Once again, the NHS is back in the spotlight. Following the Francis Review into the failure of care in Mid Staffordshire, Jeremy Hunt, the health secretary, has outlined plans to name and shame hospitals and has announced the introduction of an Ofsted style system of ratings. The NHS has many examples of good market research that has both saved money and shown the way to better patient delivery. It does need to find a way of keeping the knowledge it creates as a shared resource, not letting it get lost in inevitable reorganisations.
A time of change
A relentless focus on understanding people – patients, their relatives or carers and staff – should be the central pillar around which the NHS focuses its decisions in this period of change. This is the operational side of evidence-based decision making that has long been a clinical mantra. Research is critical to that focus, allowing the service to identify actual needs and effective solutions rather than being reactive to perceived need (or, on occasion, organisational myth).
Assessing the care received
A peer review assessment by the Greater Midlands Cancer Research Network was published in September 2012 which highlighted significant concerns and risks focused on process, management and back-office issues, with regards to the breast care multi-disciplinary team at Stafford Hospital.
The team did not interview patients as part of their assessment.
In response, Engaging Communities Staffordshire (hosts of the Staffordshire Local Involvement Network) conducted research of 48 patients who had been treated for breast cancer at the hospital. The research highlighted issues and concerns which staff were unaware of and resulted in a number of improvements in the service. As a result, each patient is now given one of the three full-time nurses as their key worker to improve the unit's communications. This nurse is able to give the patient all the information they require and this is supplemented by further information and local support groups.
Understanding how patients think
Research can also be useful to help services gain a better understanding of the wider social and emotional context surrounding a long-term condition. NHS Kidney Care commissioned the Ipsos Ethnography Centre of Excellence to conduct three ethnographic projects to understand the responsibilities patients, parents and carers have when managing a disease. The research closely followed a number of people living with kidney disease and indicated three key questions; who takes responsibility; what that responsibility involves and when that responsibility should be taken.
Films from these projects were presented at roundtable events where clinicians, support workers, charities, social workers, patients and their families discussed the key issues raised by the research. These discussions culminated in summary reports articulating key challenges and potential solutions to aid all parties with taking/handing over responsibility.
Creating compelling engagement
NHS Dudley Public Health also used research to develop their cervical screening social marketing campaign. The trust found that if women did not attend a screening when aged 25-29 they were less likely to in future, thereby putting their health at risk. Initial focus group research showed that women prioritised beauty treatments – such as getting a hair cut – over health appointments. The trust therefore used beauty as a key motivator in their campaign. As a result, the awareness of the symptoms of cervical cancer increased, more women were aware of the need to be screened and there was an increase in the number of women who said they would attend a screening. The campaign is now being expanded into new settings such as GPs' surgeries.
Research is a critical tool to help the NHS and its hospitals and doctors understand the changes taking place and the impact this will have on the service. Critically, it will also help everyone to understand not only what patients need and want but how they feel.
Research can drive better care, increase patient engagement and help the NHS understand how patients respond to diseases and treatments. In defining what patients value, it can frequently help reduce costs as well as assist in prioritising increasingly scarce resource. I have personally seen how market research has been used to do both in the justice and tax systems. I believe it has a crucial role to play in ensuring that the NHS is transformed for the better.
Jane Frost is CEO of the Market Research Society (MRS)
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