Administration is a vital part of the NHS, and when it goes wrong, it can have a huge impact on patients. Alison and Laura have both shared their stories with us. They clearly set out how poor communication and administration contributed to suicidal thoughts and post-traumatic stress disorder. They are not alone.
In June of this year, the Kings Fund released its Admin matters: the impact of NHS administration on patient care report. In particular, the report focuses on admin from a patient’s perspective. It says high-quality admin has the potential to improve patient experience, reduce inequalities and promote better care.
In this blog, we explore further why good administration matters and share some tips to improve admin and communication for the benefit of all.
Administration is essential to ensuring the NHS runs as smoothly as possible. Examples of administration include booking appointments, producing and sending out letters and dealing with enquiries.
Everyone will encounter these types of administration at some point in their lives. However, how often people experience these services varies hugely. Some may only access NHS services once in a blue moon. Others living with long-term conditions may access multiple services across different hospitals.
Administration is about far more than just medication plans, consent forms and booking appointments. It’s about putting yourself in the patient’s shoes, helping them navigate their care pathway and making sure they have the right information at the right time.
When things go wrong, it can lead to increased stress, anxiety and loss of trust in the healthcare system.
It is vital administration functions to a high quality to ensure optimum care is established and maintained. With more than 1 million people accessing the NHS every day, imagine the chaos that would ensue if the administration was of a generally poor standard?
Here are some tips to help administrative care and communication have a positive impact.
It is easy to get into habits with communication. For example, you may include the same information for two patients with diabetes. One is a retired lawyer the other is a young mother with limited English proficiency. Both these individuals have different needs to ensure they understand the information you are trying to convey.
Meeting patients where they are means establishing a baseline for their health literacy levels. We need to tailor information for their understanding.
The teach-back method has proven effective in ensuring patients understand information that is shared with them. This is when you ask patients to ‘teach-back’ what has just been discussed or information they have received via a phone call or letter. This signposts any missing information or miscommunications at an early stage.
When patients understand the information you are communicating, they are more likely to experience improved health outcomes in the future. Understanding can reduce stress and worry about what’s coming next and what they are expected to do to remain healthy.
The circumstances and timing of patient administration and communication is critical. It can either help or harm their understanding.
For example, discussing an entire care plan with a patient who just received a cancer diagnosis may not be appropriate as they are likely to feel overwhelmed. In contrast, sending out follow-up information that they can read through or watch in their own time will allow them to process and prepare themselves for the next stage of treatment.
Think about what is optimal for the patient, not the healthcare provider.
A patient’s prognosis may well change as further tests are carried out. It is important these changes are quickly and clearly communicated to the patient, especially if it will affect their treatment plan.
As Alison says in her story: “I know logically that the MRI scan results meant a change in my treatment plan was required, but no one told me. I only found out because I insisted on having another appointment to discuss my surgery options. Was it too much to expect to be involved in making decisions about my care?”
When administration and communications are efficient, they can be a fantastic tool to help you understand what your patients have experienced and where they are in their care plan.
Use previous communications to check what information the patient has already been given and if it contradicts anything you will be discussing with them. Before starting a new communication, summarise what you understand from those previous interactions and ask the patient if you have interpreted it correctly.
Walking a patient through their next steps builds a relationship and creates a culture of trust. It also helps you to understand any subtle barriers they may face in achieving a specific goal.
For example, a patient is advised to pick up their medications from a pharmacy twice per week after discharge. However, they live in a rural area or work full time and cannot get to the pharmacy before it closes. Asking the patient how they plan to achieve this step allows you to pick up on additional resources they may need to meet their plan. For example, the need to use a medicines delivery service or have access to a pharmacy that stays open late.
Telling the patient what to expect, whether that is a test result or a follow-up appointment, also helps them be more engaged in their care. This means, if there are administration errors, they are likely to be aware more quickly and able to seek advice, before losing confidence in the system.
Most patients will experience worry or stress. However, effective communication and administration can significantly reduce the burden on the patient. The patient’s sole focus should be their recovery. They shouldn’t be trying to coordinate their own care because they feel unsupported by administrative systems. Remember:
