PatientPulse GP practice survey results
Our own survey reveals how GP practices are currently measuring patient satisfaction and getting feedback – and how this might change in the future.
In the last couple of weeks we ran a survey of 125 GP practices, with the co-operation of First Practice Management. We wanted to find out from the horse’s mouth what methods of measuring patient satisfaction were currently being used, what GP practices were considering for the future, and how much importance they placed on measuring patient satisfaction.
The results were really rather interesting.
75% of practices still using their own paper survey – but why?
A high proportion of GP practices still operate (and plan to continue operating) their own paper survey – in addition to the national postal GP Patient Survey run by the Dept of Health. 75% of practices said they did this currently, with a further 11% considering doing it in the future (the full table of results is further down this blog post).
This surprised us since there is no longer a need to do this to qualify for QOF funding. The new QOF rules for 2009/10 don’t put any weight on carrying out a survey because the national GP Patient Survey will now cover all practices. Where approx. £7,000 of QOF funding for a typical surgery used to rely upon administering a survey, and acting upon its results, this is no longer the case.
In addition, because the new GP Patient Survey will now run quarterly rather than annually it really does look like running your own paper survey is likely to duplicate effort.
So are practice-level surveys dead?
If the financial incentives for running your own survey are now gone, what’s the point of doing it?
We asked GP practices what were the reasons driving them to measure satisfaction, and only 34% said that direct financial incentives such as those in the QOF were important. A higher percentage – 45% – said that giving their staff visibility of patients’ views was an important reason. This suggests there still remains some value in it to practices.
Here’s the full table showing what practices thought were good reasons for measuring patient satisfaction:
| Factors which might make Practices consider measuring Patient Satisfaction regularly | % Practices Considering this a Good Reason |
|---|---|
| Practice management wanting to improve visibility of patient satisfaction | 45% |
| Direct financial incentives for good patient satisfaction scores | 34% |
| Patient Participation Group wanting to improve visibility of patient satisfaction | 30% |
| The threat of negative patient reviews online, leading to poor reputation | 24% |
| Fines for poor patient satisfaction scores | 20% |
| The abolition of practice boundaries, leading to increased competition for patients | 13% |
| Dept of Health encouragement | 8% |
In fact, we think that the QOF changes are great for practices. They mean that practices no longer have to follow strict rules about carrying out surveys that are representative of their patients – so they are free to introduce new methods such as online & mobile methods. But practices still have a strong interest in finding out what their patients think, as their scores in the GP Patient Survey still count towards QOF funding. What practices can do is complement the GP Patient Survey with different ways of getting feedback from patients – more ‘real time’ feedback, which they can review on a weekly or monthly basis to track improvements, and more qualitative feedback which is not captured by the GPPS. Importantly, practices can avoid the administrative burdens put upon them by paper surveys and concentrate on methods which are much less administratively heavy.
Online feedback expected to grow
Here’s the full table of results showing what methods of patient feedback gathering practices currently use, and are considering:
| Methods of Measuring Patient Satisfaction | % Practices Currently Using | Further % Practices Considering for Future |
|---|---|---|
| 1 ) Face-to-face interviews by your staff | 25% | 19% |
| 2 ) Face-to-face interviews by third party company | 2% | 1% |
| 3 ) Paper survey on your premises | 69% | 11% |
| 4 ) Paper survey by post | 18% | 19% |
| 5 ) Online feedback via your website | 24% | 32% |
| 6 ) Online feedback via a third party survey company | 2% | 2% |
| 7 ) Online survey sent to patients by email | 1% | 16% |
| 8 ) Text message feedback | - | 6% |
| 9 ) Smart phones (eg Blackberry/iPhone applications) | - | 2% |
| 10 ) Terminals or handhelds on your premises | 2% | 8% |
| None of the above | 10% | 5% |
| Any of 3 ) or 4 ) | 75% | 11% |
| Any of 5 ) or 6 ) or 7 ) | 25% | 34% |
| Any of 8 ) or 9 ) or 10 ) | 2% | 13% |
You’ll notice that just 25% of GP practices use online methods of capturing patient feedback and measuring satisfaction, but that 34% are considering this for the future – a growth area. Music to our ears!
