'Patient engagement has flatlined'

The Picker Institute Europe said results from five years of patient surveys showed the 'rhetoric of patient-centredness has a hollow core'.

And the Health Foundation said there was a mismatch between government and patients' priorities, which needs immediate attention.

The Picker Institute, a national co-ordinator for the annual patient survey, raised concerns over the lack of progress on giving patients a greater say in their care.

In Is the NHS Becoming More Patient-Centred? it reports that the number of patients who said they were closely enough involved in decisions on their care has fluctuated by only 1 per cent from 2002-06.

It says: 'If the service as a whole was really moving in a more patient-centred direction, we would have expected to see improvements over time.'

Patients rated highly the quality of care they received, waiting times and trust in health professionals.

Picker Institute chief executive Angela Coulter said: 'Despite positive read-outs in many areas of care, patient engagement in decisions has flatlined.

'It means the rhetoric of patient-centredness has a hollow core,' she said. 'This represents a continually missed opportunity for a win-win-win.'

The report raises concerns over survey findings, which show patients' satisfaction with their involvement in their care fell by 4 per cent.

And it shows a 'worrying deterioration' in the availability of hospital staff, with 22 per cent of patients in 2006 not being able to find a member of staff to discuss concerns with, up 5 per cent from 2002.

It says: 'Patients in all surveys say they are not involved in decisions as much as they want to be, and support for self-care is weak. The "doctor/nurse knows best" culture is still alive and kicking.'

The Health Foundation report, which looked at the national surveys and other studies, said patient engagement had improved.

But the government was still not listening enough to what patients want, it says. 'There appears to be a mismatch between what the public and patients say are priorities for quality and what the government has chosen as being most important in policy initiatives.'

Ministers should take greater consideration of information given to patients, how they are communicated with, stronger shared decision-making and how close services are to patients and safety.

Mark Duman, chief executive of the Patient Information Forum, which represents information producers and providers including the Healthcare Foundation, said greater learning between NHS organisations was now vital to making improvements.

'There are places where they have got award-winning patient and public engagement, but no-one seems to emulate that,' he said.