We're just at the start of this journey

Update from Patient Opinion Australia

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On 2nd April 2014, Dr James Munro (CEO of Patient Opinion UK) had the opportunity to speak at a reception for Patient Opinion in the Scottish Parliament.  Below is the text of his speech. His words capture where we are heading with Patient Opinion.

"Thank you Audrey, and thank you Cabinet Secretary for your very significant and very welcome support for Patient Opinion, and for hosting this reception. It’s a great honour to be here. I’m grateful, and slightly overwhelmed, to see so many people here this evening.

First, I wanted to highlight a particular phrase you used: Patient Opinion is about empowerment. It isn’t simply a ratings site. It is not about choosing your healthcare, it’s about changing your healthcare.

I think that understanding this single point is key to understanding not just what we set out to be, but why it is that Scotland will, I believe, soon be teaching the rest of the UK about the power of listening to and acting on patients’ stories.

When people first see Patient Opinion, many think “Tripadvisor for the NHS”. Not just because rating and review sites are so common online,  but also because many countries have pursued healthcare policies over the last 25 years which have tried to turn patients into shoppers.

But when people share their stories on Patient Opinion, they don’t seem to be thinking “My story  will be helpful to people wondering which hospital to pick for their heart attack, or their bowel cancer, or their child’s panic attacks.”

Instead, the patients and carers who share their stories are often talking, first, to the staff who cared for them. They are often wanting to say, simply, thank you. They are wanting to encourage staff. They are wanting to say: “Here’s what you did well”.

And sometimes to say: “But here’s what you could have done better.” Or: “This is how you made me feel. This is how you comforted me. This is how you gave me hope” Or: “This is how you took my hope away.”

In short, people aren’t rating or reviewing, they are communicating. They want to be heard, to be acknowledged, and to make a difference. And ideally, they want to see the difference they made – just as we all do.

And I think Scotland understands this. And so – although it’s early days – I’m really encouraged by how the reaction of health service staff to Patient Opinion in Scotland has focused on listening, learning, responding and improving.

Health policy here in Scotland isn’t about consumerism and competition. It’s about quality, safety, patient rights and person-centred care.

I think Scotland will go further, and faster, with Patient Opinion than other parts of the UK because of this. I think other parts of the UK should watch and learn from what you do here.

Second, I’d like to say something about the impact of enabling people to post their stories of care online, in public, for everyone to read.

Some stories do, of course, result in a clear, identifiable change, like the one from the patient who noted that the chairs on the orthopaedic clinic weren’t suitable for people with hip or back problems. And when we see practical improvements made in response to stories like this, a small cheer goes round the Patient Opinion team.

But the impacts go far wider than this.

There is the significance for the person who tells their story – sometimes for the first time, after many years. The telling of a story can mark a moment when healing has begun.

There is the wider learning others can take, not only from the story, but from those staff who respond with understanding and empathy and practical care. These others can include future health professionals in training, like the student nurses at Edinburgh University who routinely access Patient Opinion as part of their course.

And then there is the culture of healthcare itself. It might be too much to say that Patient Opinion is changing culture, but it would be true to say that it is a small part of a much larger movement towards a more open, transparent, and egalitarian culture across health care.

These wider impacts are only possible because the stories on Patient Opinion are public. Because they are public, they can be shared. This changes a story and a response from a one-to-one communication into a many-to-many communication.

There is no limit on who might learn something from each story we publish. Feedback systems which aren’t public miss out on an enormous opportunity.

Finally, I want to say a word about technology. Of course, none of this is really about technology, it’s about people and relationships. But it’s also about our imagining of what is possible.

When new technologies arrive, we have a tendency to see them simply as a better form of what we already know.

So, for example, the engineers who built the world’s first cast iron bridge, near Telford in Shropshire, had nothing previous to go on. They saw iron as a better kind of wood. They built the bridge using traditional carpentry techniques. It took many years to understand the true possibilities of iron.

And in the same way, the NHS has tended to view the Internet as a better kind of paper. If a paper survey is good, an Internet survey is better, bigger, cheaper. In some places – even in Scotland – this is still true.

But that’s to ignore the extraordinary potential of the Internet to connect people, to teach people, to change culture, in ways we haven’t even begun to imagine.

So please don’t think of Patient Opinion as the destination. It isn’t. We’ve taken only the first few tentative steps on this journey. We have plenty of ideas still to build into our service, and there are plenty more ideas for us, and you, still to dream up. We need to keep imagining.

This is just the beginning. And if we’re going to do this well, and help our health and care services be the best they can be, it’s important that we all – patients, carers, service users, staff, policy makers and, yes, politicians too – keep learning from one another, and make the journey together, in keeping with our shared values of public service.

So thank you again, Cabinet Secretary, for hosting us here this evening. Let’s continue to learn from one another, and do this better, so that the rest of the UK – and perhaps even other countries too – can learn from what you are doing here in Scotland.

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