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NHS must listen to patients and the public

Healthcare Commission says recent disasters show that ignoring patients costs lives

OnMedica staff

Friday, 27 March 2009

The NHS is increasing efforts to listen to patients and the public, but it must go "the next step" to ensure these views are used to bring about change and save lives, according to the Healthcare Commission.

Anna Walker, the Commission's chief executive, warned health services that fail to properly involve and listen to patients can have disastrous results. She referred to the failings at Mid-Staffordshire NHS Foundation Trust where poor care and mismanagement resulted in between 400 and 1200 unnecessary deaths in the three years to March 2008.

Earlier this month a Healthcare Commission report into the trust found that patients and public complaints about scandalous levels of staffing, mismanagement and use of unqualified staff went unheeded.

In a new report published today the Commission canvassed the views of hundreds of patients, members of the public, statutory and voluntary patient representative organisations and 139 healthcare providers.

Ms Walker said that there has been a sustained effort in recent years to increase the involvement of patients and the public in healthcare. "But what we need now is to take the next step. Patients want action to be taken in response to their concerns, and we can see that this is not always happening.

"The current standards require health and social care providers to ‘engage' with patients and service users. ‘Engaging' can be as simple as having a cup of tea with someone - but it doesn't mean changes will necessarily be made as a result.

"Organisations now need to make a final push and really act upon the information given to them by patients and the public to improve services for the local community. Events at Mid-Staffordshire show what can happen when this does not occur."

The report found some excellent examples of clinicians and managers listening and responding to patients and singled out mental health and learning disability services.  Equally the independent sector was praised for its emphasis on patient satisfaction improving the in-patient experience and hospice movement was praised for involving patients and families in service planning and improvements.

But it also found that many people, particularly the oldest and sickest and those from minority ethnic groups, said they felt their views were not listened to or properly acted upon.

Patients and the public said they experienced problems when trying to make their views heard and routinely complained of a lack of openness; poorly designed local surveys and questionnaires; not enough opportunities to discuss views in an environment where they felt comfortable; no sense of NHS trusts building a relationship with them over time.

Few NHS trusts involved in the study could demonstrate that they routinely took account of people's views in their decision-making.

When the Commission asked organisations what changes they had made to services as a result of people's views, it found people are least likely to influence areas such as quality of clinical care or choice of services provided in the local area.

The Commission found that most trusts, particularly primary care trusts, were increasing efforts to involve patients and the public and that people have influenced healthcare in important ways as a result.

These include improvements in areas such as: the quality of information about services; appointment systems; opening hours; car parking and food choices.

Acute and ambulance services show a commitment to improving their understanding of patients' experiences and finding ways of feeding this information back into improvements.

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