A qualitative investigation of patient and staff experience across multiple clinical services: The case of a redevelopment programme at an English acute hospital NHS trust

Abstract

This study was a qualitative examination of patient and staff experiences within a redeveloping acute NHS hospital Trust in England. The aim of the investigation was to examine the current direction in government policy which places considerable emphasis upon delivering healthcare services structured broadly around increased patient involvement and choice. There is a need to address the gaps in the evidence for this strategic direction, which indicate an apparent lack of appreciation for the complexities involved. The qualitative methods applied in the study included the use of patient and staff interviews, observations and some documentary review. The research location was selected as an opportunity to assess and compare the perceptions and experiences of patients and staff in the context of a hospital redevelopment programme, from within three distinct clinical services. The three clinical services studied were accident and emergency, a paediatric ambulatory care unit and an adult respiratory outpatient clinic. Thematic content analysis was applied to the data. Findings indicated that generally patients were satisfied with their care and did not expect greater control or involvement. Some issues were raised by staff around uncertainty towards the change programme. Furthermore, there was a suggestion that staff and patients had differing perceptions of what constituted satisfactory care, with respect to technical versus functional quality. The notion of a ‘model’ of patient behaviour emerged. The conclusion is that given the current political agenda focused on the role of the patient, greater sensitivity in understanding towards terms such as patient-centred care, involvement and choice is required. Additionally, there is a need for greater awareness and appreciation of the discrepancy between staff and patient perspectives of what impacts the patient experience. Further research might focus upon the understanding of the patient processes and interactions involved with respect to patient-centred care and choice.