Standards: May 2012

Over the past few years there have been a number of documents and initiatives that have highlighted the importance of patient experience in the NHS and the need to focus on improving this experience where possible. Lord Darzi’s report, High Quality Care For All (2008), highlighted the importance of the entire service user experience within the NHS, ensuring people are treated with compassion, dignity and respect within a clean, safe and well-managed environment.

It was followed by the development of the NHS Constitution (2009-2010), which described the purpose, principles and values of the NHS and illustrated what staff, service users and the public can expect from the service. Since the Health Act came into force in January 2010, service providers and commissioners of NHS care have had a legal obligation to take the Constitution into account in all their decisions and actions.

Additionally, The King’s Fund charitable foundation has developed a comprehensive policy resource, Seeing the Person in the Patient: the Point of Care review paper (2008). Some of the topics explored in the paper have been used in the development of a new quality standard from the healthcare guidance body, The National Institute for Health and Clinical Excellence (NICE). In February, NICE published a quality standard and accompanying clinical guidance on patient experience in adult NHS services. NICE’s quality standards define excellent clinical care, service and practice across a topic or disease area, in the form of clear, easy-to-understand statements that describe aspirational but achievable care.

The standards are a final distillation of NICE guidance and other NHS evidence-accredited sources, and may be used as tools to aid healthcare professionals and service commissioners across the NHS, to make the best decisions for their patients.

The new standard includes the following statements:

• Patients are introduced to all healthcare professionals involved in their care, and are made aware of the roles and responsibilities of the members of the healthcare team.
• Patients have opportunities to discuss their health beliefs, concerns and preferences to inform their individualised care.
• Patients are made aware that they have the right to choose, accept or decline treatment and these decisions are respected and supported.
• Patients have their physical and psychological needs regularly assessed and addressed, including nutrition, hydration, pain relief, personal hygiene and anxiety.

Published alongside the standard, the clinical guidance on patient experience also makes a number of recommendations for healthcare professionals, including:

• To develop an understanding of the patient as an individual, including how the condition affects the person, and how the person’s circumstances and experiences affect their condition and treatment.
• To ensure that the patient’s personal needs (for example, relating to continence, personal hygiene and comfort) are regularly reviewed and addressed. Patients who are unable to manage their personal needs should be asked regularly what help they need and their needs should be addressed at the time of asking with maximum privacy ensured.

Quality standards such as this can also help patients understand what they can expect from their healthcare provider. They are produced in collaboration with the NHS and social care, along with their partners and service users. At present, they are not mandatory and the NHS is not obliged to use them. However, at the time of writing, the Health and Social Care Bill (2011) makes it clear that the secretary of state, in discharging their duty to improve the quality of health services, ‘must have regard to the quality standards prepared by NICE’.

For more information, visit: www.nice.org.uk and click on ‘quality standards’.