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How do Health Service (NHS) organisations respond to patient concerns? A qualitative interview study of PALS, 2021, Shepard et al

Discussion in 'Other Health News and Research' started by Haveyoutriedyoga, Nov 25, 2021.

  1. Haveyoutriedyoga

    Haveyoutriedyoga Senior Member (Voting Rights)

    Messages:
    111
    How do Health Service (NHS) organisations respond to patient concerns? A qualitative interview study of the Patient Advice and Liaison Service (PALS)

    Abstract

    Objectives
    To describe the current work of the Patient Advice and Liaison Service (PALS) and assess the service’s potential to resolve concerns and contribute to organisational learning.

    Design
    A qualitative study using semistructured interviews.

    Setting
    Four mental health trusts and four acute trusts in the English National Health Service, a total of eight PALS across different trusts.

    Participants
    Twenty-four participants comprising of PALS staff and clinicians working with PALS teams.

    Methods
    Semistructured interviews were undertaken with participants using video conferencing software. The framework method was used for the analysis of the large qualitative dataset, which is a conventional method of analysis, similar to thematic or qualitative content analysis.

    Results
    PALS teams fulfil their core responsibilities by acting as point of contact for patients, providing information and resolving a variety of recurrent problems, including PALS staff communication, staff attitudes and waiting times. The remit and responsibilities of each PALS has often broadened over time. Barriers to resolving concerns included a lack of awareness of PALS, limited to no policies informing how staff resolve concerns, an emphasis on complaints and the attitude of clinical staff. Senior management had widely differing views on how the PALS should operate and the management of complaints is a much higher priority. Few PALS teams carried out any analysis of the data or shared data within their organisations.

    Conclusions
    PALS teams fulfil their core responsibilities by acting as point of contact for patients, providing information and resolving concerns. PALS staff also act as navigators of services, mediators between families and staff and, occasionally, patient advocates in supporting them to raise concerns. PALS has the potential to reduce complaints, increase patient satisfaction and provide rapid organisational feedback. Achieving this potential will require more awareness and support within organisations together with updated national policy guidance.



    https://bmjopen.bmj.com/content/11/11/e053239
     
  2. hibiscuswahine

    hibiscuswahine Senior Member (Voting Rights)

    Messages:
    177
    This is a good way to improve services, people need to be encouraged to make complaints. Too often they fear they will lose service or feel disempowered in the medical environment.

    In NZ, we have a Quality Assurance Team working for a service or DHB (Same as a hospital trust in the UK) with Patient Safety Officers to receive complaints, concerns from patients. Services have to be run according to DHB/National policy that protects the health and well-being of everyone and is created with service users and staff and a formal process of audit and accreditation occurs every two years. Current users of the service are also asked to review the service in a random sample. Staff are also asked to critique the service. All staff are also surveyed by their team members on their performance (including attitude and behaviour towards clients) and this is feedback to them in performance reviews as well as any patient complaints and what they are doing to rectify their practice to improve things like communication skills, updating their clinical skills.
     
    Peter Trewhitt, alktipping and Trish like this.
  3. Haveyoutriedyoga

    Haveyoutriedyoga Senior Member (Voting Rights)

    Messages:
    111
    That sounds very robust. How do you think that plays out for ME services (for example) in NZ?
     
    Peter Trewhitt and alktipping like this.
  4. hibiscuswahine

    hibiscuswahine Senior Member (Voting Rights)

    Messages:
    177
    I have no idea, everyone has their own individual take. Most of ME is managed in primary care in NZ. We pay for GP treatment (as opposed to the NHS funding of GP’s) and if we have problems complain through the health and disability code to the GP practice manager which can be tricky if it is a small practice but they are obliged to bring it up with the GP. This is where the disempowerment often occurs due to stigmatisation. You have to change GP’s and if you live rurally or have transport problems it is a double burden. Also there is a shortage of GP’s so you have to hunt around.

    GP’s work to the standards of their professional college and although there have been advances, it is still a major problem getting correctly diagnosed and referred to appropriate specialists for comorbidities. Some GP’s (and specialists) hold to the old NICE guidelines and require re-education via CME, but only if they choose to. Some regions have a small pool of GP’s that have a special interest in ME/CFS or are better suited managing people with chronic illness and are widely sort after.

    Within the DHB’s, there are still major problems with ignorance of the condition or attribution to psychological problems. So there is a long way to go. Culturally, people do not like to complain in NZ and so collective patient advocacy can be quite difficult. Some people are reluctant to go to hospital due to their mistreatment so their lack of reports do not undergo a Quality Assurance Process. We do not have specialised ME/CFS clinics. (This may be a good thing…). Nursing staff are becoming more aware of the disability and may factor it in nursing care plans.
     
  5. alktipping

    alktipping Senior Member (Voting Rights)

    Messages:
    1,018
    they missed out on the most important group to interview the patients . i have seen many posts on other health sites that are less than complimentary of the pals service in england seeing them as complicit in covering for the wrongdoings of medical staff .
     
    Art Vandelay, Sean, Wits_End and 2 others like this.

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