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The work of the NHS institute
Edited by Hugh Rogers
Introduction
Creating a Patient-led NHS ([3] Department of Health, 2005) urges health care teams to: "move from a service that does things to and for its patients to one which is patient-led where the service works with patients to support them with their health needs". Undoubtedly there are times when as health care professionals we do need to do things for our patients but by increasing the level at which we do things with patients we can significantly improve health care services. Clinical Governance is described as a framework to guide the NHS in continually improving the quality of services and creating an organisational environment where excellence in clinical care can flourish ([1] Department of Health, 1998). The impact of both policies on improving the quality of health care services has been questioned. The [4] Healthcare Commission (2005) suggest that:
The government has set itself the aim of a "patient-led NHS". But our health services still have a long way to go before we can say that they are really putting patients first. Being an NHS patient is still too often a frustrating experience.
[7] Peak et al. (2005) propose that some organisations struggle with the complexities of implementing and monitoring clinical governance and others report that the desired cultural changes have not been achieved ([6] Roland et al. , 2001). Tensions between medicine and management have been identified as a barrier to constructive dialogue and therefore to continual improvement ([5] Plochg and Klazinga, 2005). Experience Based Design creates the opportunity to redesign service with patients. It also creates a positive connection and interaction between medicine and management, the patient and the service increasing the likelihood for continuous improvement.
Does Experience Based Design lead to real change?
For the head and neck cancer service at Luton and Dunstable Hospital, some 43 different experiences have been improved as a direct result of their involvement in the first Experience Based Design (EBD) pilot in the NHS.
The Trust's multi-disciplinary head and neck cancer service offers a range of well-defined pathways - including in-patient and outpatient care, surgery, post-surgery and radiotherapy and a range of staff who were willing to try out a new approach to service improvement.