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Nurses face 'real time' league table for patient experience


Nurses in a quarter of England’s hospitals will have patient experience on their wards measured in “real time” from April, using a customer service system borrowed from businesses like the Hilton hotel chain.

The move comes as a Nursing Times survey reveals the biggest problem facing nursing is trying to meet the expectations of patients under the shadow of cuts and savings targets.   

All acute providers in the Midlands and the East of England will be required to survey inpatients on how likely they would be to recommend their hospital to friends or family.

They will be expected to report their scores alongside other key performance measures like waiting times and hospital acquired infections, and the strategic health authorities will publish a monthly league table based on the results.

The measurement, known as the “net promoter score”, was developed by private sector chains, which use it to identify branches with particularly good or bad customer service.

The plan is being introduced by the strategic projects team of NHS Midlands and East, which also brokered the franchising of Hinchingbrooke Health Care Trust to private provider Circle.

The SHA cluster believes the programme will help to tackle failures of “basic care”, in the same way that national targets have helped to reduce MRSA rates.

NHS Midlands and East policy and strategy director Stephen Dunn said the scheme was “going to make clear who’s delivering excellent patient care, and those who need to improve”.

“For the first time we will be able to really prioritise patient experience, and elevate the discussions around it to the same level as the 18 week [referral-to-treatment target], the four-hour accident and emergency [waiting target], and the targets around healthcare-acquired infections,” he said. “It will have the same focus as those other key indicators of service standards.”

Nursing experts said the scheme could be useful if it helped to flag problem areas, but warned that the league tables should not be used to throw blame at particular wards or individuals.

NHS Midlands and East revealed its plan as a survey by Nursing Times showed that 55% of nurses felt meeting patients’ and carers’ expectations within existing resources was the “biggest problem” they currently faced.

The cluster’s briefing on the plan states: “The NHS also needs to track performance weekly and publish the results alongside other measures of clinical quality. This will enable nurses on the ward to compare with other wards on the same corridor, as well as hospitals against each other. And hospitals who fail this test must be held to account.”

Royal College of Nursing policy director Howard Catton said no one was going to “stand in the way of getting patient feedback”. But he warned: “That must not be used as some sort of blame game with staff or individuals”.

Yvonne Sawbridge, a senior fellow at Birmingham University’s health services management centre, has carried out research into the issue of compassion in nursing.  She said the SHA’s scoring system “may flag up issues, but it adds yet another data collection, and it doesn’t spend time looking at root causes of issues and how to resolve them.”

She said it was important trusts with poor scores investigated what they could do to help people provide better care, rather than seek to throw blame.

Ms Sawbridge added: “What’s not talked about is the fact that nursing is a really hard, emotionally difficult, demanding job. Telling people to be kind and compassionate doesn’t make them able to be kind and compassionate.”

What was needed was for organisations to work on how they could create a support system that could “help nurses stay compassionate and caring and not get burned out”, she said.

The SHA cluster briefing on the new system acknowledged that “poor scores tell you that you have a problem, not how to solve it”.

But it argued it would focus trust boards on identifying and tackling the issues that might be causing the problem, such as “poor staff morale, staffing levels, poor cleanliness, [and] food returned uneaten”.



Readers' comments (6)

  • Great. Something else that we now have to worry about then. A patient gets upset, has their operation delayed, has poorly managed post-operative pain management, thinks the food is bad, has a tantrum or takes a dislike to the staff and they can fill out a nice survey, degrading the ward and then a nice auditor can come along and tell everyone they are failing. A hospital is NOT a hotel. I am not impressed this is coming into force where I work.

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  • it just seems to identify problems like the CCQ. there are plenty of people and instruments that can do this but how will this help provide effective and lasting solutions.

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  • I have seen these healthcare based metrics used in a positive and negative way. In the U.S. they are obsessed with these measurements which patients can use online measuring anything from food quality to mortality rates for pneumonia. They never take into account the innumerable variables from staff turnover to the state of health of the local population.
    Unfortunately it does turn competitive, one local journalist published mortality rates from pneumonia at our hospital without disclosing the high number of admits from multiple nursing homes. The effect was very damaging. Alternatively we started a noise abatement programme after multiple complaints about the noise level at night.
    watching the near obsession with patient satisfaction surveys over the past 4 yrs the attention to staff concerns are overlooked.Morale has plummeted in recent times as patients realise they only have to raise the slightest concern to have administration jumping through hoops. Any problems concerning care at any level should be examined from all angles, patients should be able to raise concerns expecting a realistic solution bearing in mind the pressures exerted on healthcare workers.
    We are neither a hotel nor an airline in direct competition with each other for your business because our pillows are fluffy. Shame on the U.K for following the U.S route on this

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  • will hospitals also be measuring the experiences of their staff in the same way? Would they dare!

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  • I would have thought this obsession with management practices of collecting data for everything would have died out by now as it does not replace good quality and compassionate care. But this seems to be adding even more to fill the filing cabinets.

    Complaints should be taken up initially at source with the people concerned so that they have a chance to put things right and if they are unable to deal with the problems they should speak to team colleagues and managers. If staff are unable to cope with criticism then further training is required during their basic training courses.

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  • I wonder if we will get a cup or be relegated to a lower division?

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