Title: Development of New Models for Collection and Use of Patient Experience Information in the NHS
Funder: Department of Health (England)

Abstract: Background In the last decade measurement of patient experience has become prominent in NHS performance management and service improvement, with national patient surveys taking a key role. More recently the importance of patient experience has very significantly increased due to a growing policy focus on users’ outcomes and experiences. The NHS Outcomes Framework 2011/12[1] establishes patient experience of care as one of five domains used to assess performance of the NHS both nationally and locally. In the short term a number of indicators from existing national surveys can be used to monitor patient experience, but the Outcomes Framework makes clear that longer term work is needed to ensure measurement of patient experience is fit for purpose. Similarly, NICE has recently consulted on a draft report setting out 66 guidelines and 17 quality standards for patient experience in generic terms[2]. Amongst sources used by the guidelines are frameworks for patient experience such as Institute of Medicine[3] and Picker Principles[4-5]. Contemporaneously, a wide-ranging review conducted for DH, “What matters to patients?”[6], argues that there is considerable convergence of understanding on what matters most to patients, but uneven success in measuring and using evidence of patient experience. Aims The proposed study will seek to develop a simple, conceptually grounded and unified model for assessing patient experience and provide an evaluation of that model. The work will involve mixed methods: quantitative evidence in the form of patients’ responses and response rates to pilot surveys and qualitative evidence in the form of analyses of stakeholders’ views of the model and pilot surveys. A second and distinct aim is to evaluate whether and how pathway and service-line focused measures of patients’ experiences add value to standard organisational surveys. Research plan Phase 1 will aim to achieve an agreed definition of key domains of patient experience via (i) literature review and synthesis, (ii) expert consultation, and (iii) exploration of the credibility of emerging domains with key stakeholders. Phase 2 will involve: (i) Up to ten pilot surveys carried out in contrasting NHS service-line and pathway-defined settings to determine the extent to which a generic model works and to assess patterns of response, response rates, and response bias. (ii) Interviews with those involved in survey administration and potential audiences of survey results (including health professionals and commissioners). These interviews will address the meaning and interpretability of survey data, alternative ways of presenting data, potential relevance to service improvement, and leverage in the commissioning process. Phase 3 will provide an overall synthesis of evidence obtained in the study, evaluating the success of the new model of patient experience both quantitatively and qualitatively. Research team Individual members of the team are described in section 10. This application brings together groups and individuals responsible for leading quantitative and qualitative research, development, and thinking in patient experience, PROMs, and health surveys. Importantly all members of the group have worked extensively with at least some of the other members, ensuring a strong and cohesive research team. Many are also involved in the development of a multi-disciplinary Health Experiences Institute in Oxford, which provides an ideal research environment for this work. Potential impact/influence Given the current policy imperative around patient experience and the variable quality of surveys conducted locally and nationally, this project is highly timely and has significant potential for impact. The project will provide evidence-based knowledge and tools to support the NHS’s overarching policy and approach to measuring patient experience. This includes making available a range of survey instruments for use by providers and commissioners, immediately adding specific value for a wide range of stakeholders.


Research activity codes: 8.4 RESEARCH DESIGN AND METHODOLOGIES (HEALTH SERVICES)
Health categories: STROKE;CANCER AND NEOPLASMS;METABOLIC AND ENDOCRINE;CARDIOVASCULAR;ORAL AND GASTROINTESTINAL