“From birth budgets for pregnant women to cash for the care of older and disabled people, debates about healthcare continue to encourage greater patient choice in care decisions and according to the government’s choice framework (pdf), patients should be able to choose which GP surgery they attend and where to have outpatient appointments, as well as take part in health research – but how does this work in reality?” (What place should patient choice have in the NHS?, The Guardian).

Geraint’s opinion:

This is a very ambitious idea, indeed, the NHS has to involve patients if it wants to be here in the long term. Hospitals are designed as cattle ranches, you go into a holding pen, then poked and prodded as you move through holding pen. Then, once all this is finished, any insight into your condition will be told to you at the end.

Notice I say patient involvement. To actually give choice is hard. This will impact the service provided directly. The service MUST be set up to facilitate choice, you simply can’t offer it otherwise. For example, to give patients choice over when they have surgery, means having staff to offer that flexibility in timings…the NHS does not have enough staff! To give patients choice over where they have surgery will mean smaller, more localised services.

For me, patient choice will be achieved as an off shoot of patient involvement. Ask people what they prefer, let them know all the things that have gone into deciding when and where surgery is being planned. Give them a voice to challenge and query. This will lead to a perception of choice, without the promise of it.

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