An opportunity for change: Centring outcomes on patient experience

Our new report, Working for patients: How improving the experience of patients with long-term conditions can deliver the Government’s ten year health plan, examines the experience of people living with long-term conditions and lays out pragmatic solutions to help us better understand the quality of the care they receive.

A staggering 25 million people in England are currently estimated to have a least one long-term condition (LTC), with 13.4 million having two or more. The burden is also not spread evenly, with people in the areas facing the greatest socio-economic inequality developing multiple LTCs 10 years earlier than people living in the areas facing the least.  

Helping people to manage these conditions is said to account for 70% of GP appointments and 50% of hospital activity. It is an enormous chunk of what the NHS does but, unlike with elective performance or A&E waits, it’s almost invisible in the way the NHS judges performance at the moment. 

According to the GP Patient Survey, 94% of patients with an LTC who had a conversation with their GP about what was important to them in managing their condition said it was helpful to them. Shared decision making clearly makes a difference. The problem is only about half of patients are having these discussions. The net impact of these missed conversations means 22% of patients say they are either “not very confident” or “not at all confident” in managing the issues caused by their illness or condition. That is equivalent to 5.5 million patients. 

These 5.5 million patients, with their unmanaged symptoms, are highly likely to end up being more frequent users of NHS services (costing more in the short term), or be storing up more serious problems for the future (costing more in the long-term).  

There is much talk of the 10 Year Plan wanting to support patients to self-manage their health more. People with chronic conditions should therefore be an obvious focus for those currently holding the pen on the plan. The opportunity for impact is huge, both in terms of reducing demand on the NHS but also in terms of restoring confidence in the NHS among millions of people.  

Lastly, using patient experience of managing their LTCs as a key success measure for the NHS would provide a way of assessing whether the Government’s three shifts are working, as well as shifting culture from activity to experience.

At National Voices, we have an ambition to develop a clear set of new integrated care board and national metrics that can sit alongside the focus on productivity, to really challenge and change the culture within patient experience, as well as provide a valuable understanding of how the Government’s three shifts are changing care for patients.

We have made suggestions in our report of what these might look like but want to engage with stakeholders much more widely to understand appetite and focus on what might work. Do get in touch with your any thoughts on the report, by emailing Sharon Brennan, Director of Policy and External Affairs, or Lucy Seymour, Senior Policy and External Affairs Officer.

We are also delighted that the Independent has covered our report and you can read the news piece here.