Improving the quality of healthcare has been an important part of our work for most of the 21st century. So when the National Audit Office was preparing to conduct its review of clinical governance in primary care, we were delighted when they commissioned us to carry out the qualitative research part of the study.

Our approach to qualitative research is to work in ways that are most comfortable for those involved in the study, to enable them to feel relaxed and at ease so that the telling of stories and sharing of experiences becomes a shared process and not one that is conducted by one person on another. Working in familiar environments and allowing them to lead the conversation, in our experience, results in rich data, full of insights that might be lost in a more conventional questionnaire approach.

Our study was designed to build on our experience of engagement with patient and carer groups and enabling them to tell their own stories in their own words.

We convened focus groups of patients and carers to talk about their experiences of primary care and identify what more needed to be done to involve them in designing and evaluating primary care services.

We worked closely with several patient and carer voluntary organisations, including: the Alzheimer’s Society, National Endometriosis Society, Carers UK, Lindsay Leg Club Foundation, Kilburn African Caribbean Elders Centre and Cystic Fibrosis Foundation.

We organised a conference, working closely with The Friday Club – a group of carers that we convened. The views of carers were sought and recorded at the conference and a film was made, which fed into the final report. We were also able to draw on data from existing Patient Voices digital stories to support key emerging themes.

The report, Improving quality and safety: Progress in implementing clinical governance in primary care: patients, carers and voluntary organisations is available from the NAO’s website:

We also worked with the National Audit Office on three other major reports:

Reducing brain damage: faster access to better stroke care

Caring for vulnerable babies: the reorganisation of neonatal services in England

End of life care

For each of these reports, we worked with patients and carers to create digital stories of their experiences. DVDs containing the digital stories were included with the reports that that were distributed to the Public Accounts Committee, conference delegates and others involved in clinical care and education. The stories illuminated the information in the reports, giving people a more in-depth understanding of the conditions, experiences and lives of the people who had shared their stories. Karen Taylor, then Director of the Healthcare Value for Money Audit at the NAO, has called the contribution of Patient Voices stories part of the ‘evidence evolution’.


The stories can be seen here:

Reconnecting with life: stories of life after stroke

Caring for vulnerable babies: the reorganisation of neonatal services in England

End of Life Care