26. Evidence submitted by Dr Foster Intelligence
(PPI 125)
Our response is based on our experience in a
number of key areas:
— Working with three quarters of NHS
acute trusts, in particular providing information on referral
patterns, efficiency and quality.
— Managing campaigns to communicate
health messages, including focussing on particular at risk or
vulnerable groups.
— Producing information about healthcare
providers for the public.
— Primary research with members of
the public, for example, in relation to the configuration of services.
— Thought leadership and policy research
in relevant areas.
We very much welcome the committee's initiative
to examine the issue of patient and public involvement. One of
our key observations from our extensive experience in working
with the NHS is that it has a long way to go before it succeeds
in putting patients at the heart of the system.
The debate around patient and public involved
has become sterile. It has generated an industry of its own—including
its language and a bureaucracy. "Involvement" has become
an end of itself, rather than an integral element of the delivery
of health and healthcare. On the whole, the existing patient and
public involvement machinery has failed and alienated those its
success depends on: patients and frontline staff, through inadequate
or misguided consultation, jargonistic language and resource intensive
processes.
NHS organisations, commissioners and providers,
need to develop their understanding of their "customers",
those that they are trying to keep well, or who need health services.
Firstly, they need to improve their use of existing sources of
data, such as that routinely used by the market intelligence teams
in other service providing industries. Using consumer lifestyle
information, linked to health data, provides a powerful source
of insight into populations, their behaviours and preferences.
Understanding populations in this way, allows health organisations
to improve public consultation and engagement, because they understand
who they are involving and why.
Secondly, the NHS needs to improve the feedback
they receive from their customers and act on it to improve services.
Hospitals and GPs are required to collect feedback on an annual
basis which provides no meaningful insight into service delivery.
Providers need to collect, analyse and act on data systematically.
Commissioners need to ensure that evidence of feedback from patients
is built into contracts and regularly monitored.
The future system needs to redefine the language
and case for patient and public involvement. It must avoid structures
which set it apart from the commissioning and delivery of health
services, if it is to deliver services which meet the needs and
expectations of those who use it. The current system relies all
too often on one board member or an individual within an organisation
rather than promoting genuine cultural change.
There are organisations which are working in
innovative ways to engage their local communities and patients.
Examples we are aware of include:
— Brent Teaching PCT—Local teenagers
were recruited to distribute sexual health messages and a voucher
system for free condoms to tackle increasing rates of teenage
pregnancy and sexually transmitted infections. Reactions to the
campaign were overwhelmingly positive amongst the target, teenage
group. As one girl told the project team: "I don't want sex
education from some posh woman from Surrey. I want someone my
own age".
— Tower Hamlets PCT—the PCT identified
a significant spend on unnecessary admissions to local Accident
and Emergency departments. Analysis of focus groups and consumer
data found that local residents trusted the opinion of hospital
doctors more than local GPs. The PCT carried out a local education
campaign outlining the appropriate use of local health services
including GPs and pharmacists. Numbers of local residents presenting
to A&E fell.
— Slough PCT—increased its early
detection of diabetes by 164% by creating a tailored awareness
campaign for local residential areas: Action Diabetes. Local diabetes
patients, acting as health advocates, visited specific residential
areas where populations likely to be at high risk of diabetes
live. A mobile testing bus went to workplaces, shopping and leisure
centres. The campaign also included a free health magazine, health
information in different languages, celebrity support and local
media coverage.
Should the committee wish to interview representatives
of the campaign or the organisations we would be very happy to
facilitate this.
Tim Kelsey
Chair, Executive Board, Dr Foster Intelligence
January 2007
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