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JOURNAL SCAN
Year : 2021  |  Volume : 2  |  Issue : 2  |  Page : 191-192

Patient feedback on the quality of care they receive in hospitals in the UK: Is it possible to replicate this in India?


Department of Surgical Gastroenterology and Liver Transplantation, Sir Ganga Ram Hospital, New Delhi, India

Date of Submission23-Apr-2021
Date of Decision27-May-2021
Date of Acceptance27-May-2021
Date of Web Publication30-Aug-2021

Correspondence Address:
Mrs. Jini Jacob
Department of Surgical Gastroenterology and Liver Transplantation, Sir Ganga Ram Hospital, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JME.JME_38_21

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How to cite this article:
Jacob J, Thomas MN, Nundy S. Patient feedback on the quality of care they receive in hospitals in the UK: Is it possible to replicate this in India?. J Med Evid 2021;2:191-2

How to cite this URL:
Jacob J, Thomas MN, Nundy S. Patient feedback on the quality of care they receive in hospitals in the UK: Is it possible to replicate this in India?. J Med Evid [serial online] 2021 [cited 2021 Sep 25];2:191-2. Available from: http://www.journaljme.org/text.asp?2021/2/2/191/324962




  Article Information Top


Healthcare Quality. Using patient experience to run a hospital. Jacqui Wise. BMJ 2021;372n755 http://dx. doi. org/10.1136/bmj. n755.


  Background Top


The quality of healthcare is an important and widespread question that refers to a number of aspects of patient care. Healthcare that is exceptionally good is often described as being secure, reliable, patient-centred timely, accessible, equitable, and inevitable.

In the United Kingdom, healthcare is provided by the National Health Service (NHS), which is almost entirely funded by the government and to which more than 90% of British patients go.[1] By way of contrast in the USA, only 20% (like India) of healthcare expenditure is borne by the government, but unlike India where 80% of people pay out of pocket for healthcare, in the USA, the rest are mostly covered by health insurance (60% in not for profit hospitals and 20% in for private institutions). In India, only 15% of hospitals are non-profit and 85% run by corporations mainly for profit.

In this article, which was published in a recent issue of the BMJ, and rather Utopian, we think for our country, Annie Laverty, relates how scared she was when she was a patient after a motorcycle accident while on holiday in Turkey. She realised then how important it was to get feedback from patients about what was worrying them as they lay in their hospital beds. Back in Britain and after reading a paper by Donald Berwick, entitled 'What patient centred should mean: confessions of an extremist'.[2] Laverty from previously being a speech and language therapist is now Director of Patient Experience at the Northumbria Healthcare NHS Foundation Trust, and works on maintaining standards that may enhance the experience of both staff and patients.

To improve the quality and safety of treatment, she focuses on real-time patient input. The trust employs 10,000 staff and serves a population of 500,000 people in the north of England. The patient feedback is collected through 700 interviews a month which take about 30 min each. These include consistency and coordination of care, treatment with respect and dignity, involvement, doctors, nurses, cleanliness and pain control. The staffs are provided the results within hours.

Second, 2 weeks after discharge, a company called Patient Perspective collects feedback from 1500 inpatients, 1500 outpatients, 1500 emergency department users and maternity users. Feedback is sought at this time because this is when people are likely to be dissatisfied.

As a result, according to a National Inpatient Survey, the trust rose from being 111th out of 160 in the country in 2009 to 10th in 2020.

Laverty says it is important to be willing to listen, act swiftly, be transparent and have from the local executives. Starting with a team of three it has now grown to 30 and concentrates on patient experience, staff experience and quality improvement.


  Commentary Top


Is this model possible to replicate in India? We all wish it was but sadly it will take at least two to three decades before Indian patients will be able to demand what really are their rights.

This is mainly because of the fact that there is such a discrepancy in India between the inadequacy of the supply of medical care and the huge demand for it which allows doctors and other healthcare providers to dictate their own terms on whether it is admission to a healthcare facility, the investigations that are chosen or the treatment provided. All this is often motivated by personal profit or profit for the institution and it is not surprising that the Indian healthcare system has been rated, by Transparency International, to be the second most corrupt system after the police.[3]

The poor in public hospitals may have to wait 3 months, after a great deal of begging and using political influence, to be admitted with gallbladder cancer and jaundice because there are no beds and the government spends only 1.3% of the GDP on healthcare (in the US it is 17.8%).[4] If they go to the private sector, as most of them do after selling their major assets, they are not in a position to complain because they are ignorant and also they are scared they will be discharged prematurely in favour of a more compliant customer.

The rich and powerful including the people's representatives now almost exclusively go to the private sector where they are also exploited (because they are generally not paying themselves) or provided very important person treatment which may not always be what is best for them.

The vast discrepancy in social status between the healthcare providers and the poor and knowledge between doctors and the rich allows doctors here to be 'paternalistic' rather than equal to their patients. It is only the rare doctor who will explain why a particular test is being done and what the treatment options are.

At our Trust hospital, we provide printed patient feedback forms to all who are admitted. These include checkboxes for the admission process, counselling, board and lodging, care, security and discharge process.

The poor patients, who occupy 20% of our beds which are free, very rarely fill in the form being scared to criticise what they are getting gratis and the rich mainly complain about the housekeeping staff, the food, the noise and the time it takes between being told they are being discharged and the paperwork being completed.

There is hardly a single complaint against the doctors and nurses.

Enough said.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Battersby C, Statnikov Y, Santhakumaran S, Gray D, Modi N, Costeloe K, et al. The United Kingdom national neonatal research database: A validation study. PLoS One 2018;13:e0201815.  Back to cited text no. 1
    
2.
NHS Foundation. Northumbria supports patient experience feedback across the NHS. Available from: https://www.northumbria.nhs.uk/northumbria-supports-patient-experience-feedback-across-nhs/?. [Last accessed on 2021 Apr 23].  Back to cited text no. 2
    
3.
Kumar S. Health care is among the most corrupt services in India. BMJ 2003;326:10.  Back to cited text no. 3
    
4.
Das SA, Nundy S. Rationing medical resources fairly during the COVID-19 crisis: Is this possible in India (or America)?. Curr Med Res Pract 2020;10:127.  Back to cited text no. 4
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