Chapter Four: Conclusions
4.1 This research into the issues that patients see as important about the NHS in Scotland has highlighted a great deal of good will towards and support for the NHS. Patients are generally thankful to have an NHS and compare the free provision of services at the point of contact to what they see as a much worse service in other countries. Some patients gave examples of where the NHS had kept them alive in an emergency.
4.2 In addition to the positive aspects of their care, patients also highlighted a number of themes which they saw as important and in which room for improvement was possible. The themes identified by patients were:
- Access to systems and staff
- Environment and facilities
- Good communication
- Expert clinical care
- Well coordinated care and treatment
4.3 The issues identified as being important and the subsequent themes are similar to themes identified from similar research elsewhere. For example, the Department of Health in England has 5 themes for their Public Service Agreement ( PSA) target on patient experience for both inpatient and primary care - Access and waiting, safe high quality co-ordinated care, better information more choice, building closer relationships and clean friendly and comfortable place to be.
4.4 While this research has described the issues that are important, this is only from the viewpoint of a relatively small group of people. The report doesn't set out to reliably assess the relative importance to patients and users of each of the issues. However, a preliminary rating exercise using card-sorts has shown that issues related to patients' clinical care, for example getting the best available treatment, doctors knowing enough about the patients care and treatment and a quick diagnosis were rated as more important than issues around the environment such as car parking, noise at night, travelling time to hospital and choice of hospital as well as healthcare advice. This is in line with similar research carried out elsewhere. For example 4 of the top ranked items in the inpatient card-sort were also ranked in the top 10 most important items in similar research carried out by Picker Institute Europe in 2006 2 in England - doctors knowing enough about my condition and treatment, staff cleaning their hands between touching patients, feeling confident in the doctors, being told the risks and benefits of any treatment in a way I can understand.
4.5 The next stage of this project is to mail out a questionnaire to large number of patients asking them to rate the importance of the issues highlighted in this report. The results from the survey will, in turn, inform the coverage of the main patient survey questionnaires used by NHS Scotland from 2009.