Using people’s experiences to improve health services

CHPR Blog January 2019 – Mark Gamsu

The School of Health and Community Studies at Leeds Beckett University has just come to the end of a review of the approach taken by Leeds and York Partnership NHS Foundation Trust to understanding what people think of their services and how it involves them in service improvement.

One of the areas that struck us was the different mechanisms that are used in the NHS to capture individual patient feedback and their relative strengths and weaknesses.

For understandable reasons, tools that are used to capture people’s opinions about services they have used tend to sit at the boundary between the organisation and community life. However, we think that some are more successful at bringing professionals and the public together.

The best known example is probably the NHS Friends and Family Test.

The Friends and Family Test is just about capturing experience – it offers no opportunity for interaction between the person filling it in and the recipient of the information. The only responsibility that the person who is providing the information has is to be truthful in giving their view about their experience of the service. In most cases people will give a numerical or star rating – they may also leave a brief comment.

The receiving organisation has to take note of the comments – it does not have to acknowledge receiving the rating or tell the person who provided the rating what they did as a result.

There are also a number of national surveys that are commissioned by the Care Quality Commission every year. Examples of these include the annual GP survey and the Community Mental Health Survey.

They ask a much more comprehensive range of questions but are restricted to smaller sample sizes and only happen once a year. So, they require people to be willing to answer quite a lot of questions and the outcomes are based on a small but representative sample of people who have used a particular organisation. This means that they are more useful at giving a view of an organisation rather than of specific services.

Other mechanisms for capturing experience go further. The Care Opinion platform puts an emphasis on allowing respondents to tell a story about their experience, it offers moderation and it allows others to see this story on the web. Furthermore, it encourages the organisations who receive this story to respond, ask questions, follow up the comments with the individual off line and to say what they did in response to the story. Care Opinion also provides mechanisms for other agencies who might not have been mentioned in the original story to engage and comment.

All of this interaction happens on line.

Finally, the in house Patient Advocacy and Liaison Service which is provided by NHS trusts has specialist staff who respond to people’s concerns about services that they have used or are receiving. Here, the PALs officer is likely to talk directly with the person who wishes to leave a comment or make a complaint; indeed, they may encourage or make it easier for people to express their views. They might also support someone in ensuring that their views are heard. Again, like Care Opinion there is a greater emphasis on the story of the experience than there is on giving the service a score or rating.

Summary

chpr blog gamsu table

For further discussion of the Friends and Family Test see: https://localdemocracyandhealth.com/2019/01/09/nhs-friends-and-family-test-feedback-a-distorted-view/

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