Your experiences of Hospital Patient Advice and Liaison Services (PALS) in Sussex

PALS provides a point of contact for patients, their families and their carers. They offer confidential advice, support and information on health-related matters.

We heard:

94 people from across Sussex shared their views with us, including 24 from Brighton and Hove.

• 36.2% told us PALS made little difference to their experiences of managing their health, 33.0% found it made it easier/better and 10.1% harder/worse.
• The feature of PALS most identified as Excellent (30.9%) was ‘Delivering the outcome you were seeking’. However, this was also the aspect most identified as Poor (33.0%).
• More than a quarter of respondents rated PALS as Poor for ease of access, being kept informed, quality of information and delivering outcomes.
• PALS were most identified as Not at all helpful in: resolving problems, signposting outside the NHS, explaining complaints advocacy and listening to feedback.

What did people from Brighton and Hove tell us?

• 55% told us PALS made little difference to their experiences of managing their health, 10% found it made it easier/better and 35% harder/worse.
• Nearly two-thirds (62%) of respondents from Brighton and Hove rated PALS as Poor for being kept informed, whilst 28.5% said it was excellent or good. 
• 57% said the service was Poor for responding quickly, whilst 33% said it was excellent or good.
• 52% said it was Poor for how easy it was to get support/advice, whilst 33% said it was excellent or good.
• 50% said the service was Poor for delivering the outcome they were seeking, whilst 30% said it was excellent or good.
• Three areas where the service can improve are listening to feedback, signposting to support organisations outside the NHS and explaining how to access independent support (advocacy) to make a complaint to the NHS. Over 60% of respondents identified these areas as being 'unhelpful' (60%, 66% and 78% respectively).
• At least a third of respondents said the PALS service was 'extremely helpful/helpful' at helping with questions related to NHS treatment, resolving problems and providing solutions and listening to feedback.

"The introduction of inviting, on their discharge, all persons using the NHS for their comments as to the services they received should be made standard practice.This would give a running summary of each department’s status."

"Make it better known to everyone."  and "Being given advice about PALS when I first started treatment"

"Return a message and be brave to listen to feedback. It starts with listening to the patient's experience for quality improvement."

Respondents to our poll told us they would like to see:

A continuation of the support PALS delivers to hospital users around advice and information on health-related matters and complaints processes.

“Everything was clearly explained, procedures moved along efficiently and smoothly, and everyone I encountered were helpful, kind and friendly.”

Improved awareness of PALS amongst patients so all hospital users are pro-actively made aware of them, the support they offer and how to contact them.

“Be more visible – not everyone know about PALS and what PALS is and stands for.”

Increased responsiveness from PALS to patient enquiries so people receive prompt acknowledgements, updates on actions taken and outcomes achieved.

“It takes too long to get a response, you are left waiting in limbo which is upsetting and feels cruel when the issues are so personal.”

“Get back to callers! Needs to be same day or next day at latest.”

PALS to modify how and when people can contact them so their needs and preferences are met, especially those who may struggle during usual office hours.

“Making the hours available to later in the day not – 3pm – maybe 5pm.“

“7 day Service.”

Clarity on powers and levels of independence so users of PALS can be confident their needs are being championed and where appropriate changes will occur.

“To actually have the authority to take charge and be able to make demands and make things happen.”

“PALS being more proactive to ask the staff to investigate the issue rather than just relaying my query.”

A focus on using feedback and issues raised to develop and improve services

“The service only apologised for their mistake but not offered any action plan how they are planning to avoid similar mistakes in the future.”

“Return a message and be brave to listen to feedback. It’s starts with listening to the patient experience for quality improvement.”

Next steps

As the public champion for local health and care services, Healthwatch Brighton and Hove will continue to work in partnership with commissioners and providers to monitor the experiences of patients and the public in accessing health and care services locally and explore how ongoing improvements may be delivered.

We shared the attached report with University Hospitals Sussex NHS Trust, NHS Sussex, Healthwatch England and others to share this insight and encourage its incorporation into future initiatives.

Hospitals Sussex NHS Trust,responded as follows:

"We thank Healthwatch Brighton and Hove for sharing the results of a patient survey regarding patient advice and liaison services at University Hospitals Sussex.  Our small PALS team covers seven hospitals and manages thousands of patient enquiries each month, including compliments, concerns and requests.  

We were disappointed to see that our service fell short of some patients’ expectations.  Although we cannot currently increase the staffing levels or service availability due to budget restrictions, we recognise there are some opportunities to improve our service.  

As such, we are producing a new leaflet for patients to explain about PALS and we have launched a new patient information and experience section on the Trust website.  We are also introducing a new process for responding to the increasing numbers of patients with mental illness contacting the service to ensure as many patients as possible get the right support at the right time."