1. By Ria Earp Chief Executive
Building a Sustainable Healthcare System The role of the Patient Voice Symposium
By Ria Earp
Chief Executive

2. Focus for the presentation:
‘Patient Voice’ – who are we talking about?
‘Patient Voice’
– processes & why it is so hard
– understanding the ‘other voices’
‘Patient Voice’ – voice of family, whanau, carers?
‘Patient Voice’ – voice of community, voice of Māori, other ethnicities?

3. What will not be covered …..
Is the ‘patient voice’ important?
Does the ‘patient voice’ contribute to the discussion?

4. Patient Voice – who are we talking about ?
Identifying clients, consumers/users, patients….
- using a ‘segmentation’ approach; are there natural sub-groupings (e.g. age, locality, ethnicity, illness, gender) that may have differing views on the service?
- using different approaches to ensure patient views are expressed? (e.g. focus groups, co-planning design, advisory groups, surveys, highlighting opportunities to give feedback & complaints, understanding the patient journeys)

5. Patient Voice – processes: advisory groups
Clarity around the expectations for the ‘consumer representative’
Expectations examples;
– using ‘one person’ as the patient voice on ‘expert committee’ - high risk of failure
– i.e. digesting ‘wads’ of information; understanding ‘status issues’; training as a form of mitigation (e.g. Cancer Voices’); single person isolation

6. Patient Voice – processes: advisory groups
Examples continued;
– Māori DHB Board members (2 members); included in legislation; seeking nominations; appointed versus elected; training & networks
– training days held over 2 days x 3 a year; briefings on legislation, strategies; health systems, understanding DHB accounts; networking with local communities & with each other

7. Patient Voice – processes: surveys & research
Using tested tools & peer reviewed methodologies
Other approaches (eg audits; survey monkey)
Understanding the limitations of different approaches;
– evidenced based research methodologies (quantitative and qualitative); funding; long time frames
– rapid approach – potential to fall into ‘question trap’; possibly not seen as credible; audits give good indications but may be subjected to bias

8. Patient Voice – why is it so hard?
Organisational or system inertia
Health systems and a layered approach using ‘expertise’ to make the recommendations & decisions
Needs to fit with the political environment
Information asymmetry
Easy for the patient voice to be ‘drowned out’

9. Patient Voice – other voices?
Systems and strategies
Funder (contracts or donors or fees)
Professionals – clinical, organisation staff, volunteers, health partners
Patients, clients, consumers, turoro (advance care planning)
Caregivers, family or whanau, EPOA, NOK
Communities (ethnic, locality, ‘sector’, interest)

10. Mary Potter Hospice- what we use
Value base – patient and family focus
Use range of approaches (targeted advisory groups, research, regular patient/family survey, audits, widely available ‘You talk, We Listen’ pamphlets, posters, written/web based information; adhoc service consultation, pilot testing approachs)
Clarity about when we are giving information & when we are consulting or seeking views & what we are seeking views on
Managing complaints- policies & processes

11. Kia ora koutou