Case study: Sheffield primary care addiction service

Sheffield's primary care addiction service has received national recognition for its innovative use of Patient Opinion. We asked Roger Smith and Jason Gough why.

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What are your roles at PCASS?

Roger: As clinical director I am responsible for the clinical governance and clinical protocols. I also share in the day-to-day running of the clinic, and have a case load of five clinical sessions. More importantly I think a clinical director is responsible for the ethos of the clinic, capturing people’s enthusiasms, watching out for new ideas and developments and keeping up the general morale of the place.

Jason: As a service user representative I represent the needs and interests of service users, advocating on their behalf and gaining feedback from them about the services they receive. As a former service user, I also have a role in supporting service users in their journey towards abstinence and recovery.

So how are you using Patient Opinion in your service?

J: PCASS was the first substance misuse service in the country to use Patient Opinion. We recognised that responding to feedback from our users was important and should be integral to what we do. Service users felt that, being independent and anonymous, Patient Opinion was a very safe place for them to offer feedback. Most of our feedback comes through leaflets and all our postings and responses are displayed publicly in the service as well as on the site.

R: This is our vital feedback link from people using our service, and the best one we have found for all the reasons Jason has given. This link has been absent in the past and I think we should make use of it in all future developments at the clinic.

What is involved in doing this? How much work is it?

R: When I first became involved it seemed as though I would be overloaded with the work replying to the responses, but I quickly realised the way through was to have a main co-ordinator – Jason – so I would only need to respond to question relevant to my position.

J: Setting it up was pretty straightforward with Patient Opinion supporting us. Actively encouraging service users to give feedback was helped by using volunteers/peer facilitators and generated feedback straight away. This bottom up approach made it less work. Responses were done by those the feedback related to. This allowed the benefits of the feedback to been seen really early and encouraged others to become involved.

How have you involved other staff in the service?

R: Through explaining Patient Opinion at the clinical and general meetings, the staff realised how useful it was and didn’t need any persuasion to be involved.

J: All the staff are involved to some degree, not only in feedback that relates directly their roles – they also have the wider picture of feedback for the service. I have raised awareness by distributing the feedback as widely as possible and brought it into our existing user engagement processes. We encouraging frontline staff to offer service users the opportunity to give feedback in this way.

And how have staff reacted?

R: Reactions have all been favourable.

J: Well, initially there was a little bit of apprehension – but when the postings came in it was great to see staff reactions to positive stories about the treatment service users had received, and the impact this had made in their lives. As we progressed, and feedback turned into service improvements, staff could see that although some postings are critical, each represents a learning opportunity. Real time listening and responding in the safe way which Patient Opinion offers allowed the team to broaden its reach to service users.

Has there been any impact for patients?

J: There has been an impact for patients. Even if they have not posted themselves, they can see the postings and responses in the clinic – and more importantly the changes that have been made. They find this very empowering.

Addiction can be a very isolating and stigmatising experience and a lot of our users enter treatment via the criminal justice system, and feel very vulnerable. Having a place where a dialogue can take place without people feeling exposed has made it comfortable for them to engage more fully. Their care becomes much more something that is done with them, not at them.

Have you had any really critical feedback? If so, how have you handled it?

R: This is the stuff of progress and we welcome it. Praise and non-critical feedback is good for us and means we are doing some things right – but critical progress is where the development comes from.

J: We have certainly had some that has given us cause to think about the way we do things. What we have found in these situations is that what people want is to be heard and recognised. We can’t change a negative experience that should not have happened, but we can recognise it – and quickly, without need to resort to a lengthy process.

What have you learnt from using Patient Opinion?

R: That, as ever, we don’t have all the answers – but on the other hand we have got a lot of things right and patients appreciate our service.

J: Being able to listen and respond to our patients in this way has really re-emphasised how important this is to the quality of care we offer. Good communication is crucial to a lot what we do.

And what's the benefit for service users?

R: Potentially enormous.