This article is from the source 'guardian' and was first published or seen on . It last changed over 40 days ago and won't be checked again for changes.
You can find the current article at its original source at http://www.theguardian.com/healthcare-network/2016/mar/02/patient-choice-in-the-nhs-five-key-questions
The article has changed 2 times. There is an RSS feed of changes available.
Previous version
1
Next version
| Version 0 | Version 1 |
|---|---|
| Patient choice in the NHS: five key questions | Patient choice in the NHS: five key questions |
| (6 months later) | |
| Should patient choice be a priority in the NHS? | Should patient choice be a priority in the NHS? |
| Peter Beresford, service user activist and emeritus professor of social policy, Brunel University: Patients talk about having control, not choice. It’s politicians who go on about choice – as they quietly increase privatisation in the NHS. Good healthcare isn’t like buying a holiday or motor car and deciding which we’ll buy on the basis of adverts. How does any ordinary individual choose between good and bad healthcare? | Peter Beresford, service user activist and emeritus professor of social policy, Brunel University: Patients talk about having control, not choice. It’s politicians who go on about choice – as they quietly increase privatisation in the NHS. Good healthcare isn’t like buying a holiday or motor car and deciding which we’ll buy on the basis of adverts. How does any ordinary individual choose between good and bad healthcare? |
| Keith Holden, head of patient choice, NHS England: Although there have been high profile cases of poor care in the NHS, patient choice isn’t about choosing between good and bad care. All providers of clinical services are required to meet NHS standards of quality, including safety. Rather, choice is about enabling patients to make informed decisions about particular aspects of their healthcare to best meet their needs and preferences. | Keith Holden, head of patient choice, NHS England: Although there have been high profile cases of poor care in the NHS, patient choice isn’t about choosing between good and bad care. All providers of clinical services are required to meet NHS standards of quality, including safety. Rather, choice is about enabling patients to make informed decisions about particular aspects of their healthcare to best meet their needs and preferences. |
| @GdnHealthcare Choice is an admirable concept, but does not guarantee quality. | @GdnHealthcare Choice is an admirable concept, but does not guarantee quality. |
| Colin Campbell, director of professional services, Specsavers hearing centres: Can we raise informed debates about patient choice above NHS privatisation arguments? Those debates are valid – but many services suffer from a lack of patient choice. For example, around one million patients made journeys into hospital last year to collect NHS funded hearing aid batteries – all of which can be accessed (still free at the point of access to patients) from community audiologists – close to home and seven days a week. However, this is still only available in 50% of England due to clinical commissioning groups’ inability to tackle outmoded hospital models. | Colin Campbell, director of professional services, Specsavers hearing centres: Can we raise informed debates about patient choice above NHS privatisation arguments? Those debates are valid – but many services suffer from a lack of patient choice. For example, around one million patients made journeys into hospital last year to collect NHS funded hearing aid batteries – all of which can be accessed (still free at the point of access to patients) from community audiologists – close to home and seven days a week. However, this is still only available in 50% of England due to clinical commissioning groups’ inability to tackle outmoded hospital models. |
| What problems does the idea of choice create? | What problems does the idea of choice create? |
| Jonathan Hearsey, extended scope practitioner, Sussex MSK Partnership: The confusion regarding what choice means in some clinical situations could break the valuable relationship between patient and clinician and, ultimately, [possibly affect] outcomes. In musculoskeletal medicine, it is common for patients with non-specific mechanical back pain to attempt to exercise choice in order to demand needless imaging or clinical tests like MRI scans or blood tests. In some instances it is perfectly correct to order tests but in the majority of cases MRI scans are unnecessary and lead to patient concern about normal changes in discs or joints. | Jonathan Hearsey, extended scope practitioner, Sussex MSK Partnership: The confusion regarding what choice means in some clinical situations could break the valuable relationship between patient and clinician and, ultimately, [possibly affect] outcomes. In musculoskeletal medicine, it is common for patients with non-specific mechanical back pain to attempt to exercise choice in order to demand needless imaging or clinical tests like MRI scans or blood tests. In some instances it is perfectly correct to order tests but in the majority of cases MRI scans are unnecessary and lead to patient concern about normal changes in discs or joints. |
| @GdnHealthcare "You can have hideously under-funded care here or hideously under-funded care up the road. Which would you prefer?" #7dayscam | @GdnHealthcare "You can have hideously under-funded care here or hideously under-funded care up the road. Which would you prefer?" #7dayscam |
| Natalie Koussa, programme lead, National Voices’ Wellbeing Our Way programme: People need to understand that patient control isn’t just about simple offers such Choose and Book for elective procedures, but around people taking control of the decisions which enable them to live in the ways which matter to them. End of life is an area in which we know that the vast majority of people would prefer to die at home, and yet are unable to. Charity Compassion in Dying found that 75% of service users who completed a written statement about their wishes for their end-of-life care – such as an advance decision or advance statement – stated they felt happier about the future or had greater peace of mind. | Natalie Koussa, programme lead, National Voices’ Wellbeing Our Way programme: People need to understand that patient control isn’t just about simple offers such Choose and Book for elective procedures, but around people taking control of the decisions which enable them to live in the ways which matter to them. End of life is an area in which we know that the vast majority of people would prefer to die at home, and yet are unable to. Charity Compassion in Dying found that 75% of service users who completed a written statement about their wishes for their end-of-life care – such as an advance decision or advance statement – stated they felt happier about the future or had greater peace of mind. |
