Patient choice – is it what patients really want?

I’ve been intrigued for a while by the politicians voicing their opinions that we patients want choice from the NHS and that we are ‘consumers of healthcare’. Mr Hunt has been particularly vocal on the subject recently. Choice seems to be held up as a ‘Holy Grail’ by those designing healthcare policy.

I’m not sure that choice is what patients want at all. Obviously I write this from a personal perspective and cannot speak for all patients, but what I want when I am in patient role is a decent standard of healthcare delivered with compassion from somewhere fairly close to my home. I am extremely lucky to live only ten minutes drive from an Oncology centre. The Bexley Wing is a modern, well designed hospital environment which is probably about as comfortable as it gets in the NHS. I have sometimes thought to myself how much harder the past 18 months would have been on me and my family if we lived further away. Despite being a well informed patient I have never desired second opinions or treatment from other more specialist hospitals and have not exercised my right to choice personally.

Healthcare cannot be compared to choosing the best deal on car insurance or scouring the shelves for bargains in the supermarket. Patients have a right to a good standard of care – which to me means safety combined with a good experience – wherever they are treated. Creating choice in some ways discriminates even more in my opinion. For example many of my patients are very frail and have cognitive impairment. Would these people choose to go to another hospital other than their local one because it may have a better reputation for treating their condition? ‘Choose and book’ is probably an alien concept to these patients, perhaps all they really want is their problems sorting out in a timely fashion without having to travel too far. I wonder how frequently people choose to be seen somewhere other than their local hospital and whether these people have any characteristics in common?

So instead of creating a consumer market would it not be better to invest in a patient safety culture and focus on patient experience to improve care for everyone everywhere? For Trusts that are succeeding to share their best practices with organisations that are struggling? This blog seems to ask a lot of questions, but I think this is because there are no easy answers to fix the NHS. However, I do think the politicians are so out of touch with what patients really want and how healthcare professionals really work that they do not really understand what they are trying to change.

Courtesy of Dr Kate Granger