The views and experience of service users on the quality of health care delivery in UK
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Chapter 1: Introduction to the research
1.0 Introduction to the chapter
This chapter will give background information related to the research topic and the contexts of research. It will introduce the audience to the research problems and the rationale for conducting the research. The significance and likely benefits of the research on wider community, health care services and policy making will be discussed too. Chapter one will state the purpose and overall objective of the research too.
1.1 Background to the problem
Public health service in UK is driven by the National Health Service (NHS), which is one of the largest publicly funded health service. It was founded in 1948 and the main goal of NHS had been to provide health care access to all. To meet this demand, around 9.6% of the GDP consists of health care expenditure. Although the number and types of services for citizens have increased, health service in UK has received criticism because of long waiting times and increase in number of accidents and medical errors (Grosios, Gahan and Burbidge 2010). Long waiting time can have adverse effect on patient outcome and lead to high mortality rate and increase in medical cost. From 2012-2016, there were around 1.1 million waits over 4 hours in England and this contributed to mounting pressure on emergency department and primary care. If this issue remains unaddressed, it will have an impact on quality of care too (Gaughan et al. 2020). There is a need to explore the issue in greater depth by evaluating perspective of users regarding quality of care and health care access issues.
Inequalities and inequities in access to care is also a problem currently facing the UK health care system. The study by Cookson et al. (2016) highlights about socioeconomic inequalities in health care in UK. The distribution of health care and health in UK is not uniform. Variations in health care access has been found in terms of factors like education, income, deprivation and social class. Gender related and ethnicity related to barrier to care has been found. Inequalities in the access of care can have profound impact on the health care outcomes and there is risk of wider disparities. For instance, Grey et al. (2013) gave evidence aboit mental health inequalities among Black and minority ethnic communities BME in UK. The study reported that BME faced barriers in accessing culturally appropriate care, Increase in these problems will have direct impact on service users and they are likely to experience poor satisfaction with care (Crawford 2015). Exploring more about inequities in health care access from the perspective of service user is important to make further improvement and ensure development of patient focused health services. Research regarding the quality of care in UK can help to develop awareness about current status quo and understand the factors that may contribute to quality care issues. This will help in increase the provisions for quality care and lowering health inequity.
1.2 Aim/objectives or research question
The aim of the dissertation is to explore quality of health care delivery in UK by reviewing literatures on quality of care in UK. The research has the following objectives:
- Objective 1: To build a patient-focused integrated primary health care
- Objective 2: To improve quality, safety, performance and accountability of care.
- Objective 3: To improve access and lower inequity.
1.2 Rationale of the research
There are many reasons behind conducting research on the topic of quality of health service in UK. Firstly, the NHS has set up few goals and targets to ensure quality care and equitable access to health service. By investigating about services user’s perception about quality care in UK, it will be possible to reduce burden on the health care system and focus on other areas where more time and effort is required. Long waiting time is an issue that would lead to high patient morbidity and eventually greater burden on health care staffs. Waiting time is a factor that can influence service timing and patient’s satisfaction. If the reasons andthe events leading to long waiting time is not known, there is a possibility that the goal of continuous quality improvement may not be achieved. Long waiting time is the most common cause of dissatisfaction with care and decreased willingness to return to the services. Thus, to ensure that the public returns and adequately use available health services across UK, addressing quality care concerns is important (Xie and Or 2017). The research on the topic can give clues about areas of improvements.
In the context of poor health care access issues and inequities in care, it can be said that these factors can lead to various long-term consequences. Thus, research related to exploration of service user’s view on quality of health care services is important to evaluate improvements or deteriorations in the scenario and make future plan of action informed by the findings obtained. A study investigating about the impact of health inequalities revealed that health inequities may have adverse impact of life expectancy and future health outcomes of citizens. However, the research may to understand the issue in depth and find solutions to address gaps in care. This would pave the way for implementation of strategies to improve social determinants and pay more emphasis of consumer driven needs (Barr, Higgerson and Whitehead, 2017). It would also help to estimate how far the UK government’s health strategies and policies have workers to enhance the quality of care. Thus, the research is aimed to enhance accountability of care and ensure development of patient focused health policies for UK citizens.
