9. Patients' Evaluations of Healthcare and Relationships between Patients and Professionals

Question 1

What is the NHS patient prospectus (2000)?

Answer 1

An account of patients’ views and action taken as a result, it is published annually.

Question 2

What is the ‘Involving patients and the public in healthcare (2001)’?

Answer 2

Builds on the patient prospectus as a formal response to Bristol enquiry.

Question 3

How must health authorities and trust involve and consult patients and the public (2006)?

Answer 3

Decisions about the planning, developing and considering changes in way services are provided.

Question 4

What is the purpose of the NHS outcomes framework (2012/13)?

Answer 4

Ensure people have a positive experience of care.

Question 5

What are LINks (local involvement networks)?

Answer 5

Independent networks of individuals or community groups that aim to ensure each community has services that reflect needs and wishes of local people. They make recommendations to those who plan and run services.

Question 6

What are PALS (patient advice and liaison services)?

Answer 6

On the spot help about health services that listen to patients’ concerns, suggestions, and experiences and provide early warning system identifying problems/gaps in services. Provide information about NHS complaints procedure.

Question 7

What is the current NHS complaints procedure?

Answer 7

Single system since 2009, focuses on satisfactory outcomes and uses risk assessment to deal with serious complaints seriously. Independent investigators are used if necessary. Have special advocates for special needs.

Question 8

What is the parliamentary and health service ombudsman report?

Answer 8

Ultimate and independent view of what has happened based on independent investigations into complaints that NHS has not acted properly or fairly in England.

Question 9

How can qualitative methods be used in investigating patients’ views?

Answer 9

Interviews, focus groups, observations to identify patients’ priorities and how they evaluate care.

Question 10

What can quantitative methods be used in investigating patients’ views?

Answer 10

Cheap, easy, anonymous ways of monitoring performance. Use national, validated surveys generally.

Question 11

What are the limitations of using local DIY instruments for quantitative investigation of patients’ views?

Answer 11

Lack comparability, don’t have proven reliability, tend to find higher levels of satisfaction.

Question 12

What can cause dissatisfaction in patient surveys?

Answer 12

Poor communication from health professionals, inconvenience (e.g. waiting times), hotel aspects like food, culturally inappropriate care, competence, health outcomes.

Question 13

What are the advantages of using patient-based outcomes to assess doctors’ performance?

Answer 13

Care is for patients, so they should find it adequate.

Question 14

What are the disadvantages of using patient-based outcomes to assess doctors’ performance?

Answer 14

They may not give an objective view - from a selfish point of view, not applicable on national scale.

Question 15

What are the four sociological approaches to understanding patient-professional relationships?

Answer 15

Functionalism, conflict theory, interpretivism/interactionism, patient-centred/partnership.

Question 16

What is functionalism as a patient-professional relationship?

Answer 16

Doctor is powerful and patient has a sick role. Lay people don’t have technical competence to remedy situation so are helpless.

Question 17

What is a sick role?

Answer 17

Legitimate reason to be freed of social responsibilities and obligation. Situation of dependence and want to get better so seek technical help.

Question 18

What is the doctor’s role in functionalism?

Answer 18

Tending to sickness in society using skills for the benefits of the patients and in return have intimate access to patients.

Question 19

What are the criticisms of the functionalist approach to patient-professional relationships?

Answer 19

Sick role doesn’t work for patients who never get better. Assumes incompetence from sick role and beneficence of medicine.

Question 20

What is the conflict theory of patient-professional relationships?

Answer 20

Doctor’s control is from professional values/technical expertise but also from the fact that the doctor holds all bureaucratic power so doctors have a monopoly on health and illness as people become dependent on medicine.

Question 21

What are the criticisms of the conflict theory?

Answer 21

Patients can exert control so aren’t always passive.

Question 22

What is the interpretive/interactionist approach to patient-professional relationships?

Answer 22

Focus on meanings that both parties give to the encounter according to informal, unwritten rules so encounters are framed by a set of expectations.

Question 23

What is a patient-centred model/partnership approach to patient-professional relationships?

Answer 23

Less hierarchical and more cooperative as the patients views are more seriously considered. Emphasis on equality and health promotion as patients have power.

Question 24

Which approaches to patient-professional relationships are explanatory and aspirational?

Answer 24

Explanatory - functionalism, conflict, interpretive/interactionism.
Aspirational - patient-centred/partnership.