Patient experience in adult NHS services

Short Text

Improving the experience of care for people using adult NHS services

Introduction

This pathway is about ensuring that people using adult NHS services have the best possible experience of care.
Despite various initiatives to improve the patient's experience of healthcare, further work is needed to deliver the best possible experience of care to people using adult NHS services. This pathway provides the NHS with clear guidance on the components of a good patient experience, with the aim of creating sustainable change that will result in an 'NHS cultural shift' towards a truly patient-centred service.

Equality Act 2010

The Equality Act 2010 replaces all previous anti-discrimination legislation, and includes a public sector equality duty requiring public bodies to have due regard to the need to eliminate discrimination and to advance equality of opportunity and foster good relations between people who share certain protected characteristics and those who do not. The protected characteristics are age, disability, gender reassignment, pregnancy and maternity, race, religion or belief, sex and sexual orientation. The Act provides an important legal framework which should improve the experience of all patients using NHS services.

Source guidance

The NICE guidance that was used to create the pathway.
Patient experience in adult NHS services. NICE clinical guidance 138 (2012)

Quality standards

Quality statements

Respect for the patient

This quality statement is taken from the patient experience in adult NHS services quality standard. The quality standard outlines the level of service that people using adult NHS services should expect to receive and should be read in full.

Quality statement

Patients are treated with dignity, kindness, compassion, courtesy, respect, understanding and honesty.

Quality measure

Structure
Evidence of local arrangements to provide guidance to staff on how to treat patients with dignity, kindness, compassion, courtesy, respect, understanding and honesty.
Outcome
Evidence from patient experience surveys and feedback that patients feel they have been treated with dignity, kindness, compassion, courtesy, respect, understanding and honesty.

Description of what the quality statement means for each audience

Service providers ensure that systems are in place giving guidance to all staff on treating patients with dignity, kindness, compassion, courtesy, respect, understanding and honesty.
Health and social care professionals treat patients with dignity, kindness, compassion, courtesy, respect, understanding and honesty.
Commissioners ensure they commission services that have guidance that enables staff to treat patients with dignity, kindness, compassion, courtesy, respect, understanding and honesty.
Patients are treated with dignity, kindness, compassion, courtesy, respect, understanding and honesty.

Source guidance references

NICE clinical guidance 138 recommendation 1.2.1.

Data source

Structure
Local data collection.
Outcome
Local data collection. Providers may be able to use questions contained within the patient surveys available from NHS Surveys.

Demonstrated competency in communication skills

This quality statement is taken from the patient experience in adult NHS services quality standard. The quality standard outlines the level of service that people using adult NHS services should expect to receive and should be read in full.

Quality statement

Patients experience effective interactions with staff who have demonstrated competency in relevant communication skills.

Quality measure

Structure
a) Evidence of local arrangements to ensure that annual appraisals or performance assessments of staff include mentoring for and evaluating compliance with the NICE guidance on patient experience.
b) Proportion of staff involved in providing NHS services who have compliance with the NICE guidance on patient experience examined at their annual appraisal or performance assessment.
Numerator – the number of staff in the denominator who have compliance with the NICE guidance on patient experience examined at their annual appraisal or performance assessment.
Denominator – the number of staff involved in providing NHS services.
Outcome
Evidence from patient experience surveys and feedback that patients feel staff communicated with them in a clear and understandable way.

Description of what the quality statement means for each audience

Service providers ensure that systems are in place to train and assess staff competency in relevant communication skills.
Health and social care professionals ensure that they receive training in relevant communication skills and can demonstrate this competency.
Commissioners ensure they commission services that have arrangements for competency-based training and assessment of relevant communication skills.
Patients are cared for by staff who can communicate with them in a clear and understandable way.

Source guidance references

NICE clinical guidance 138 recommendation 1.5.10.

Data source

Structure
a) and b) Local data collection.
Outcome
Local data collection. Providers may be able to use questions contained within the patient surveys available from NHS Surveys.

Patient awareness of names, roles and responsibilities of healthcare professionals

This quality statement is taken from the patient experience in adult NHS services quality standard. The quality standard outlines the level of service that people using adult NHS services should expect to receive and should be read in full.

Quality statement

Patients are introduced to all healthcare professionals involved in their care, and are made aware of the roles and responsibilities of the members of the healthcare team.