1. 4 Significance of the research
The research mainly aims to gain more insight into the quality of health services in UK by investigation regarding the perception of service users. The significance of using service users as a source of information is that they are the ones who are most in need of such service and taking feedback from them is the most vital piece of information to plan quality improvement activities. The study can improve the understanding about differences and diverse point of views related to quality care. Advanced research and comparison of the response with that of health care professionals would further promote change in services and style of delivery. Any infrastructure related concerns or training related issues can be readily identified through this research. This would help to prioritize specific courses of actions and develop suggestions for policy change (Campos, Negromonte Filho and Castro 2017). Thus, this research is likely to help diverse points of views related to quality of care in UK.
The NHS has been criticized for long waiting time and poor access to care. The outcomes obtained from the research can help to interpret the gravity of the problem and understand how users have faced issues because of health inaccessibility issues and waiting time. The feedback and opinions suggested may help to narrow the gap in care and pave the way for development of stronger and better health equality policies. For instance, the ethnic minority also comprise a majority of service users and their experience about care access and quality would help to understand competence of health care staffs. The readiness of the NHS for the development of culturally appropriate can be judged and it will be possible to find out how to train new and upcoming health care professionals. Some of the obstacles to equality includes presence of marginalization agenda, ambivalent attitude among health care professionals, limited confidence in handling conflicts and poor political actions. NHS have claimed several ways to address inequalities (Salway et al. 2016). They proposed development of a resource to assess local issues and develop learning materials for staffs related to good practice. However, the reality between what they claim and what they actually do can be understood by the review of service user’s view (NHS 2020). Thus, this research is a likely to give genuine data on the preparedness and action of the government in enhancing the quality of care. The research project should be funded and approved because of the positive benefits for health consumers.
1.5 Summary of the chapter
This chapter gave a summary about the background issue related to the topic. The research on quality care in UK from the perspective of service users is planned because of presence of several problems in UK health care system. The chapter gave overview and consequences of problems like long waiting time, poor access to care and gender and ethnic disparities in health services. The problems in the NHS and its consequences suggested the need for research whereas the rationale for research discussed what consequence made the research necessary. The chapter looked into several benefits of research namely awareness about current problems, evaluation of outcome of current health policies and strategies and plan to resolve future problems in the health care system. Overall, the chapter gives a broad overview of the topic and the likely benefits of completing the research on the topic.
References:
Barr, B., Higgerson, J. and Whitehead, M., 2017. Investigating the impact of the English health inequalities strategy: time trend analysis. bmj, 358, p.j3310.
Campos, D.F., Negromonte Filho, R.B. and Castro, F.N., 2017. Service quality in public health clinics: perceptions of users and health professionals. International Journal of Health Care Quality Assurance.
Cookson, R., Propper, C., Asaria, M. and Raine, R., 2016. Socio‐economic inequalities in health care in England. Fiscal Studies, 37(3-4), pp.371-403.
Crawford, S.M., 2015. Inequity of access to healthcare is still a problem in the NHS. Bmj, 351, p.h3761.
Gaughan, J., Kasteridis, P., Mason, A. and Street, A., 2020. Why are there long waits at English emergency departments?. The European Journal of Health Economics, 21(2), pp.209-218.
Grey, T., Sewell, H., Shapiro, G., and Ashraf, F. 2013. Mental health inequalities facing UK minority ethnic populations: Causal factors and solutions. Journal of Psychological Issues in Organizational Culture, 3(S1), 146-157.
Grosios, K., Gahan, P.B. and Burbidge, J., 2010. Overview of healthcare in the UK. EPMA Journal, 1(4), pp.529-534.
