Issue 2: March 2012

WHAT DO PATIENTS THINK?

By Dr Jean Turner, Executive Director, Scotland Patients Association

Most people, including health professionals working in the NHS, rarely think about their own ill health until it becomes an immediate concern. Some of us may reach our nineties before we become critically dependent upon the NHS but we all hope it will be there for us when we do need it. In hard financial times we should value our NHS more and consider how we pay for it, other than by taxation.

The many changes within the NHS, especially over the last 20 years, have rebalanced the flow of spending toward private funders and providers, through PFI and a mixed economy of care. Despite this we could still do a great deal to improve continuity of care to patients throughout the NHS, which has been the greatest casualty of change.

we could still do a great deal to improve continuity of care to patients throughout the NHS, which has been the greatest casualty of change

Scotland Patients Association (SPA) suggests we promote a more “do-as-you-would-be-done-by-culture” for health organisations and also make sure we learn from NHS complaints, to improve services.

Patients and their families often tell the SPA that food and drink is not well received by patients and much is discarded as waste. This would not continue for long in a restaurant, as customers would not return but hospital patients have limited choice. Good nutrition is important and can prevent deterioration in health and wellbeing and even death. Yet despite public agencies doing lots to recommend standards of nutrition these are often not implemented at patient level, in hospital or in the community.

When the SPA examines complaints the commonest problems arise out of poor communication or the absence of communication both amongst health professionals and between them and their patients. The next commonest problem is poor staff attitudes often associated with poor communication. It sometimes appears that some organisational practice encourages patients to be “processed “ swiftly from unit to unit and then discharged, which can cause patients to feel they are incidental to busy wards and to busy general practice surgeries.

Dr Jean TurnerWhether a retired professor, or a care worker in the NHS, we all feel vulnerable in pyjamas and are at multiple disadvantage when ill, so it is perfectly reasonable to wish to know what is happening to us as patients and to be both better informed and treated with care and respect.

Good practice can be seen where communication is better and leads people to feel they are treated with respect and dignity. Such practice will promote better outcomes for patients and staff with the added bonus of cutting costs in time and money by reducing the number of complaints and repeated treatments.

Over the years we have seen changes in the health care workforce as nurses have taken over many tasks from doctors; and care assistants have taken over nursing tasks. So patients can be quite unsure these days who is dealing with them, partly due to the poor distinction in the colour of uniforms and the fact that too many health professionals do not clearly introduce themselves.

When the SPA examines complaints the commonest problems arise out of poor communication or the absence of communication both amongst health professionals and between them and their patients

With confusion over professional regulation of care assistants there is a strong case for greater clarity over regulation and review of professional standards and status. The SPA is also concerned about the standard of care offered in our care homes, mainly run by the private and voluntary sector, which employ more CAs than registered nurses. To provide greater protection for residents, SPA considers that the Care Inspectorate should move to unannounced inspections of such facilities to ensure unprompted adherence to care standards.

SPA feels we need a wider debate on how to improve speed in diagnoses and treatment, and suggests we need more doctors and specialist nurses as well as allied health professionals to operate diagnostic and treatment centres 24/7 rather than Monday to Friday. Recent research published in medical journals shows quite persuasively that weekend hospital admissions produce far worse outcomes for the patients involved – i.e. a disproportionately higher number of them die. Extended consultation times also provide for expensive diagnostic equipment and theatres to be better utilised.

In Scotland we have the added factor of sparsely populated areas and remote rural communities and the growing impression that people who talk to SPA are basing their judgement on where they live on access to well provisioned health care. Perhaps a compulsory part of all health professionals training should be to work in remote and rural areas to help them understand the difficulties and the advantages in different communities.

 

By Dr Jean Turner, Executive Director, Scotland Patients Association

Issue 2: March 2012

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