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Patient Choice Schemes

Volume 493: debated on Monday 1 June 2009

To ask the Secretary of State for Health what recent research his Department has (a) commissioned and (b) reviewed on patient choice in the NHS. (276710)

The Department commissions and reviews numerous papers on choice. The following answer shows the details of many of the papers, research and surveys on patient choice that the Department has commissioned and reviewed in recent years.

As part of its ongoing patient choice programme the Department commissions research on various aspects of choice policy.

The Department commissioned a series of national patient choice surveys to assess the implementation of choice at primary care trust (PCT) level. The National Patient Choice Survey is a series of surveys, conducted by Ipsos MORI on behalf of the Department. They monitor patient awareness of choice and recall of having been offered a choice of hospital for their first outpatient appointment. They were designed to provide a national overview of choice with summary results at PCT level (initially bi-monthly and now quarterly) and generally have an effective response rate around 30 per cent. Surveys also contain information on respondents' age, sex and ethnicity. The report of the December 2008 survey was published on 7 May 2009.

The Health Reform Evaluation Programme (HREP) is a programme of research being coordinated by the London School of Hygiene and Tropical Medicine (LSHTM) to evaluate the reforms set out in the Department's publication “Health Reform in England: update and next steps”. This includes research on a range of issues including patient choice. Final reporting will begin in 2010. As part of the HREP, LSHTM have also conducted a “systematic review of the impact of patient choice of provider in the English NHS1” (2009). An ongoing study under this programme which is yet to report is entitled “Effects of choice and market reform on inequalities of access to health care”.

The Department commissions a module on attitudes to health issues in the British Social Attitudes annual survey conducted by Natcen. This involves a series of questions about social attitudes towards health and health services. Some of these questions are about attitudes towards patient choice. The results of the survey are published in a report on an annual basis2.

The Department is conducting regional awareness campaigns on patient choice and has commissioned an evaluation of these campaigns.

Other research on patient choice commissioned by the Department includes:

Title of document/research programme

Date

Author

Available from/on

London Patient Choice Programme

2005

NHS London

www.londonchoice.nhs.uk/about-programmeoverview.php

Are patients choosing?

2009

Henderson, Robertson and Dixon

British Journal of Healthcare Management 15 (2): 77-80

NHS maternity services quantitative research

2005

TNS System Three

www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4124246

Literature review on choice and mental health

2005

Sainsbury Centre for Mental Health

www.library.nhs.uk/PPI/ViewResource.aspx?resID=250438

The Department reviews research on various aspects of choice policy. Following is a table with details of many of the pieces of research that have been reviewed that are directly relevant to patient choice in the national health service.

Title of document

Date

Author

Available from/on

Improving choice at end of life. London: King's Fund

2008

Addicot, R. and Dewar, S. King's Fund

http://www.kingsfund.org.uk/research/publications/improving_choice_at.html

Cancer and the future of Choice

2006

Barclay, M. (Macmillan Cancer Support)

“Why do patients change their general practitioner? A postal questionnaire study of patients in Avon”

1993

Billighurst, B. and Whitfield, M.

British Journal of General Practice 43: 336-338

Will more choice improve outcomes in Education and Health Care?

2005

Burgess, S. The Evidence from Economic Research. CMPO: London

www.bris.ac.uk/Depts/CMPO/choice.pdf

Just what the patient ordered. Better GP services. CBI: London

2007

CBI

www.cbi.org.uk/pdf/gpservices0907.pdf

A healthy choice: building a stronger NHS. CBI: London

2008

CBI

www.cbi.org.uk/pdf/A%20healthy%20choice_Building%20a%20stronger%20NHS_June2008.pdf

Hospital at Home or Acute Hospital Care? A Cost-Minimisation Analysis

1998

Coast J., Richards S.H., Peters T.J., Gunnell D.J., Darlow M.A., Pounsford J.

BMJ 316: 1802-1806

“Registering choice: how primary care should change to meet patients needs”

2005

Corrigan, Social Market Foundation

http://www.smf.co.uk/registering-choice-how-primary-care-should-change-to-meet-patient-needsl.html

Evaluation of London Patient Choice

2004

Coulter A. et al (Picker Institute)

www.londonchoice.nhs.uk/documents/Patient-Experience-Study-LPC-(PICKER).pdf

Evidence on the effectiveness of strategies to improve patients' experience of cancer care

2007

Coulter, A.

www.pickereurope.org/Filestore/PIE_reports/project_reports/Cancer_reform_strategy_Macmillan.pdf

Where are the patients in decision-making about their own care? Copenhagen: WHO

2008

Coulter, A. et al

www.euro.who.int/document/hsm/3_hsc08__ePB_6.pdf

Patients' involvement in decisions about medicines. GPs' perceptions of their preferences.

2007

Cox, K., Britten, N., Hooper, R. and White, P.

British Journal of General Practise 57: 777–784

Our Choices in Mental Health

2006

CSIP

www.parliament.uk/deposits/depositedpapers/2009/DEP2009-0074.pdf

Audit of Acute Maternity Services

2006

Department of Health

Building on the Best: Choice, Responsiveness and Equity in the NHS

2003

Department of Health

www.dh.gov.uk/en/Consultations/Responsestoconsultations/DH_4068391

Choice Matters. Working with libraries

2008

Department of Health

www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_083956

Maternity Matters: Choice, access and continuity of care in a safe service

2007

Department of Health

www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_073312

Long Term Conditions Personal Care Plan Impact Assessment

2009

DH

http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsLegistation/DH_095647

Patient choice: What does ‘choice' mean to people with diabetes?

2005

Diabetes UK

http://www.diabetes.org.uk/en/Professionals/lnformation_resources/Reports/Patient_choice/

Is greater choice consistent with equity. The case of the English NHS.

2006

Dixon, A. and Le Grand, J.

Journal of Health Services and Policy 11: 162-166

Patient choice in general practice: the implications of patient satisfaction surveys

2008

Dixon, A. et al

Journal of Health Services and Policy 13: 67-72

Patients choosing their healthcare

2005

Dr. Foster

www.drfoster.co.uk/patientchoice/pdf/Patient_Choice_Workbook.pdf

Patient Choice and the Organisation and Delivery of Health Services: Scoping Review

2005

Fotaki M. et al

What benefits will choice bring to patients? Literature review and assessment of implications.

2008

Fotaki, M. et al

Journal of Health Services and Policy 13(3): 178-184

A bed too far. The implementation of freedom of choice policy in the NHS.

2008

Garcia-Lacalle, J.

Health Policy 87: 31-40

Home or Hospital? Choices at the end of life.

2004

Gomes, B. and Higginson, I.

Journal of the Royal Society of Medicine 97(9): 413-414

National survey of local health services 2008

2008

Healthcare Commission

http://www.healthcarecommission.org.uk/_db/_documents/PCT08_Comparative_tables_v4_1-24-07-08_-_backup.pdf

Does Publicising Hospital Performance Stimulate Quality Improvement Efforts?

2003

Hibbard, J. et al

Health Affairs, vol 22, no 2

Priorities and Preferences for End of Life Care in England, Wales and Scotland

2003

Higginson I.J. National Council for Hospice and Specialist Palliative Care Services

NHS Reforms Workshops

2006

Ipsos-MORI

Choice in Mental Health Care

2006

King's Fund and SCMH

www.scmh.org.uk/pdfs/briefing31_choice_in_mental_health_care.pdf

Improving Choice at end of life

2008

King's Fund

http://www.kingsfund.org.u/research/publications/improving_choice_at.html

LSE Depression Report

2006

LSE—CEP

cep.lse.ac.uk/textonly/research/mentalhealth/depression_report_layard.pdf

“Choice and Contestability in primary care”

2004

Maclean (2004) Social Market Foundation Health Commission

http://smf.smf.co.uk/choice-and-contestability-in-primary-care.html

Liverpool Care Pathway: Promoting best practice for care of the dying

2006

Marie Curie

http://www.lcp-mariecurie.org.uk/

Valuing Choice—Dying at home

2004

Marie Curie

campaign.mariecurie.org.uk/NR/rdonlyres/646C31D0-49C1-42C5-8BFE-D1A8F3F3A499/0/campaign_valuing_choice.pdf

British Social Attitudes: the 22nd report. Two terms of New Labour the Public's reaction

