What does patient feedback reveal about the NHS? A mixed methods study of comments posted to the NHS Choices online service

Abstract

ObjectiveTo examine the key themes of positive and negative feedback in patients’ online feedback on NHS (National Health Service) services in England and to understand the specific issues within these themes and how they drive positive and negative evaluation.DesignComputer-assisted quantitative and qualitative studies of 228 113 comments (28 971 142 words) of online feedback posted to the NHS Choices website. Comments containing the most frequent positive and negative evaluative words are qualitatively examined to determine the key drivers of positive and negative feedback.ParticipantsContributors posting comments about the NHS between March 2013 and September 2015.ResultsOverall, NHS services were evaluated positively approximately three times more often than negatively. The four key areas of focus were: treatment, communication, interpersonal skills and system/organisation. Treatment exhibited the highest proportion of positive evaluative comments (87%), followed by communication (77%), interpersonal skills (44%) and, finally, system/organisation (41%). Qualitative analysis revealed that reference to staff interpersonal skills featured prominently, even in comments relating to treatment and system/organisational issues. Positive feedback was elicited in cases of staff being caring, compassionate and knowing patients’’ names, while rudeness, apathy and not listening were frequent drivers of negative feedback.ConclusionsAlthough technical competence constitutes an undoubtedly fundamental aspect of healthcare provision, staff members were much more likely to be evaluated both positively and negatively according to their interpersonal skills. Therefore, the findings reported in this study highlight the salience of such ‘soft’ skills to patients and emphasise the need for these to be focused upon and developed in staff training programmes, as well as ensuring that decisions around NHS funding do not result in demotivated and rushed staff. The findings also reveal a significant overlap between the four key themes in the ways that care is evaluated by patients.

Exploring UK doctors’ attitudes towards online patient feedback: Thematic analysis of survey data

“…The perception that most online feedback is negative is not supported by previous work which shows that most is largely positive in nature 27,28 and covers similar areas to those obtained through more traditional feedback routes. 29 Furthermore, it has been demonstrated that motivations for leaving feedback are more likely to be for praising a service rather than making a complaint.…”

“…1 It is worth noting that a study by Brookes and Baker examining the content of patient feedback left on NHS Choices found that while most feedback is positive, the interpersonal skills of medical staff were one of the most frequently negatively evaluated aspects of care. 27 Negative evaluation of interpersonal skills may therefore resonate more strongly with clinicians (because it is commenting on something personal about them as individuals) compared to a positive evaluation of something less personal, such as administrative processes or waiting times. This perhaps explains the perception that online feedback is negative and the view that it may encourage personal attacks.…”

GP perspectives on hospital discharge letters: an interview and focus group study

“…32 CL is a branch of linguistics that focuses on analysing patterns of co-occurrence and meanings in corpus data 33,34 ; its application can bring new insights to research questions. 35 CL has previously been demonstrated as useful for health-related research related to communication [36][37][38][39][40] and, therefore, was considered suitable for this study. CL techniques allowed pattern-identification of important content items (research question 1) and GP views on patients receiving letters (research question 2).…”

Cocreation of a digital patient health hub to enhance education and person-centred integrated care post hip fracture: a mixed-methods study protocol

“…The study suggested patients’ perceptions for possible areas of improvement within various aspects of NHS service provision. High priority was given to the interpersonal aspects of healthcare provider interaction as well as system or organisational issues in coordinating services 43. Similarly, by involving the user in a participatory design ensures consumers’ requested functionalities can be incorporated to optimise the usability of the potential solution and simultaneously empower healthcare providers 44…”