Community mental health survey 2017

Latest survey from Care Quality Commission (CQC) looks at the experiences of people receiving community mental health services

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A survey of over 12,000 people who received care or treatment for a mental health condition found around two-thirds of respondents reported a positive experience of overall care.

The vast majority of respondents said that they knew how to contact the person in charge of their care if they had concerns. Higher proportion of respondents this year also knew who to contact out of hours if they were experiencing a crisis.

However, concerns remain about the quality of care some people experience when using community mental health services. There has been little notable improvement in survey results in the last year in the majority of areas.

The CQC believe the results suggest scope for further improvements in a number of areas including: crisis care, access and coordination of care, involvement in care, monitoring the effects of medication and receiving additional support.

Further detail via Care Quality Commission

Full analysis: 2017 Community Mental Health Survey Statistical release

Related:  CQC Report Finds ‘Major Issues’ Surrounding Access To Mental Health Care

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Digital Technology and health

Patient Carers and Service User Vision | National Information Board | Department of Health

This policy paper examines how changes in digital technology can be used to improve patient, carer and service user experiences of health services. The document will allow people to understand why and how changes are being introduced and to see whether the planned improvements are really happening.

Person-centred care

This report provides a snapshot of the extent of person-centred care, based on how people report their experience of treatment, care and support.  The report concludes there is a need for person-centred care to be given greater priority and a need for a strategic overhaul of what is measured.

Key findings:

  • Person-centred care is inadequately measured
  • A mixed picture: people’s experiences can be highly variable
  • Some aspects of person-centred care have improved
  • Progress towards involvement in decisions and being in control
  • Steady progress is now deteriorating, both for general practice and inpatient care
  • Little evidence of personalised care and support planning
  • Coordination of care is not measured
  • Family involvement is not central, and most carers need better support

Full report: Person-centred care in 2017: Evidence from service users

Communication difficulties experienced by deaf male patients during their in-hospital stay

Studies available have described several specific issues affecting healthcare accessibility by deaf people, but to date, no research has reported the experience of deaf patients with in-hospital communication | Scandinavian Journal of Caring Sciences

The aim of the study was to explore the communication experience of deaf patients with regard to their in-hospital stay. A purposeful sample of participants was selected. The data collection process was based on a focus group. The focus groups were conducted in Italian sign language and videorecorded; subsequently, the entire conversation was faithfully transcribed. A qualitative content analysis of the transcription was performed and the findings are reported using the Consolidated Criteria for Reporting Qualitative Research approach.

Four themes have emerged:

  • experiencing a common vulnerability: the need for reciprocal understanding and sensitivity,
  • being outside the comfort zone: feeling discriminated against once again,
  • perceiving a lack of consonance between care and needs and
  • developing a sense of progressively disempowerment.

The experience of deaf individuals during their in-hospital stay may be critical: they are exposed to protracted communication and interaction with healthcare providers and an environment that is not prepared and designed for these vulnerable patients. Two levels of strategies should be identified, implemented and developed to increase the quality of communication with deaf people during hospitalisation, both at the hospital/health system level and at the healthcare professional/clinical level.

Full reference: Sirch, L. et al. (2017) Communication difficulties experienced by deaf male patients during their in-hospital stay: findings from a qualitative descriptive study. Scandinavian Journal of Caring Sciences. Vol. 31 (no. 2) pp. 368–377

8 out of 10 patients are positive about GPs

As the NHS treats more patients than ever before, a new nationwide survey shows the majority of people are positive about their GP care – with almost 85 per cent rating their overall experience of their GP surgery as good | NHS England

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The GP Patient Survey 2017 compiled responses from more than 800,000 people across the country on their experience of healthcare services provided by GP surgeries, including access to GPs, making appointments, the quality of care received from GPs and practice nurses, satisfaction with opening hours and out-of-hours NHS services.

The majority of patients (84.3%) say they were able to get an appointment the last time they tried and around seven in ten patients (68%) say it is very or fairly easy to get through to someone at their GP surgery on the phone.

The survey found that confidence and trust in GPs remains extremely high at 91.9%, while almost three in four patients (77.4%) would recommend their GP surgery to someone who has just moved to the local area and 72.7% of patients rated their overall experience of making an appointment as good.

There has also been a marked improvement in the awareness of online GP services, with more patients saying they are aware of how to book appointments (up 3.8% on last year to 36.1%), ordering repeat prescriptions (up 2.6% to 34.1%) and access to medical records (up to 8.9%).

However, it also suggests areas for improvement, with one in ten patients (11.3%) saying they weren’t able to get an appointment – an increase of 0.5% on the 10.7% in 2016. And the number of patients reporting they can usually see their preferred GP dropping to 46.2% – down by 2.4% on last year.

Why UK hospital staff find it difficult to make improvements based on patient feedback

Patients are increasingly being asked for feedback about their healthcare experiences. However, healthcare staff often find it difficult to act on this feedback in order to make improvements to services | Social Science and Medicine

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This paper draws upon notions of legitimacy and readiness to develop a conceptual framework (Patient Feedback Response Framework – PFRF) which outlines why staff may find it problematic to respond to patient feedback.

A large qualitative study was conducted with 17 ward based teams between 2013 and 2014, across three hospital Trusts in the North of England. This was a process evaluation of a wider study where ward staff were encouraged to make action plans based on patient feedback.

Through the development of the PFRF, we found that making changes based on patient feedback is a complex multi-tiered process and not something that ward staff can simply ‘do’.

  • First, staff must exhibit normative legitimacy – the belief that listening to patients is a worthwhile exercise.
  • Second, structural legitimacy has to be in place – ward teams need adequate autonomy, ownership and resource to enact change. Some ward teams are able to make improvements within their immediate control and environment.
  • Third, for those staff who require interdepartmental co-operation or high level assistance to achieve change, organisational readiness must exist at the level of the hospital otherwise improvement will rarely be enacted.

Case studies drawn from our empirical data demonstrate the above. It is only when appropriate levels of individual and organisational capacity to change exist, that patient feedback is likely to be acted upon to improve services.

Full reference: Sheard, L. et al. (2017) The Patient Feedback Response Framework – understanding why UK hospital staff find it difficult to make improvements based on patient feedback: A qualitative study. Social Science & Medicine. 178. pp. 19-27.

 

Treatments and technologies matter, but patients most want to be seen as people

Patient stories are a raw and compelling new kind of online feedback. They can prompt rapid improvements in services – if the NHS is willing to embrace them | The Guardian Healthcare Network

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People have always shared their experiences of healthcare, usually privately, with family, neighbours or workmates. But online, patients and carers are increasingly willing to share accounts of their health service encounters with the wider world, often in intimate detail. There are websites devoted to collecting and publicising patient ratings and reviews of healthcare professionals, services, diagnoses and treatments.

The stories of patients and carers are becoming an unavoidable part of modern healthcare. In the US, people searching online for information about local services are more likely to read patient comments than official clinical outcome measures or patient experience metrics. In the UK, staff routinely read online patient feedback and share it on social media. NHS regulators have even started to think in terms of monitoring and analysing patient stories to provide an “early warning” for when things might be going wrong.

Read the full news story here