Joan Saddler on patient centred services

If we want quality to be at the heart of the NHS then we need to place the views of patients there too. Patient feedback should never be seen as some backroom activity. Instead we have to embrace it in GP surgeries and on hospital wards and use it to drive up the quality of services we provide.

I have seen what is possible. I have just spent a couple of days talking to patients and staff in hospitals that are leading the way in using patient feedback to provide better care.

Homerton University Hospital foundation trust in London uses electronic surveys on wards so that patients can provide instant feedback. The results - on subjects like privacy and staff attitude - are displayed with any agreed actions for improvement.

This is just one example of using patient feedback in innovative ways. Yet it is far from the norm.

I have never met a health service professional who disagrees with the idea of involving patients. But many struggle to understand just how important it is to meet the expectations that the public, that is tax payers, have of us.

As consumers, we demand services that understand and respond to our individual needs. In the public’s mind, the NHS is no different. They pay their taxes and in return they want an NHS that gets the basics right, that fits services around their lives, that treats them as an individual and not just a set of symptoms, and that works with them as equal partners.

We are starting to meet these expectations. Every week, I see services getting better at finding out, understanding and learning from people’s experiences in order to improve care. But we have to go further. This needs to become part of the health service’s DNA.

At a national level, the importance of listening, understanding and responding to patients is woven into the fabric of NHS reform. World class commissioning requires primary care trusts to show how they have engaged with communities and how they are using their feedback to shape decisions.

High Quality Care for All has made patient experience one of the three measures of service quality. The NHS constitution will raise awareness of the rights that patients and communities have in determining their own care.

There are further developments in the pipeline, such as a new statement of involvement, which trusts will publish each year to show how they have used the views of patients to improve their work.

The main task for government is to help the NHS - on the front line and in the boardroom - to learn from those already leading the charge.

The NHS gathers a vast amount of information through surveys, complaints and many other ways. One service I know of received a complaint from a woman whose mother had died, about the way that staff had communicated with her family. Not only did the manager resolve the specific complaint, they asked the woman to share her experiences in staff training. They try to learn as much as possible from every bit of feedback.

NHS Bradford and Airedale has developed a database to capture what people say about the PCT’s services. Patients are encouraged to share their experiences and the system then analyses each story, tags it as positive, negative or neutral and files it under one of five quality indicators. The results are used with other data to track patient perceptions and identify where improvements can be made.

NHS Hampshire asked local patients to identify the aspects of hospital care that they were most concerned about. Seven themes emerged, which were developed by the PCT into improvement targets. These were then written into the quality schedule of the contract for acute services.

These are just three examples of how the NHS is using the experience of patients to improve the quality of care. But the information we collect is not always used effectively. We need to spread the word of our successes and encourage others to follow suit. The Department of Health’s Understanding What Matters: a guide to using patient feedback to transform care is just the start of a process to do this.

The DH also has the empowerment programme, which will help raise awareness among people and communities about how they can influence their own healthcare and local services. The promotion of the NHS constitution and local involvement networks will play an important part in this.

The DH’s accountability programme will help the NHS to better engage with and respond to local communities. It is helping commissioners involve people in the planning and delivery of care and strengthen the scrutiny of local services.

We must all play our part, from chief executives to front-line staff.