Dr Caroline Johnson

It is a pleasure to serve under your chairmanship, Mr Stuart. I congratulate the hon. Member for Chelmsford (Marie Goldman) on securing this debate on a subject important not only to her constituents but to all of us right across the country. The performance of the NHS is key to the health of the nation. It gives us all the best chance of good health and recovery, which is important for our social wellbeing and brings economic benefits. The first question is this: how do we know which trusts are performing well and which are not? First, we need to decide what good performance looks like. We can look at that in a couple of ways, in particular in relation to outcome and experience, both of which are important. The outcome, for example, may be a death. That will come to us all eventually, but the experience might be one of comfort, in line with the wishes of the individual—as good as can be delivered. Conversely, one could on the face of it have a good surgical outcome from a trust but a poor experience of care during that experience. Experience is measured in a number of different ways: individual staff, such as consultants, have patient feedback as part of their appraisal and revalidation; the friends and family test enables people to give anonymous feedback; the number of complaints or compliments can be measured; and trusts do their own surveys—but those are all to some extent internal processes.