Intended for healthcare professionals

Practice Guidelines

Improving the experience of care for people using NHS services: summary of NICE guidance

BMJ 2012; 344 doi: (Published 16 March 2012) Cite this as: BMJ 2012;344:d6422
  1. Norma O’Flynn, clinical director1,
  2. Sophie Staniszewska, senior research fellow, lead for patient experiences and public involvement programme2
  3. on behalf of the Guideline Development Group
  1. 1National Clinical Guideline Centre, Royal College of Physicians, London NW1 4LE, UK
  2. 2Royal College of Nursing Research Institute, University of Warwick, Warwick, UK
  1. Correspondence to: N O’Flynn norma.oflynn{at}

The emphasis in healthcare has often been on clinical efficacy and outcomes, which can come at the expense of the patient’s experience. Developments in healthcare delivery can make giving attention to the individual more difficult, especially as healthcare has become more technological and specialised, increasing the number of people and services that a patient has contact with. Changes in the working practices of healthcare staff (such as more part time working) and the rise in the number of large institutions delivering care can mean that patients have less opportunity to develop relationships with professionals who treat them and are more likely to be treated by a team.

The NHS “next stage” review, a review commissioned to develop a vision of an NHS fit for the 21st century, recognised the experience of patients as one of three dimensions of quality.1 The other two dimensions were clinical effectiveness and safety. This article summarises the most recent recommendations from the National Institute for Health and Clinical Excellence (NICE) on improving patients’ general experience of NHS care.2 The recommendations are for all settings and all who use adult NHS services and cover mainly the interactions between healthcare staff and patients, and aspects of organisation.


Recommendations in this guidance were developed using published NICE guidelines, systematic reviews in areas viewed as a priority by the Guidance Development Group (GDG), and the GDG’s experience and opinion of what constitutes good practice. Evidence levels for the recommendations are given in italic in square brackets.

Essential requirements of care

  • Do not discuss the patient in their presence without involving them in the discussion. [Based on the experience and opinion of the GDG]

  • Be prepared to raise sensitive issues (such as sexual activity, continence care, and end of life) as these will not be raised by some patients. [ …

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