13) Patients' Evaluations of Healthcare

Question 1

Why are we interested in patient’s views of healthcare?

Answer 1

Patient satisfaction important
Humanitarian and ethical impetus
Patient’s involved in healthcare
Accountability and legitimacy - obtaining funding

Question 2

What are some ways that patients can give feedback on healthcare?

Answer 2

Friends and family test

Comments and rating on NHS choices

Question 3

What is the function of Healthwatch?

Answer 3

Gives consumers a voice that is heard by commissioners and regulators of healthcare

Question 4

What are the functions of patient advice and liaison service?

Answer 4

To offer confidential advice, support and information on health related matters
Advise on complaints procedures

Question 5

Describe the current complaints process:

Answer 5

Can complain to CCG or hospital

If unsatisfied goes to health service ombudsman

Question 6

What are patient’s problems with complaints?

Answer 6

Lack info on how to complain
Lack confidence that concerns will be resolved
People need support to complain
Want to know services learn from complaints

Question 7

How can patient’s views be investigated indirectly?

Answer 7

Complaints, ombudsman’s report

Question 8

How can patient’s views be investigated directly?

Answer 8

Qualitative - interviews, focus groups, observations

Quantitative

Question 9

Why are quantitative investigations used more often that qualitative?

Answer 9

Cheap and easy
Less staff training
Anonymity guaranteed
Easy analysis

Question 10

What are some things that cause patient dissatisfaction?

Answer 10

Interpersonal skills - poor communication, poor history taking
Content of healthcare - waiting times, poor access, poor outcomes, poor hygiene

Question 11

What are the challenges in responding to dissatisfaction?

Answer 11

Patient’s views not reasonable or rational

Limit to resources

Question 12

What is the functionalism approach to patient-professional relationship?

Answer 12

Lay people don’t have technical competence to remedy situation when ill, state of helplessness. Medicine restores good health

Question 13

What are the features of the sick role?

Answer 13

Situation of dependence
Freed of social responsibilities
Should seek help and comply with treatment

Question 14

What is the doctor’s role?

Answer 14

Use skills for benefit of patient

Question 15

What are the criticism of the functionalism approach?

Answer 15

Chronic illness doesn’t fit sick role
Assumes patients are incompetent and passive
Doesn’t explain why things go wrong

Question 16

What is the conflict theory approach to patient-professional relationship?

Answer 16

Doctors define health and illness and patient has little choice but to agree with this
Medicalisation causing loss of control for patient

Question 17

What are the criticism of the conflict theory?

Answer 17

Patients aren’t always passive, can exert control by non-adherence
Patients can also medicalise issues

Question 18

What is the interpretive approach to patient-professional relationship?

Answer 18

Looking at features of interaction that can help or hinder good care

Question 19

What is the patient-centred approach to patient-professional relationship?

Answer 19

More egalitarian relationship, considering whole person and using shared decision making

Question 20

What do patients need to contribute in a patient centred care approach?

Answer 20

Concerns and priorities

Severity of health problems

Question 21

What are the challenges of shared decision making?

Answer 21

Some people don’t want to do it
When should patient power be limited?
Who has final responsibility?
Is there time?

Question 22

What are the benefits of patient centred care?

Answer 22

Enhances prevention, health promotion and continuing relationship
Patient’s views taken into account