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Can we use patient-reported feedback to drive change? The challenges of using patient-reported feedback and how they might be addressed
  1. Kelsey Margaret Flott,
  2. Chris Graham,
  3. Ara Darzi,
  4. Erik Mayer
  1. Centre for Health Policy, Institute of Global Health Innovation, Imperial College London, London, UK
  1. Correspondence to Kelsey Margaret Flott, Centre for Health Policy, Institute of Global Health Innovation, Imperial College London, St Mary's Campus, Pread Street, London W2 1NY, UK; k.flott14{at}imperial.ac.uk

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Introduction

The resolve to put patients at the heart of the National Health Service (NHS) has been ubiquitous in the aftermath of the Francis Report, and the policy agenda is beginning to reflect attempts to deliver that promise. The introduction of new care models at NHS ‘vanguard’ sites, the 3-year target to give all patients access to their electronic care records, and the expansion of integrated care services all exemplify the salience of patient-centricity at the national level.1 This pattern has been witnessed across many developed health systems.2

The ideals of this paradigm have also captured the attention of local commissioners and providers, offering an evolved concept of service design that resonates with patients' needs. As a result, providers are increasingly turning to patient-reported feedback to drive local improvement. This trend is indicative of progress in the field of patient experience: policy discourse has advanced from being curious about patients' feedback, to actually collecting it, to valuing it as a lever for quality improvement. Furthermore, this trend is not specific to the UK; large amounts of work, including cross-national feedback collections, have been conducted across and between health systems around the world.3 However, even with this momentum, much patient-reported feedback remains dormant and underutilised, drawing into question its ability to drive change.4 ,5 Consequently, improvements in patients' experiences over the last decade have largely been limited to transactional aspects of care and driven by top-down national targets; there has been little change in measures that reflect a person-centred approach.6 ,7

In principle, patients are unique experts in their lived experience of care, and respecting their insights has extraordinary potential to enhance quality. In practice, however, more must be done to ensure that the collection of patient experience data can be translated locally into service …

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