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Patient revolution

In the last edition of NHE, we quoted Patients Association trustee Ann Lloyd CBE, former NHS Wales chief executive, who said she “almost despairs” when patients keep quiet about poor care ‘in case something happens’. We asked the organisation’s chief executive, Katherine Murphy, to expand on that.

The quality of the NHS in the future depends on a patient revolution in customer services, as well as care services.

The Patients Association was established almost 50 years ago. Ever since then we have been listening to patients and speaking up for change across the health and social care system.

Our helpline has always provided the evidence base for our campaigns and policy work, whilst it is shocking to hear the personal stories of patients with poor experiences of the NHS there are always wider lessons to draw from these cases.

At the end of August the Health and Social Care Information Centre (HSCIC) published new figures on NHS complaints. They showed that over 3,000 complaints were made by patients about their NHS experiences each week between 2011- 2012; sadly this is just the tip of the iceberg.

We all too often hear from patients who have either been put off from raising concerns because they have no faith in what can be a hugely difficult system to navigate, or they have gone through a process only to receive no response or inadequate answers.

More worryingly, others tell us that they are afraid to raise concerns because they fear it may have a negative impact on their treatment.

An important part of the work our helpline does is to explain to patients their NHS rights.

The NHS Constitution sets out rights that patients have in relation to complaints. Crucially, that “you have the right to have any complaint you make about NHS services dealt with efficiently and to have it properly investigated” and “you have the right to know the outcome of any investigation into your complaint”.

But as our recent research report ‘The NHS Constitution: Fact or Fiction?’ showed, knowledge of the NHS Constitution is very low, both among healthcare professionals and patients alike.

As a direct response to some of the concerns we hear about, The Patients Association launched our Care Campaign, in conjunction with the Nursing Standard, last year. This aims to raise the fundamentals of care and refocus the attention of trusts onto the key areas that matter to patients most: communicating with compassion, assisting with toileting and ensuring dignity, relieving pain effectively, encouraging adequate nutrition. We are delighted that 80% of trusts have now signed up to the care pledges and we have had some very welcome feedback.

We have recently followed this up by publishing our Practices in Care Review which highlights some of the most innovative examples of local initiatives that are really tackling some of those big concerns that patients have and finding new solutions.

Many of the examples we point to have been developed as a direct response to patient concerns in hospital wards. And we want to do more of this too, working in partnership with the NHS to share good practice.

There are two sides to the complaints coin. Firstly there is a need for a robust complaints process, which is easy to understand and access. This means a strong awareness campaign across the NHS so patients and professionals have a better knowledge of the entitlements that exist.

Secondly, a positive step change in culture within the NHS should be encouraged at all levels around complaints handling and wider public engagement with services to achieve better outcomes.

Whilst some trusts and healthcare professionals may be anxious about rising complaints figures, those that are genuine about engaging and listening to patients will find they develop the truly innovative approaches that will be crucial to driving up standards of care. The quality of the NHS in the future depends on a patient revolution in customer services, as well as care services.

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