Can we link productivity improvements to patients’ experience and how can we ensure value is as much about experience of care as clinical outcomes?

Quality adjustment assumptions Patient experience is probably more important where treatment is part of a continuing relationship, and the patient’s expectations of health gain from any single episode may be relatively low. On this basis, it is assumed that patient experience is relatively more important for primary care and for mental health services, rather than hospital inpatient, outpatient and accident and emergency services. The patient experience element of accident and emergency services is assumed to be relatively lower, since focus for these patients is the receipt of immediate help with acute health problems. Patient experience is measured through surveys commissioned by the Care Quality Commission (CQC), formerly the Healthcare Commission. Survey questions are grouped into five domains, including ‘better information, more choice’ and ‘safe, coordinated, high quality care’. DH and ONS treat each of the domains as equally important in measuring overall patient experience.

ONS quality adjustment of NHS output Where:

Impact of quality adjustment on NHS productivity Quality adjustment based on the extent to which services meet users’ needs or patient experience accounts for around 2.5 per cent of total quality change

Back to the questions… Can we link productivity improvements to patients’ experience and how can we ensure value is as much about experience of care as clinical outcomes? Yes… …but what weight do we want to give patient experience vs other aspects of productivity such as quantity? What types of experience should we count? What weights to give to different types of experience?