Quality measure

Structure
Evidence of local arrangements to ensure that patients are introduced to all healthcare professionals involved in their care, and are made aware of the roles and responsibilities of the members of the healthcare team.
Outcome
Evidence from patient experience surveys and feedback that patients were introduced to all healthcare professionals involved in their care, and were made aware of the roles and responsibilities of the members of the healthcare team.

Description of what the quality statement means for each audience

Service providers ensure that local policies are in place to make sure that patients are introduced to all healthcare professionals involved in their care, and are made aware of the roles and responsibilities of the members of the healthcare team.
Health and social care professionals ensure that they introduce themselves to patients and give a clear explanation of their role and responsibilities.
Commissioners ensure they commission services that have local policies in place requiring that all healthcare professionals introduce themselves to patients and give a clear explanation of their role and responsibilities.
Patients are introduced to all healthcare professionals involved in their care, and are made aware of the roles and responsibilities of the members of the healthcare team.

Source guidance references

NICE clinical guidance 138 recommendations 1.4.4 and 1.4.5.

Data source

Structure
Local data collection.
Outcome
Local data collection. Providers may be able to use questions contained within the patient surveys available from NHS Surveys.

Giving patients opportunities to discuss their health beliefs, concerns and preferences

This quality statement is taken from the patient experience in adult NHS services quality standard. The quality standard outlines the level of service that people using adult NHS services should expect to receive and should be read in full.

Quality statement

Patients have opportunities to discuss their health beliefs, concerns and preferences to inform their individualised care.

Quality measure

Structure
Evidence of local arrangements to ensure that patients have opportunities to discuss their health beliefs, concerns and preferences, and these inform their individualised care.
Process
Proportion of patients given the opportunity to discuss their health beliefs, concerns and preferences.
Numerator – the number of patients in the denominator who were given the opportunity to discuss their health beliefs, concerns and preferences.
Denominator – the number of patients accessing NHS services.
Outcome
Evidence from patient experience surveys and feedback that patients feel they had opportunities to discuss their health beliefs, concerns and preferences, and these informed their individualised care.

Description of what the quality statement means for each audience

Service providers ensure that systems are in place to provide opportunities to establish patients' health beliefs, concerns and preferences and use them to inform individualised care.
Health and social care professionals establish the patient's health beliefs, concerns and preferences and use them to inform individualised care.
Commissioners ensure they commission services in which the patient's health beliefs, concerns and preferences are established and used to individualise care.
Patients have opportunities to discuss their health beliefs, concerns and preferences, and these are taken into account when making decisions about their care.

Source guidance references

NICE clinical guidance 138 recommendation 1.1.4.

Data source

Structure
Local data collection.
Process
Local data collection.
Outcome
Local data collection. Providers may be able to use questions contained within the patient surveys available from NHS Surveys.

Understanding treatment options

This quality statement is taken from the patient experience in adult NHS services quality standard. The quality standard outlines the level of service that people using adult NHS services should expect to receive and should be read in full.

Quality statement

Patients are supported by healthcare professionals to understand relevant treatment options, including benefits, risks and potential consequences.

Quality measure

Structure
Evidence of local arrangements to ensure that healthcare professionals support patients to understand relevant treatment options, including benefits, risks and potential consequences.
Outcome
Evidence from patient experience surveys and feedback that patients were supported by healthcare professionals to understand relevant treatment options, including benefits, risks and potential consequences.

Description of what the quality statement means for each audience

Service providers ensure that systems are in place to support patients to understand relevant treatment options, including benefits, risks and potential consequences.
Health and social care professionals support patients to understand relevant treatment options, including benefits, risks and potential consequences.
Commissioners ensure they commission services in which patients are supported to understand relevant treatment options, including benefits, risks and potential consequences.
Patients are helped by healthcare professionals to understand relevant treatment options, including benefits, risks and potential consequences of care.

Source guidance references

NICE clinical guidance 138 recommendations 1.5.20 to 1.5.22, 1.5.24 and 1.5.25.

Data source

Structure
Local data collection.
Outcome
Local data collection. Providers may be able to use questions contained within the patient surveys available from NHS Surveys.

