Posts Tagged ‘Patient satisfaction’

Tories offer deal that doctors should probably take

By Stephen Campion, HCSA chief executive - 9th October 2009 12:01 pm

Late last evening I received a text. The message from a friend of mine simply asked: “What did I think of David Cameron’s speech?”

I have not yet replied because the real answer is that I simply do not know what to make of it. Certainly the promise to end the target culture was encouraging - and indeed not surprising. Targets have done much to destroy the doctor/patient relationship.

We have consistently argued to government and the opposition that the competing priorities between clinical need and political targets have led to a dilemma for doctors almost impossible to reconcile. So, well done David Cameron.

But the flip side is that doctors will be asked to trade-off the target culture against a new measure of patient satisfaction, and greater patient choice. The concept of patient satisfaction is in itself no bad thing. If you don’t like the service from the bank, then change bank.

As the Royal Mail is finding to its cost, if you don’t like the service then change to a different courier or use the electronic technology now available.

But how does a patient assess the quality of medical care and treatment? No matter how good the doctor, prognosis and treatment are not necessarily indices of success. And the environment is not one necessarily controlled by the doctor alone; the doctor may lead the team but health outcome is governed by a complex combination of factors often outside the doctor’s influence.

If we have to work through these issues as a price for losing the dreaded target culture it seems to me that is a price worth paying. I think I will reply to my friend’s text as follows: “Speech encouraging - the devil will be in the detail!”

Funding to be linked to happy patients

By Francesca Robinson - 23rd September 2009 11:34 am

Doctors will have to make sure their patients are happy or their hospitals could lose money.

This is the latest policy announcement from health secretary Andy Burnham who wants payments for acute care to be linked to levels of patient satisfaction.  

In a speech to the King’s Fund on the future of the NHS, he said a “powerful, new financial framework” will reward people-centred service and care. “This is a big culture change for the NHS, which has traditionally been paid by volume,” he said.

Earlier this year a web tool that allows people to compare the standards of care at different hospitals was launched on the Government website NHS Choices.

But Burnham wants to go further by measuring patient satisfaction service-by-service in each hospital and publishing the results on a regular basis. Patients will be able to rate issues such as dignity, cleanliness, how they were spoken to and car parking.

“At the moment, quality is only faintly recognised in the tariff. In the future, we’ll progressively link a much bigger proportion of a trust’s income to quality and, importantly, levels of patient satisfaction,” he said.

He also warned that the new payment system would encourage commissioners to move services away from hospitals that patients were not happy with.

Next year the Department of Health will introduce a best practice tariff for stroke, hip fractures, gall bladder and cataract surgery. “This will link tariff payment to delivering the highest quality, not just the average cost,” explained Burnham.

Whitehall sources are reported as saying “significant” sums will be involved because the new policy is at the heart of Labour’s vision for service improvement.

Under a pilot scheme launching next spring in NHS Northwest, hospitals will be able to earn a premium of up to 4% of their budgets if patients are satisfied with their care.

Stephen Campion, chief executive of the HCSA described the idea as a “non starter”.

“How can patients judge what is the benchmark around which they are assessing the quality of service? What is the point of having a Care Quality Commission which is there to assess and monitor the quality a trust provides if that responsibility is going to be passed to patients, who with the greatest respect are probably not best placed to judge the quality of care they are given?”

Dr Hamish Meldrum, BMA Council chairman, added: “In the long run, the overall benefits of treatment on a patient’s health - which can take months to become clear - are more important than factors such as the distance of the car park from the ward.

“Rewarding quality is a laudable aim but we must avoid penalising hospitals or their staff on the basis of factors beyond their control.”

Mr John Black, president of Royal College of Surgeons, said discovering and rewarding high quality care would mean measuring health outcomes and this would require increased funding for clinical audits and systematic patient reported outcome measures.

“Mr Burnham’s recent speech dwelt heavily on patient and staff satisfaction surveys and, while these are useful, we won’t find out the true quality of NHS treatment by these alone,” he said.

Read coverage of NHS Choices.