When there are 500,000 reviews on iWantGreatCare, UK healthcare will be safer and better than it is now - thank you for making your contribution to that journey.
Showing posts with label National Health Service. Show all posts
Showing posts with label National Health Service. Show all posts
Monday, 13 December 2010
Smoke alarm to detect poor patient care
Dr Neil Bacon has written a short piece on his personal blog describing how patient experience (the ratings and reviews that patients submit on their doctor and hospital) can act as a “smoke alarm” for patient safety.
Thursday, 18 February 2010
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:
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.
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.
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.
Thursday, 17 September 2009
Finding great GPs and fantastic hospitals
[Today's announcement by the Health Secretary will be of interest to all those using, following, or already working with, iWantgreatcare. As you are aware, the iWantgreatcare service is the only way for the UK public to get information on individual doctors to help them choose great care for themselves and their families.]
In fact, much of the NHS is not even good - but parts of it are fantastic.
Harnessing the experience and views of patients and their relatives is the key to driving out the poor, building on the good, and identifying the fantastic - this is the central truth underpinning iWantGreatCare.
But today's speech by the Secretary of State is important in announcing the overdue policy change that will allow the power of patients to drive the quality improvements that can make the NHS great. By giving patients the ability to choose who cares for them, and by linking hospital budgets to patient experience, those delivering care who do not focus on the total satisfaction and experience of their patients will be exposed, will lose patients and will lose funding. They will improve - or be replaced by better services, delivering better quality care.
With free choice over who cares for themselves and their family, patients will seek out the information to make informed decisions. NHS Choices, iWantGreatCare and others will meet this need, empowering patients and allowing them to find truly great care. Indeed, the thousands of patients already using iWantGreatCare shows the scale of public demand for transparent, independent knowledge about the quality and experience of healthcare - and the unique way in which users value the views and experiences of their fellow patients.
The best NHS Trusts, doctors and hospitals know this already and are using new ways to capture, understand and use patient experience to improve quality, reduce costs and ensure total focus on the needs of their patients. iWantGreatCare already works with some of the UK's most innovative healthcare providers; NHS Trusts who know that continuously capturing and understanding real-time patient experience from thousands of users, every day of the year, across all the services they deliver is the key to quality improvement. These are organisations not afraid of the suggestions and criticisms of users, but who actively encourage and facilitate such feedback, seeing all comments as opportunities to correct and improve everything they do.
Today's announcement shows that they (and their patients) will be the winners.
As Andy Burnham said today, the NHS is good, but needs to be great.
In fact, much of the NHS is not even good - but parts of it are fantastic.
Harnessing the experience and views of patients and their relatives is the key to driving out the poor, building on the good, and identifying the fantastic - this is the central truth underpinning iWantGreatCare.
But today's speech by the Secretary of State is important in announcing the overdue policy change that will allow the power of patients to drive the quality improvements that can make the NHS great. By giving patients the ability to choose who cares for them, and by linking hospital budgets to patient experience, those delivering care who do not focus on the total satisfaction and experience of their patients will be exposed, will lose patients and will lose funding. They will improve - or be replaced by better services, delivering better quality care.
With free choice over who cares for themselves and their family, patients will seek out the information to make informed decisions. NHS Choices, iWantGreatCare and others will meet this need, empowering patients and allowing them to find truly great care. Indeed, the thousands of patients already using iWantGreatCare shows the scale of public demand for transparent, independent knowledge about the quality and experience of healthcare - and the unique way in which users value the views and experiences of their fellow patients.
The best NHS Trusts, doctors and hospitals know this already and are using new ways to capture, understand and use patient experience to improve quality, reduce costs and ensure total focus on the needs of their patients. iWantGreatCare already works with some of the UK's most innovative healthcare providers; NHS Trusts who know that continuously capturing and understanding real-time patient experience from thousands of users, every day of the year, across all the services they deliver is the key to quality improvement. These are organisations not afraid of the suggestions and criticisms of users, but who actively encourage and facilitate such feedback, seeing all comments as opportunities to correct and improve everything they do.
Today's announcement shows that they (and their patients) will be the winners.
Monday, 23 March 2009
Mid Staffordshire - why was nobody listening to the patients?
There are so many ways in which the disaster at Mid Staffordshire hospital should - and must - lead to improvements in patient care, not just locally but across the entire system of the NHS. Whilst politicians and the Department of Health have been quick to claim that it is just an isolated example, the reality is that it reveals an almost total inability of the national monitoring and safety systems to protect the patients who were admitted to the Mid Staffordshire hospital.
The facts are as clear as they are shocking: analysing mortality data for Mid Staffordshire Hospital reveals excess mortality since 2003, yet in the six years since then the Health Care Commission increased the rating for the hospital from Fair to Good and the hospital was given Foundation status - supposedly a marker of excellence in which patients can have complete trust.
To make matters worse, the company monitoring outcomes data only "raised the alarm" in 2007, after they were alerted and asked to look in detail at the mortality information. This would be analogous to an organisation responsible for ensuring airline safety "alerting" the public to problems years after a plane crash that killed 400 people.
So what lessons can be learnt, what changes have to be put in place to ensure that we don't have yet another "one-off" in a few years time, and what role does patient experience have to play in this?
