Public Views on Healthcare Performance Indicators and Patient Choice

Abstract

Patients on certain waiting lists in the UK National Health Service (NHS) are now offered the choice of persevering with their home hospital or switching to another hospital where they will be treated on a guaranteed date. Such decisions require knowledge of performance. We used facilitated focus groups to investigate the views of patients and members of the public on publication of information about the performance of healthcare providers. Six groups with a total of 50 participants met in six different locations in England. Participants felt that independent monitoring of healthcare performance is necessary, but they were ambivalent about the value of performance indicators and hospital rankings. They tended to distrust government information and preferred the presentational style of 'Dr Foster', a commercial information provider, because it gave more detailed locally relevant information. Many participants felt the NHS did not offer much scope for choice of provider. If public access to performance information is to succeed in informing referral decisions and raising quality standards, the public and general practitioners will need education on how to interpret and use the data.

Barriers to patient involvement in health service planning and evaluation: An exploratory study

“…Despite its prevalence, performance data is rarely used by patients in the United States and United Kingdom, who claim to prefer anecdotal reports from family and friends [15][16][17]. Performance data tends to focus on biomedical outcomes of treatment such as survival, but studies focused on primary, nursing and acute care found that patients are more interested in knowing about the quality of interpersonal interactions with health care providers [18][19][20].…”

Patient's need for choice and information across the interface between primary and secondary care: A survey

“…It is therefore highly important to inform these professionals on the characteristics of hospitals [21]. When undertaking an advisory role, the GP should be able to distinguish their personal opinions from objective information [22,23].…”

A Fair Range of Choice: Justifying Maximum Patient Choice in the British National Health Service

“…It would dramatically change the position of the health care professions, whose position I shall discuss further below. And although I have argued that this kind of choice follows a cultural trend in western society, as Magee et al [33] point out, it is far from clear that patients actually want choice on this scale at present, or feel able to exercise it. Despite being culturally resourced (as I have suggested) to formulate a wide range of preferences, people seem to be held back by the lack of other necessary resources, such as information, confidence [41] or the skill to use information appropriately [29].…”