Why is there so little training on patient experience?
30 September 2019
Our chief executive Jocelyn Cornwell argues that more training and support should be available for patient experience professionals
Last month our Foundations in Patient Experience course obtained ‘Approved’ status from the Institute of Leadership and Management. The course is, remarkably, the only formal course in Britain designed for staff in patient experience roles. Why is this remarkable? Because the government told us a decade ago that quality of care was the number one priority for the NHS, and defined quality as having three dimensions: experience, safety and clinical quality (see Darzi 2008 High Quality care for All). There are many courses on patient safety and clinical quality but only the one course on patients’ experience.
The dearth of training options reflects a wider neglect of patient experience professionals in the NHS.
In the US, hospitals are creating executive Chief Experience Officers to lead patient experience, but there is only one Chief Experience Officer in the whole of the NHS (Annie Laverty at Northumbria Healthcare NHS Foundation Trust). In most trusts, heads and managers of patient experience (or as they are known in Scotland, heads and managers of ‘care experience’*) are lower down the managerial hierarchy.
A few NHS trusts in England have heads of patient experience who are former directors of nursing, speech therapy, physiotherapy, or one of the other allied health professions. These are skilled people: experienced at building rapport with colleagues across the organisation; strategically savvy; excellent communicators; and very effective. But they are a minority. Most heads and managers of patient experience are recruited from management or nursing roles lower down the hierarchy, and they need training to fill these challenging roles effectively.
Patient experience roles are not easy. They tend to be isolated from other disciplines and report to the director of nursing, although they are not nursing roles. They belong neither to clinical services nor to support functions. A fortunate minority work closely with colleagues in patient safety, clinical audit and quality improvement with whom they have much in common.
The sources of patient feedback add to the difficulty. When staff hear the word “feedback”, they think of the FFT (the Family and Friends Test), national patient surveys, and complaints. The Family and Friends Test has always been an easy target for sceptical clinicians who object that it lacks statistical rigour and technical credibility. The national surveys do not have that problem, but because the results arrive months after patients completed the survey, they feel too remote and disconnected from any particular service to engage clinicians’ full attention. Complaints, quite simply, make everyone defensive.
Eleven years on from High Quality for All, and six years on from Sir Robert Francis’ Report of the Inquiry into the Mid-Staffordshire Trust (2013), it remains the case that a great many people in the NHS, including senior leaders, see a good experience for patients as ‘nice to have’ but not ‘essential’. Patient demand is high, and staff who feel they do not have enough time to do their jobs properly challenge their patient experience colleagues to justify the relevance and importance of their work.
These factors, which make patient experience roles so hard, make the Foundations in Patient Experience course all the more valuable and important.
The course is intended for heads and managers of patient experience and those whose jobs involve engaging patients in service delivery, governance and improvement. The curriculum covers:
- history, policy and evidence related to patient experience
- organisational strategies for patient experience and involvement
- methods for measuring and reporting patient experience
- patient involvement and engagement (PPIE) and
- practical methods that enable staff to connect to patients’ experience as part of the work of making care more efficient, safer and more clinically effective.
Throughout the course we build in time for people to learn from colleagues in other organisations. The course is taught by a team of expert academics, patients (people who live with illness) and front-line professionals with a deep understanding of the links between patients’ experience of care, patient safety, clinical quality and staff satisfaction.
The feedback we have received from the 100-plus students who have participated in the course to date is captured in this quote from one head of patient experience, who told us:
Some people still have the myth that patient experience is just about ‘pink and fluffy’ hence it is treated as an add-on to portfolios of managers and executives. The ‘Foundations in Patient Experience Course’ was a real eye opener for me and empowered me with deeper understanding of patient experience and how to use this knowledge and skills to lead and do my job better.
We believe that leadership for patient experience is essential and aim to help heads and managers of patient experience be as effective and influential in their roles as possible. In Scotland, earlier this year, everyone in a care experience* role was offered access to the course. If the government’s promises about quality of care are to be honoured, we need to ensure that every single patient experience professional across the rest of the UK gets that opportunity.
* Note: In Scotland, where health and social care are more integrated, they talk more about ‘care experience’ than in England