Over the past few years several documents and initiatives have highlighted the importance of the service user's experience and the need to focus on improving this experience where possible.
Lord Darzi's report High quality care for all (2008) highlighted the importance of the entire service user experience within the NHS, ensuring people are treated with compassion, dignity and respect within a clean, safe and well‑managed environment.
The development of the NHS Constitution (2009–2010) was one of several recommendations from Lord Darzi's report. The Constitution describes the purpose, principles and values of the NHS and illustrates what staff, service users and the public can expect from the service. Since the Health Act came into force in January 2010, service providers and commissioners of NHS care have had a legal obligation to take the Constitution into account in all their decisions and actions.
The King's Fund charitable foundation has developed a comprehensive policy resource – Seeing the person in the patient: the point of care review paper (2008). Some of the topics explored in the paper are used in the development of this guidance and quality standard.
National initiatives aimed at improving service users' experience of healthcare include NHS Choices, a comprehensive information service that helps people to manage their healthcare and provides service users and carers with information and choice about their care. Initiatives, such as patient advice and liaison services (PALS), have also been introduced.
Despite these initiatives, there is evidence to suggest that further work is needed to deliver the best possible experience for users of NHS services. The Government signalled in its White Paper, Equity and excellence: liberating the NHS (July 2010) that more emphasis needs to be placed on improving service users' experience of NHS care. This guidance on service user experience in adult mental health services is a direct referral from the Department of Health.
In 2005 the Department of Health published Delivering race equality in mental health care: an action plan for reform inside and outside services and the government's response to the independent inquiry into the death of David Bennett. The report contained recommendations about the delivery of mental healthcare to service users, in particular those from black and minority ethnic communities. The recommendations also address wider issues in mental health settings, such as the safe use of physical interventions.
High‑quality care should be clinically effective, safe and be provided in a way that ensures the service user has the best possible experience of care. This guidance on service user experience aims to ensure that users of mental health services have the best possible experience of care from the NHS.
A NICE quality standard for service user experience in adult mental health has been developed alongside this guidance. NICE quality standards are a set of specific, concise statements and associated measures. They set out aspirational, but achievable, markers of high‑quality, cost‑effective care. Quality standards are derived from the best available evidence and address three dimensions of quality: clinical effectiveness, service user safety and service user experience. The quality statements for service user experience in adult mental health are listed in the next section.
NICE clinical guidelines are usually shaped around both clinical and economic evidence, and include recommendations concerned with ensuring a good service user experience, with the recognition that such advice should sit alongside evidence of clinical and cost effectiveness. The recommendations in the current guidance have been informed by research evidence, recommendations in previously published NICE clinical guidelines, national survey data and consensus processes that have identified the key elements that are important to service users and how these can be improved to ensure a good experience of care. The guidance draws on multiple evidence and data sources in developing the recommendations, which are further distilled into commissioning guidance in the quality standard.