Patient Evaluations

Question 1

Give five policies for patient evaluations

Answer 1

NHS plan (2000)- emphasis on care around patient and must publish patient views
Involving patients and public in healthcare (2001) by DoH- proposals built on NHS plan as response to Bristol Enquiry
NHS act (2006)- placed duty on CCGs to involve patients
White Paper (2010)- consumer champion health watch England will strengthen public vote, encourage surveys and feedback informs choices
NHS Outcomes Framework (2015-2016)- ensuring positive care experience

Question 2

How can patients give feedback?

Answer 2

Friends and family test
NHS choices website
Forums

Question 3

What does local health watch do?

Answer 3

Has power to enter and view services
Influence service set up and commissioning
Reports to influence design and development
Pass info to health watch England

Question 4

What does PALS do?

Answer 4

Trust based patient advice and liaison services to give info and advice for concerns, info or complaints

Question 5

How are complaints dealt with?

Answer 5

Raise informally or through PALS-> formal complaint to CCG or hosp-> if satisfied then no more action but if not then goes to ombudsman

Question 6

What are the problems with complaints systems?

Answer 6

Lack of info, doubt concerns will be reviewed, complex system, lack of support

Question 7

How can views be investigated?

Answer 7

Indirectly: complaints
Directly: qualitative-patient priorities, quantitative-measure performance
National patient surveys
Locally developed DIY instruments

Question 8

Why are patients normally dissatisfied?

Answer 8

Poor communication

Content of care

Question 9

What are the four theories of patient-professional relationships?

Answer 9

Functionalism: emphasises consensus and reciprocity
Conflict theory
Interpretive approach
Patient centred models

Question 10

What is functionalism?

Answer 10

Relationship works due to sick role so ill person enters social role of helplessness, no responsibilities, seek help. Doctor tends to sick using skills

Question 11

What are the criticisms of functionalism?

Answer 11

Chronic illness won’t get better, assumes passive and incompetent patients

Question 12

What is the conflict theory?

Answer 12

Doctor has bureaucratic power and exploits many health and illness definitions
Discount lay ideas
Childbirth medicalised so loss of control for women

Question 13

What are the criticisms of the conflict theory?

Answer 13

Patients have control through non-adherence
Patients may seek to medicalise issues
Is there always conflict?

Question 14

What is the interpretive approach?

Answer 14

Interaction patterns
Focuses on meanings doctors and patients give to meetings
Informal and unwritten rules govern social life

Question 15

What is the patient centred model?

Answer 15

Egalitarian relationship
Hope doctor-patient relationship is less hierarchical so patient views addressed
Both share info and make decision
Increased prevention and promotion
Ideas about quality vs quantity of life

Question 16

What are the criticisms of patient centred model?

Answer 16

Patient may want to be told what to do
Who is responsible?
Power of patients is limited
Time

Question 17

Why do we need patient evaluations of healthcare?

Answer 17

Evidence of patient satisfaction and treatment outcome
Shared decision making
Consumerism (patient chooses hosp)
Increased external regulation of services