the NHS. Should these advanced nurses be specified differently? With traditionally structured academic routes into medicine it is easy to see how this has come about, but I am not sure Peter proposes a solution. Anyway, certainly thought provoking and it chimes with what we see a lot of the time.
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Comment on: Lansley adviser criticises friends and family test focus
I wonder how Mr Morgan would create “a stable, long-term indicator that can measure improvement in shared decision making”? It is very easy to pick holes in FFT, but I wonder if critics have bothered to investigate how recommendation and satisfaction strategies actually work and where they sit in relation to other quality improvement strategies? Reading most critical comments, they all sound rather similar – usually ending with a rather general comment about an ideal solution. The reality is that all attempts at an ideal solution – that utopian vision of “shared decision making” – have failed to deliver precisely because they have been so “robustly” developed that they miss the real heartbeat of involvement: dialogue. If you place any value in “no decision about me without me” then you should be a very big advocate of a mandated process to encourage all providers to present the opportunity in a timely and consistent manner for you to express your view. I can only assume Mr Morgan does not support this and would rather design a more complex and far reaching model. I wonder, though, how a “shared decision making” initiative would work where the patients view is restricted to a sample who are acceptable while the majority are systemically excluded from having their voice heard? I recently saw a poster in a London trust that read “your opinion matters”, or words to that effect. When I asked how I should leave my feedback I was told that they dished out surveys on a Tuesday. Are we then to assume that they don’t care about the views of patients on other days of the week? Patient experience is the bedrock of patient and public involvement. Kick this census based approach into the long grass if you want – but how will you replace it? if you want involvement in decision making for individuals and collectives, you can’t really side step the fact that you need to create the same opportunity for all, and that means ensuring that all of us feel engaged before we can become involved. That is one of the areas that the FFT has it right – there are actually many others if critics did a bit more homework.
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Comment on: Restrict friends and family test to hospitals, says DH
page 81!
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Comment on: Restrict friends and family test to hospitals, says DH
I think there is a role for GPs in FFT but it may not be as most view it. We published this last week http://issuu.com/maritimemedia/docs/innovation-healthcare-vol5?mode=embed&layout=http%3A//skin.issuu.com/v/light/layout.xml and it suggests there is a productive role for primary care. The reality is, unsurprisingly, that done well FFT is not automatically expensive and can be highly effective. If implemented poorly it will not be effective and is likely to be poor value for money, whatever the cost. the real issue is going to be how the service uses the information to facilitate improvement and as yet this has received little or no coverage.
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Comment on: Doubts raised over friends and family test
It is great to see so many people talking about this. I feel that a really important point to bear in mind is that while FFT is going to become a very useful indicator of how well organisations actually behave, it is at the start of its journey. I understand some of the comments about certain statistical concerns as well as acknowledging there will be challenges in implementation, but to focus on these exclusively is to avoid a core benefit of FFT. Make no mistake, 15% minimum sample of all patients per year is a serious undertaking for any trust or organisation. Because of the census approach FFT demands, it will not be possible to get it right without the involvement of staff, patients, in fact all stakeholders. This is fundamentally different from most survey-driven patient experience activity we’ve seen in the last few years – and we’ve seen a lot of small base sizes and differing modes of collection all over country. FFT cannot replace all the other tools and approaches which can dive deeper into the patient experience. But, it will ensure that many more people are aware of their right to express their views and the fact that the NHS is facilitating this. Part of the thrust behind FFT is to try and create a more communicative and open dialogue between all of us. If you spend just a couple of minutes a week talking about why your score is what it is, I’m prepared to bet it would be two minutes more than most people currently spend on the subject of their patients’ views. With the discussion will come greater understanding and involvement. As one poster has correctly pointed out here, when this all gets started, what counts is what to do with the information that’s collected. And, that is whole new discussion that will be all together more meaningful because of FFT. In fact, would there even be a discussion without it?