NHS 2020. Reducing inequalities in access to general practice services. Retrieved from: https://www.england.nhs.uk/gp/gpfv/redesign/improving-access/reducing-inequalities-in-access-to-gp-services/
Salway, S., Mir, G., Turner, D., Ellison, G.T., Carter, L. and Gerrish, K., 2016. Obstacles to “race equality” in the English National Health Service: Insights from the healthcare commissioning arena. Social Science & Medicine, 152, pp.102-110.
Xie, Z., and Or, C. 2017. Associations between waiting times, service times, and patient satisfaction in an endocrinology outpatient department: A time study and questionnaire survey. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 54, 0046958017739527.
Health care
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Title: Views and experience of service users on the quality of health care delivery in UK
Background to the research:
The UK health care system and the National Health Service (NHS) came into existence on 5th July 1948. The NHS works under the principle of universality, health equity and free at the point of delivery. Providing the best patient experience is the ultimate goal of NHS (Grosios, Gahan and Burbidge 2010). However, to know how far they are successful in deliverying quality care and best patient experience, taking feedback from service users is important.
Statement of the problem:
The current problem in the UK health care system is that there has been slow growth in health care spending. With the increase in the ageing population and the demand of care, poor health spending can have impact on the quality of health care. Recently, other issues that were seen included staffing gaps, inadequate pay and patient safety issues (Papanicolas et al., 2019). Thus, as service users are the one who get direct hands on experience in health care setting, exploring their perspective about quality care may help to find solutions.
Research question: The research question for the proposal is as follows:”
What are the views and perceptions of service users related to quality of health care delivery?
By finding answer to this research question, the dissertation aims to:
- Evaluate views on the quality of health services received by service users
- To identify gender disparity during health care delivery in UK
- To examine the factors influencing experience of service users.
Literature review:
Various research literature have explored about patient’s views about health care quality. A comparative study by Grøndahl et al. (2018) indicated that patient’s perception about care quality reflects standard of care and they define what norms and experiences and individual encounter while seeking care. Similarly, the study by Annandale et al. (2007) highlighted about gender and access to health care in UK. This two aspects were explored as gender is a factor that clearly dictates access to health service. This study indicated that gender equality can be fostered in health care by gender awareness and understanding impact of different gender values. However, there is lack of studies that have specifically explored about quality of health service in UK.
Methodology
Systematic review method will be used to investigate about the topic. The research for research literature will be done in CINAHL and PubMed and the key term used will include ‘health care’, ‘quality’ and ‘service users’. Only papers published within the last 10 years will be taken and quality of the paper will be evaluated by looking at the research methodology used and considerations to eliminate bias in the paper.
Timeline
It is expected that the dissertation will be completed within six months. The following is the timeline for the project:
| Activities | 1st month | 2nd month | 3rd month | 4th month | 5th month | 6th months |
| Ethical approval of research | ||||||
| Engaging in data base search | ||||||
| Screening of articles | ||||||
| Data extraction | ||||||
| Data analysis | ||||||
| Framing of research findings | ||||||
| Dissemination of research |
References:
Annandale, E., Harvey, J., Cavers, D. and Dixon-Woods, M., 2007. Gender and access to healthcare in the UK: a critical interpretive synthesis of the literature. Evidence & Policy: A Journal of Research, Debate and Practice, 3(4), pp.463-486.
Grøndahl, V. A., Kirchhoff, J. W., Andersen, K. L., Sørby, L. A., Andreassen, H. M., Skaug, E. A., … & Helgesen, A. K. (2018). Health care quality from the patients’ perspective: a comparative study between an old and a new, high-tech hospital. Journal of Multidisciplinary Healthcare, 11, 591.
Grosios, K., Gahan, P.B. and Burbidge, J., 2010. Overview of healthcare in the UK. EPMA Journal, 1(4), pp.529-534.
Papanicolas, I., Mossialos, E., Gundersen, A., Woskie, L. and Jha, A.K., 2019. Performance of UK National Health Service compared with other high income countries: observational study. bmj, 367.
