Patient feedback – a responsible officer’s view Nigel Acheson NHS England Regional Medical Director, South

RO regulations relate to the following categories The designated body and the responsible officer Appraisal Monitoring performance and responding to concerns Recruitment and engagement

The role of the patient and the quality of their outcome and their experience from start to finish is at the heart of enhanced recovery Patient feedback needs to be as close to real time as possible, and to be reflected upon as part of the process of continuous quality improvement

“Patients’ experience of the service can be very different from what was intended and it would run contrary to the principles of continuous improvement merely to assume a high quality experience. Only by providing structured consultation using a variety of methods can they tell us what works, what doesn’t and what could be done better.” Should we evaluate the context in which an individual is working? Patient experience is of care provided by teams of individuals working together

Concerns about poor patient experience related to the behaviour and attitude of some medical staff working in Kaiser Hospitals Solution? Patient experience now collected for every patient….. and linked to pay Patient experience

“The most important single change in the NHS in response to this report would be for it to become, more than ever before, a system devoted to continual learning and improvement of patient care, top to bottom and end to end”

Not enough just to undertake the exercise Reflection required – Frimley Park have formalised this: First thoughts – pleasantly or unpleasantly surprised? Areas of strength/weakness What changes to practice are required? What development support is required? Formal patient feedback

Seen by some as: Once in a cycle, stand alone process (static) Compliance activity and burdensome (potentially costly and no improvement if done this way with no reflection/action/re-evaluation) Really want to see this (and appraisal as a whole) as part of a continual QI process – a view shared by patients, RCGP and Berwick (and to develop an assessment of team / context) Problems with formal questionnaire approach

Patients as self carers, partners or advocates in care – as individuals and helping with service design – dynamic patient feedback would be helpful* At all levels – patient perspective on complaints, compliments, incidents* Assessment of teams/individuals Revalidation – quality assurance of patient experience elements of appraisal portfolio* Patient experience – beyond questionnaires *Leading together programme – Oxford AHSN, Thames Valley and Wessex Leadership Academy and NHS England – partnering health care professionals with lay people to work together in organisations