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What to do about the erratic variation in NHS quality and experience

December 28, 2010

Like many large organisations the quality of service provided by the NHS varies from place to place, and time to time. This story in the Guardian typifies the erratic experience and will be familiar to anyone who has worked, visited or been treated at more than one or two NHS locations in the last twenty years. If you’ve only been to one hospital, or been treated just once or twice you might not believe the account (we can see this in some of the comments posted on the Guardian site) – but I’m afraid it is 100% accurate of the care received by many thousands of people every day in the NHS. The only consistency in the inconsistency is that it applies just as much to primary care (GPs) as to secondary care (hospitals).

But what can you do as a patient or a carer, knowing that where you are treated is likely to profoundly determine not only your experience, but very often your actual recovery and outcome? In time, I hope that iWantGreatCare will be one of a number of ways by which carers and patients will be able to make informed choices about who looks after them or their family – benefitting from the detailed ratings and reviews placed by fellow NHS users. The volume of reviews is building steadily – for example, if you are looking for a world class paediatrician to care for your child in London we are now able to provide some useful information to guide your decision.

The key to driving down the variation will be to identify it, accept it, and publicise it in ways that drive changes in the behaviour of patients, doctors and organisations. It was encouraging to see Andrew Lansley welcome the publication of figures showing variation in hospital mortality, and he has committed the NHS to transparency in a whole host of outcome and experience measurements.

In the next post, I will offer some specific advice for those having to choose NHS care for themselves or those they care for.

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