Citizen power will transform the NHS

An article by Dr Neil Bacon, founder of iWantGreatCare, has been published on the Public Service website. Co-written with Professor David Kerr, advisor to the Government, it describes the unique power that the public and patients have to transform the NHS, and ensure that they and their familes get the very best care.

How can the public properly understand what sort of care their local GP, dentist or hospital provides, let alone be part of a process of improving the quality?

Some would say that sort of improvement programme should be left to the government, hospitals and medical professions. However, evidence suggests otherwise. Perhaps in this case, rather than the doctor, it is the patient who knows best.

In order to start this information revolution citizens need unfettered access to two sorts of information: clinical outcome and performance data (hospital infection rates, cancer survival figures) and the shared experiences of other patients.

Will you be the one in five who gets poor care?

One in five women ‘failed by NHS’ in labour.

This weeks report about the variation in quality of UK maternity services provides yet another example of why patients and the public need to make careful choices about their care - who provides it and where it is is delivered.

But how to find the best care when there is so little information allowing you to compare one hospital or doctor against another?

The views and opinions of other patients and users of healthcare is known to be accurate in predicting where great care can be had - and helping all of us avoid those hospitals that doctors and nurses know to avoid!

This brings with it an obligation on all who use services to provide their feedback: to help the next patient, to say thank you for great care, and to highlight how hospitals can improve what they do.

Doctor-patient communication (again!)

Hospitalized patients and their doctors often have differing beliefs regarding patients' knowledge and aspects of their care, suggesting a need for improved patient-physician communication, according to research published in the Aug. 9/23 issue of the Archives of Internal Medicine.

Nearly all physicians (98%) stated that they at least sometimes discussed their patients' fears and anxieties, compared with 54% of patients who said their physicians never did this (P = .001).

As a doctor if you really want to know if your communication with patients is any good (and where you can improve), then you need to ask every patient and every relative how well you are doing - they will tell you! iWantGreatCare makes this simple, easy and revealing, and can be fully integrated with your appraisal and personal development. Start here.

As a patient, please help your doctor by telling them how they are doing in this respect. All as good as it could be? Then use iWantGreatCare to praise and thank those looking after you.

Over-50s increasingly doing research online

Recent research by the UK Online Measurement Company revealed that the number of Britons using the internet had risen by nearly 2 million in the space of 12 months, with the biggest growth witnessed in the over-50s age group. The charity Age UK advises older people to make the most of the internet, claiming that they could save both time and money by getting online. It also notes that broadband access gives older people "a wealth of information at your fingertips" and - in a brochure produced with BT - recommends use of online comparison sites.

It is interesting how many people in senior health positions across the UK claim that web-based ratings and reviews of healthcare discriminate against the older patient. I wonder where they get that prejudice from?

Peer learning, support and online communities

If you were designing a disease treatment system from scratch, bringing together clinicians, patients, researchers, and advocates, what platform would you use to take advantage of the community created by this umbrella group?

This is the question posed by Susannah Fox of the Pew Internet project. She uses the extended discussion session that iWantGreatCare was part of at Health 2.0 in Paris earlier this year to consider some of the challenges, opportunities and lessons already learnt.

As we move from hospital-based to shared, integrated, community models of delivering services this is a question of urgent importance to all those in the UK.

Take home message: it is not about the doctors or buildings, it is all about the patients.

Embed direct feedback into the system

It’s very flattering when iWantGreatCare gets mentioned in high places and by those who really understand and care passionately about caring for patients.

It’s even more exciting to know that the work the team does, and the way in which iWantGreatCare works together with doctors, nurses and other health professionals, is enabling colleagues to improve what they do on a day to day basis. This is of course the vision of iWantGreatCare - to harness patient experience to drive up quality of healthcare.

Thus being mentioned in the House of Lords recently, counted as a great moment for the small team here and another step on the way to realising our aspirations:

On incentives, we should remember that healthcare professionals are proud. They want to deliver a good service. If you embed direct patient feedback into the system, as we have in Wales for palliative care using iWantGreatCare, it can become a powerful driver to quality improvement. One team does not want to perform less well than another, but patients need to provide feedback in an anonymised way so that they are not fearful that their comments might antagonise the clinicians looking after them.

If you are a patient or carer and wish to help improve the quality of care you (or others) receive, simply go to the iWantGreatCare.org website now and add a review about care you’ve received. It makes a difference.

Putting patients in the driving seat works

Gosh, it’s been an incredibly busy few weeks.

So much for a summer-break, the iWantGreatCare team has been fully occupied helping our existing clients realise all the benefits of real-time, direct patient experience.

One of the fascinating things about enabling organisations to harness patient experience as an outcome metric, is how rapidly it becomes an essential and powerful tool affecting so much of what they do, and how they do it “from ward to board”. This is exciting and satisfying - sort of like letting a genie out of the bottle, but with every one winning (not just the person who gets to make the wish!).

In addition to the Health Secretary Andrew Lansley once again naming iWantGreatCare as an example of patient-centric outcomes which “put patients in the driving seat”, the Department of Health have released their Outcomes document and Health White Paper.

All those who are passionate about high quality care and patients getting the very best treatment, will be delighted by the new focus on outcomes. Most importantly, the measures to be used include those that are reported directly by patients (including experience ratings at a highly detailed level).

This shift from targets to outcomes is long overdue and - if done properly - will benefit every single user and employee of the NHS.

Exciting times.