Review of targets and indicators for health and social care in Scotland

Opinion indicators

104. Many of the health and social care integration indicators measure satisfaction with services. These indicators are measured by questionnaire every 2 years. They give insight into broad trends in satisfaction with services but are probably not useful for providing insight into the impact of efforts to improve services in real time.

Percentage of adults able to look after their health very well or quite well

Percentage of adults supported at home who agree that they are supported to live as independently as possible

Percentage of adults supported at home who agree that they had a say in how their help, care or support was provided

Percentage of adults supported at home who agree that their health and care services seemed to be well co-ordinated

Percentage of adults receiving any care or support who rate it as excellent or good

Percentage of adults supported at home who agree that their services and support had an impact in improving or maintaining their quality of life

Percentage of carers who feel supported to continue in their caring role

Percentage of adults supported at home who agree they felt safe

Percentage of people with positive experience of care at their GP practice

Percentage of staff who say they would recommend their workplace as a good place to work

Proportion of care services graded 'good' (4) or better in Care Inspectorate Inspections

105. The involvement of people in shaping their own services is of considerable importance in improving outcomes. The indicators already in place are based on data collected by questionnaire every two years. These surveys provide robust national data on performance in important aspects of patient experiences.

106. These surveys tell us that, for most of the indicators, the level of satisfaction is high. However, it also appears that there is considerable variation in satisfaction levels across Scotland. The national surveys could be usefully supplemented by more focussed data collection in specific areas. For example, effectiveness of services which support people who need help to live independently seems to be variable and dependent not just on the area the person lives in but also the type of disability with which they are living. Efforts to improve those areas where satisfaction is lower require data which is current and which can be seen to improve in response to intervention. At present, patient feedback in Scotland is supported by Care Opinion, an independent website which provides a means by which people are able to provide real-time feedback directly to services about their experiences of care and engage in a dialogue with services that is focussed on improvement. The Scottish Government has supported NHS Boards to engage with this website since 2013. There are now more than 8,000 stories about people's experiences in Scotland on this site alone. Analysis of the "tags" associated with these stories has proved valuable, particularly in a local context, in identifying areas of good and poor performance and generating ideas for improvement. Analytics have now been developed that stratify this data nationally, by board, by hospital and by specific service.

107. As part of its Person-Centred Health and Care Programme, Healthcare Improvement Scotland has tested approaches to gathering feedback at, or shortly after, the point of care and is supporting local teams to use that feedback for improvement. HIS is also testing experience based co-design methodology, which brings groups of people who have experience of using services together with the staff who deliver those services to make improvements to services.

108. Recommendation:

a) Existing indicators should continue to be collected since they provide a national baseline for measuring progress locally. They should, however be supplemented by more regular assessments of service utilization and effectiveness. Methods for current and relevant data collection are being developed. A small working group to consider more effective ways of collecting data on people's views of services should be convened and a strategy for rapid, locally sensitive feedback of opinions should be developed.