Patient priorities: Research into patient confidence and choice

Patient perspectives

The result is our new 'Patient priorities' report, the findings of which we believe provide useful  information to the whole of the private sector, as well as to patients.

We wanted to ensure we engaged with a representative sample of the UK’s private healthcare patients; specifically for inpatient and day surgery procedures, as supplied by private hospitals, and NHS facilities, offering private care and published on PHIN’s website. 

We also wanted to engage with people who may be treated in the NHS but could access private healthcare as an alternative option, and people who might not have ever considered themselves as private patients.

After consideration we opted to do most of the patient research ourselves and use external input to challenge and improve our approach. This helped us to substantially reduce our costs and to expand our scope of participation. It also allowed us greater opportunity to follow up on points of interest in the discussions, to respond in an informed way to questions, and to hear more clearly and directly the patients’ own voices, experiences and concerns. 

We did this in two ways:

A series of in-depth qualitative focus groups with a total of 41 patients in distinct clinical specialty areas. The focus groups were conducted online, to allow us to reach a broad demographic group. We reached out to over 30 organisations, consisting of hospitals, charities, patient research organisations, user research platforms, survey hosts and Royal Colleges to help us recruit participants. This meant that many of those involved were more knowledgeable than the general population might be about healthcare and might take a more sophisticated approach. This is demonstrated in some of their responses and proved useful in terms of peer-to-peer learning and short-cutting to specific issues rather than having to take a very broad view.

A broader online quantitative survey of c.2,000 people (2,036) based on the themes that emerged through the focus groups and conducted by international online research data and analytics technology group, YouGov.

Further details of our approach are available in Annex 1 of the report with demographic information in Annex 3.

Illustrative findings

• Not all patients have a ‘consumer mindset’ when navigating private healthcare; guidance is contained in this report to help both patients and the sector ensure that there is better communication, understanding and use of the choices that are distinctive to private healthcare.
• Patients’ private journeys are very diverse because of their priorities and circumstances. So too their appetites for information, which can depend on their physical or emotional state, confidence in handling such information and previous experience in the private sector. 
• Participants told us there’s a lack of clarity and completeness in how private healthcare costs are represented, particularly the full set of in-hospital fees, as well as financing options. This prevents patients from making an informed choice and managing trade-offs. This was especially true for self-pay patients who felt that costs often seemed opaque, if not misleading.
• Patients told us that consultants should invest in their ‘shop windows,’ including participation in legally-mandated processes like PHIN and provide information that adds a human touch to their clinical information.
• The focus group participants liked PHIN’s website, neutrality and centrality in the sector, and felt it needed greater promotion; the majority had never heard of it before. However, many thought it would benefit from better navigation and search function, and greater use of everyday health terms.
• Many patients (71% in our research) are going private not because they want to, but because they feel they have to, especially in the context of much longer waiting-lists and their impact; they also ‘mix and match’ between NHS and private treatments.
• Patients consult multiple sources of information before making their healthcare choices, with 51% citing the significantly persuasive value of a recommendation from a friend, family member or colleague.
• Patients would value a ‘map of private healthcare,’ with key decision points highlighted. 30% of people surveyed overall were not confident about using private healthcare, and 19% of those who’d had prior treatment in the past three years were still not confident about navigating through it. The lack of knowledge creates anxiety and, for some, the sense that people with better access to information or understanding of the process can obtain faster or better outcomes.
• Location is the key factor when choosing a hospital (58%).
• When researching private healthcare, top topics are hospitals (54%) and procedures (52%).
• A significant majority (84%) of patients said they hadn’t considered treatment abroad. In our focus groups, many spoke of their concern if something went wrong in a foreign context without comparable standards and support that patients might find in the UK.

Read the full report

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