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Improve staff morale for patients' sake

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Jeremy Hunt launched the NHS mandate Jeremy Hunt launched the NHS mandate

Last week, health secretary Jeremy Hunt launched the 'historic' NHS Mandate, setting out 'what every patient in England can expect from GPs, hospitals and the wider NHS'. It represents 'a central strand of the government's determination to improve the quality of people's experience of the NHS'.

The mandate pledges to improve standards of care, not just treatment, especially for the elderly and vulnerable. It promises better diagnosis, treatment and care for people with dementia. Pregnant women will have a named midwife; all patients will be able to book general practice appointments online.

This focus on patient experience is valid. Independent health charity the King's Fund considered the relationship between patient experience and key domains of healthcare quality in the QOF. It found GP practices that deliver a good experience for their patients have higher QOF outcome scores. Meanwhile, a study published in the BMJ showed that ignoring or misinterpreting patient preferences in treatment decisions can lead to 'silent misdiagnosis': better diagnosis of patients' preferences is not only the right ethical thing to do, but may also reduce the cost of healthcare. Engaged, informed patients often choose less intensive care and become more careful about having lots of procedures.

Ironically, according to a three-year study by the National Nursing Research Unit at King's College, London, levels of satisfaction and wellbeing among health staff also have a direct impact on patients' experiences of healthcare. It concludes that 'investing in staff wellbeing is not only important for the nursing workforce but for the quality of care overall'.

Given nurses' low morale over pay and pensions and the RCN's stark warning that the NHS is 'sleepwalking into crisis', this is one aspect of the patient experience that needs urgent attention.

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