Patients are willing to sacrifice faster access to treatment in favour of better hospital care, says a new report published today.
A joint study by RAND Europe, The King's Fund and City University reveals that patients are more likely to choose to be treated at a hospital with a good reputation rather than one that has shorter waiting times. Patients who were surveyed for the study were also willing to trade off longer waits for operations if the NHS was prepared to pay for and arrange travel.
The report says the findings raise questions about the government's policy on patient choice, which, so far, has only offered patients a choice of quicker treatment.
Lead researcher Peter Burge said:
'This study shows that waiting time isn't everything. Some patients will be prepared to wait considerable amounts of time in order to obtain treatment at a hospital with a better reputation.'
The findings are based on an evaluation of the London Patients Choice Project (LPCP) - one of the first government schemes to offer patients on waiting lists quicker access to hospital treatment. The project was established in June 2002 and ran until March 2004, with patients first being offered a choice in October 2002. During this period 22,500 patients were offered choice in five specialties covering 35 operations. Of these, 15,000 patients accepted treatment at another hospital rather than their local one. Their care was paid for by the LPCP.
The study found that less wealthy patients are more willing to accept being treated at hospitals with a poor reputation. 'The reality of these differences in choice raises uncomfortable questions about how best to provide a health service that ensures equal access for those in equal need,' said Burge.
The research also identified the lack of existing information available to patients on hospital reputation to help patients make informed choice.
'If the government is serious about offering real choice to NHS patients, then it has to start providing the right sort of information to help patients choose,' said Professor John Appleby, another key researcher involved in the evaluation.
'Unfortunately there is little or no adequate information currently available on reputation or quality of care.'
Finally, the research finds that the government's decision not to pay, or at least organise, patient transport to hospitals beyond their local area will reduce the range of opportunities for patients to exercise choice in some cases.
Professor Nancy Devlin, key researcher in the study, said:
'Our research shows that if transport were provided and paid for by the NHS then this would increase patients' willingness to choose hospitals out of their area. However, in its roll out of choice across the country, the Government has decided not to organise or pay for transport.'
Policy implications of the study could lead to better-informed decisions and improvement in NHS healthcare delivery, with the research providing useful lessons that are highly relevant to the NHS 'Choose and Book' initiative.
Notes to editors:
- In support of its 'Choose and Book' initiative, the Department of Health has asked the same research team to look into the Government’s commitment to offer all patients who require elective surgery a choice of up to five hospitals for treatment at the point of their GP referral from December 2005. Unlike today's research that surveyed patients already on a hospital waiting list, this future project will identify the factors important to patients choosing a hospital earlier, at the time of referral.
- RAND Europe is an independent not-for-profit policy research organisation that serves the public interest by improving policymaking and informing public debate. Our clients are European governments, institutions, and firms with a need for rigorous, impartial, multidisciplinary analysis of the hardest problems they face.
The King's Fund is an independent charitable foundation working for better health, especially in London. We carry out research, policy analysis and development activities, working on our own, in partnerships, and through funding. We are a major resource to people working in health, offering leadership development programmes; seminars and workshops; publications; information and library services; and conference and meeting facilities.
City University, London, is "The University for the business and the professions". City offers postgraduate programmes in economic evaluation and health economics. The City Health Economics Centre aims to provide innovative and policy relevant health economics research.
For further information or interviews, please contact the King's Fund media and public relations office on 020 7307 2585; or Lynne Saylor in the RAND Europe external affairs department on 01223 353329.