Most importantly, everybody working in healthcare has to listen intently and continuously to the patients. If patient-centric care means anything, and is to be more than just a politically correct buzz-word, it means continuous, detailed and open listening to the voices, experiences and opinion of patients. Patients, their families and carers in Staffordshire had been complaining loudly from 2003 about the shocking state of their hospital and their voices were ignored completely. The Trust itself appears to have dismissed them, and the Healthcare Commission has no system to track and monitor the level of complaints made about a hospital - until the patients themselves complains to the HCC. There is extensive evidence that the perceptions of patients and their experience is an accurate marker of quality standards in hospitals - yet the NHS does not harness what is probably the most accurate, early system of detecting poor quality healthcare: the voices of those using the service. One can only speculate how many lives would have been saved if the NHS systematically incorporated real-time collection and monitoring of patient experience as part of safety and monitoring systems.
"Insanity: doing the same thing over and over again and expecting different results." Albert Einstein
Rather than listen in real-time to the public, the HCC requires patients to be dead before their "experience" activates the systems and alerts. One doesn't need medical training to realise that this might be somewhat too late! However, not only is this a patently ridiculous way to protect patients (akin to a smoke-detector that only goes off months after the house has burnt to the ground), but it also lacks the sensitivity necessary to improve quality across the NHS. As anyone who has worked in a hospital will tell you, things can be very bad indeed before mortality rates increase.
Continuous, real-time, granular monitoring of patient experience has the unique ability to solve some of these problems and greatly increase the sensitivity, accuracy and timeliness of systems put in place to monitor quality and safety of the NHS. We need to make it easy for patients and their carers to not only record their experience, but to ensure this invaluable information is analysed in real-time and provided to Trusts (and the regulators and monitors) in a fully open, transparent way. At the simplest level, all Trusts (primary, acute and mental health) should be required to display the number of complaints they have received, standardised to the number of patients they see, on the front page of their website. Even such a simple thing would help inform the choice that patients now "enjoy", whilst perhaps concentrating the mind of the management. (Perhaps Monitor might even be tempted to look at that number when coming to their decisions?)
The experience of patients has to be a metric and tool that the board and management of Trusts use in the same way that they use data about infection rates: a critical, sensitive and core metric of quality. Perhaps then we might actually get closer to a truly patient-centric NHS.
The facts are as clear as they are shocking: analysing mortality data for Mid Staffordshire Hospital reveals excess mortality since 2003, yet in the six years since then the Health Care Commission increased the rating for the hospital from Fair to Good and the hospital was given Foundation status - supposedly a marker of excellence in which patients can have complete trust.To make matters worse, the company monitoring outcomes data only "raised the alarm" in 2007, after they were alerted and asked to look in detail at the mortality information. This would be analogous to an organisation responsible for ensuring airline safety "alerting" the public to problems years after a plane crash that killed 400 people.
So what lessons can be learnt, what changes have to be put in place to ensure that we don't have yet another "one-off" in a few years time, and what role does patient experience have to play in this?
Most importantly, everybody working in healthcare has to listen intently and continuously to the patients. If patient-centric care means anything, and is to be more than just a politically correct buzz-word, it means continuous, detailed and open listening to the voices, experiences and opinion of patients. Patients, their families and carers in Staffordshire had been complaining loudly from 2003 about the shocking state of their hospital and their voices were ignored completely. The Trust itself appears to have dismissed them, and the Healthcare Commission has no system to track and monitor the level of complaints made about a hospital - until the patients themselves complains to the HCC. There is extensive evidence that the perceptions of patients and their experience is an accurate marker of quality standards in hospitals - yet the NHS does not harness what is probably the most accurate, early system of detecting poor quality healthcare: the voices of those using the service. One can only speculate how many lives would have been saved if the NHS systematically incorporated real-time collection and monitoring of patient experience as part of safety and monitoring systems.
"Insanity: doing the same thing over and over again and expecting different results." Albert Einstein
Rather than listen in real-time to the public, the HCC requires patients to be dead before their "experience" activates the systems and alerts. One doesn't need medical training to realise that this might be somewhat too late! However, not only is this a patently ridiculous way to protect patients (akin to a smoke-detector that only goes off months after the house has burnt to the ground), but it also lacks the sensitivity necessary to improve quality across the NHS. As anyone who has worked in a hospital will tell you, things can be very bad indeed before mortality rates increase.
Continuous, real-time, granular monitoring of patient experience has the unique ability to solve some of these problems and greatly increase the sensitivity, accuracy and timeliness of systems put in place to monitor quality and safety of the NHS. We need to make it easy for patients and their carers to not only record their experience, but to ensure this invaluable information is analysed in real-time and provided to Trusts (and the regulators and monitors) in a fully open, transparent way. At the simplest level, all Trusts (primary, acute and mental health) should be required to display the number of complaints they have received, standardised to the number of patients they see, on the front page of their website. Even such a simple thing would help inform the choice that patients now "enjoy", whilst perhaps concentrating the mind of the management. (Perhaps Monitor might even be tempted to look at that number when coming to their decisions?)
The experience of patients has to be a metric and tool that the board and management of Trusts use in the same way that they use data about infection rates: a critical, sensitive and core metric of quality. Perhaps then we might actually get closer to a truly patient-centric NHS.
Wednesday, 4 February 2009
NHS Constitution 2
The NHS Constitution makes the following demand of patients:
"You should give feedback – both positive and negative – about the
treatment and care you have received, including any adverse reactions you
may have had." (Section 2b of the NHS Constitution)
Interesting to think how much feedback this could result in if even 50% of patients took their obligations to the Constitution seriously? How could that much information be collected, what would the NHS do with it, and what tools and systems would patients need to "do their bit"?
"You should give feedback – both positive and negative – about the
treatment and care you have received, including any adverse reactions you
may have had." (Section 2b of the NHS Constitution)
Interesting to think how much feedback this could result in if even 50% of patients took their obligations to the Constitution seriously? How could that much information be collected, what would the NHS do with it, and what tools and systems would patients need to "do their bit"?
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