Ockenden's silver lining
Our guest blogger, Miles Sibley, one of the founders of Patient Experience Library, argues that the public health and care sector should take patient’s experience evidence just as seriously as any other clinical evidence to further improve their services.
The Ockenden report on maternity services at Shrewsbury and Telford could be seen as par for the course in a year that has been full of bad news. The pain of the families can barely be imagined, and we can only hope that there is some relief for them in knowing that the truth is finally starting to come out.
But is there any good news from the Ockenden review? My answer is a clear "yes".
The review gives us cause for hope because it nails the myth that in our evidence-based healthcare system, only some types of evidence are worth having.
NICE - the National Institute for Healthcare Excellence - offers clinical guidance, drawing on "the highest quality and best available evidence". But none of that was able to prevent a potential 1,862 cases of harm stretching over a period of years.
The Care Quality Commission regulates healthcare providers, based on rigorous, evidence-driven inspection processes. But none of that was able to detect the scale or severity of harm occurring at the Trust.
It was families - with no formal methodology, no analytical rigour, and no peer review - who were able to reveal the truth about the failures in maternity care. In the end, patient feedback - so-called "anecdotal evidence" - proved more reliable than any other form of evidence.
This is the third time this year that patients have shown that their evidence is vital. First it was Paterson. Then it was Cumberlege. And now it is Shrewsbury and Telford. In every single case, it was patient testimony, more than any other source of evidence, which revealed the shortcomings in care.
So, we are hopeful that the tide is turning, and that the medical establishment must now start to take note of Baroness Cumberlege's demand that patient experience "must no longer be weighted least in the hierarchy of evidence-based medicine".
We hope that in 2021:
• NICE will make patient experience evidence part of its National Core Content.
• NIHR - the National Institute for Health Research - will help us to make a proper assessment of strengths and weaknesses in the patient experience evidence base.
• Health Education England will support our efforts to develop high quality accredited training for patient experience staff.
• NHS England will work with us on analytical tools that can cut through the morass of patient experience data.
All of this would indicate that NHS leaders were starting to take patient experience seriously - accepting it as a valid form of evidence and moving it up the evidence hierarchy.
The Ockenden report reveals some terrible truths - but we don't have to despair. If we can use it to get patient experience seen differently, we can ensure that some good comes from the pain.
Please download the report here.
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