NHS monitoring systems

Patient experience - solving the problems of today's failed monitoring systems.

Existing methods of measuring and monitoring NHS quality and safety are repeatedly shown to be slow, insensitive, inaccurate and misleading. The Care Quality Commission relies on expensive, centralised, backward-looking data collection which does not drive the change needed, nor build confidence amongst the public.

After further hospital disasters in Mid-Staffordshire and Basildon (and, we are told, more to come) we need new approaches that actually work and win the support and con?dence of the public, professionals and the media. Harnessing the user-voice to understand patient experience has the ability to:

• reduce costs,
• raise quality,
• empower patients,
• increase safety.

Using innovative technologies (well proven in other industries) makes it easy for patients (and their relatives and carers) to provide feedback in a valid, robust, structured manner, thereby delivering accessible, meaningful information about the things that matter to users.

To deliver this change requires vision, resolve and a willingness to absolute transparency in public services. It will reveal some difficult truths about the variation in quality across the NHS - but ultimately all patients, all staff and all NHS organisations will benefit.

Service improvements or simply closed hospitals?

The NHS needs to save money, Huge amounts of money. This requires fundamentally changing how things are done, not merely making current practices more efficient.

However, whenever PCTs embark on what is claimed to be service-redesign to deliver better, modern care in new ways that also save costs, they are rapidly attacked by their regional media and "angry, local people". For example, NHS Surrey told HSJ:

"...the campaigners were completely focused on “bed closure rather than service improvement” and invitations to come and see how new services were being delivered had so far been shunned."

This is of course not surprising and requires PCTs to re-engage with their public in innovative, open and transparent ways. Again, a whole new way of operating. iWantGreatCare is working with PCTs to address this problem, using real-time patient experience as a "barometer" of opinion, whilst also showing service-users that current structures and services are not only financially unsustainable, but also frequently deliver mediocre patient experience.

Real-time monitoring through iWantGreatCare allows PCTs to demonstrate that patient experience with existing services is far from satisfactory, and then to show that redesign has not led to a worsened patient experience. Only systematic, quantitative systems (implemented before redesign) have the potential to counter the problems that NHS Surrey and others are already facing.

It is hard to tell people their local hospital has to close. It is not quite so hard if you show them that real people - their peers - prefer the new provision and that the solutions deliver happier, healthier patients. That is the level of patient engagement needed not just locally, but also at a national level as we battle to reshape the NHS into a high quality, cost-effective, patient-centric service fit for 2010.