Care by Design understands the fundamentals of organisational development, service management and leadership for the 21st century public sector organisation and communities.

Patient Experience Now a Key Performance Measure for Acute Hospitals

The NHS Performance Framework now places great emphasis on measuring patient experience. The measure of patient experience sadly only applies to Acute Trusts and Mental Health Trusts. If one of these Trusts is failing on patient experience then it can only be ranked overall ‘performance under review’.

Performance on User Experience will be assessed by monitoring scores to a subset of survey questions in the national patient survey, which are categorised under 5 distinct “themes” that patients identify as important to them. The five broad headings that make up this domain are set out below: 

  • Access and waiting
  • Safe, high quality coordinated care
  • Better information more choice
  • Building closer relationships
  • Clean, friendly comfortable place to be

I feel it is a shame that patient experience of primary and community services isn’t included. Poor experience and service in the community setting often means an admission and additional pressure on secondary care and a person deteriorating unnecessarily.

My Mum died sadly last June with primary bowel and secondary liver cancer. Her journey and experience over the 3 years since first symptoms appeared to the last months of her life were on a continuum of excellent (especially the blood transfusion service) to very poor (wouldn’t treat a dog that way). 

Throughout Mum’s interactions with health professionals the one thing she wanted was to be seen as a person; with feelings and not an object (the patient) and her disease. Even more I and my brothers had to step in on occasions when it was assumed that because our Mum was older that it meant that her mental capacity was in question. A couple of times she spotted that she hadn’t been given some medication and when we brought it to a member of staff’s attention it was assumed Mum had forgotten – on both occasions it turned out to be Mum that was right. Mum kept her mental capacity to the last hour of her life and fortunately died as well as possible with her family with her and her grandchildren whom she adored and they her holding her to the end. 

If building closer relationships means seeing the patient as a person and an equal partner in their care, then this is excellent. The patient and their family are a great source of control in the quality, safety and coordination of their care and treatment. Giving patients access to their medical records helps this even more. Please look at the excellent work of Dr Amir Hannan a paradigm pioneer in this area. 

Maybe if we start talking about person-centred care (seeing the person the disease or condition has got) rather than as a patient (an object of care) then we may well make a step change in creating excellent service experience for people who use them and their families.

We need to consider how we help busy hospital clinicians raise the bar on patient experience especially building relationships and delivering safe, high quality patient care. Please see the work of Dr Gordon Caldwell on the Care by Design Better Care web pages.

I stayed at a great hotel last week where I was impressed that the group director’s mobile number and email was made available to all guests and there was a card to complete ranking overall experience and asking to name any member of staff who shone overall – wouldn’t it be interesting to do this in hospitals?


Published 1st November 2018