2005

Natcen

http://www.natcen.ac.uk/natcen/pages/op_socialattitudes.htm#bsa

End of Life Care

2008

National Audit Office

http://www.nao.org.uk/publications/0708/end_of_life_care.aspx

The NHS Cancer Plan and the New NHS: Providing a Patient-Centred Service

2004

NHS

Impact of patients' socioeconomic status on the distance travelled for hospital admission in the English National Health Service

2007

Propper, C. et al

Journal of Health Services Research, vol 12, No 3. The Royal Society of Medicine Press: London

Does competition between Hospitals Improve the Quality of Care? Hospital Death Rates and the NHS Internal Market. University of Bristol, CEPR and CMPO

2007

Propper, C. et al

Ideas.repec.org/a/eee/pubeco/v88y2004i7-8p1247-1272.html

The costs of alternative types of routine antenatal care for low-risk women: shared care vs. care by general practitioners and community midwives

1996

Ratcliffe J., Ryan M., Tucker J.

J Health Serv Res Policy 1(3): 135-40

Patient choice

2008

Robertson, R. and Thorlby, R.

www.kingsfund.org.uk/document.rm?id=7356

“Patient Choice in general practice: the implications of patient satisfaction surveys”

2008

Robertson, R. Dixon, A. Le Grand, J. (2008)

Journal of Health Services Research Policy 13(2): 67-72

The anatomy of GP referral decisions: A qualitative study of GP views on their role in supporting patient choice

2006

Rosen, R., Florin, D. and Hutt, R.

www.kingsfund.org.uk/publications/the_kings_fund_publications/an_anatomy_of_gp.html

Randomised Controlled Trial Comparing Hospital at Home with Inpatient Hospital Care. II: Cost Minimisation Analysis

1998

Shepperd S., Harwood D., Gray A. Vessey M. Morgan P.

BMJ 316: 1791-1796

Economic analysis of two models of low risk maternity care: a freestanding birth centre compared to traditional care

2000

Stone P.W., Zwangziger J., Hinton P.H., Buenting J.

Res Nurs Health 23: 279-89

Implications of offering “Patient Choice” for routine adult surgical referrals

2004

Taylor R./Dr. Foster Ltd./University of Nottingham

An Overview of the Literature on Palliative Care in Primary Care

2003

(Taken from chapter 5 in 'Caring for the Dying at Home: Companions on the Journey by Thomas K. (2003))

http://www.goldstandardsframework.nhs.uk/content/guides_and_presentations/Evidence_base.pdf_

Free choice at the point of referral

2008

Thorlby, R. and Gregory, S.

www.kingsfund.org.uk/document.rm?id=7526

Choice and Equity. PCT Survey.

2007

Thorlby, R. and Turner, P. Kings Fund

http://www.kingsfund.org.uk/404.rm?doclink=true&destination_id=6915&referer=http%3A%2F%2Fwww%2Elibrary%2Enhs% 2Euk%2Fhealthmanagement%2FViewResource%2Easpx%3FreslD%3D260851

Patient reactions to hospital choice in Norway, Denmark, and Sweden

2007

Vrangbaek, K. et al

Health Economics, Policy and Law, Vol. 2, pp: 125-152

Exploring cost and quality: Community based versus traditional hospital delivery

1996

Walker, P., Stone, P.

J Health Care Finance 23:23-41

Improving Supportive and Palliative Care for Adults with Cancer. Economic Review.

2004

Ward S., Salzano S., Sampson F., Cowan J./NICE

NHS Messaging: Attitudes of NHS staff

2004

Wardle McLean

Choice literature review

2006

Warner et al. / Kings Fund and SCMH

Palliative Care: The Solid Facts

2004

World Health Organisation Europe (edited by Davies, E. and Higginson, I.J.)

http://www.euro.who.int/lnformationSources/Publications/Catalogue/20050118_2

The costs to the NHS of maternity care: midwife-managed vs. shared

1997

Young, D., Lees, A., Twaddle, S.

Br J Midwifery 5(8): 465-71

The lure of patient choice

2007

Bryant, L.D., Bown, N., Bekker, H.L., and House, A.

British Journal of General Practice 57: 822-826

1 http://www.lshtm.ac.uk/hsru/hrep/publications/index.htm

2 http://www.natcen.ac.uk/bsa/