In November last year I gave a lecture on Patient Experience to District Nurses, Health Visitors and School Nurses who are training at the Leeds Beckett School of Health.
I was lucky enough to be able to develop this in collaboration with the excellent Sarah Neill who heads up patient experience at Sheffield Clinical Commissioning Group.
Here are some of the things that I learnt and some information about a symposium we are planning for the 2nd of March this year.
We need to be clearer about what we mean by patient experience and why it is useful.
Finding out about how people feel about a service they received is generally seen to be a ‘good thing’. In the wider world of e-commerce leaving comments is increasingly understood as being useful. For businesses it can help them improve and promote their products, for customers it helps them avoid a bad service, find good ones and provides a way to ‘give something back’.
Yet, in the world of the NHS the use of patient experience feedback still feels to be inconsistent and its role poorly understood. I think this is for a number of reasons:
Top down
Many of the official or statutory methods for capturing patient experience feel as though they have little relevance to front line provision. In a number of cases this is because the perception is that these measures are really there to assure distant decision makers at the top of organisations or government that they know what is going on. Further, the relatively low number of respondents at a service or GP level can lead front line staff to feel that these are merely the views of an unrepresentative minority.
Resources
Health and care services are under unprecedented demand and have experienced real reductions in funding and a reduction in the rate of growth ever since the austerity imposed by the Coalition Government in 2008. For many clinicians there is a view that there is insufficient time and resource to develop patient experience while they are struggling to provide front line services.
Clinical training
I do think that some clinicians feel (after devoting years to professional training and ongoing CPD) that the reported experience of patients provides little added value to their practice.
The added value of patient experience
Despite the above challenges I think that systematically listening to the experience of patients is really important for the following reasons:
Validation and empowerment
Getting feedback on a specific action can be empowering. Most feedback to the NHS is positive. In the tough times we are experiencing with the pandemic, made worse by the actions of some of the press and government ministers it is so important that front line practitioners get to hear a different and often more positive view from people who actually use their services
Understanding the pressures that people face.
This quote is from a manager in an NHS Care Trust
“Can we look at the more social side of peoples lives – housing, isolation which may be the cause of or at least exacerbate a mental health problem. To understand experience properly do we need to understand it in the context of peoples lives?”
As we move to yet another reorganisation of the NHS one of the key words is integration – if we are to move to an integrated approach to service provision we need people to help us to understand how the social determinants of health impact on their health and there ability to use services.
The two quotes below come from a piece of work that Macmillan initiated to try to better understand what people with cancer were most concerned about.
Advocacy
Many NHS front line staff are working with defined populations of people (parents, a geographic community, people with a specific condition such as HIV or motor neurone disease etc). Understanding how this population collectively experience services and how these fit into the context of their lives can empower clinicians by providing them real stories of their patients. Clinicians can use these to advocate for service improvement and development in their organisations and with colleagues.
Join us!
As part of a wider piece of work Leeds Beckett are collaborating with the Patient Experience Library, with the support of NHS England and NHS Improvement to develop more training and support for people responsible for Engagement and Experience in the NHS and local Health and Care Systems. We are starting this work with a national symposium on the 2nd of March.