On Friday morning I spent a couple of hours helping to man a Gloucestershire LINk stand in a shopping centre, asking passers-by for their opinions on health and social care. Not many people were around, and of those that were, not many offered their opinions. Even so, there were some common themes.
The place was not busy. Several of the shop units were vacant and several others did not open until late in the morning. The busiest business was a café in the far corner. Outside in the main street, though, there were plenty of shoppers.
The LINk’s stand is poorly designed, I thought. It has two large professional-looking displays that are clearly visible from a distance, but the message they carry is complicated and not quite true.
They give the impression that if you join the LINk you can influence health and social care. In fact you don’t have to join at all. You can simply pass on information about your experiences of health and social care, and collectively that information can have some influence.
What’s more, even if you do join you will probably not have any influence as a member. The great majority of LINk members are passive. They receive information, and perhaps attend lectures and take part in discussions, but they have no direct influence on anything.
I watched many people read the message on one of those large displays and then turn away. The prospect of joining did not attract anyone at all to the stand.
The main part of the stand is a table with a selection of freebies, including copies of the last Annual Report and newsletter, pens and squeezy foam “stress balls”. Behind them, a message invites comments on health and social care.
That message did attract people’s attention, and it is truthful. It is just a pity it looks so unprofessional, appearing to have been made by using an office photocopier to enlarge separate words, laminating them, and sticking them on to the background with Blu-Tack.
There’s no clear information on what the LINk actually is. Many people wanted to know that first, before they were prepared to pass on information about their experiences. I felt it should have been made obvious on the stand, even though it is complicated to describe truthfully.
So the stand as a whole gives the impression of a bunch of amateurs with money to burn, though not enough money to hire professional advertising and PR expertise. While that impression may be painfully accurate, it’s not the most desirable one.
The LINk needs to recruit marketing and PR directors from amongst its members in order to build a more serious public image, it seems to me.
Another complication was that the stand was in the charge of a paid employee of the LINk’s host organization, Gloucestershire Rural Community Council. This made it untruthful to say to the public, “We’re volunteers.” I am baffled by the need for an organization with hundreds of volunteer members to use paid staff to put up a stand in a shopping centre.
The cost of using paid staff on the stand was perhaps offset by placing the stand in a partly-derelict centre, where the LINk did not have to pay anything for the site. It would have been more effective to pay for a busy site. For example, a hundred yards away on the street outside the centre, another charity stand had perhaps ten or twenty times the number of passers-by to work with.
The LINk’s method for collecting opinions was also costly, giving each member of the public a personal interview that sometimes lasted many minutes. That severely limited the number of people who could be engaged with. Although the LINk has cards that people can take away so that they can send in their opinions later, it made little use of them on this occasion.
The opinions I heard from members of the public all concerned health care, not social care. They covered a wide range of topics, and I heard a mixture of compliments and complaints. I did not speak to enough people to form an impression of any particular topic. It’s only when many comments from events like this are collated back in the office that a clear impression about a particular service might emerge.
Even so, many of the comments I heard did have something in common. It was that people seemed much more concerned about feeling cared for by the NHS than by the medical quality of their care.
For example, people who praised their GPs or hospital staff generally praised them for being caring and attentive, responding quickly and taking time to listen. People who criticised GPs or hospital staff criticised them for having waiting lists, seeming rushed, or not paying enough attention to them.
The medical success or failure of NHS treatment, on the other hand, didn’t seem to matter much. Several people told me stories about having repeated or ongoing treatment, making me wonder to myself whether they had perhaps been treated ineffectively or even incompetently, but the medical outcome of their treatment was never the subject of a complaint. Equally, no one praised any example of outstanding medical skill.
From these few conversations, I got the impression that what used to be called “bedside manner” matters to the public far more than clinical effectiveness. People seem happy to remain ill as long as they feel cared for.
Liberating the NHS
If my impression is accurate, it has serious implications for the government’s planned changes to the NHS. On the one hand, it is planned to give the public more of a say in how their local NHS is run. On the other hand, it is planned to hold the NHS accountable for clinical outcomes.
Those two things might turn out to be incompatible. The public might prefer treatments that make them feel comforted but have poor clinical outcomes. Is that wrong? I can’t decide one way or the other.