Patients' perception of health care

In the past the NHS has been accused of being a paternalistic organisation (Dieppe and Horne, 2002). Using patients' views to improve health-care delivery has only developed over the past decade or so (Wensing and Elwyn, 2002). But despite all the recent changes, are patients today really free to have their say and truly involved in managing their treatment? After all, where do patients get their perception of how health care is delivered? Arguably, the two main influences are the media and personal experience. While shock headlines may influence some patients to view health care with a jaundiced eye, those who have used the service and had a good experience are less likely to offer criticism (Judge and Solomon, 1993).

Unfortunately, the laudable era of openness and encouragement of patients to voice their dissatisfaction has also led to high and perhaps unrealistic expectations on their part.

Much emphasis is given to the fact that patients have a voice and that patient-centred care is the way forward. We resort to grading the effectiveness of one hospital against another by counting how many operations have been cancelled or how many patients have died following surgery. This does not reflect the quality of care a typical patient has received. We are doing ourselves a disservice by suggesting that measuring health-care delivery is that simple.

Are patients really worried about league tables? Ultimately, what patients want is expert care when they need it, in a safe environment, and delivered by people who care for them as individuals, not statistics on a page.

Perhaps what we should be aiming for is improving communication between professionals and patients. Only then will we be able to develop initiatives that change behaviour on both sides (Dieppe and Horne, 2002) and start to build a more realistic and effective health-care delivery system based on rigorously evaluated methods of measuring patient perception and satisfaction with the service (Wensing and Elwyn, 2002).

OPINION - Nurse sponsorship in urology
Sponsorship is a controversial topic that is guaranteed to engender heated debate among nurses.

The advantage of sponsorship is having the means to employ more staff and set up or expand a department without the hassle of trying to wring money out of one's directorate.

The disadvantage is that there is no such thing as a free lunch. Unfortunately, as nurses, we can often find ourselves between a rock and a hard place, especially if the only way to move forward is with company money.

I am not saying that all forms of sponsorship compromise care and that there should be no such practice in the NHS. What I am saying is that, as nurses, we should be aware of the potential pitfalls and ensure we are involved in any discussions and agreements undertaken by our managers with companies offering sponsorship. We must make our position clear and not agree to anything that would compromise our code of conduct or our ability to offer optimum unbiased care to our patients. The sad thing is that trusts feel the need to resort to sponsorship at all either to save money or because there is no money there in the first place.

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