A question of quality: the citizens’ view

17 April 2012

By Tim Wilson, Partner, PwC


Reassurance, respect, relationships, responsibility and reporting... these are the five criteria for quality that 30 members of the general public - broadly representative of the English population with different needs and experiences of the NHS - developed after two intensive days sitting as a PwC Citizens’ Jury. 

We wanted to understand what quality looks like to citizens and what’s important to them when measuring and reporting on quality.  Using the NHS Outcomes Framework, the Jurors developed their set of recommendations on the priority improvement areas and also those that they think are missing from the NHS Outcomes Framework.  Here's our report on this.

Citizens clearly take real pride in ‘their’ NHS.  They want it to remain free and accessible to all, with world-class treatment and care that uses resources efficiently without waste, provides value for money, and gives people a positive personal experience.

The Citizens’ Jury all felt a real sense of ownership of, and pride in, the NHS – it is a true national icon. In summing up their thinking they described their criteria for quality in the NHS as the 5 Rs :

  • Reassurance Wherever you access the NHS you can be confident and reassured that you will get high quality, safe treatment and will leave healthier than you arrived
  • Respect All patients deserve to be treated with respect and dignity no matter what their age or circumstances
  • Relationship The quality of relationship between patient and professional is essential for high quality service provision.  Sharing of information and knowledge, considering options together and being supported in your choices are all part of an adult, mature relationship
  • Responsibility There is a mutual responsibility between patient and professional.  The professional has the responsibility to communicate effectively, take ownership of and responsibility for a programme of treatment.  The patient has the responsibility to take the best care of themselves that they can and to engage responsibly with the services, not wasting precious time and resources
  • Reporting What gets measured gets done, so these measures should be communicated, for instance, in an annual report so citizens can see progress and improvements in the NHS at both a national and local level.

So what does this mean for the NHS? Our Citizens’ Jury want policy-makers, commissioners and providers to keep these 5Rs front-of-mind when making any decisions about NHS care. In their eyes these are the things that will improve the quality of healthcare.

A version of this blog first appeared in Health Service Journal (Thursday 12 April)


Contact details
Email: Tim Wilson
Tel: +44 (0) 20 721 32147

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