BACKGROUND: Every NHS trust and Primary Care Trust (PCT) in England now has a Patient Advice and Liaison Service (PALS) which provides an identifiable person to whom service users can turn if they have a problem or need information while using the NHS. This paper reports data from a 2-year qualitative study of London PALS. OBJECTIVE: To develop patient-centred criteria by which to assess PALS. DESIGN: Data were generated from qualitative interviews with 15 PALS service users and 15 members of local user/carer organizations, and from a workshop with representatives of 14 user/carer organizations (national and London-wide). Emergent findings were circulated to other user/carer organizations (n = 32) for critique and comment. RESULTS: Findings suggest that users and their representatives want PALS to: be responsive to the needs and wishes of individuals; be accessible to all sections of the community, including older people, ethnic minorities and groups with special needs; offer clear, accurate and comprehensive information about local health and other services; work with their NHS organization to create a more patient-centred service; collaborate effectively with other organizations; be adequately resourced. CONCLUSIONS: These criteria resemble the national standards for PALS compiled by the Department of Health, with the exception of the need for adequate resourcing. They also resemble previous work on users' and carers' criteria for service delivery. Interestingly, PALS' lack of independence was not a major concern, though clients do need access to independent advocacy when 'insider' trouble-shooting fails. Although an alternative to the adversarial approach of complaints is welcome, PALS, like complaints procedures, may be under-used by marginalized or demoralized service users.
BACKGROUND: Every NHS trust and Primary Care Trust (PCT) in England now has a Patient Advice and Liaison Service (PALS) which provides an identifiable person to whom service users can turn if they have a problem or need information while using the NHS. This paper reports data from a 2-year qualitative study of London PALS. OBJECTIVE: To develop patient-centred criteria by which to assess PALS. DESIGN: Data were generated from qualitative interviews with 15 PALS service users and 15 members of local user/carer organizations, and from a workshop with representatives of 14 user/carer organizations (national and London-wide). Emergent findings were circulated to other user/carer organizations (n = 32) for critique and comment. RESULTS: Findings suggest that users and their representatives want PALS to: be responsive to the needs and wishes of individuals; be accessible to all sections of the community, including older people, ethnic minorities and groups with special needs; offer clear, accurate and comprehensive information about local health and other services; work with their NHS organization to create a more patient-centred service; collaborate effectively with other organizations; be adequately resourced. CONCLUSIONS: These criteria resemble the national standards for PALS compiled by the Department of Health, with the exception of the need for adequate resourcing. They also resemble previous work on users' and carers' criteria for service delivery. Interestingly, PALS' lack of independence was not a major concern, though clients do need access to independent advocacy when 'insider' trouble-shooting fails. Although an alternative to the adversarial approach of complaints is welcome, PALS, like complaints procedures, may be under-used by marginalized or demoralized service users.