The Health Foundation's response to the NICE consultation on patient experience in generic terms
Date: July 2011
Download: The Health Foundation's response to the NICE consultation on patient experience in generic terms
Background
NICE is an independent organisation responsible for providing national guidance on promoting good health and preventing and treating ill health.
NICE is currently developing clinical practice guidance on patient experience in generic terms for use in the NHS in England, Wales and Northern Ireland (see original consultation documents). An associated quality standard is being developed for use in the NHS in England. The Health Foundation submitted comments on the clinical guideline, draft guidance and quality standard.
The Health Foundation’s response
The Health Foundation warmly welcomes the decision to create this guideline. Its development demonstrates an appreciation of the importance of patient experience as a core aspect of good clinical care. However, our preference would be that guidance on how to deliver care so that it reliably delivers a good patient experience is common to every piece of guidance issued by NICE. We would therefore like to see:
- the guideline amended in order that it is much clearer about how it will be implemented
- clarity about how existing and future guidelines will incorporate the good practice set out within this document consistently
- clarity about how the linking will be achieved between condition specific guidelines and this generic one.
A fundamental problem with the current draft of the guideline is that the underpinning research strategy is not clarified with sufficient rigour. The guideline consequently omits a great deal of relevant evidence that ought to be reflected within the theme of 'enabling people to actively participate in their care'. We recommend that the related recommendations are redrafted based on a much more coherent and comprehensive literature review.
There are significant inconsistencies between the generic guideline for adult health services and the separate guideline for mental health services. We recommend that the guideline development group for the generic patient experience guideline considers which aspects of the mental health guideline should be incorporated into the generic guideline.
The Health Foundation welcomes and supports the inclusion of the theme 'enabling people to actively participate in their care'. It is a critical aspect of high quality health services and one that has been much neglected. As currently drafted, however, we think that the level of expectation placed on health services around this domain within the guideline is limited and does not reflect the strength of the evidence.
The Health Foundation welcomes the prominence of the term shared decision making with the quality standard and we support the requirement not just to 'involve' patients in decisions but to 'support them to be involved'. In any revisions made as a result of this consultation process, we would urge that this important distinction is not lost.
The most significant weakness of the guideline, from our perspective, is the almost total absence of self-management support from the guideline beyond passing reference within the patient education section. Firstly, the evidence cited here is both incomplete and extremely out of date. Secondly, the inclusion of self-management support within a section titled patient education reflects a fundamental failure to understand the aims of self-management support and how it is broader than patient education.
