Research in today’s healthcare landscape

In light of the recent political party conferences, and in the run up to the general election next May, a torch is being shone on the future of the NHS. Never has it been more important for policymakers and healthcare decision-makers to use research to evidence decisions.
   
Policy, procedures and processes which are not based on hard evidence are unlikely to prove successful or be long-lasting. With resources stretched ever more thinly, it has never been more important to have solid facts at the heart of decision making.

Caring conversation
Significant evidence has appeared in a number of publications regarding the power of the placebo effect and many sectors have also experienced the power of trust in steering decisions and supporting behaviours. This leads the question, as to whether or not the healthcare sector is applying these lessons sufficiently in managing their interactions with patients and their families. There is a real opportunity to explore and learn by understanding the lead indicators created from the factors driving trust. Qualitative and quantitative techniques could be used to identify problems much earlier than most performance metrics currently used. Talking and listening to how patients, relatives and visitors feel, and respecting qualitative feedback is a lot cheaper than purchasing expensive hardware for monitoring.
   
We should assume that research participants understand the, generally unwanted, reason for being in the healthcare system and the difficulties under which the system operates. Likewise, that they know when they are being treated with respect and well looked after. Evidence from the US suggests that doctors with a good manner recieve fewer legal actions against them than those without, showcasing that ‘soft’ metrics are early warnings of deeper problems and delivering in these areas can save valuable financial resources.
   
The placebo effect can be used as a premise on which to drive and structure research and planning in hospitals to improve levels of care. Amid criticism over care quality in the NHS, the government should look to address perceived failings starting first with patient satisfaction. According to the placebo effect, if patients believe that they are being treated well, and are being well looked after, their health should improve as a result. Patients are at the centre of the healthcare system and understanding their attitudes towards, and perceptions of, the service provided by practitioners will help hospitals and doctor’s surgeries address confidence in care. As issues are addressed, patient confidence in the treatment they are receiving will improve which, in theory, should lead to improved results for patients if positive attitudes arise as a result.

Elderley people
Recent news stories have highlighted that the quality of care received by elderly people is not up to standard. Mentally degenerative diseases such as dementia and alzheimers are on the rise and it is increasingly difficult to get a sense of how such patients are feeling about the quality of their care. This often falls to the families of those who are unwell and so the comfort of relatives should be an area of focus for hospitals and care homes. 
   
Extreme measures have recently been discussed in the media, such as the Quality Care Commission’s proposals for the potential use of hidden surveillance to test the quality of care provided. Such measures won’t work as well as sitting down and listening to relative’s opinions or the opinions of the patients themselves. Observation is all well and good, but it is engaging with people that will make the biggest difference and really pinpoint areas for development.
   
The effect of surroundings, comfort and perceived care quality are also hard to ascertain without recognising consumer behaviour. Patients are consumers of care. Surveys are all very well, but some inpatients won’t provide honest answers for fear that levels of care might decline or not improve if they are critical of the service they are receiving. This method also often doesn’t allow for issues to be addressed immediately. Healthcare professionals need to be less fearful of speaking with patients and conducting more qualitative research to engage with the public. Patients will feel more cared for if they believe that time is being taken to listen to them, and that the system is truly interested in them and their experiences.  This can enhance their mood and positivity about getting better. In turn, this can have a marked impact on the success of treatment and recovery time, as evidenced by the placebo effect.
   
This form of qualitative research is excellent at providing real time insight into how inpatients are feeling about their treatments while they are occurring. It allows healthcare professionals to rectify problems before they become more prevalent and ultimately, more costly. Research is a good early indicator of whether or not things are going well and it can help to keep an eye on lead indicators to stop mishaps in the future too. 

Research before making a decision
Resolving issues in the health sector can be extremely expensive and conducting research prior to, and during, implementation of new practices or processes can really help to ensure that precious time and financial resources are not wasted. With the industry more stretched than ever before, getting it right first time is essential and research will help decision makers to do this.
 
Earlier this year, the Care.data scheme was postponed due to the public’s reaction to the sharing of personal data. This could have been avoided had research been conducted to provide insight into public sentiment on this issue, enabling these concerns to be addressed head on before its proposed roll out. While the appeal is certainly there for government bodies to use data and research to retrospectively justify decisions, decision makers must implement schemes that are entrenched in evidence, particularly as there are so many techniques now available to gain fast and reliable guidance before developing costly policy or systems.
   
The Care.data scheme is now being ‘trialled’ as pilot schemes in six areas covering over 250 GP surgeries across Hampshire, Blackburn, Leeds and Somerset. While it is important to trial the scheme to help inspire confidence about the safety of the data, the government must listen to the results and feedback from those involved in the pilots. There is no point in commissioning these trials if the research results are going to be ignored. The government must recognise that the public want to be equipped with all of the necessary information before agreeing to the scheme, such as how easy it will be to opt out and guarantees that their personal information won’t be passed on to insurance companies.
   
For the scheme to be successful the pilots must use social research to track unease and issues in response to problems to make sure that citizens feel confident in how their data will be used and stored. Feedback mechanisms should be put in place, in the same way that they are in hospitals regarding care satisfaction, to make sure that the public’s voice is being heard and actually being responded to. The government’s job now is to prove that the scheme is robust and that concerns have been recognised and acted upon.

Industry prescription
Healthcare relies on trust and confidence to run throughout it. The system can only work to get better if it is perceived to be doing its job. In the case of the health sector, this perception can’t purely be down to the placebo effect. It has to be followed through with the actions of key decision and policymakers. The industry can learn a lot from research and can improve if it listens to its patients and implements changes based on the feedback it receives. Qualitative research is essential to the success of projects, and feedback loops must be implemented to ensure that all viewpoints are considered. The public must have confidence in the changes that policymakers are implementing in order for them to be successful. In the run up to the election next year, politicians will need to navigate their way through challenges on patient data, elderly care and general quality of care. They need to work hard to gain the trust of citizens and convince them that their proposed reforms to the healthcare sector are the best treatment options. Research will help them to identify areas for improvement and ultimately recognise the voices of citizens who rely on the healthcare system every day.

Further information
www.mrs.org.uk