One hour, 51 minutes: patient complaint, hospital acts, personal apology

A modern NHS: Less than two hours: patient highlights problem, Trust starts actions to improve care, patient receives personal email response

In a world where the public rightly expects organisations to respond quickly and positively when they contact them, too much of the NHS still lags way behind – many Trusts feeling pleased if they manage to send a standard “we are looking into your complaint” letter within 14 days, let alone actually resolving the issue.

Such a “traditional” approach is so out of step with the way in which the world’s best organisations now listen to, learn from, and act on the feedback from their users: both to increase trust and confidence, but more importantly to make improvements within hours, not weeks or months. And of course in healthcare, making changes in hours means that better, safer, greater care can be delivered to the next patient.

The good news is that a number of pioneering Trusts are now leading the way and showing the rest of the NHS just what is possible in terms of using sophisticated, efficient and rapid ways to continually measure the experience of every patient, relative or carer. More importantly these hospitals know how the NHS should be using “ratings and reviews” not to merely monitor, but to actually respond and make improvements in real-time.

I’ve described many great examples in previous articles, but something wonderful happened this Friday afternoon that might be of interest to those who feel that the current way of dealing with complaints and feedback in the NHS too often leaves something to be desired. It may also resonate with many mothers!

A lady who’d given birth at Royal Shrewsbury Hospital used iWantGreatCare to rate and review her care online. Her full personal story, detailed and honest, is available online 

 “The midwife in charge of my care was growing increasingly impatient with me as I was becoming anxious. She tutted, sighed, and told me to ‘snap out of it’ and ‘pull yourself together’.  Telling this to someone with a panic disorder to calm them down really is not helpful. I was in immense pain and terrified, being shouted at in a dingy room just made it so much worse…I think much needs to be done so that the midwives know how to deal with people with mental health issues.”

Here is the subsequent event timeline as recorded by iWGC quality-monitoring systems:

• 2.45pm Patient posts her review (part of iWGC maternity Friends and Family Test system) – review enters assessment process
• 3.00pm iWGC continuous analysis and semantic text monitoring, flags low score and negative comments – alert passed to iWGC account manager for Royal Shrewsbury
• 3.08pm Account manager triggers email alert to Shrewsbury & Telford Trust with details of low score / poor review
• 3.47pm Trust asks iWGC for permission to respond direct to patient [reviews are always anonymous, iWGC holds contact details for patients]
• 3.53pm iWGC contacts patient to seek permission to release contact email to Trust
• 4.02pm Patient responds and gives permission – with thanks
• 4.04pm iWGC sends Trust the patient contact email.
• 4.30pm Trust emails patient with apology, reassurance that actions already taken (memo sent to all staff) and issue being further investigated.
• 4.36pm Thanks sent from patient to iWGC for her voice “being listened to”.

“an awesome example of what the words patient-centred, responsive and listening should mean in a Post-Francis NHS”

The way that Shrewsbury & Telford Trust responded in this case is something they should be hugely proud of, it is an awesome example of what the words patient-centred, responsive and listening should mean in a Post-Francis NHS. And this Trust is not one of the “big, famous, rich ones” – if Shrewsbury can respond in minutes on a Friday afternoon, then there is no excuse for any part of the NHS not to meet such quality standards.

(To put things in context, Shrewsbury now has 946 pages of ratings and reviews online, over 5,000 reviews and growing daily. Nearly all are glowing tributes to great care, kind staff and superb outcomes. Yet, they were able to – and had the passion to – immediately identify a rare negative comment amongst the hundreds of positive comments received each week, and to act in minutes.)

The important aspects of this one individual’s care would never be picked up by traditional systems to monitor waiting times, process, morbidity, infection rates etc, yet it shows a fundamental aspect of the way care was delivered and perceived for that mother. For any Nursing Director, Medical Director or CEO who thinks culture is important, or whose organisation has patient experience as one of their “core values”, such feedback is absolute gold-dust. Patient experience is the smoke-detector of safety in the NHS – Royal Shrewsbury knows this and the way they acted on a Friday afternoon shows that their smoke-detector is working and being heard across the organisation, from ward to board.

Every word of every review written by patients at Shrewsbury & Telford Trust is made public and shared on the web by an organisation which is not scared of feedback and complaints but understands that they are the lifeblood of organisations which are obsessed with improvement, and that transparently sharing every word not only makes them more responsive, but builds trust with their public and patients that they are an open, honest organisation that hides nothing.

But the final word – as it always should be – should be that of the patient. Her review this week was just one of nearly a million now on iWantGreatCare, but you couldn’t get a better example of why every single-time a patient gives feedback it is a real gift, given not to help themselves, but a present to help make things better for the next patient.

 “I am thankful my daughter was delivered safely and that we are both well and healthy and were looked after. I only wish that the consultant midwives could have acted in a kinder, gentler manner. The carrot, rather than the stick, so to speak.”

This new Mum didn’t need to give such a long, personal and honest review – heaven knows with a new baby extra time is the last thing she probably has – but she shared her experience to improve things for the next person like her. And in less than two hours from the time she clicked “submit”, she received an email, not just apologising, but telling her that her words would change things for other Mums in Shrewsbury.

I’d like to add my thanks to her (and congratulations on the birth of your wonderful daughter!), and to all those patients using iWantGreatCare to rate their care. You are improving the NHS and making sure that the next patient gets great care. Thank you.