Abstract
Anne Frank proclaimed ‘How wonderful it is that nobody need wait a single moment before starting to improve the world’.
The Gosport enquiry has revealed significant failures in the way our systems listen and act on feedback. Both the NHS and the police appear to have failed many patients and their relatives. What can we learn? We seem to be in a revolution of patient involvement in health care. Lay members are vocal on many boards that plan future healthcare services and patient feedback is fed into many decisions around care. Patient participation groups are now the norm. Complaints procedures are tighter, with closer monitoring and social media, along with the family and friends test, further scrutinise services and publicise feedback about patient experience.
So patients are being heard, but are we really listening? And is listening enough? It is surely action that is needed to improve failures and save lives. Listening on its own can't be enough. Active listening and listening with fascination are essential virtues to understand what is being said and the first step in promoting change. Quality improvement is all the rage across healthcare. Are patients actively involved enough? Are we now equipped to prevent another Gosport? And what further steps and shift in culture do we need to be certain that we are.
We must really listen to patients. The reflections around Gosport, as well as Mid-Staffordshire have highlighted the importance of really listening to patients and relatives as an important source of information about the services we provide. Too often patients who complain are felt to be a nuisance that need to be placated and managed. When patients take the time and trouble to give feedback, by way of complaints or NHS choices comments or patient participation group meetings, it must be acknowledged that they are trying to reconcile their experience and ensure that their experiences are valued. We must never be too grand to learn or be taught from a variety of sources. We must ensure we bring this out in how we change and commission services while being explicit about why we have chosen to change path in the light of patient experience. This ensures acknowledgement to patients and relatives taking time to give feedback.
We must learn from the patient’s journey. Recently a patient was obliged to see an orthopaedic surgeon in order to access physiotherapy. This inefficient, convoluted pathway was amended with liaison between primary and secondary care leadership. Following patients’ journeys across the health and social care landscape can reveal where improvements are needed.
With the rich resource of social media, healthcare leaders have never been in a better place to listen to patients and act on feedback. Simply hearing patients isn't enough and listening without action falls short of the cycle of feedback and change. Action can bring change and the potential to improve services and save lives.
Pip Hardy, the founding director of the Patient Voices Programme in Cambridge, reminds us that a MORI poll conducted in 2004 revealed that patients care more about being treated with dignity and respect than they do about mortality rates (Hardy, 2014). What more evidence do we need?
Roy T Bennett said: Listen with curiosity. Speak with honesty. Act with integrity. The greatest problem with communication is we don’t listen to understand. We listen to reply. When we listen with curiosity, we don’t listen with the intent to reply. We listen for what’s behind the words.