Dr Susi Caesar is a GP and is Medical Director for Revalidation for the Royal College of General Practitioners.
Susi was part of the advisory group of doctors, patients and employers which was set up to help us review our requirements for patient feedback for revalidation. We’re now consulting on a number of proposed changes to give doctors more flexibility in how they collect and reflect on patient feedback. Visit www.gmc-uk.org/feedbackyourway to find out more and take part in the consultation.
Here, Susi shares how patient feedback has helped her in the past and how changes to the process could bring further benefit to doctors.
Feedback from my patients is very important to me
From time to time, and I admit it’s usually when the going gets tough, I look back at the feedback I have received from patients. It reminds me of why I love being a GP, and helps me to recall the joy and privilege I feel at being at my patients’ side on their health journey.
Patient feedback has also been instrumental in creating critical changes in my practice. For example, I hadn’t realised the value of patient information leaflets until a patient wrote in a satisfaction survey on how much they value to have something to read, and re-read, with their family at home. Now, the leaflets are readily available across my practice.
Sometimes, the change has come from the more informal, unsolicited ‘by the way’ type of comment from a patient. One told me that it was a relief for them that I came to get them from the waiting room rather than them worrying about not being able to read or hear our automated calling system. So, I started coming out of my room and greeting every patient – not only do I get to assess any changes in their health watching them get up and walk down the corridor – but my wellbeing also benefits from a moment away from the screen and a few extra steps.
So, if patient feedback is welcome and important to my practice, why do I have mixed feelings about it?
It feels like an administrative burden. I believe this is because, paradoxically, the current requirement of one patient survey every five years in each revalidation cycle means that it is just an additional piece of work not sufficiently embedded into my practice to be seamless.
It can also seem artificial. I often feel that my patients tell me what they think I want to hear. This might be a well-needed boost to morale, but a survey comment of ‘good’ or ‘excellent’ doesn’t help me improve my practice. I value the free text comments the most – the more specific a patient is, the better.
Presently, patients that provide constructive criticism have it treated as a complaint. Letters to my practice that start: ‘I don’t want to make a complaint but I think you should know that…’ end up in our complaints process, and this is a nonsense. We all make mistakes. We all have our ‘oops’ moments where something could have gone better, but treating such feedback as a complaint is not a good way to process them quickly and make the appropriate changes to improve.
The changes I would welcome to the patient feedback process
I think the principle of patients being able to give feedback, as and when is convenient and accessible, is very important. Solicited feedback, where patients are specifically asked to respond when they otherwise might not, and unsolicited feedback, that is spontaneous, both have their roles to play.
I also believe that we have a lot to learn around interpreting patient feedback and how we share the changes that we make to our practice because of it. As a consumer, I am always pleased to know about changes an organisation makes that my views have contributed to. As a doctor, I want ways to tell my patients what I have done because of what they have told me.
I would like meaningful channels that are seamless and embedded into my practice, allowing my patients’ comments to reach me in a timely way. I would like feedback to be more specific, telling me more about what they think I do well, what they want me to keep doing, what they want me to do more of and, basically, what I need to do better.
And I really don’t want to have to ask my reception staff to hand out any more patient satisfaction surveys
If you are a doctor or a patient, please contribute to this GMC consultation on the best ways to give, collect and reflect on patient feedback.