Shared decision making

This quality statement is taken from the patient experience in adult NHS services quality standard. The quality standard outlines the level of service that people using adult NHS services should expect to receive and should be read in full.

Quality statement

Patients are actively involved in shared decision making and supported by healthcare professionals to make fully informed choices about investigations, treatment and care that reflect what is important to them.

Quality measure

Structure
a) Evidence of local arrangements to ensure that patients are actively involved in shared decision making, including using the most effective way of communicating to maximise the patient's participation in decisions.
b) Evidence of local arrangements to ensure that patients are supported to make informed choices using risk communication and decision support, such as patient decision aids.
c) Evidence of local arrangements to ensure that information provided to facilitate shared decision making is evidence-based, understandable and clearly communicated.
Process
a) Proportion of patients who were asked about any issues that may prevent them being actively involved in decisions about their care.
Numerator – the number of patients in the denominator who were asked about any issues that may prevent them being actively involved in decisions about their care.
Denominator – the number of patients accessing NHS services.
b) Proportion of patients supported to use an evidence-based patient decision aid.
Numerator – the number of patients in the denominator supported to use an evidence-based patient decision aid.
Denominator – the number of patients accessing NHS services for whom there is a relevant evidence-based decision aid.
Outcome
a) Evidence from patient experience surveys and feedback that patients found that the information provided to facilitate shared decision making was understandable and clearly communicated.
b) Evidence from patient experience surveys and feedback that patients feel able to make decisions that reflect what is important to them.

Description of what the quality statement means for each audience

Service providers ensure that systems are in place to actively involve patients in shared decision making and to support patients to make fully informed choices about investigations, treatment and care that reflect what is important to them.
Health and social care professionals actively involve patients in shared decision making and support patients to make fully informed choices about investigations, treatment and care that reflect what is important to them
Commissioners ensure they commission services in which patients are actively involved in shared decision making and supported to make fully informed choices about investigations, treatment and care that reflect what is important to them.
Patients are actively involved in shared decision making and supported to make fully informed choices about investigations, treatment and care that reflect what is important to them.

Source guidance references

NICE clinical guidance 138 recommendations 1.1.2, 1.5.4, 1.5.23 and 1.5.25 to 1.5.27.

Data source

Structure
a), b) and c) Local data collection.
Process
a) and b) Local data collection.
Outcome
a) and b) Local data collection. Providers may be able to use questions contained within the patient surveys available from NHS Surveys.

Supporting patient choice

This quality statement is taken from the patient experience in adult NHS services quality standard. The quality standard outlines the level of service that people using adult NHS services should expect to receive and should be read in full.

Quality statement

Patients are made aware that they have the right to choose, accept or decline treatment and these decisions are respected and supported.

Quality measure

Structure
Evidence of local arrangements to ensure that patients are made aware of their right to choose, accept or decline treatment and that these decisions are respected and supported.
Process
Proportion of patients made aware of their right to choose, accept or decline treatment.
Numerator – the number of patients in the denominator made aware of their right to choose, accept or decline treatment.
Denominator – the number of patients accessing NHS services.
Outcome
Evidence from patient experience surveys and feedback that patients know about their right to choose, accept or decline treatment and feel that their decisions were respected and supported.

Description of what the quality statement means for each audience

Service providers ensure that systems are in place to make patients aware of their right to choose, accept or decline treatment, and to make sure that healthcare professionals respect and support these decisions.
Health and social care professionals ensure that they make patients aware of their right to choose, accept or decline treatment, and respect and support these decisions.
Commissioners ensure they commission services in which patients are made aware of their right to choose, accept or decline treatment and these decisions are respected and supported.
Patients have their choices respected and supported when deciding whether to accept or decline treatment, and when choosing between treatments.

Source guidance references

NICE clinical guidance 138 recommendations 1.3.7 and 1.3.8.

Data source

Structure
Local data collection.
Process
Local data collection.
Outcome
Local data collection. Providers may be able to use questions contained within the patient surveys available from NHS Surveys.

Asking for a second opinion

This quality statement is taken from the patient experience in adult NHS services quality standard. The quality standard outlines the level of service that people using adult NHS services should expect to receive and should be read in full.

Quality statement

Patients are made aware that they can ask for a second opinion.

