Some thoughts on patient feedback...

I'm sure that by now there have been about a million or so blogs written about the Francis report...and rightly so.  This blog isn't about the report per se, more a nod to certain parts of it.

(I think its also important to add given the heightened concerns currently in regard to the NHS that none of my comments below are reflective of my witnessing poor / bad practice, more observations based on a number of years experience working in the NHS as well as my experiences as a service user / visitor; my over-whelming feeling is that the NHS and its staff do a superb job).

One of the main things that I have taken from the report is that the NHS is not broken - far from it in fact; there are many, many parts of the service that are highly effective and efficient, where high quality care is delivered and outcomes for patients are world class.  Without the NHS, the UK's healthcare system would undoubtedly be in a worse place.

I have worked in (various parts of) the NHS for 15 years - the whole of my nursing career in fact (student nurse to nurse specialist / service lead).  I am genuinely proud to work in the NHS and the hospital in which I am based, and passionate about enhancing care and the overall patient experience.  I feel aggrieved that the NHS has come under such attack as a result of Mid-Staffs, it saddens me that an institution as worth while as the NHS is at risk to an extent because of the actions of people that work in it; patients should NEVER experience some of the things that they did, there can be and are no excuses.

However if the Francis report is to be effective and to have a true meaning, it has to be seen as an opportunity to learn, to improve and to enhance the organisation as a whole...

One of the key features of the report was the importance (or lack of) given to listening to and acknowledging the views of patients / service users / customers.  This is crucial and the NHS as a whole definitely hasn't done this as well as it should.  As an organisation / business it cannot afford to do it in a half-hearted manner, it must make every effort to become world-class in service user involvement, in much the same way as it is able to deliver world-class in so many areas.

And there are so many opportunities to do so...

We need to ensure that patients are genuinely involved in their care; the decisions we make around care-planning should be first and foremost FOR the patient and done with the patient at the heart of those decisions.  There will be many good examples of this already but too many times, patient involvement is not central to the care process.

We need to manage our work as far as possible around the patient; not the reverse which happens all too often, whereby patients come to see us at OUR convenience for example.

We MUST listen and be open to feedback in a variety of formats - patient forums, social media, patient surveys, ad-hoc opportunities...the list could go on and should be as innovative as possible.  We have to make it as easy as possible for patients to provide feedback and for Trust's to respond to this, and Trust's must show how they've responded.  Again there will be numerous great examples of this already.

Crucially therefore the NHS needs to abandon it's 'silo culture' and share good practice, allowing others to use in part or full guidance that already exists.

I certainly don't get all of the above right all of the time....however in the last 8 years whilst working as a hospital-based specialist, I've learnt so much about the importance and benefits of patient involvement.  Whether that be from abandoning the age-old practice of staff booking patients into a clinic and turning this on its head, allowing the patient to choose an appointment on a day and time of their convenience to the greatest possible extent (DNA rate 10% compared to others running similar clinics and expecting >30-40%), to sending a copy of the GP discharge summary letter to the patient it refers to.  Ensuring that patients have access to the service's office number (direct dial), staff bleep numbers and email addresses, encouraging (anonymous) service feedback in a variety of mediums.  Being prepared to listen...

None of this particularly ground-breaking (I hope) and yet it all adds to the patient experience.  We need to clearly hear what our patients / service users think and strive to use this to enhance what we do...whether this is positive or negative feedback.

On a final note and pertinent to this blog, the service I currently lead was recently mentioned in a story on Patient Opinion; I am genuinely appreciative of this positive feedback, which was not requested or asked for.

However mainly I am pleased for the individual whoever he is, that he was able to use his experience of being in hospital so positively and to make changes to his lifestyle  that are obviously beneficial to him, his health and therefore to those around him.  Whoever you are, WELL DONE and keep up the great work you're already doing - I'm glad that we could be of assistance at an opportune moment:

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