NHS England and the Department of Health and Social Care have today published new patient experience minimum standards for elective care. The Strategy Unit, working in partnership with Ipsos UK, was commissioned to develop the evidence base that informed these standards. Through extensive research and engagement with patients, unpaid carers, children and young people, NHS staff and voluntary, community, faith and social enterprise (VCFSE) organisations, we explored what matters most to people while they wait for care and what is realistic for NHS organisations to deliver.
Reducing elective care waiting times remains a major priority for the NHS, and waiting times continue to act as a litmus test for public confidence. While there has been some progress towards the 18-week referral-to-treatment target, this is still far from reality for most patients. For many, waiting for elective care remains a long, uncertain and often frustrating experience.
Improving how long people wait is important, but so too is improving what it feels like to wait.
This commission builds on the Strategy Unit’s wider programme of research and analysis supporting improvements in elective care and patient experience.
Developing a comprehensive evidence base
Our aim was to ensure the standards reflected what matters most to patients and unpaid carers, while also being realistic for the NHS to put into practice. We heard from a wide range of people, making sure we had a focus on including those whose perspectives are often underrepresented.
- Reviewing the evidence
We began with a rapid review of existing research and best practice to understand what shapes good and poor experiences while waiting for elective care, and where there were opportunities for improvement.
- Extensive engagement
Working with Ipsos UK, we carried out qualitative research with a diverse sample of 135 people who were currently waiting, or had recently waited, for elective care. This included unpaid carers, children, young people, and parents, with particular emphasis on hearing from people whose experiences are often underrepresented.
The Strategy Unit also spoke with:
- VCFSE organisations representing patients and underserved groups
- NHS staff across the system, including:
- Leaders involved in elective recovery
- Operational and digital teams
- Frontline booking and scheduling staff
This helped us understand both what patients need and the practical challenges and opportunities facing NHS organisations.
- Co-designing the minimum standards
We then worked with members of the public, including people from marginalised groups and representatives from VCFSE organisations to co-design the standards through a series of focus groups.
Throughout the project, we worked iteratively with national stakeholders and policy makers to
What our research found
Across every stage of the research, one finding came through consistently: better communication would improve the experience of waiting for many people (but it won’t fix everything for everyone). And we are happy to see this at the centre of the new standards.
Experiences vary depending on clinical need, urgency, and people’s wider circumstances. Some patients and unpaid carers need more than good communication, they need practical support, flexibility, and a system that adapts to them.
The findings were synthesised into four key themes:
Why this matters
Improving communication is not simply about patient satisfaction.
Our research found that when people feel informed and supported, they are more likely to attend their appointments, stay well while waiting, have better outcomes and report a more positive experience.
Improving patient experience can also reduce missed appointments, ease pressure on services, and improve staff experience.
The importance of implementation
Our research also highlighted the realities NHS organisations face. Legacy patient communication systems, complex scheduling processes, ongoing capacity constraints and tensions between patient experience and elective recovery priorities.
At the same time, we found strong examples of organisations already leading the way, demonstrating improving patient experience is achievable through strong leadership, thoughtful service design and a commitment to putting patients at the centre of elective care.
The publication of these minimum standards represents an important milestone. Turning the standards into reality will take the right support. The organisations that get furthest will likely be those that see patient experience as a core part of elective care recovery and make it part of how they work day-to-day -and achieving these standards will make a real difference to patients, and their carers.
Read more about the standards here https://www.england.nhs.uk/publication/minimum-standards-for-planned-patient-care/