Quality measure

Structure
Evidence of local arrangements to ensure that patients are made aware that they can ask for a second opinion.
Process
Proportion of patients made aware that they can ask for a second opinion.
Numerator – the number of patients in the denominator made aware that they can ask for a second opinion.
Denominator – the number of patients accessing NHS services.
Outcome
Evidence from patient experience surveys and feedback that patients know that they can ask for a second opinion.

Description of what the quality statement means for each audience

Service providers ensure that systems are in place to make patients aware that they can ask for a second opinion.
Health and social care professionals ensure that patients are made aware that they can ask for a second opinion.
Commissioners ensure they commission services in which patients are made aware that they can ask for a second opinion.
Patients are made aware that they can ask for a second opinion.

Source guidance references

NICE clinical guidance 138 recommendation 1.3.9.

Data source

Structure
Local data collection.
Process
Local data collection.
Outcome
Local data collection.

Tailoring healthcare services to the individual

This quality statement is taken from the patient experience in adult NHS services quality standard. The quality standard outlines the level of service that people using adult NHS services should expect to receive and should be read in full.

Quality statement

Patients experience care that is tailored to their needs and personal preferences, taking into account their circumstances, their ability to access services and their coexisting conditions.

Quality measure

Structure
Evidence of local arrangements to ensure that care is tailored to patients' needs and personal preferences, taking into account their circumstances, their ability to access services and their coexisting conditions.
Process
The proportion of patients with care tailored to their needs and preferences, taking into account their circumstances, their ability to access services and their coexisting conditions.
Numerator – the number of patients in the denominator who have care tailored to their needs and preferences, taking into account their circumstances, their ability to access services and their coexisting conditions
Denominator – the number of patients accessing NHS services.
Outcome
Evidence from patient experience surveys and feedback that care was tailored to the patient's needs and personal preferences, taking into account their circumstances, their ability to access services and their coexisting conditions.

Description of what the quality statement means for each audience

Service providers ensure that systems are in place to tailor care to patients' needs and personal preferences, taking into account their circumstances, their ability to access services and their coexisting conditions.
Health and social care professionals ensure that they tailor care to patients' needs and personal preferences, taking into account their circumstances, their ability to access services and their coexisting conditions.
Commissioners ensure they commission services in which care is tailored to patients' needs and personal preferences, taking into account their circumstances, their ability to access services and their coexisting conditions.
Patients experience care that is tailored to their needs and personal preferences, taking into account their circumstances, how easy it is for them to use the services they need, and any other health problems they have.

Source guidance references

NICE clinical guidance 138 recommendations 1.3.1 to 1.3.3.

Data source

Structure
Local data collection.
Process
Local data collection.
Outcome
Local data collection. Providers may be able to use questions contained within the patient surveys available from NHS Surveys.

Physical and psychological needs

This quality statement is taken from the patient experience in adult NHS services quality standard. The quality standard outlines the level of service that people using adult NHS services should expect to receive and should be read in full.

Quality statement

Patients have their physical and psychological needs regularly assessed and addressed, including nutrition, hydration, pain relief, personal hygiene and anxiety.

Quality measure

Structure
Evidence of local arrangements to ensure that patients have their physical and psychological needs regularly assessed and addressed.
Process
Proportion of patients who have their physical and psychological needs regularly assessed and addressed.
Numerator – the number of patients in the denominator who have their physical and psychological needs regularly assessed and addressed.
Denominator – the number of patients accessing NHS services.
Outcome
Evidence from patient experience surveys and feedback that patients feel their physical and psychological needs were regularly assessed and addressed.

Description of what the quality statement means for each audience

Service providers ensure that systems are in place to regularly assess and address patients' physical and psychological needs.
Health and social care professionals regularly assess and address patients' physical and psychological needs.
Commissioners ensure they commission services in which patients' physical and psychological needs are regularly assessed and addressed.
Patients are regularly checked and asked whether they need any extra support, for example with eating and drinking, pain relief, continence problems or anxieties.

Source guidance references

NICE clinical guidance 138 recommendations 1.2.4 to 1.2.9.

Data source

Structure
Local data collection.
Process
Local data collection.
Outcome
Local data collection. Providers may be able to use questions contained within the patient surveys available from NHS Surveys.

