Strengthening the patient voice

Update from Care Opinion Scotland

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About: NHS Scotland

picture of Gina Alexander

It’s been a lively two days on our twitter feed (@po_scotland), during the time we spent at NHS Scotland Event on Sustaining and Spreading Quality.  #nhsscot14

The feed was prolific, reaching trending status. There was genuinely a lot to tweet about, example after example of great practice, innovation, idea sharing, harnessing technology, partnership. Even rousing plenary sessions from the DG of the NHS in Scotland, his Quality Tsar and the Cabinet Secretary. We saw, on video, the No 1 at IHI say that if she was ever to get ill, she’d want to come to Scotland to be treated. Quite an accolade. At one point yesterday morning, I felt myself swelling with pride, hearing the laudable ambition that Scottish Government has: that Scotland will be the best health service in the world! I am, unashamedly, an enthusiast – a believer in the potential!

Back in the office today, I was reading all the patient stories I’ve missed over the last few days. They show the reality that great things are happening. Not because the officials tell us, but because the patients do. Patients are also telling us that things are going wrong.

Yesterday, the Scottish Cabinet Secretary announced plans to further strengthen the patient voice in health. Good!  Because we need to do better!  And I include Patient Opinion in that.

A front line clinician commented to me yesterday that Patient Opinion was part of the DNA of the Scottish health service. I appreciate the sentiment, but I really hope not! I prefer to think of what we provide as an antibody: to apathy, to complacency, to the “it could never happen here” syndrome.  

The independence of Patient Opinion is crucial. We are not part of “the system”. Our painstakingly constructed moderation policy determines the publication of stories, not government and not health services. Happily, everyone seems to appreciate that the strength of Patient Opinion lies in its independence, as well as the unprecedented level of openness and transparency. My hope is that the Cabinet Secretary’s new plans for patient voice take on our learning, that independence is vital for constructive and powerful patient involvement.

I also hope that this new system is based on collaboration. We have learnt that getting real and far reaching impact from patient stories means working as part of the health landscape. Beyond working with the Scottish Government and the health service, we are strengthened by working alongside the Alliance, Voluntary Health Scotland, Patient Advice and Support Service, the Health Council, the Ombudsman and other third sector organisations. Cooperation and collaboration have long been guiding principles for these working relationships, and we can wholeheartedly sign up to that!

So plans to strengthen the patient voice are all good. Bring on the enthusiasm: we know we have plenty!

Response from Ian Reeves, Consultant geriatrician, Medicine for the Elderly, SGH GGC on

I see your role as an amplifier - making a small voice heard by a large organisation, and change as a result.

I see your role as an ambassador - opening doors for citizens where the NHS prefers to keep them closed and providing justice where poor care has occurred.

But more than anything else - I see your role as the same as you do, that Patient Opinion is an 'antibody' working to improve, but not support, the current system. Your Patient Opinion antibody can cure the unresponsive and impersonal feedback and complaint systems of the NHS,  by removing the shield of institutional silence,  stripping off the armour of professional indifference and consigning corporate apathy to the lymph nodes of history.

I think we are about to see a revolution in NHS Scotland in how we use organisations such as Patient Opinion to improve public scrutiny, and it's an exciting movement to follow.

Response from danderson1 on


could you tell me the literal meaning of an antibody.

Apart from that,you are to be commended for being so honest,and as you say the whole system is in need of a good shake up.

Keep up the good work...........danderson

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