So GPs don’t like on-line feedback. At least that’s what a report in yesterday's Observer said. At Patient Opinion we were particularly interested in this as we are just beginning to pilot how the PO system could be used with ‘consenting’ Clinical Commissioning Groups (CCGs) who have asked us to put their GP services on the system as well as using us to inform their commissioning decisions.
The article was based on figures released by NHS Choices which showed that over the last 2 years 28,000 people have posted comments about their general practice via the NHS Choices service. Some 2,000 of these were not published because they did not meet the editorial policy whilst the same number – 2,000 – of responses from staff had to be withdrawn because they were deemed to increase rather than decrease disagreement between the parties.
From our point of view both figures are extraordinarily large. At Patient Opinion we would expect to have to removed very many fewer stories (around 3 per 10,000 stories) due to swearing, profanity or racist comments. And whilst we don’t prohibit NHS responses, and certainly recognise that in many instances they are woefully inadequate, ones that are aggressive enough to make us think about asking them to be taken down are vanishingly rare.
So what is going on? An obvious answer is that general practice is just starting out on its learning curve about how to handle negative comments on line. But perhaps it is also the case that practices feel more strongly precisely because they sit in their communities and the relationship with patients is – or at least feels – different to them? And last but not least GPs of course have long had trhe option to ‘throw patients off the list’ as a last resort. So maybe this lowers the threshold for them being less courteous on-line.
Interestingly the very early results from our pilot with practices although showing many positive stories also has a significant number of negative ones – accompanied by some very good, sensible responses. So maybe another key variable is when websites are explicit about working with professionals rather than doing to them, as perhaps NHS Choices does
GPs and on-line feedback
GPs and on-line feedback https://patientopinion.blob.core.windows.net/profile-pictures/953c3114-eec8-45a7-b334-2c12be6f7553.jpeg Care Opinion 0114 281 6256 https://www.careopinion.org.uk /content/uk/logos/co-header-logo-2020-default.pngUpdate from Care Opinion
Posted by Paul Hodgkin, Chair, Patient Opinion, on
Thanks for your feedback.
Response from JohnR3 on 8 Dec 2011 at 14:56
Hi Paul, I'd like to clear up some issues with the figures as The Observer got them wrong, and in doing so it skewed the story hugely (and has skewed your blog post and other subsequent media reports accordingly). We have not rejected 2,000 GP responses. I don't have an exact figure because we don't monitor it (which is what we told them) but my feeling is it'll be 50 at the very most. And none of these will have been 'to stop already violent exchanges escalating' as The Observer put it.. Most often it will be because the reply is on the wrong comment or inadvertently reveals confidential information. Of the 2,000 patient comments rejected, between 100 and 150 are for offensiveness or defamation. The largest number of rejections are where the issues raised have been such that it's better the user makes a formal complaint, which we direct them to do. The rest are because the comment is timed out, submitted twice, uninformative etc... There's a fair few test comments in there as well. It is still fair to say that most GP practices don't like online feedback though. They're used to the old, familar complaints system where everything is behind closed doors. And they are closer to their patients so are more affronted when one of them goes public with their concerns. I'm not sure your point that practices may be less courteous in responding online because they've always had the 'throw them off the list' option with patients is correct though. Or your view about negative responses being more likely because NHS Choices was 'done to them'. While replies certainly vary in quality, most practices make the effort to be polite and increasingly they recognise the value of a good reply as it can often turn around a negative comment. The arts of reputation management are slowly filtering their way into general practice as more surgeries recognise that hundreds of thousands of patients every month are using NHS Choices to select where to register and are using patients' feedback alongside the range of other data we publish to make their choice. All the best John, NHS Choices
Response from PaulH on 8 Dec 2011 at 17:12
Hi Jon Thanks for taking the time to comment on this. And good to hear that GPs are less negative or discourteous than the Observer article had implied. I'm sure your right that like everyone else (Patient Opinion included!) GPs are on a learning curve about how best to use on-line feedback. I do think however that - whatever the intent from NHS Choices - the sentiment amongst GPs when Andy Burnham annouced that the public would be allowed to comment on GP services was one of being 'done to' and this may have shaped how they react to the Choices service. Interestingly we are just piloting a feedback service for GPs via a few CCGs who have actively requested this service from us so in time we may have some figures to compare the pros and cons of both approaches. Here is a nice piece of pictorial feedback about a GP practice to show how this can look. http://www.patientopinion.org.uk/opinions/56173 Good to hear from you. All the best Paul
Response from JohnR3 on 8 Dec 2011 at 17:51
I like it. Don't know how we'd moderate out Dr Marshall's name given our policies. Give the moderators Photoshop perhaps? :) John