Continuity of care

This quality statement is taken from the patient experience in adult NHS services quality standard. The quality standard outlines the level of service that people using adult NHS services should expect to receive and should be read in full.

Quality statement

Patients experience continuity of care delivered, whenever possible, by the same healthcare professional or team throughout a single episode of care.

Quality measure

Structure
Evidence of local arrangements to ensure continuity of care and that, whenever possible, patients see the same healthcare professional or team throughout a single episode of care.
Process
Proportion of patients seeing the same healthcare professional or team throughout a single episode of care.
Numerator – the number of patients in the denominator seeing the same healthcare professional or team throughout a single episode of care.
Denominator – the number of patients accessing NHS services.
Outcome
Evidence from patient experience surveys and feedback that, whenever possible, patients saw the same healthcare professional or team throughout a single episode of care.

Description of what the quality statement means for each audience

Service providers ensure that systems are in place for care to be delivered, whenever possible, by the same healthcare professional or team throughout a single episode of care.
Healthcare professionals ensure that, whenever possible, the patient sees the same healthcare professional or team throughout a single episode of care.
Commissioners ensure they commission services in which, whenever possible, patients see the same healthcare professional or team throughout a single episode of care.
Patients see the same healthcare professional or healthcare team throughout a course of treatment whenever this is possible.

Source guidance references

NICE clinical guidance 138 recommendation 1.4.1.

Data source

Structure
Local data collection.
Process
Local data collection.
Outcome
Local data collection. Providers may be able to use questions contained within the patient surveys available from NHS Surveys.

Coordinated care through the exchange of patient information

This quality statement is taken from the patient experience in adult NHS services quality standard. The quality standard outlines the level of service that people using adult NHS services should expect to receive and should be read in full.

Quality statement

Patients experience coordinated care with clear and accurate information exchange between relevant health and social care professionals.

Quality measure

Structure
Evidence of local arrangements to support coordinated care through clear and accurate information exchange between relevant health and social care professionals.
Outcome
Evidence from patient experience surveys and feedback that patients feel that information about their care was shared clearly and accurately between relevant health and social care professionals.

Description of what the quality statement means for each audience

Service providers ensure that systems are in place to support coordinated care through clear and accurate information exchange between relevant health and social care professionals.
Health and social care professionals ensure that they support coordinated care through clear and accurate information exchange.
Commissioners ensure they commission services in which coordinated care is supported through clear and accurate information exchange between relevant health and social care professionals.
Patients can expect information about their care to be exchanged in a clear and accurate way between relevant health and social care professionals, so that their care is coordinated with the least possible delay or disruption.

Source guidance references

NICE clinical guidance 138 recommendations 1.4.2 and 1.4.3.

Data source

Structure
Local data collection.
Outcome
Local data collection. Providers may be able to use questions contained within the patient surveys available from NHS Surveys.

Definitions

Recommendation 1.4.3 in NICE clinical guidance 138 highlights that consent should be obtained from the patient before information is shared between relevant health and social care professionals.

Sharing information with partners, family members and carers

This quality statement is taken from the patient experience in adult NHS services quality standard. The quality standard outlines the level of service that people using adult NHS services should expect to receive and should be read in full.

Quality statement

Patients' preferences for sharing information with their partner, family members and/or carers are established, respected and reviewed throughout their care.

Quality measure

Structure
Evidence of local arrangements to ensure that patients' preferences for sharing information with partners, family members and/or carers are established, respected and reviewed throughout their care.
Process
Proportion of patients whose preferences for sharing information with partners, family members and/or carers are established, respected and reviewed throughout their care.
Numerator – the number of patients in the denominator whose preferences for sharing information with partners, family members and/or carers are established, respected and reviewed throughout their care.
Denominator – the number of patients accessing NHS services.
Outcome
Evidence from patient experience surveys and feedback that patients' preferences for sharing information with partners, family members and/or carers were established, respected and reviewed throughout their care.

Description of what the quality statement means for each audience

Service providers ensure that systems are in place to establish, respect and review patients' preferences for sharing information with partners, family members and/or carers.
Health and social care professionals establish, respect and review patients' preferences for sharing information with partners, family members and/or carers.
Commissioners ensure they commission services in which patients' preferences for sharing information with partners, family members and/or carers are established, respected and reviewed.
Patients are asked if they want their partner, family members and/or carers to be given information about their care, and their preferences are respected and reviewed throughout their care.

