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‘Patient opinion matters’

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Health services deal with people and their problems – patients, relatives, staff, politicians and media representatives.

Our approach to customer satisfaction is very different from that of other large organisations for whom the public are the lifeblood. Supermarkets not only engage in price wars but also seek out and promote products and services.

And how different they are when it comes to delivering what consumers want. Time and money are invested to determine market trends
and demands.

They pursue customer satisfaction policies, such as no-quibble replacement of goods. They promote programmes linked to community involvement and education, and myriad ‘green initiatives’.

Cynically, one might argue that this is intended to achieve business return, inclusion of children in the customer base and a general feel-good factor associated with shopping in those supermarkets.

What is so different about health? The independent sector has, for some time, surveyed consumer satisfaction, majoring on hotel facilities but more recently on clinical aspects.

Consumer feedback in the NHS is patchy, and true involvement of patients in design and execution of services generally only occurs where there are really strong patient focus groups with an authoritative voice.

There are similarities between nurses and doctors. Both are trusted – substantially more than politicians. Both enjoy an ‘agency relationship’ with patients, that is, the opportunity to guide and sometimes decide for patients who prefer their clinical adviser to act on their behalf, or who are not capable of making decisions themselves.

Nursing staff have often taken on a guiding and advisory role, often with holistic knowledge of the patient and family wishes. Doctors are often accused of acting like God, in spite of best intentions. This may be because of the limited time invested in developing relationships.

But does either really care about the patient experience and whether aspirations are identified and met? Does any one of us really step into a patient’s shoes, see what they see, feel what they feel? The epiphany when medical or nursing staff fall ill and spend time in hospital suggests that few of us truly understand what it is like to be on the receiving end of care.

If we were truly committed to improving the ‘customer experience’, we would ask patients, with genuine interest: ‘How was it for you?’ and act on the response. What a difference it would make if we all took the time to ask that question tomorrow, then wholeheartedly acted on what was said.

Martin Sandler is a consultant physician at Heart of England NHS Foundation Trust

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