Quality in Primary Care Open Access

Patient articles in professional journals used to be seen as an invasion of territory. Now patients are invited to contribute. We need to share each others’ space if we are to understand one another.

So writes Mitzi Blennerhassett, one of the contributors.

This is the first in a series of special issues of Quality in Primary Care that we plan to publish as a regular feature. As well as this issue on the ‘Patient Perspectives on Quality in Primary Care’ we are also planning an issue on ‘Commissioning for Quality Improvement’ later this year and next year the ‘Development of Nursing Practice and Scope’, ‘Professional Regulation’ and finally ‘Organisational and Educational Interventions for Quality Improvement’.

One could reasonably ask what perspective of quality is there, other than the viewpoint of the patient? ‘The customer knows best’ is an adage from the business world that medical care has been slow to adopt. But increasingly doctors, nurses, other health professionals and organisations are realising that the user’s is arguably the most important judgement of quality, whether this relates to the care that they receive or the clinical outcomes that they experience. In this regard it can be said that professional perspectives are simply a proxy for that of the patient.

This issue of the journal therefore justifiably focuses on the patient perspective. Many claim to represent the patient perspective including patients themselves, patient representatives, academics, clinicians, managers and commissioners of services. To what extent do the views presented here represent the genuine patient voice? I think the reader must judge for themselves the credentials of contributors, the sincerity of the story they tell and the evidence that they present. The style of this issue is notably discursive, and in this regard it is important to appreciate that the ‘patient voice’, while not necessarily constrained by an academic style, should be based on evidence and argument.

Weare also outlining, in the section entitled Quality Improvement in Action, a series of nine quality improvement and research studies funded by the Health Foundation which form a major investment in our understanding and application of quality improvement.

Ben Skinner with Sharon Springham reminds us in the popular and informative regular feature ‘Knowledgeshare’, that healthcare workers including doctors can be patients and users too. I worked as a house officer at Barts in the mid-1980s and was privileged to work in my first post as a houseman on the endocrinology unit there. The late Vicky Clement Jones was a medical registrar and researcher at that time who, while undertaking pioneering research into enkaphalins, contracted ovarian cancer. Through her experience of cancer she helped found BACUP (the British Association of Cancer United Patients), which subsequently became Cancerbackup.

I am very grateful to all the authors who have contributed to this issue, and in particular to Patricia Wilkie, lay member of the Editorial Board of Quality in Primary Care and guest editor of this issue of the journal, who has used her extensive knowledge and experience of the field to commission lay and professional experts to write personal, informed and wellargued articles on the user perspective of quality. Her attention to detail and diligence have led to an impressive and varied series of articles.