Patient experience letdown

The NHS has published its “Patient Experience Framework”.  Do we need one of these?  That’s the question the Kings’s Fund’s Jocelyn Cornwell poses in her blog.  Yes we do, is our answer – but not this one.  Here’s why. Patient experience is becoming like governance – the more the NHS talks about it and generates frameworks, principles and guides, the less it seems to really understand it or be able to apply it.

The latest NHS framework is no doubt very well intended, but reading through it I could not help but react (badly) to its rather twee and patronising tone. What do patients and carers want?  It isn’t rocket science.  Just look at “The Patients’ Dozen”  list that David Gilbert of InHealth Associates has put together (December 2011) for a direct and simple framework about quality and the patient experience that is easy to remember and to apply.

Where’s the leadership dimension? 

The other key thing the NHS patient experience framework lacks, is the patient leadership dimension. Patients and carers can become resources, assets and advisors about care quality and not just passive recipients of well directed care from others. Patient leadership will be the X-factor which  will change the way care is delivered and experienced.  Providers in particular have to understand that.  That’s what “nothing about me without me really means.”

NICE complaints anyone? 

NICE has also lept into the patient experience arena with its new  patient experience quality standard for  NHS adult care.  The 14 domains have good things to say about shared decision making and continuity of care, but there’s something big missing.  I could find nothing about what should happen when things go wrong and how users and carers should be told how to say “I don’t like it”.  It happens, even under the best conditions – and many are far from that –  and we should not pretend otherwise.

The words “complain” and “complaints” don’t occur in the 20+ pages of NICE text.  It won’t do.

The NHS has to get better about complaints – the Ombudsman’s reports  repeat this endlessly as we clock up £ms on payouts and litigation.costs.  Just reflect on this: during 2010-11 the NHS Litigation Authority paid out £257m in legal costs relating to clinical negligence claims  – a 58% increase on the previous year’s figure of £163m.  Lawyers are the biggest beneficiaries of this escalation.   In total 5,398 clinical negligence claims closed with a damages payment in 2011.

That is a shocking indictment of quality failures and a complete waste of public resources.   We do not see this getting better any time soon.

The Moore Adamson Craig Partnership supports user and public participation,  trains lay representatives and develops responsive  health, care and education organisations.  We are ready to work with and support all those who want to make sense and a success of the new structures of patient and public engagement within the new arrangements for health and social care commissioning and providing.  Feel free to contact us to discuss the opportunities.


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