Not Demanding Enough?

Interesting to see Ben Page writing about the NHS in the King’s Fund Time to Think Differently slot. In addition to making his usual point that people are more worried about the economy than the NHS, he says:

one of the challenges for the NHS is that expectations of it are in some ways not high enough, and also that patients cling to what they have been used to – ’the status quo’ normative bias. For example, there is very little relationship between standardised mortality rates and patient satisfaction; no matter how likely their hospital is to kill them, patient satisfaction varies relatively little. It is ‘softer’ measures like ‘dignity and respect’ that correlate much more strongly with patient satisfaction.

Steady as she goes

People’s expectations and attitudes remain very steady on the subject of the NHS and this is reflected in their choices – the best hospital is the nearest hospital; doctors and nurses are to be trusted. They make judgements on what they can see and understand – the soft measures that Ben mentions.  More abstract issues at one remove from the daily life experience count for less. Little seems to change although 58% of us are now ready to agree that there should be limits on what is spent on the NHS.

Flash in the Pan?

It may be encouraging in this context to hear of the formation of a political party focusing on the NHS. But they do face a challenge  – do you remember  now what happened in Kidderminster? What about that BBC chap in a white suit?  Q: campaigning vigorously about..? (A. The Hamiltons – that engaging pair)What became of that? People will answer the call to the colours if the campaign looks exciting – but they all hope that the war will be over by Christmas and if it is not, they may go back to their hearths and homes anyway. How to keep it going?

Talking to each other

At a conference the other day on Customer and Consumer Engagement, one of the main points that came out was how many customers were now by-passing organisations to find solutions to their problems and answers to their questions. We have not yet seen much of this user to user communication in the health and social care services. Patient Opinion has only received 45,000 stories in the seven years it has been running. If there is a big national conversation being carried on about the health service between users, where is it happening? The audience at the conference were hungry for advice on how to cope with bewildering amounts of user-generated data to try and keep up with fickle modern customers. They turn to the user forums and trust more the views of their fellow customers than they do the puffs of any corporation. Where are NHS users in all this? Silent, fragmented? Who are they listening to and are they doing it on the web?

The Silence of the Grans

The clue may be in the age breakdown – some BT figures show that this behaviour of turning to fellow users is most pronounced in th age group 35-44 and least evident in the 65+ one – the latter being the heaviest user of health and social care services while being the least turned on to the internet etc. Their sons and daughters may be their proxies but are they the ones who are too busy complaining via channels that they have no time for internet chatter and in any case, in this case fellow users have little in the way of a solution. Fellow users are best mobilised for short sharp battles around withdrawal of service or calamitous care.

Sickening Digital Natives Needed

Patient representation still needs a sustainable model for engagement that provides some continuity of input in sufficient quantity to make it a dependable source of information – must we wait for the internet cohort – the digital natives – to age and sicken before we start getting the volume of comments, views, complaints, compliments, stories that this service at the heart of the  national life – what? – deserves or desires or fears?




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