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CCG Series: Listen and learn


23 August 2013

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In this week's CCG Series, the chair of South Devon and Torbay CCG describes the challenges – and the rewards – of truly listening to patients in order to improve services
“Most people do not listen with the intent to understand; they listen with the intent to reply.” 
— Stephen R. Covey

In this week's CCG Series, the chair of South Devon and Torbay CCG describes the challenges – and the rewards – of truly listening to patients in order to improve services
“Most people do not listen with the intent to understand; they listen with the intent to reply.” 
— Stephen R. Covey
Although many of us have been enjoying the summer sunshine and warmth, it has certainly not been a time when nothing has been happening. Quality in the NHS remains a very pertinent issue. We have seen a series of reports including the Keogh review into mortality rates but, most recently, the review by Professor Don Berwick, former health advisor to President Obama. He stated that problems exist ‘throughout’ the system but that the NHS remains an ‘international gem’. Certainly, quality and safety have always been, and remain, high priorities for us as a CCG, but we do have to reflect on these nationally-highlighted issues and their relevance to our local communities. What is clear though is that quality and safety are everyone’s responsibility.
But how to measure these effectively?  Yes, we have our Safety Thermometers, CQUIN, SIRIs and never events, and so on – all important measures but do they capture the full picture? For me, excellent healthcare as defined by the user of that service means something more than this. We are reminded in some of the recent reports about the ‘softer’ elements of the delivery of healthcare – compassion and listening being recurrent themes. I use the word ‘softer’ in the sense of harder to quantify; by no means do I imply less important or an optional extra. It is clear that our patients frequently see these as paramount and their most important marker of excellent healthcare so we ignore these at our peril.
As CCGs therefore it is imperative we find ways of capturing these experiences. I mentioned the word listening earlier. Listening should not be tokenistic; listening should not be mere topping on the cake but part of the fundamental recipe we use as commissioners to inform our decision-making processes.  I recently attended a mental health engagement event, one of several organised by my CCG involving people who have used the services, family and carers , providers and commissioners, whose purpose was to give a voice but, as importantly, an ear to people’s experiences. Aided by use of a playback theatre company, the stories we heard (which ranged from the inspirational to the tragic and all shades in between!) were remarkable, not only for their candour but their power to illustrate and inform our views on mental health services locally. The buzz of the day and the stories that literally poured out from participants (and that included those working in the system) made me realise that that ‘soft’ data has a very hard and cutting edge. Each unique experience is valid.
Achieving this as commissioners will remain a real challenge. How do we contract for this kind of system? No rule book exists for this as far as I am aware. Yet we need to build a system that recognises individuality, and then responds in a way that begins its response to that person, not a generic patient.  As one participant commented, ‘Don’t ask me what’s wrong, ask me what happened. Only then will you see the real me.’ Excellence includes respecting others, and, in the words of Bryant McGill,  ‘One of the most sincere forms of respect is actually listening to what another has to say.’

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