Patients will set the agenda

The NHS is giving people more control over their own health and a greater say on how services are provided

By Ann Keen

As modern consumers, we demand high quality services that respond to our individual needs. In the public’s mind, the NHS should be no different. Patients have told us they want an NHS that gets the basics right, fits services around their lives, treats them as individuals and not just a set of symptoms, and works with them as equal partners.

Although the care delivered by the NHS has always been focused on the patient, their needs have sometimes been assumed and the powerful role they can play in boosting the quality of services has often been overlooked. In the last decade, this situation has started to change but if we want to continue to improve services then we must do more and at a faster pace.

The NHS not only faces higher public expectations, it also facing other challenges. The cost of keeping pace with an ageing population, as well as modern technology and medicine, is already putting pressure on funding - as is the increased prevalence of lifestyle diseases.  However, in difficult economic times, the NHS will have to make more of existing resources by boosting the efficiency and productivity of services.

In their life, the average person will use the NHS over 2000 times. This staggering figure means that most of us will have a wealth of experiences and views that could, if harnessed, be of real value to the NHS. However, a recent survey suggests only around one in five people has had a say on how health and care services could better meet their needs despite six out of 10 saying they would like to express their views.

This is not to say that the NHS never asks. The NHS has a long history of asking people for feedback about services – whether through direct contact, complaints, surveys or public consultations. It is also not the case that the NHS never listens. There has been a move to provide a more personal approach to care - involving patients in decisions, offering more choice and tailoring treatment to fit someone’s specific needs.

However, it does suggest that the systematic engagement of individuals and communities in decisions is not yet the norm for every NHS service. We also know that if the NHS is to drive up quality, meet public expectations and increase productivity then every service must be able to understand its ‘customer’.

In the last few years, we have moved to encourage a new equal partnership between staff and patients. We want an NHS where patients have more control over their own health and a greater say over their care. We also want an NHS which understands its patients and uses this insight to improve prevention and focus resources where they can make the biggest difference.  

Launched last December, the strategy ‘NHS 2010-2015: from good to great. Preventative, people-centred, productive’, unveiled the latest initiatives designed to help encourage this new relationship.

In the NHS, patient experience is already a measure of service quality and real-time feedback from patients is often used to improve front-line care. For example, organisations like the Homerton University Hospital NHS Foundation Trust use electronic surveys on wards to get instant feedback on issues such as privacy and staff attitude. While the website www.nhs.uk enables patients to rate and provide feedback to any general practice or hospital.

However, ‘NHS 2010-2015’ went one-step further to encourage hospitals to pay attention to patient experience. A new payment system was announced, under which hospital income will increasingly be linked to patient satisfaction, rising to 10 per cent of their payments over time.

Over the last few years, individuals have also been given greater control over their own health and the power to have their views heard. This has either been delivered through specific initiatives like Information Prescriptions – which provide people with with the tailored information they need to better understand and manage a long-term health condition.  Or it has been set out in the NHS Constitution, which articulates  what people should expect from the NHS and all the rights they have, including the right to be involved in decisions about their own care and local services.

However, ‘NHS 2010-2015’ set out plans for potential future rights to high quality care that will be, as well as other initiatives such as better access to personal care plans that allow patients to choose the right care tailored to their individual needs.

For years, front runners in both the private and public sectors have demonstrated that effective engagement of ‘customers’ and a good understanding of their needs results in innovation, a higher quality service, increased productivity and a better reputation.

However, we are determined that this should not be something that is just done in a few leading NHS organisations. Listening, understanding and responding to what really matters to patients needs to become part of the health service’s DNA.

The initiatives we have introduced as part of the reform of the NHS will go some way to achieving this vision but our main task will be to inspire change. We need to help staff – on the front-line and in the boardroom – to learn from those who are already showing that we can make patients’ experiences count.

25 February 2010

Ann Keen. Health Minister,