“We must put citizen and patient voice absolutely at the heart of every decision we take in purchasing, commissioning and providing services” Tim Kelsey, National Director of Patients and Information, NHS England
Taken from, Transforming participation in health and care – the NHS belongs to us all’ NHS England, 2013
NHS England suggested action plan for commissioners to engage individual patients (1)
- Understand what individual patient participation is and what is already happening locally. What are patients saying about how they are involved in their care? How can individual participation better meet their needs and improve outcomes?
- Identify the gap. What more is needed locally to ensure that patients and carers are involved in decisions about their healthcare? For example, access to relevant information and informed discussions with clinicians; integrated personal care planning for patients with long term conditions, and, where appropriate, the option of a personal health budget. Consider how information and support can be targeted to ensure it reaches appropriate audiences, for example support for those who lack capacity.
- Identify local champions and resources, linking in with local patient groups, other CCGs, Commissioning Support Units (CSUs), voluntary organisationsand other partners.
- Use the tools and support guides available, many of which are highlighted in this guidance, to develop local implementation plans.
- Monitor implementation, and measure the impact of patient participation, for example on service improvement and health outcomes.
- Seek feedback about what is working well and areas for improvement, through commissioner assurance and wider patient engagement.
- Share learning though local, regional or national networks
According to NHS England (1) ‘Evidence suggests that engaging and involving communities in the planning, design and delivery of health and care services can lead to a more joined-up, co-ordinated and efficient services that are more responsive to local community needs. Public participation can also help to build partnerships with communities and identify areas for service improvement.’
Suggested action plan for commissioners to engage with groups of patients and the public (2)
- Identify experts within your own organisation and networks, for example Lay Members and Practice Managers with thriving Patient Participation Groups.
- Build upon existing structures and relationships, use tried and tested methods to involve patients, carers and the public – especially those who represent excluded or marginalised groups. Work with community development workers to identify assets in your community and develop collective approaches.
- Work with health and well-being boards and local Healthwatch to plan shared approaches with communities. Invest collectively in building assets
- Develop joint approaches with local authorities, local Healthwatch, voluntary groups and other organisations, especially those who have existing relationships with local communities and have successfully worked together with local people in the past.
- Through your CCG assurance process, ensure you seek feedback from your partners and communities about what is working well and areas for improvement.
- Make sure your participation plans reach those who experience the greatest health inequalities.
- Feed back to communities about the impact of their involvement, and the difference they have made.
Ultimately – the NHS is legally obliged to undertake patient and public involvement under the Health and Social Care Act 2012 (4)
How to engage with patients and the public? (3)
There are a wide range of insight and feedback tools available. Each one will be applicable in different situations, depending on which audience you are trying to reach and what information you are trying to obtain. These tools fall into two main categories:
– Qualitative – more suitable for answering questions about why something is happening and what we could do to change things;
– Quantitative – tells you the extent to which something is happening.
- Large-scale surveys allow us to measure patient experience and establish differences between groups and areas over time.
- Examples of this quantitative method at a national level include the GP Patient Survey and the CQC Inpatient Survey plus a range of other national surveys. Local surveys allow us to supplement national survey data, because there may be more specific questions you need to ask or particular groups in your local population that you need to know more about.
- Patient stories are an incredibly rich, powerful but underused source of information. They bring to life issues that really matter to people, in their own words. They can be collected through a number of sources including social media, letters, complaints and websites like
- Focus groups and in-depth interviews allow us to understand subjects in greater detail and depth than surveys because questions are less structured, allowing room for exploration of the issues. They can often be used to inform the development of questionnaires for subsequent surveys.
- Engagement and consultations with citizens and communities provide rich sources of insight and feedback beyond the specific issue under consideration.
- They are, therefore, not only an important tool for collective participation but also a key source of insight that can be used for wider purposes.
- Social media is an emerging, fast growing and important source of insight. There are some 500,000 comments about the NHS in England every week. These data sources can be harnessed to provide a deeper and richer understanding of people’s concerns and interests relating to health services. Using social media can also help to engage a wide range of people who are often already discussing the issues you are trying to address.
- Observational work is particularly useful when designing interventions which people might not want to talk about or where actual behaviour differs from reported research, as in this case study looking at how to reduce violence in A&E. View the case study here.
- Peer research: Training people to undertake research themselves in their own communities is an excellent way of obtaining insight into aspects of people’s lives and cultures
NICE Quality Standard 15 – patient experience in NHS services (5)
The National Institute for Health and Clinical Excellence (NICE) develops and publishes Quality Standards that underpin the outcomes frameworks. Quality Standard 15 covers patient experience in NHS services
This NICE quality standard defines best practice within this topic area. It provides specific, concise quality statements, measures and audience descriptors to provide the public, health and social care professionals, commissioners and service providers with definitions of high-quality care.
The aim of this quality standard is to provide the NHS with clear commissioning guidance on the components of a good patient experience. The quality standard gives evidence-based statements for commissioners that provide the foundation for an ‘NHS cultural shift’ towards a truly patient-centred service.
Giving feedback to the NHS
Patient Opinion was founded in 2005 and is now the UK’s leading independent non-profit feedback platform for health services.
Patient Opinion is about honest and meaningful conversations between patients and health services. We believe that your story can help make health services better.
How it works:
- Share your story of using a health service
- We send your story to staff so that they can learn from it
- You might get a response
- Your story might help staff to change services
(1 -3) Patients and information directorate, NHS England, 2013. ‘Transforming participation in health and care – the NHS belongs to us all’, or to download from the tookit below.
(4) Health and Social Care Act 2012