NICE clinical guidelines
Issued: February 2012
CG138

Patient experience in adult NHS services: improving the experience of care for people using adult NHS services

This is an extract from the guidance. The complete guidance is available at guidance.nice.org.uk/cg138

Introduction

Over the past few years, several documents and initiatives have highlighted the importance of the patient's experience and the need to focus on improving these experiences where possible.

Lord Darzi's report High quality care for all (2008) highlighted the importance of the entire patient experience within the NHS, ensuring people are treated with compassion, dignity and respect within a clean, safe and well-managed environment.

The development of the NHS Constitution (2009–2010) was one of several recommendations from Lord Darzi's report. The Constitution describes the purpose, principles and values of the NHS and illustrates what staff, patients and the public can expect from the service. Since the Health Act came into force in January 2010, service providers and commissioners of NHS care have had a legal obligation to take the Constitution into account in all their decisions and actions.

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.

Despite these policy initiatives, there is evidence to suggest that further work is needed to deliver the best possible experience for users of NHS services. The Government signalled in its White Paper Equity and excellence: liberating the NHS (2010) that more emphasis needs to be placed on improving patients' experience of NHS care.

This guidance is a direct referral from the Department of Health. It focuses on generic patient experiences and is relevant for all people who use adult NHS services in England and Wales. The aim of the guidance is to provide the NHS with clear guidance on the components of a good patient experience. This guidance provides the evidence and the direction for creating sustainable change that will result in an 'NHS cultural shift' towards a truly patient-centred service.

A NICE quality standard for patient experience in adult NHS services has been developed alongside this guidance. NICE quality standards are a set of specific, concise statements and associated measures. They set out aspirational, but achievable, markers of high-quality, cost-effective care. Quality standards are derived from the best available evidence and address three dimensions of quality: clinical effectiveness, patient safety and patient experience. The quality statements for patient experience in adult NHS services are listed in the next section.

NICE clinical guidelines are usually shaped around both clinical and economic evidence, and include recommendations concerned with ensuring a good patient experience, with the recognition that such advice should sit alongside evidence of clinical and cost effectiveness. The recommendations in the current guidance have been informed by research evidence, recommendations in previously published NICE clinical guidelines, national survey data and consensus processes that have identified the key elements that are important to patients and how these can be improved to ensure a good experience of care. The guidance draws on multiple evidence and data sources in developing the recommendations, which are further distilled into commissioning guidance in the quality standard.

The recommendations in this guidance are directed primarily at clinical staff, but patient experience is also significantly affected by contacts with non-clinical staff such as receptionists, clerical staff and domestic staff. Services need to ensure that non-clinical staff are adequately trained and supported to engage with patients in ways that enhance the patient experience.

Taken together, the recommendations in this guidance capture the essence of a good patient experience. Their implementation will help to ensure that healthcare services are acceptable and appropriate, and that all people using the NHS have the best possible experience of care.