The powerful consumer expects more

Patient and service-user have more demanding expectations of access to care, wanting greater choice and involvement in decision making. Patients and service users are seeing themselves more as consumers of services, developing expectations similar to those they have for other services. Health and social care has been relatively slow to respond.

Patient expectations are changing. The post-war baby boomers experienced periods of substantial economic growth and prosperity, and living conditions have drastically improved. People in this group are now retiring and will be the major consumers of health and social care services. This will change demand on services as they’ve lived very different lives from that of their parents. Baby boomers also differ greatly from their children, and changes in public expectations have accelerated.

Patients expect doctors to spend more time with them, explaining the implications of their illnesses and the options for treatment. This takes up more of doctors’ time. The higher level of patient knowledge and awareness will also impact their expectations, especially regarding choice of care provider, type of treatment and the style of interaction with their doctor. Patients no longer expect care to be paternalistic but rather to be in an informed partnership with care providers. This will demand more interpersonal and soft skills from doctors.

However, the greatest expectations are for care services to catch up to others in the services sector, such as banking and retail, where access is easy and immediate, services are provided around customer needs, and technologies are used to improve services interactions. People are also expecting greater customisation and personalisation of care, and to be more involved in shared decision making. A majority of patients and service users report a desire for greater involvement and control in the care that they receive.

Services have already responded to the changing expectations. Information about services, choices, other patient’s experiences, etc. is now widely available online. For instance, the Department of Health has a plan for patients to access GP records from 2015. These changes, though important, are largely superficial, and it is recommended that cultural changes be set in place.

Sources or references

• Interviews with healthcare professionals as part of the CfWI’s Medical and Dental Student Intakes project, 2012
• King’s Fund, 2012, Transforming the delivery of health and social care
• Department of Health, 2012, Long Term Conditions Compendium of Information
• Doulgeris, J, 2011, Top 10 Changes in Patient Expectations (Part I)
• Doulgeris, J, 2011, Top 10 Changes in Patient Expectations (Part II)
• Williams, S. et al (1995). Patient expectations: what do primary care patients want from the GP and how far does meeting expectations affect patient satisfaction?. Family Practice 12(2): 193-201
• Barnes, M. (1999) Policy Futures for UK Health No.10 Public Expectations. From paternalism to partnership: Changing relationships in health and health services

Some of the information in this section is provided by stakeholders and expert groups, and does not necessarily represent the views of the CfWI.