"The patient and family as your customer"
About: Royal Sussex County Hospital Royal Sussex County Hospital Brighton BN2 5BE
Posted by Yehuda Shapiro
My comment here is not on the quality of the medical care, which at point-of-delivery seemed to be of a high quality, even though the outcome -- the death of my father -- was obviously not what anyone would have wished.
My huge frustration, two days after my father's death, remains the fact that, during his time at the Royal Sussex, it was surprisingly hard for the members of his family to find out exactly what was going on, what was planned, what the risks were and what the likely/possible outcomes were. Our ‘customer path’ was unclear, as were the ’rules of engagement’ with members of staff. I worked out for myself that ‘red uniform = doctor’ (or, at least, I think so), but that was about it. In general, information rarely seemed to be spontaneously forthcoming. You have your structures and routines, but they remain mysterious to the patient and his/her family.
Moreover, the interface with members of staff was astonishingly inconsistent. Some were exceptionally attentive and responsive (my father especially appreciated the commitment and professionalism); others were frankly quite casual and occasionally patronising and seemed to have more than a little time on their hands. (I could go into specific detail on this). For better or worse, today’s NHS is a service industry, albeit one that demands high levels of skill from its staff, and the patient and his/her family are customers and should be treated as such. When I met a doctor on my first visit to the hospital they mentioned that patients sometimes need ‘sharp elbows’ to get prioritised -- not, sadly a characteristic of my late father. The most obvious manifestation of a ‘dropout’ came when my father (89 years old, definitely compos mentis, but heavily medicated at the time) thought he had been told by a doctor that surgery would not be required and told us so; yet no-one took the initiative of informing my mother (at the hospital that day as she was almost every day during my father's time in the ward) what in fact WAS happening. On Tuesday 9th August, both my mother and I expressed concerns (my mother in person at the ward; I by phone) about the apparent lack of transparency and clearly-communicated official information. Things seemed to gear up somewhat after that. All that being said, the great irony for me is that - as far as I can tell - a doctor only really took the time to give my mother (along with my brother and me) a coherent, layman-friendly explanation of the whole medical situation after my father had died.
It is a bit like a lawyer only explaining the case to his client once he has been sentenced. As I mentioned to to a member of staff, I am a communications specialist with substantial experience of customer-focused industries and some professional experience of healthcare. I have ideas for ways in which your systems and service could be improved, so this is not just some kind of general rant from a recently bereaved relative, angry and disappointed though I am.