Inspired by Patient Safety Day (17 September 2025), we wanted to highlight how the accreditation process focusses on improving patient care and experience. During accreditation assessments, this area is the focus of our dedicated lay assessors, none of whom are more experienced than Andy Hudson, who has been with the Accreditation Unit, (AU), since 2013 and has become one of our most trusted assessors. He kindly gave us an insight into his experience and offered advice to both assessors and services experiencing the accreditation process for the first time.
After spending most of my career working in regulatory bodies, my role as a lay assessor for the AU is not surprising. I worked for City of York Council for 35 years, ultimately holding the role of chief officer for regulatory services. I oversaw a variety of domains including environmental health, trading standards, licencing, bereavement services, city centre management and many more.
After retiring from this role, I then spent 7 years as chief executive of my local Citizens Advice, working with the governing body of the Clinical Commissioning Group to achieve an enhanced standard of patient care. This is an area that I am especially passionate about, which made the decision to become a lay assessor an easy one. I began working as an assessor with JAG endoscopy 12 years ago and have since worked on assessments from programmes across the Accreditation Unit.
Thinking about my experiences over that time, one of the most exceptional assessments I have been involved in was also one of my most recent, when I visited the hepatology team at Aintree University Hospital on behalf of the Improving Quality in Liver Services (IQILS) programme. The team has been incredibly innovative in the ways that they have worked to support their patients. So many aspects of the service were exemplary, from their partnerships in their region to their seamless referral pathway. The Kirkby Cookbook, created with various collaborators, is an excellent resource providing low-cost, healthy recipes for patients, with a particular focus on liver disease. This is the element of accreditation that I’m so passionate about, improving patient care, and it’s really pleasing to see examples of best practice, which in turn can be used to inspire and inform other services working to improve – one of the many benefits of participating in an accreditation programme.
Thinking about the role of a lay assessor in more detail, an assessment consists of two parts. First, the online review of a service’s evidence, followed by the site visit. During the initial review, I look at all the evidence, but I try to focus mainly on the standards of particular concern for a lay assessor – those centred around patient care and experience.
Lay assessors are also provided with a ‘patient pack’, containing examples of any communications given to patients, including appointment letters, information leaflets and directions etc. We assess whether the documents provide adequate, comprehensible guidance and check if additional support (from local or national organisations) has been signposted.
Ahead of the site assessment, we also speak to a selection of patients from the service over the phone. I ask them about their experience, from simple details like confirming that they have received the relevant documents, to their treatment pathway, including the level of consultation they’ve received from clinicians. I always emphasise that I’m not there to trip anybody up, I just want to hear about their experience in their own words. It's an opportunity to hear about areas where a service could improve, which we ultimately feed back, but also aspects that have really benefited patients.
On the day of a site assessment, there is of course a busy timetable that includes a service tour and group meetings. But during periods where I have time to myself, if possible, I speak to patients in the clinic, as well as walking around the site, trialling the experience of a patient from arrival to being seen. Are signs and maps clear and up to date? Are there adequate seating and toilet facilities? How are patients being processed upon arrival? These are all questions that I attempt to answer.
One of the most valuable elements of an assessment is providing feedback to the service team. I prefer to give my feedback in person, always aiming to be constructive when necessary and giving praise where it’s due. Being able to give positive feedback from patients that clinicians wouldn’t usually hear is really powerful; you can see what it means to the team and my colleagues in the AU have confirmed that lay assessor feedback is often referenced as a highlight for services. This reaffirms how much clinicians care about their patients and their desire to provide the best care possible.
I think the greatest challenge I’ve faced on assessments is that services often lack a complete understanding of the lay assessor’s role. Compared to our medical and nurse assessor colleagues, the part that lay assessors play is not always initially clear.
Consequently, my advice to new assessors would be to outline from the beginning that you’re there to assess patient experience and offer a little about your background – something I do during every assessment. When appropriate, I also ask the team to make patients on site aware of who I am and ask for their consent to speak about their care.
From experience, it’s very important not to say anything during a review that you cannot evidence, because you can reasonably expect services to challenge those queries. At the same time, lay assessors shouldn’t be afraid to give constructive feedback where relevant; that’s what we’re there for and it will benefit everybody in the long run.
Services embarking on their accreditation journey have plenty to consider already, so my advice to them is brief: when completing your initial self-assessment, don’t ‘dump’ evidence. Including material ‘just in case’ only makes an assessor’s job harder and will not enhance your position; if you’re unable or unsure of how to evidence any criteria, speak to the AU team – they are there to support you.
Lay assessors have the unique benefit of being able to join assessments across different disciplines – something that is very fulfilling. I have taken part in almost 80 assessments so far and my passion for improving the quality of patient care is all the motivation I need to try and reach at least 100 before I retire!
Thank you to Andy for his insights and his phenomenal contribution to the Accreditation Unit.