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PALS - Active For An NHS Life Introduction
Doctors are often easy emotional punch bags for a number of patients lounging in a hospital ward. Everything that has gone wrong - the food, the refusal to use mobiles and the nursing staff refusing to answer the patient is blamed on the doctor. There are occasions on your ward round where an unassuming SHO is bombarded with a screaming patient. The substandard service in some units making life a misery for many patients is something many doctors are actually not responsible for. Yet, the buck stops with the doctor to solve all present problems. Doctors these days often act as social workers, porters, and agony aunt and have to wear many hats - simply to get through the day. These days, life is indeed much easier because - all you say to the patient is this " I understand your problems, PALS are very kind and will sort out all your problems but do make a list before they come and see you". That defuses a huge amount of anger. PALS are amazingly useful. For example, a patient may be unhappy with your medical decision and instead of having an argument - the doctor may simply say - PALS will address your concerns but this is my justification for your treatment". PALS are really the mediator between patient and doctor and often prevent unnecessary litigation and misunderstandings. For patients, they are an information resource for complaints procedures, contacts to other support networks etc. For many patients, it often provides a port of call where people actually understand and take concerns seriously. They are able to liase with hospital staff in difficult times such as bereavement. They are an invaluable source of information for patients. Often busy doctors seem unsympathetic and PALS is a route to coherent communication that is very important in an NHS today. Personally, I have always been thankful to the staff in the little PALS Office in our hospital. They often assist me to sooth the ruffled brows of a patient who I cannot seem to see eye to eye with no matter how many explanations I provide. It is not unknown for the surgeons to be tearing their hair out over a patient who seems impossible. Naturally, busy surgeons have little time to address the concerns surrounding the day to day living in a hospital ward. They usually call the psychiatrists as a first port of call. The last referral to PALS resulted in a very angry patient sending me a huge bunch of flowers to thank me. Not bad for simply handing out a leaflet :). The motto of the story is - never leave reception without a handful of PALS leaflets. Creating Pals For once it seems that the NHS and the government managed to get something right in the health service. In 2000, the NHS Plan set out plans to establish a new system of patient and public involvement (PPI) to replace Community Health Councils in England, bringing the service much more up to date. This was not, however, something that was simply imposed on the public. Before publication of the plan, the most comprehensive consultation exercise in the history of the NHS took place, seeking the views of everyone working in, or affected by the health service, to find out what changes people most wanted to see. A system was needed, according to the Bristol Royal Inquiry report, which recommended representation of patient interests "on the inside" of the NHS and at every level. PALS stand for Patient Advice and Liaison Service. The NHS Plan committed every NHS Trust to establish one to address the needs of patients, families and supporters at the point of origin, and PALS implementation began in April 2001 with the establishment of over 100 Pathfinder or early implementer PALS. Lesley Hilton, acting head of patient representation for the DOH, said, at the time, "PALS are there to provide patients, families and carers with information, and also to give them on-the-spot help when things go wrong. There's nothing new about PALS in terms of the work they will do. The NHS has always given help and support to patients and their families and carers, but now we are aiming to ensure this is happening everywhere and to a consistent standard." West Yorkshire by Pinderfields and Pontefract Hospitals NHS Trust was among the first to set up the service. At Pontefract, 179 calls and visits were made to the information centre in just one day, so the public were obviously enthusiastic about it. The trust's head of communications, Bridget Gill commented. "Sometimes people don't know where to turn to get help and we can be that first port of call for them," she said. "We have a very broad role, and we're not a complaints service as such. I've actually wanted information centres like this for a couple of years and we did some research and looked at another information centre at St James's Hospital in Leeds. We also held a public event last October asking local people what they thought." PALS provide their customers with information and advice on all aspects of health care. From finding a GP or dentist, to accessing community services or support groups. They can also ask for clarification from a health professional, if a patient is unsure about what the doctor has told them. They also give full advice on how to make a complaint and what can reasonably be expected. The government and the NHS realised that patients really did want to have a say in what went on in their healthcare, and rightly so. People have every right to expect that they can question anything they feel nervous about, and receive both honest and forthright answers. This public desire for real involvement was recognised and indeed acted upon. The Commission for Patient and Public Involvement in Health (CPPIH) was set up in January 2003 to establish a national system supporting the involvement of the public in local decision making about health and the provision of health services. It is an independent, non-departmental public body, sponsored by the DOH, to promote the voice of patients and the public in health matters. PALS In Action PALS officers are based in every NHS trust, both within hospitals and within Primary Care. They are complimentary to the complaints service, providing an approachable, accessible route to sorting out concerns that a patient, relative or carer might have with the NHS. They can identify problems and provide information. The PALS officer will always contact the patient with an explanation of what has happened and let them know what has been done to sort out the problem for the future. They can also, in the event of matters not being satisfactorily resolved, advise on making a formal complaint, on where to seek specialist advice or independent advocacy. They should be able to provide information about your local Trust and local health services, external sources of advice, information and support, how to access relevant financial support e.g. hospital travel cost schemes, the NHS Complaints Procedure and how the NHS uses confidential information about patients. There is also another service available for complaints. ICAS (Independent Complaints Advocacy Service) is a new service that can offer you experienced advocates and caseworkers to help you make a complaint about a service provided by the NHS. It is free and available from the Citizens Advice service to help guide you through the process. It is an independent and completely confidential service, which is not part of the NHS. This service started on the 1 September 2003. Email: icasnes@cabnet.org.uk You should also be able to find information about your local PALS at a local hospital; your public library should also be able to help you find details about the hospitals near you. PALS aim is to help sort out any problems or concerns you may have when using health services, working with patients and staff to improve things by listening and responding quickly to concerns, suggestions or queries, and helping sort out problems quickly on the customer's behalf. They will always ask for your permission before personal information is discussed with others, and can talk to staff, management and other organisations on your behalf. The service is free and confidential. Only in exceptional cases where the customer safety or that of others must be considered will they have to pass on information, but they will always tell you if they have to do this. Their stated aim is to agree the best way to deal with a problem and get it resolved quickly - if possible on the spot. A couple of examples of how good the service can be - Mrs B from Liverpool rang for information on specific support groups as her child had undergone a rare clinical procedure, and wanted to meet with other children who had undergone this procedure. PALS were able to locate a national support group who got in touch with the family. Mr C had contacted PALS when moving his family to Warwickshire. His child was disabled and he wanted to ensure that they would have a GP and other health related services to contact, which had been made aware of the family history and ready to provide care. His local office contacted PALS in the Warwickshire area and obtained local telephone numbers and information, which were then passed onto the family. With the advent of the PALS service, there is a definite reassurance about future dealings with the health service. Everyone needs PALS, and this new service certainly appears, at this stage, to be capable of being counted amongst the best. We'd love to hear about our readers' experience with PALS. Drop us an email to palsexperiences@nhs-exposed.com Resources Health information for surgery patients Patient advice and liaison services Equip - excellent links page for a wealth of useful information
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PALS
stands for Patient Advice and Liaison Service. It is a little known
service to doctors and patients, yet their service is actually
excellent. That is my own experience of them. I find their staff
approachable and friendly. They have bailed me and my colleagues out
of the firing line when it comes to patient antagonism. 