Source guidance references

NICE clinical guidance 138 recommendation 1.3.10.

Data source

Structure
Local data collection.
Process
Local data collection.
Outcome
Local data collection. Providers may be able to use questions contained within the patient surveys available from NHS Surveys.

Information about contacting healthcare professionals

This quality statement is taken from the patient experience in adult NHS services quality standard. The quality standard outlines the level of service that people using adult NHS services should expect to receive and should be read in full.

Quality statement

Patients are made aware of who to contact, how to contact them and when to make contact about their ongoing healthcare needs.

Quality measure

Structure
Evidence of local arrangements to ensure that patients are made aware of who to contact, how to contact them and when to make contact about their ongoing healthcare needs.
Process
Proportion of patients made aware of who to contact, how to contact them and when to make contact about their ongoing healthcare needs.
Numerator – the number of patients in the denominator made aware of who to contact, how to contact them and when to make contact about their ongoing healthcare needs.
Denominator – the number of patients accessing NHS services.
Outcome
Evidence from patient experience surveys and feedback that patients know who to contact, how to contact them and when to make contact about their ongoing healthcare needs.

Description of what the quality statement means for each audience

Service providers ensure that systems are in place so that that patients are made aware of who to contact about their ongoing healthcare needs, and how and when to contact them.
Health and social care professionals ensure that patients are made aware of who to contact about their ongoing healthcare needs, and how and when to contact them.
Commissioners ensure they commission services in which patients are made aware of who to contact about their ongoing healthcare needs, and how and when to contact them.
Patients are given clear advice about who to contact about their healthcare needs, how to contact them and when to contact them.

Source guidance references

NICE clinical guidance 138 recommendation 1.4.6.

Data source

Structure
Local data collection.
Process
Local data collection.
Outcome
Local data collection. Providers may be able to use questions contained within the patient surveys available from NHS Surveys.

Effective interventions library

Successful effective interventions library details

Implementation

Commissioning

These resources include support for commissioners to plan for costs and savings of guidance implementation and meeting quality standards where they apply.
These resources will help to inform discussions with providers about the development of services and may include measurement and action planning tools.

Pathway information

Information for the public

NICE produces information for the public that summarises, in plain English, the recommendations that NICE makes to healthcare and other professionals.
NICE has written information for the public explaining its guidance on each of the following topics.

Patient-centred care

Patients and healthcare professionals have rights and responsibilities as set out in the NHS Constitution for England – all NICE guidance is written to reflect these. Treatment and care should take into account individual needs and preferences. People should have the opportunity to make informed decisions about their care and treatment, in partnership with their healthcare professionals. If the person is under 16, their family or carers should also be given information and support to help the child or young person to make decisions about their treatment. Healthcare professionals should follow the Department of Health's advice on consent. If someone does not have capacity to make decisions, healthcare professionals should follow the code of practice that accompanies the Mental Capacity Act and the supplementary code of practice on deprivation of liberty safeguards.
For young people moving between paediatric and adult services, care should be planned and managed according to the best practice guidance described in the Department of Health’s Transition: getting it right for young people.
Adult and paediatric healthcare teams should work jointly to provide assessment and services to young people. Diagnosis and management should be reviewed throughout the transition process, and there should be clarity about who is the lead clinician to ensure continuity of care.

Updates to this pathway

27 March 2014 Minor maintenance updates
12 February 2013 Minor maintenance updates

Supporting information

Glossary

The Equality Act 2010 replaces all previous anti-discrimination legislation, and includes a public sector equality duty requiring public bodies to have due regard to the need to eliminate discrimination and to advance equality of opportunity and foster good relations between people who share certain protected characteristics and those who do not. The protected characteristics are age, disability, gender reassignment, pregnancy and maternity, race, religion or belief, sex and sexual orientation. The Act provides an important legal framework which should improve the experience of all patients using NHS services.

