October 2nd 2019
3 Minute Read
In his best-selling book ‘This is Going to Hurt’ author and former junior doctor Adam Kay delivers an eye-opening insight into how the National Health Service operates in the United Kingdom.
Not surprisingly the book has topped the charts with its ability to both make you laugh out loud and cry when detailing his experiences.
Yet one section caught the eye.
In a note on page 45, Adam writes of “something very unsatisfying about house-officer jobs was the way you never found out the end of the story”. “Extreme nosiness aside, it always felt like it might have been useful to find out if our management plans were any use,” he adds.
Perhaps it is because of the ‘clinical’ nature of the job that doctors are never expected to get too involved with their patients. But imagine the power to this NHS employee if he knew how his patients feel about their experience.
All of a sudden he would have a direct insight into what was working and what could be improved. Yet when was the last time your doctor asked you how you feel beyond trying to establish a diagnosis?
We’re not talking about in the course of establishing a diagnosis, but how you feel about the service you received?
As a country, the UK spent £191.7bn on NHS services in 2016/17 and by 2020 spending is likely to account for 7% of UK GDP.
So given the enormous sums spent, you would be right in thinking that there is a lot of interest in patient feedback about the services, both to deliver improvements in services and to give assurances about quality.
In fact, the NHS England website states:
“We believe it is important to hear patients’ views on services they have received.”
“The information we gather is key to helping people working in the NHS to make improvements where necessary. Positive feedback helps too because it provides a morale boost for hard-working NHS staff.”
In short, there is a lot of number crunching going on to establish data on the patient experience.
Typically, they will ask for patient experiences on the following:
- Access to the service and waiting times
- Whether they received safe high-quality coordinated care
- Were they well informed and offered choices
- How they could build closer relationships
- Whether its a clean, friendly and comfortable place to be
A lot of questions. But none that directly help managers organise clinicians’ time more effectively to improve care pathways.
Most confusingly, there is a myriad of ways patients can leave feedback about services. They can do it either nationally or locally such as the Friends and Family Test, posting online on the NHS website, or taking part in a patient survey.
Mixed results with Net Promoter Score
The health service has had mixed results with feedback. In fact, NHS England announced it would no longer use Net Promoter Score (NPS) in 2014. This was after publishing national results for the Staff Friends and Family Test after a Care Quality Commission report concluded that:
“Interviewees reacted badly to the concept of ‘recommendation’, particularly in the mental health setting, and a number of interviewees misunderstood what the question was asking.”
According to a British Medical Journal study hospital board of directors also struggle to make the most of patient feedback to explicitly monitor or assure the quality of care.
But with growing calls to modernise services through more patient-led care, understanding patient happiness with services and acting on it is going to be crucial.
Happier patients mean better services
A blog written by Niamh Coghlan on the NHS Innovators website hits the nail on the head.
“Putting patients back at the heart of what the NHS does, can seem altruistic but… happier patients means better services which means better savings. It, of course, results in a win for all involved”
The NHS is a monolithic organisation and, like many large entities, has generated hugely complex processes and procedures as a result.
But imagine the insight the NHS would gain by just asking their patients how they feel. One question, many answers and unlimited insight for a sector that revolves around making its patients happy and healthy.