Why Joan Taylor matters: current research on patient experience

Joan Taylor is in her late 50s now, and was diagnosed with type 2 diabetes 8 years ago. She attends her GP practice for her annual diabetic review, so the nurse can “tickle her feet”, as she describes it. She still doesn’t quite understand what being diabetic means – she’s never had a funny fit or anything like that, and finds it hard to engage with the nurse’s advice on all that healthy lifestyle stuff. Anyway, today she has an appointment with a GP at her practice as she’s got a cough that just won’t shift, and wonders if she needs antibiotics. It was a bit of a pain making an appointment, as it often is; she had to phone quite a few times to get through, and then when she did she felt she got a grilling about why she wanted to take up the doctor’s precious time. She finally got offered a slot that afternoon, with a doctor she’s never heard of. She’s a bit late and flustered arriving for her appointment – there were no parking spaces in the practice’s tiny car park, and she had to park much further up the street. She could do with losing a few pounds, as she has admitted to a few good friends, and is a bit puffed out from the walk. She tried to use the check-in thingy but couldn’t get it to work, so queued up instead to tell a frosty seeming receptionist she was here. After a long wait, a voice came over the tannoy system calling something which could have been her name. She wasn’t quite sure where she was supposed to go, so listened again and eventually headed off down the corridors to try to find the GP.

This is patient experience. This is the complex set of expectations and events that make up a critical component of quality of care: not the effectiveness of the clinical care on offer, but the interpersonal aspects of that care and the environment in which it is delivered. And this matters. Joan needs accessible care; she needs information and education; she needs emotional support; and she needs to be respected as the central actor in her own health.

Our current programme of work, funded by the National Institute for Health Research and led by Martin Roland from CCHSR and John Campbell from Exeter University Medical School, aims to develop our understanding on a whole range of issues around the assessment and utilisation of patient experience to improve primary care. Actually, we’re particularly interested in how patients assess the interpersonal aspects of consultations – what happens when Joan finds the GPs’ office and explains about her ongoing cough? Does she feel she has enough time, is she listened to, does she understand the GP’s explanation? Does she have confidence and trust in the GP? These issues are the primary focus of our seven research projects over five years, including:

  • How reports of patient experience vary between GPs within a practice as well as between practices
  • How GPs and practices understand, process and use patient experience feedback for their development and improvement
  • The associations between patients’, GPs’, and external raters’ assessments of the quality of interpersonal aspects of consultations, using video-recorded consultations
  • Why ethnic minorities, particularly South Asians, consistently report more negative experience of primary care

Patient experience may be firmly on the policy agenda, but there’s a long way to go in ensuring we most effectively capture and act on the views of people like Joan. We’ll keep you posted on our findings.

Further reading

NHS patient experience framework

Roland M. Measuring and improving patient experience in primary care (editorial). Primary Health Care Research and Development 2012; 13: 103-5

 

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  • The Cambridge Centre for Health Services Research (CCHSR) is a thriving collaboration between the University of Cambridge and RAND Europe. We aim to inform health policy and practice by conducting research and evaluation studies of organisation and delivery of healthcare, including safety, effectiveness, efficiency and patient experience.