Boards must make decisions with patients, not for them

There is almost universal agreement in the NHS that involving patients and the community in designing and delivering their care is a good thing. 

After all, what would be the point of working hard to improve a service if the result doesn’t make things better in the way patients actually want?

At NHS Improvement we have seen trusts up and down the country listen to patients and work alongside them, their families and communities to make sure they get it right.

East London Foundation Trust, recently rated outstanding by the Care Quality Commission, is just one example of a trust that has worked hard to ensure patients lead in designing their own care plans.

But with the ever increasing demands on NHS services, it is even more crucial that we keep this momentum going.

We have to be careful that as we get busier, patient experience does not become an optional extra, something that can be dropped when budgets are tight. We can prevent this risk by sharing our experiences of how those we serve have helped us transform services for the better.

Trust boards need to continue to work on understanding the implications of their decisions from top to bottom, and show how involving the public has influenced those decisions and improved care

We want boards to continue making the case for patient and community involvement because dismissing it as an additional expense will, ultimately, cost their trusts more in the long term.

Often it isn’t just care that can be improved. Money can be saved by tuning into common-sense practical suggestions from patients that wouldn’t necessarily be spotted by clinicians or managers.

For example, one acute trust worked with local partners to install signs at the nearby railway station and include bus route information on appointment letters to help patients plan their journey and avoid getting lost. This reduced the number of missed appointments.

Simple patient insights like this can save significant money in the short and long term.

We want to work with trusts and learn from their experiences so we can create a vision together of how they can involve patients and local people.

We also want to ensure vital learning from foundation trusts’ work with their members feeds into the process, which is why I was keen to speak at Membership Engagement Services (MES) recent conference ‘Challenge 2020’, describing the benefits of involving members in helping the NHS achieve a new vision of co-created services.

Patient-centred services already exist, but let’s build on them and support each other to deliver excellent care

Over the last 10 years, many trusts have shown how genuine involvement of local people can transform and improve services as well as save money. For example, King’s College Hospital Foundation Trust has improved cancer and maternity services after consulting members and others.

By using patient consultations such as these, trusts can focus investment in areas they know will improve patient experience. 

Trust boards need to continue to work on understanding the implications of their decisions from top to bottom, and show how involving the public has influenced those decisions and improved care.

I believe the ‘perfect patient experience’ goal, pioneered by Virginia Mason Hospital in the US, is achievable in the NHS. What other service industry looks at money and ways to save it without focusing on its service users first and foremost?

For instance, you will only find out if moving maternity services would remove access for a significant community of mothers, due to lack of reliable public transport, by talking to them.

Patient-centred services already exist, but let’s build on them and support each other to deliver excellent care.

Julia Holding is head of patient experience with NHS Improvement