Neutrality and translation problems in measuring patient experience.

Picker Institute Europe develops and co-ordinates large parts of the national patient survey programme in the English National Health Service. We are in strong agreement with much of Diana Delnoij’s article, so it may be most useful to add some further learning from our experience, and to identify outstanding problems in harmonizing patient experience measurement in Europe. Delnoij’s contention that ‘researchers who develop patient experience questionnaires must work miracles’ is apt. The stakeholder involvement she describes is prone to many tensions. A crucial lesson from England is that the survey programme needs a ‘buffer’ from undue stakeholder pressure if it is to remain intact, based on what patients value, and objective and reliable in its findings. Here, this ‘buffer’ was created by placing the survey programme under the independent healthcare regulator (now the Care Quality Commission). Pressure on the survey methods can come from: