Recommendations
  1. Develop an understanding of the patient as an individual, including how the condition affects the person, and how the person’s circumstances and experiences affect their condition and treatment.
  2. Ensure that factors such as physical or learning disabilities, sight, speech or hearing problems and difficulties with reading, understanding or speaking English are addressed so that the patient is able to participate as fully as possible in consultations and care.
  3. Ask the patient about and take into account any factors, such as their domestic, social and work situation and their previous experience of healthcare, that may:
    • impact on their health condition and/or
    • affect their ability or willingness to engage with healthcare services and/or
    • affect their ability to manage their own care and make decisions about self-management and lifestyle choices.
  4. Listen to and address any health beliefs, concerns and preferences that the patient has, and be aware that these affect how and whether they engage with treatment. Respect their views and offer support if needed to help them engage effectively with healthcare services and participate in self-management as appropriate.
  5. Avoid making assumptions about the patient based on their appearance or other personal characteristics.
  6. Take into account the requirements of the Equality Act 2010 and make sure services are equally accessible to, and supportive of, all people using adult NHS services.
  7. If appropriate, discuss with the patient their need for psychological, social, spiritual and/or financial support. Offer support and information to the patient and/or direct them to sources of support and information. Review their circumstances and need for support regularly.
Relative values of different outcomesThe GDG believed that knowing the patient as an individual was an essential aspect of good patient care.
Trade off between clinical benefits and harmsThe GDG considered that while the recognition and response to the patient as an individual was a right for each patient, consideration of the patient as an individual also improved safety, efficiency and effectiveness of health care. Recognising the individual needs of each patient for help with communication for example allows patients to benefit from services that are available and accessible in a timely way. The GDG was mindful, however, that unnecessary pressure should not be placed on patients to discuss ay subjects they might be unwilling on unready to do so.
Economic considerationsThe GDG considered that some of the recommendations may have time, and therefore cost implications; however they were considered an essential part of good patient care. They also considered that there may be cost offsets due to improved safety, efficiency and effectiveness of healthcare.
Quality of evidenceThe GDG used evidence from the patient experience scoping study and consensus to develop the recommendations.
Other considerationsThe GDG used their own professional and personal experiences to inform these recommendations.
The GDG recognised that healthcare professionals working in the NHS can be under pressure to deliver care in busy environments. For the individual patient however each interaction with professionals and services is a unique experience and part of a wider life experience. The patient cannot be separated from their wider life experience and services need to recognise patient individuality and their social embeddedness.
The GDG recognised that many healthcare professionals and patients achieve this balanced approach despite working in busy environments and that this was related to attitude and skills of those professionals.
The GDG emphasised the importance of healthcare professionals seeing the patient as equal, and to value their lived experience. The GDG felt it was important for clinicians to establish the patient’s background, such as personal circumstances, social and work situation, health literacy, and previous medical experience.
The GDG believed that clinicians have an important role in helping patients to have realistic expectations of treatment. The first step of this process is to explore a patient’s beliefs and understanding of their treatment and procedures.
The GDG considered that it was essential for healthcare professionals to have a non-judgemental attitude towards the patient. The Equality Act 2010 covers nine protected characteristics: age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex and sexual orientation. The GDG considered that a good patient experience should not be compromised because of any patient’s physical and mental characteristics, for example appearance or dress. The GDG felt it was important for clinicians to be supportive but not patronising, and to describe to patients the pertinent options and tools available to support them.

From: 6, Knowing the patient as an individual

Cover of Patient Experience in Adult NHS Services: Improving the Experience of Care for People Using Adult NHS Services
Patient Experience in Adult NHS Services: Improving the Experience of Care for People Using Adult NHS Services: Patient Experience in Generic Terms.
NICE Clinical Guidelines, No. 138.
National Clinical Guideline Centre (UK).
Copyright © 2012, National Clinical Guideline Centre.

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