Patient Experience
Using patient experience creatively is key to quality improvement and a patient-centred NHS. However, it is important to find the best way to use patient experience to really make a difference to how NHS services are delivered.
The information below outlines some of the work on patient experience being undertaken in England, and some of the methods that are being adopted to better explore this critical issue.
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Experience-based co-design
Experience-based co-design is an innovative approach to quality improvement, using ‘video narrative’ interviews with local patients, and then working alongside them to design quality improvement together. However, it is not an easy method for local services to adopt.
The Healthtalk database is an existing national resource of ‘video narratives’ which may provide an easier way of doing this work.
Research, supported by the Health Services Research specialty of the Clinical Research Network, tested whether it was possible to use the videos from the existing Healthtalk database to stimulate local service redesign, and found that it was acceptable to patients and professionals, and much quicker to deliver.
A toolkit on experience based co-design is now available.
Large-scale patient surveys
Surveys are well known methods for assessing the views of patients, and a potentially efficient method of gathering information at scale.
Experience of primary care is one of the most important aspects of quality of care for patients. The NHS centralised the use of standardised measures in the assessment of patient experience in 2007-2008, sending the General Practice Patient Survey (GPPS) to samples of patients in a rolling programme of quality measurement. This has resulted in GPPS being completed by millions of patients every year, with their views assessed and analysed on a large scale and sustained basis over time.
Outcomes and findings
Collection of data on patient experience is not simply for the benefit of managers and policy makers. All NHS patients can now access information on GPPS scores of their local general practices from a website to help them assess the quality of care that they can expect, and to make choices about local services.
Value to the NHS
As well as providing patients and clinicians with up to date information on patient experience, these large scale surveys have been highly productive in allowing research on what drives patient experience and the way that patient experience varies between different groups, such as different ethnic groups and different sexual orientations.
Potentially even more importantly for health services researchers, it has allowed assessment of the impact of service and organisational change – GPPS provides an assessment of patient experience across England, allowing comparisons of the experience of patients in areas which are introducing innovations, versus comparator sites providing conventional services.
Some of the ways that GPPS has been used are outlined below.
Patient experience of research
Much patient experience work is focussed on patient experience of services. However, there is a drive to make research an integral part of services. NIHR campaigns like OKToAsk and I am Research, and the introduction of Patient Research Ambassadors are all part of the drive to make research part of the NHS.
That means there is a need to consider patient experience of research as an important part of their overall experience.
Although there has been quite a lot of research on patient experience of some aspects of research (such as attitudes and understanding of randomisation), we don’t know much about the overall experience of patients taking part.
The NIHR CRN is working to change this, through its active programme on patient experience of research.
