Difficult conversations? Engaging patients in reducing waste in health care

Abstract

Purpose – Reducing waste in health care can result in savings that could be used to meet the projected shortfall in NHS funding or to meet the care needs of vulnerable groups. Patients and their families can contribute to the identification and reduction of waste. To do so their understanding of the costs of health care and treatment needs to be increased. The paper aims to discuss these issues. Design/methodology/approach – The approach formed part of the Close Partnering work stream of the NHS Future Focused Finance (FFF) programme. Included in this was a review of the literature relating to waste reduction, patient engagement and reference to experts in the field of public and patient engagement. Engagement of the patient voice in the NHS FFF programme to provide the patient perspective and engage in discussions with patients. Discussions with experts in patient and public involvement and clinicians were also undertaken. Findings – The public and patients have little awareness of NHS finances and generally perceive efforts to reduce costs and achieve efficiencies as impacting on the quality of care. Engaging the public and patients in discussions about the costs of health care is challenging and existing methodologies for patient and public engagement may not be appropriate for what could be termed difficult conversations. Social implications – Increasing patient awareness of the costs of health care and treatment may result in patients and the public demanding greater involvement in decisions about health care expenditure and use of resources. Originality/value – Difficult conversations with patients and the public about the costs of health and their role in reducing waste are rarely invited. This paper brings to the fore the issues and challenges that such discussions engender.

Too Vulnerable to Involve? Challenges of Engaging Vulnerable Groups in the Co-production of Public Services through Research

“…Several studies reported communication challenges arising from contributors' limited understanding of relevant project aspects due to lack of maturity, cultural, language, or literacy barriers (e.g., Steelman et al, 2019;Williams & James, 2008). Here, some authors described the inherent challenge of breaking down complex topics to make them relatable and understandable to lay audiences (Minogue et al, 2016;Williams & James, 2008). When discussing NHS funding with patients, Minogue et al (2016) found it difficult to identify appropriate methods of communication that would suit the needs of the various groups involved in the discussion.…”

“…Here, some authors described the inherent challenge of breaking down complex topics to make them relatable and understandable to lay audiences (Minogue et al, 2016;Williams & James, 2008). When discussing NHS funding with patients, Minogue et al (2016) found it difficult to identify appropriate methods of communication that would suit the needs of the various groups involved in the discussion. Communication challenges also related to contributors' ability and/or desire to express themselves.…”

“…More general recommendations related to the importance of positive attitudes towards involvement (e.g., Moule & Davies, 2016;Taylor et al, 2018) and the need for both institutional support and flexibility to accommodate the needs of research not following traditional science production models (e.g., Gratton & Beddows, 2018;Minogue et al, 2016). Over-recruiting (Gray et al, 2016) and the promotion of involvement to ensure equity of access to co-production (Mitchell et al, 2019) were less pronounced strategies.…”

“…Some authors also proposed offering the contributors different forms of monetary and non-monetary recognition. This included items such as money, thank you certificates, vouchers, co-authorship, or officially recognizing them as members of the research team (e.g., Ayre et al, 2018;Minogue et al, 2016).…”

Patient and public involvement in reducing health and care research waste

“…‘Difficult conversations? Engaging patients in reducing waste in the commissioning and delivery of health care’ [ 11 ], examined the potential role of patients in reducing waste recommended taking the learning from PPIE to engage in dialogue and partnership in the reduction of waste. This recommendation also has resonance for the reduction of waste in research.…”