robert-francisSince qualifying as a barrister in 1973, Sir Robert Francis QC has specialised in medical law, including medical and mental health treatment and capacity issues; clinical negligence and professional discipline. He has chaired several health-related inquiries, including two inquiries into the care provided by Mid Staffordshire Foundation Trust and the Freedom to Speak Up Review into the treatment of NHS staff who raise concerns.

As Chair of Healthwatch England, Sir Robert has insight into how those using health and social care services can make their voice heard. In this blog, he reflects on the importance of making it easier for people to give feedback about their doctor and explores how our proposed changes to patient feedback requirements could help.

Understanding experiences of care

Making it easier for people to give regular feedback is essential to ensuring health and social care services improve and provide people with a good experience.

At Healthwatch, we work to understand people’s needs, experiences, and concerns, to put them at the heart of health and social care. We champion policy changes which share this approach.

We know that most people would like to share feedback with their doctors to improve services or express their appreciation, but only a small proportion do. The most common reason for this is that people don’t know how to provide comments and share concerns; in our recent survey 37% said they were unsure how to do so[1]. We also hear from people who worry they will receive worse care if they leave negative comments.

How can we encourage more patients to share their views?

By asking doctors to reflect on patient feedback more frequently, and giving them the freedom to use different tools to collect feedback in more flexible ways, the General Medical Council’s proposed changes will make it easier for different groups to speak up and encourage more meaningful learning.

At Healthwatch, we know that the quality of people’s experiences of healthcare cannot just be counted: the only way to get an accurate understanding of someone’s experience is to listen to their story. It is particularly positive that the GMC’s proposed changes would require doctors to encourage patients to offer comments, not just ratings or scores.

Technology can be extremely useful for people who can use and access it to share their views, and we expect to see doctors making greater use of online tools and texts to collect feedback in future. But it’s important that such changes do not leave behind those who prefer to use more traditional methods.

In 2017, we found that people who had recently provided feedback to their family doctor were most likely to do so through a comment box, and least likely to do so through social media. When we asked people who had never given feedback how they could be encouraged to do so in the future, text or email follow-ups were the most popular choices, followed by the comment box[2]. This suggests that a variety of tech-based and traditional methods should be used to allow everyone to share their views in a way that suits them.

Making feedback systems accessible and inclusive

When it comes to sharing experiences, some people are more likely to face barriers that prevent them from doing so, for example, those whose first language is not English or those who are homeless. Efforts to encourage more feedback should include ways to target those who may find it most difficult to share their views. This would contribute to developing a truly representative sample of what people think.

Healthwatch regularly speak to people across the community about their experiences of care and can help to understand the needs of different groups. If doctors want to understand more about what their patients think, they can approach their Healthwatch for help. For example, in 2017/18 Healthwatch Dudley worked with Dudley Group NHS Foundation Trust to make vibrating pagers available in hospital waiting areas, resulting in a less anxious wait for appointment times for deaf patients and people with learning disabilities.

Being clear about the purpose of feedback

It is also crucial that patients are told clearly how their feedback will be used and understand how it contributes to improvement. We know the people who give feedback and raise concerns across health and social care do so because they want to make sure health and social care improves[3]. Four in five people have told us[4] that seeing other people’s complaints having an impact would encourage them to make their own voices heard. So, it is important that people who have taken the trouble to offer feedback are informed what has happened as a result.

The GMC is right to emphasise the value of patient experiences by ensuring that more patients share them. I look forward to seeing Healthwatch staff and volunteers working with doctors and services to learn more from patients and encourage everyone who shares our aims to participate in the GMC’s consultation. This is a positive step towards maintaining and enhancing the public’s trust and confidence in the medical profession.

Let us know what you think about our proposed changes to the way patients give feedback about their doctor by taking part in our consultation before 23 July 2019.

[1] https://www.healthwatch.co.uk/news/2017-09-19/call-gps-make-sharing-feedback-easier-patients

[2] https://www.healthwatch.co.uk/news/2017-09-19/call-gps-make-sharing-feedback-easier-patients

[3] Care Quality Commission, 2019, https://www.cqc.org.uk/news/releases/new-research-cqc-shows-people-regret-not-raising-concerns-about-their-care-those-who

[4] https://www.healthwatch.co.uk/report/2014-10-14/suffering-silence