The patient as an individual

Knowing the patient as an individual

Knowing the patient as an individual

Develop an understanding of the patient as an individual, including how the condition affects the person, and how the person's circumstances and experiences affect their condition and treatment.
Ensure that factors such as physical or learning disabilities, sight, speech or hearing problems and difficulties with reading, understanding or speaking English are addressed so that the patient is able to participate as fully as possible in consultations and care.
Ask the patient about and take into account any factors, such as their domestic, social and work situation and their previous experience of healthcare, that may:
  • impact on their health condition and/or
  • affect their ability or willingness to engage with healthcare services and/or
  • affect their ability to manage their own care and make decisions about self-management and lifestyle choices.
Listen to and address any health beliefs, concerns and preferences that the patient has, and be aware that these affect how and whether they engage with treatment. Respect their views and offer support if needed to help them engage effectively with healthcare services and participate in self-management as appropriate.
Avoid making assumptions about the patient based on their appearance or other personal characteristics.
Take into account the requirements of the Equality Act 2010 and make sure services are equally accessible to, and supportive of, all people using adult NHS services.
If appropriate, discuss with the patient their need for psychological, social, spiritual and/or financial support. Offer support and information to the patient and/or direct them to sources of support and information. Review their circumstances and need for support regularly.

Quality standards

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Source guidance

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Tailoring healthcare services to the individual

Tailoring healthcare services for each patient

Tailoring healthcare services for each patient

An individualised approach to services

Adopt an individualised approach to healthcare services that is tailored to the patient's needs and circumstances, taking into account their ability to access services, personal preferences and coexisting conditions. Review the patient's needs and circumstances regularly.
Inform the patient about healthcare services and social services (for example, smoking cessation services) that are available locally and nationally. Encourage and support them to access services according to their individual needs and preferences.
Give the patient information about relevant treatment options and services that they are entitled to, even if these are not provided locally.

Patient views and preferences

Hold discussions in a way that encourages the patient to express their personal needs and preferences for care, treatment, management and self-management. Allow adequate time so that discussions do not feel rushed.
Review with the patient at intervals agreed with them:
  • their knowledge, understanding and concerns about their condition and treatments
  • their view of their need for treatment.
Accept that the patient may have different views from healthcare professionals about the balance of risks, benefits and consequences of treatments.
Accept that the patient has the right to decide not to have a treatment, even if you do not agree with their decision, as long as they have the capacity to make an informed decision and have been given and understand the information needed to do this. (For more information about capacity, see consent and capacity in this pathway.)
Respect and support the patient in their choice of treatment, or if they decide to decline treatment.
Ensure that the patient knows that they can ask for a second opinion from a different healthcare professional, and if necessary how they would go about this.

Involvement of family members and carers

Clarify with the patient at the first point of contact whether and how they would like their partner, family members and/or carers to be involved in key decisions about the management of their condition. Review this regularly. If the patient agrees, share information with their partner, family members and/or carers.
If the patient cannot indicate their agreement to share information, ensure that family members and/or carers are kept involved and appropriately informed, but be mindful of any potentially sensitive issues and the duty of confidentiality.

Feedback and complaints

Encourage the patient to give feedback about their care. Respond to any feedback given.
If necessary, provide patients with information about complaints procedures and help them to access these.

Quality standards

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Source guidance

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Continuity of care and relationships

Continuity of care and relationships

Continuity of care and relationships

Assess each patient's requirement for continuity of care and how that requirement will be met. This may involve the patient seeing the same healthcare professional throughout a single episode of care, or ensuring continuity within a healthcare team.
For patients who use a number of different services (for example, services in both primary and secondary care, or attending different clinics in a hospital), ensure effective coordination and prioritisation of care to minimise the impact on the patient.
Ensure clear and timely exchange of patient information:
  • between healthcare professionals (particularly at the point of any transitions in care)
  • between healthcare and social care professionals (with the patient's consent).
All healthcare professionals directly involved in a patient's care should introduce themselves to the patient.
Inform the patient about:
  • who is responsible for their clinical care and treatment
  • the roles and responsibilities of the different members of the healthcare team
  • the communication about their care that takes place between members of the healthcare team.
Give the patient (and their family members and/or carers if appropriate) information about what to do and who to contact in different situations, such as 'out of hours' or in an emergency.

Source guidance

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Service user experience in adult mental health pathway

View the 'Service user experience in adult mental health services overview' path

Paths in this pathway

Pathway created: March 2012 Last updated: March 2014

Copyright © 2014 National Institute for Health and Care Excellence. All Rights Reserved.

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