If you’re one of the GP practices currently doing a paper survey, consider ditching it for something that takes up less administrative time, and that offers you ‘real time’ information and qualitative patient views.
Download Survey press release and data tables
Published February 23, 2010 by Helen under Information, Opinion, Patient Pulse.Tags: NHS funding, patient feedback, patient satisfaction, QOF, real-time feedback
Where do angry patients go?
If your patients are angry with you, where do they go? We survey your patients’ options when they feel their needs aren’t met.
The worst extreme – legal action
In extreme cases, angry patients may launch legal action. This may or may not be motivated by the possibility of financial compensation. Competition between lawyers fighting to represent angry patients in legal action is intense, and many lawyers take on this work on a “no win no fee” basis.
The NHS Complaints Procedure
More commonly, angry patients will follow the official NHS Complaints procedure. Many official sources of support will lead angry patients down this route – from the Department of Health website, to the Patients Association, which operates a helpline for patients to talk about their experiences (and advises the official procedure if suitable) to PALS (the Patient Advice and Liaison Service) which exist in every NHS trust and PCT. PALS are not themselves part of the complaints procedure, but, like the Patients Association, they help resolve problems informally or can tell angry patients more about the complaints procedure.
Whichever of these routes angry patients come through, most roads lead to the offical process. The formal NHS complaints procedure was re-vamped in February 2009 and has two stages. Firstly patients are advised to contact either the local Practice Manager or a senior member of staff in their hospital department. Complaints may be made in writing or verbally (in which case they will be recorded in writing), and patients are then updated as to the progress of their complaint. If a complaint remains unresolved at a local level, the second stage is a referral to the Health Ombudsman.
Additionally, official complaints can be made to a medical staff member’s professional body, eg the General Medical Council, the General Dental Council, or the Nursing and Midwifery Council. However before taking on the complaint, these bodies are likely to await the conclusion of an NHS complaint.
Unofficial Routes
For patients unwilling to go through a formal procedure, or whose gripe or niggle is not quite serious enough for an official complaint, the NHS Choices website is one officially sanctioned place where they can let off steam about a poor experience. Since November, NHS Choices has allowed the general public to comment on and rate their GP practice or hospital, and has bravely been publishing these comments (following moderation) online. Patients’ contributions needs to be “constructive, relevant and civil” and must not “name and shame” particular medical professionals.
But this isn’t the only way. NHS Choices’ new feedback service follows in the footsteps of a service which already existed – Patient Opinion. Patient Opinion is an independent website founded by a GP from Sheffield, and funded by subscriptions from PCTs, regulators and patient groups. It accepts stories from patients about care received, and publishes these on its website, after moderation of the stories to ensure that they are not defamatory. Anything strongly critical is checked with the author to verify before publishing, and where a story is making a serious allegation against a named professional, Patient Opinion will not publish, but will encourage the author to pursue the complaint instead through formal channels.
There are other websites where you can make critical (or indeed positive) comments about healthcare provision, and some of these (irresponsibly in our view) allow comments to be posted about individual doctors – something Patient Opinion refuses to allow. For example, a US-based website called RateMDs (which also has, at the time of writing 232 doctors listed in England on the site) contains such anonymous claims as “This [named] doctor abuses vulnerable patients”. It’s hardly surprising that the founders of this site report that they get death threats from doctors angry that such comments are allowed to stand without being verified!
Relatively few surgeries actually invite angry patients to have their say on their treatment on the practice premises, or from the comfort of their own homes in an informal but immediate way that’s also non-confrontational. We find this surprising. We would have thought that GP practices that are really interested in improvement would want to encourage patients to tell them first about anything that’s wrong – whether large or small. But in reality, it’s not surprising that they don’t want to encourage niggles to be brought to the fore, because they would have to record these as official complaints, or it would risk increasing the number which get escalated to official complaints. We believe there should be an acceptable middle ground where patients feel free to register their small complaints without fear of getting pulled into (or pulling their practice into) a long formal process.
Published December 4, 2009 by Helen under Information, Opinion.Tags: NHS Choices, patient feedback, Patient Participation Groups
