Autumn In-Brief 2018 V10 FINAL - Flipbook - Page 3
Continued from previous page.
In many organisations, PALS have dwindled to a near
skeleton service and are a shadow of their former selves;
having a PALS service which is manned single-handedly
is not unusual these days. Of course, in some
organisations PALS services are still thriving, these
services tend to have been well incorporated, well-funded
and have been able to find ways to demonstrate their
worth above and beyond just supporting with way-finding.
Having senior leaders who believe in the value of the
service is useful, as is the affection and regard that many
patients and families still hold for their local PALS service.
Being a good PALS officer is an intensely skilful job.
Despite our prior (admittedly) jaundiced assessment of
the service today, PALS officers do have to develop an
almost encyclopaedic knowledge of local services and
how to overcome the blocks to accessing these. They
have, on instant recall, a vast array of consultant
knowledge, knowledge about procedures, risks and
importantly, to know when to sign-post and to know when
someone else is better placed to support. PALS officers
must deal with a multitude of personalities (staff and
patients), emotions and complexity every single day. They
enable tens of thousands of patients each year to access
support and to flow through services and most of this
work is unseen to the organisation itself.
Could another function fulfil the work of PALS? There
have been various fashions to rename PALS as
‘customer care’ or ‘patient services’, however, this just
does not extend quite the same fit. The clever acronym of
PALS indicates a more patient centric approach, an
arrangement where someone is reaching out their hand to
give you a lift and support you through the myriad of
complexity which is the NHS. And anyway, surely an
organisation which is as vast and unique as the NHS
deserves its own very unique way of providing this sort of
interface for patients (the ‘John Lewis model’ is not the
panacea for all customer care models). This valuable
interface is exactly what PALS does, and it does this, on
the whole, very well indeed.
The service does not necessarily need to be reimagined
or redesigned; it just needs to be supported and reinvested with belief and purpose. PALS should be around
the table at key decision-making forums and not politely
shunted off to the periphery. We say we want to listen but
does the NHS really want to hear? Almost everything you
ever need to know about the impact of your services can
be sourced from a PALS office. Can the way that this
intelligence is interpreted and used be improved? –
absolutely – can we do away with this valuable service? –
yes, if utterly dubious decision making prevails; but do
this at your peril.
16 years on, it’s time to reflect on the true value of this
unique service and to once again love your PALS.
How to better support your PALS service
It’s probably time to reflect upon your own PALS
service, if you still have one, and to revisit the
core functions described back in 2002. Ask
yourselves some hard questions about whether
your PALS service has been properly supported
or retained on a shoestring just because you feel
you need to have one.
Some of the best ways to support your PALS
service includes:
1. Ensure that they are given a voice around
the table, yes, even at clinical governance
forums. If they are given early sight of the
agenda PALS could have the opportunity to
prepare some reflective insights around, for
example, the way services are working.
2. Think about how best your PALS team is
able to collate and report their activity.
Have you invested in the relevant modules
on Datix or Ulysses (for example) – can they
be systematic in their approaches?
3. Use PALS activity data to cross-reference
with other data, such as formal complaints,
CQC outcomes, well-led reviews and local
audits. Get the most insight from your
intelligence.
4. Senior leaders should, whenever possible,
visit the PALS service when they are on
quality walks or visits. They are an often
overlooked service but they can provide a
fascinating view on the organisation.
5. Really think about how accessible the
service is. The front door isn’t always the
best place and they can be deluged with
demands. As long as they are somewhere
that can easily be reached then they will be
sought out by people who really need to use
the services (rather than car park refunds!).
6. Recognise what a valuable (and often
invisible) role this team play operationally.
Kate Jury (Partner at Niche) has
been a healthcare governance
expert for 15 years. Kate also spent
a good deal of time as a PALS
officer (many years ago)…
Kate.jury@nicheconsult.co.uk
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