| What are the main obstacles to patient choice? | What are the main obstacles to patient choice? |
| Jacob Lant, head of policy and partnerships at patient advocacy organisation Healthwatch England: I think one of reasons choice doesn’t always work as intended is because of simplistic examples of villages with only a single GP practice with just one GP. The conversation often focuses on the fact the patient has no choice of which GP to go to in that situation. But there are lots of constructive conversations that could be had about how that single surgery offers a range of services. We shouldn’t let local variation in services prevent conversations about how choice can work. | Jacob Lant, head of policy and partnerships at patient advocacy organisation Healthwatch England: I think one of reasons choice doesn’t always work as intended is because of simplistic examples of villages with only a single GP practice with just one GP. The conversation often focuses on the fact the patient has no choice of which GP to go to in that situation. But there are lots of constructive conversations that could be had about how that single surgery offers a range of services. We shouldn’t let local variation in services prevent conversations about how choice can work. |
| Sean O’Sullivan, head of policy, Royal College of Midwives: I was struck in the Mid Staffs report by the weakness of the then patient organisations. This feels like a perennial issue since the demise of community health councils. For maternity services there are maternity services liaison committees, which can be effective and dynamic vehicles for user involvement where they work well, but this is not the case everywhere. | Sean O’Sullivan, head of policy, Royal College of Midwives: I was struck in the Mid Staffs report by the weakness of the then patient organisations. This feels like a perennial issue since the demise of community health councils. For maternity services there are maternity services liaison committees, which can be effective and dynamic vehicles for user involvement where they work well, but this is not the case everywhere. |
| Frontline midwives have the information necessary to inform patients of their options, but they lack time. There are so many issues that midwives are expected to discuss with women at antenatal booking appointments – smoking, diet, nutrition, breastfeeding, FGM, domestic violence, immunisation etc – but the time available is finite and it can be hard to do more than what feels like a tick-box exercise rather than a genuine discussion. | Frontline midwives have the information necessary to inform patients of their options, but they lack time. There are so many issues that midwives are expected to discuss with women at antenatal booking appointments – smoking, diet, nutrition, breastfeeding, FGM, domestic violence, immunisation etc – but the time available is finite and it can be hard to do more than what feels like a tick-box exercise rather than a genuine discussion. |
| What efforts to include patients’ opinions are working already? | What efforts to include patients’ opinions are working already? |
| @GdnHealthcare @Annaisaac Choice is not an end in itself, but a lever (not the only one) to encourage providers to improve quality | @GdnHealthcare @Annaisaac Choice is not an end in itself, but a lever (not the only one) to encourage providers to improve quality |
| Lant: We know patients are very positive about their pharmacy services and where we see increased services – consultation booths or provision of flu vaccine we see increase in use of pharmacy (which should help take pressure of GPs). This is example of more convenient choice for people that also helps the system. | Lant: We know patients are very positive about their pharmacy services and where we see increased services – consultation booths or provision of flu vaccine we see increase in use of pharmacy (which should help take pressure of GPs). This is example of more convenient choice for people that also helps the system. |
| Giuseppe Paparella, policy officer, Picker Institute Europe: According to research we published with the King’s Fund, patient feedback on services has produced little improvement in care. Analysis of trends in NHS inpatient surveys 2005-13 shows that improvements have generally been modest and typically driven by national initiatives and policies to tackle widespread or high-profile problems. Ward cleanliness is the clearest example. See more here. | Giuseppe Paparella, policy officer, Picker Institute Europe: According to research we published with the King’s Fund, patient feedback on services has produced little improvement in care. Analysis of trends in NHS inpatient surveys 2005-13 shows that improvements have generally been modest and typically driven by national initiatives and policies to tackle widespread or high-profile problems. Ward cleanliness is the clearest example. See more here. |
| What benefits can patients choosing services offer the NHS and practitioners? | What benefits can patients choosing services offer the NHS and practitioners? |
| Holden: The choices patients make can send important signals to commissioners and providers about the services that attract more patients and how other services should adjust and change, including any services – particularly in community settings – where choice might be limited or non-existent. Choice should be part of the mix of factors that contributes to quality and improvement. | Holden: The choices patients make can send important signals to commissioners and providers about the services that attract more patients and how other services should adjust and change, including any services – particularly in community settings – where choice might be limited or non-existent. Choice should be part of the mix of factors that contributes to quality and improvement. |
| O’Sullivan: Choice has to be real, we know from surveying our heads of midwifery that many of them are having to contend with cuts to training budgets, temporary closure of units, and reduced services as well as staffing shortages. This can only constrain the ability of services to accommodate choice. | O’Sullivan: Choice has to be real, we know from surveying our heads of midwifery that many of them are having to contend with cuts to training budgets, temporary closure of units, and reduced services as well as staffing shortages. This can only constrain the ability of services to accommodate choice. |
| Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views. | Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views. |
Previous version
1
Next version