Dr Krishnan Anantharamakrishnan, Consultant Urological Surgeon at the Sherwood Forest Hospital in the East Midlands, has spent the last 21 years working in the NHS. In this blog, he explains his views on patient feedback, suggests improvements and reflects on how the GMC’s proposed changes might help both doctors and patients.
When I first moved to the UK in 1996, the healthcare system here was a big cultural shock – it was vastly different to what I was used to in India. In these early days of UK practice, it was difficult to know if my approach to patient care was okay and whether I was on the right track. A formal system around patient feedback would have been an amazing help during this time.
Nevertheless, whenever I received an adhoc comment from a patient, I made sure I reflected on it and made changes to my practice, so that I could give my patients the care they wanted. Since then, I’ve seen the General Medical Council (GMC) transform the appraisal process, introducing a standardised approach to patient feedback through revalidation. This process can play an important role in maintaining the public’s confidence in the profession.
Taking feedback on board
I think patient feedback is an essential element of the learning process – it’s definitely had a positive impact on my practice. It has improved my confidence, my self-awareness and my enthusiasm for learning.
A while ago, some of my patients gave me feedback on how I approach clinical consultations and how I engage with them. Hearing this enabled me to think about how I could make patients feel more involved during consultations. I now explain that I’ll be using my computer to make notes and may read reports while I talk to them, which I sometimes invite them to read with me.
Not a perfect system
Although I’ve learnt a lot from patient feedback, the process has its challenges. As doctors are only required to collect feedback once every five years, it can sometimes feel like a tick box exercise. And I don’t feel the standard questionnaire works for all my patients – some of the questions aren’t relevant and there’s no space for free comments.
I know that some doctors find the process cumbersome with the onus on us to organise feedback systems that work. That’s why many doctors would appreciate help and support from their organisations, for example through a local feedback champion or training on how to reflect on feedback.
Making feedback work for everyone
If we’re to succeed in engaging doctors in patient feedback for revalidation, it has to be convenient, done in real-time and solicited on a regular basis.
I welcome the GMC’s proposal to introduce more flexibility into their patient feedback requirements, which would enable doctors to use mechanisms that work best for us and our patients. For example, I’d like to be able to collect feedback using a range of methods, such as via apps and smiley face buttons, so that all my patients, including those with additional needs, are able to give me feedback.
I also think we should make sure any questionnaires we use have short, open questions focusing on what went well and what could be improved, so that patients can feed back on issues that matter to them.
Another of the GMC’s proposals emphasises that patients should be told how they can feedback and what it will be used for. I think this is really important so that patients understand what we’re asking for and how it differs from feedback about the organisation. We also need to make sure we let patients know what we’ve done as a result of their feedback, whether that’s through posters in waiting rooms or updates on social media.
Share your views
I know there are a range of views about patient feedback for revalidation among doctors and there’s still work to do to find a system that works well for all specialties and sectors. That’s why I’d encourage all doctors to share their views on GMC’s proposed changes before 23 July 2019.
I look forward to seeing what comes out of the consultation and what the next steps are in improving the way we collect and reflect on patient feedback.