QLD Health Blueprint

Queensland Health has released its Blueprint for its approach to a better health system. Their key values include openness, a better service for patients and empowering local communities with a greater say over their hospital and local health services. Underpinning all of this is placing the patient at the centre of the health system, and that transparency should promote public confidence.

Public confidence is more than clinical excellence. There’s a psychological dimension to public confidence that goes beyond technical competence. Technical competence is important, but wins the hearts and minds of patients are the relational aspects of care.

So how can we know, in a transparent way, that the public and patients feel that the relational aspects of care are being implemented, and that they are being empowered to have their say and be heard? The recent Francis Report released in the United Kingdom, the biggest public inquiry into the NHS since the Royal Bristol Infirmary disaster, highlights the deficiency of health systems and health services to engage patients in an open and transparent conversation about what works well and what does not work so well in the delivery of their care.

The Francis Report goes on to say that it is recognised that effective patient feedback is a powerful means of scrutinising the performance of health providers in terms of safety and quality. Obtaining feedback from patients and others during an outpatient appointment or a course of in-patient treatment is desirable to offer but not a sufficient means of obtaining a true account of patient and public opinion of a service. It is quite clear that patients and their supporters can be very reluctant to raise concerns or make critical comments at a time when they feel vulnerable.

Here’s one story that clearly highlights this issue https://www.patientopinion.org.au/opinions/58572of managing patient complaints ‘behind closed doors’. This story, posted by a patient advocate, follows their journey through the complaints process ending in what they said were ‘threatening’ emails from an Ombudsman at the National Health Practitioner Ombudsman and Privacy Commissioner (NHPOPC). Would this have been different if this correspondence were transparent and public? The answer is yes, unless the employee in question at the NHPOPC wanted to lose their job. People need to be held accountable for their actions and patient complaints and concerns should not be allowed to be swept under the rug. We have since contacted the NHPOPC offering them the opportunityto respond but we have not yetreceived a reply.

Publication of comments online, good and bad, is a powerful tool for patient choice and in forcing providers to address, in public, criticisms made. While making a response is not mandatory, failure to do so is likely to cause the public to draw adverse inferences.

The Francis Report goes on to say that the results and analysis of patient feedback need to be made available to all stakeholders as near “real time” as possible, even if later adjustments have to be made.

Public, transparent, independent and anonymous social media platforms enable this type of productive conversation that is good for the patient and beneficial for health services in order to demonstrate their responsiveness to the voice of the patient and bring about patient-centred, patient-focused service improvement.