Patients rate good local services above choice

A report into patient choice has argued that while Choose and Book is seen by the public as a positive service improvement in the NHS, it does not meet their priorities for healthcare choice.

The report found that the vast majority of patients value having high quality local health services available above choice.  Interviewed by Which? 89% of patients put a good local hospital ahead of a choice of places.

The author of the report cautioned that patient choice should not be seen as a a panacea to the problems faced by the NHS and will not automatically improve standards or ensure that people get the sort of care they need. 

Consumer body Which? interviewed a series of focus groups for their report, and found that patients wanted to be able to choose the GPs and the consultants they saw and the time of their operation. They also wanted better transport options and  wards for people of similar ages with similar conditions; none of which is on offer from Choose and Book, they said.

According to the report the DH’s pilots of Choose and Book showed that patients tended to be somewhat erratic in the way they tried to exercise choice; for instance, trying to opt for providers not on the list, or splitting their care between more than one organisation.

"If and when consumers have experience of choosing where they are treated, they may not be satisfied with such limited choices," say the report.

Lack of information about the choices that patients can make and about Choose and Book is a crucial problem, and Which? accused the DH of underestimating this: "We do not believe the Government has fully recognised the restrictions placed on meaningful choice by the lack of reliable and useful information, and the limited ability and willingness of most consumers to use it."

Frances Blunden, author of the report, said: "Increased patient choice is not the answer to all the problems of the NHS. It will not automatically improve standards or ensure that people get the sort of care they need, when they need it."

Blunden added that the information gap needed bridging in order to give patients meaningful choice and to prevent exacerbating existing inequalities. "Better information and support is needed; the regulatory framework for professionals and services must be adapted to the new healthcare environment and a more sophisticated approach in funding individual patient choices is vital. And not least patients should be given the sorts of choices they want to make."

Simon Williams, director of policy at the Patients’ Association, told E-Health Insider that he agreed more information was needed: "Patients would welcome choice if it were a genuine choice. We have so little information about the performance and outcomes of hospitals."

People were minded to choose their local hospital for no other reason than it was convenient, he said. "I think that people will travel once they know that not every hospital is the same and not everybody in white coats is the same."

The report added that some sections of the public are intimidated by the idea of choice, feeling that they lacked the confidence to make the decisions and preferring to leave them to healthcare professionals.

"For many, the concept of choice was so alien to their experiences of the NHS that they found it difficult to imagine how it would work in practice," said the report. "They had little knowledge of current proposals to increase choice and develop new roles for health professionals and primary care services."

Which? also found that many people they interviewed were sceptical that the NHS would be able to implement Choose and Book successfully.

Links

Which? report into choice in health [PDF, 575K]