Notes from the field of public involvement

Wednesday, 05 July 2006

What patients want to know about the Healthcare Commission's "Health Check"

NHS organisations have completed their first 'health check' for the year ending 31st March 2006. Some are posting their compliance declarations on their websites. Here's a good local example www.wandsworth-pct.nhs.uk/work/healthcarecomm/annualhealthcheck.asp But what does compliance with the Healthcare Commission's standards really mean to patients and the public? The question is, "How can NHS organisations explain to patients in a tangible way that the Healthcare Commission compliance declaration (the 'health check') makes a difference to the services they receive?"

Recently I facilitated some groups of NHS managers that pondered this question at a meeting organised by the Health and Social Care Quality Centre. Here is a summary of the main answers they came up with:

  1. Patients are concerned with ends. The Health Check and everything that flows into and out from it (standards, action plans etc) is about means. Just describing the process of compliance (which is piling on more detail about means) won't tell patients what they want to know, though it can show that the organisation is honest and can be trusted (which is valuable in itself). Policies alone, no matter how good they are, don't make things better for patients. There has to be evidence that good policies are put into practice and that things are better (in the sense of safer, cleaner, quicker, more culturally appropriate etc) as a result.
  2. What patients want to be shown is evidence (in the form of proof they understand) that something has happened, e.g. infection rates are going down and staying down; post-operative readmissions are dropping; delayed discharges from hospital are becoming a thing of the past; health professionals are doing things differently and getting better results; care pathways that join up health and social care are becoming a reality and patients acknowledge this.
  3. Patients aren't always right about everything, but their views on the quality of services they experience are always valid. So NHS organisations must ask users if they agree that services really are getting better because of the Health Check compliance. Mental health and long term conditions are good test areas. User expectations and experiences are intertwined and both have to be taken into account. Check the PALS activity - it should reflect the positive change in patient experiences if the service is really getting better.
  4. See what choices patients make and if their choices are changing. A test of tangible improvement is that more people are choosing a good local service because there is evidence about its quality that they understand and trust. Compliance with the Health Check standards ensures that the NHS does the "day job" better. This is what patients want because it directly benefits them. It means there are fewer crises and those that may occur will be handled much better.

As we head into the second year of health checks - and there will be no trial runs this time - it will be interesting to see how many NHS organisations seriously address the big question of explaining what it all means to patients and the public. Or will it be just a dialogue between themselves and the quality inspection body?


Andrew Craig | Send feedback