Patients are the lifeblood of our work and giving them the best vision possible is a wonderful gift that all ophthalmic practitioners share. That inner feeling of accomplishment can be increased when our patients are vocal about the benefits improved vision have brought to their lives. On the flip side, the few patients who speak out about a poor outcome can lead to that heart-sink moment and make us feel less worthy.
But what about the other, less vocal patients? Are they satisfied with the results? Unless they are asked about their outcome, one would never know. Patient feedback – that is the views and opinions of patients and service users on the care they have experienced – is a key test of both overall and clinician performance, and one which has traditionally made a minor impact on NHS services due to a lack of patient choice. Multiple NHS providers have now made patient choice a reality and feedback has become a core component of NHS services. Indeed, clinical commissioning groups include feedback rates as part of their scoring system for NHS providers so there is a huge impetus to get as much feedback as possible.
So how do we get this feedback? Well, as it turns out it’s quite a challenge and a nut that we as providers need to crack. Currently, the largest type of NHS feedback comes in the form of the Friends and Family Test (FFT) where patients are invited to anonymously respond to the question, ‘How likely are you to recommend the service to your friends and family if they needed similar care or treatment?’ by choosing one of six options, ranging from ‘extremely likely’ to ‘extremely unlikely’.
The idea behind the test is very simple and readily understood by patients; latest figures show the NHS as a whole receives an impressive 1.2 million responses per month – making it the biggest source of patient opinion in the world. Although this is a fantastic mechanism to highlight both good and poor patient experience, unless the respondent completes comments to justify their response, the FFT does not tell you anything about your service itself, what you are doing well, or where improvements are needed.
This concern has been addressed somewhat by the NHS Choices Review. Launched just over 10 years ago as part of NHS Choices website, it is a method of receiving feedback for any provider listed on NHS Choices including hospitals, GPs, dentists and of course opticians. Many patients and even providers are still unaware of the Review but it gives a star rating for specific areas of a service – cleanliness and involvement in decisions are examples – and displays the average star-rating alongside the number of reviews. In areas of multiple providers, the savvy patient might look on the NHS Choices website to take the rating and reviews on board when choosing a provider. As consumers, our patients have a glittering array of choices in every aspect of their lives – from a mini Sumatran espresso light frappuccino in the morning to a Tanqueray No 10 with cucumber tonic water in the evening for example – so choice within the context of NHS services will be an easy seed to plant in our patients’ minds. With millions of people looking at reviews for hotels, restaurants and holidays, it’s not really that far-fetched to envisage patients looking up reviews of their medical service provider.
What about personal feedback as clinicians? Well the NHS tends to steer clear of personalised comments but it is still incredibly important to know how our patients perceive us. Most providers have some sort of internal feedback questionnaire. The trouble is that seeking direct feedback puts the individual on the line and open to criticism – and who wants that? Well, really only those striving to improve, who appreciate that our patients ultimately have a choice of whom they trust for care of their eyes. We have all received feedback from colleagues, assessors or at annual reviews for example, so treating patient feedback objectively may take at least some of the emotional sting out of negative comments.
So although feedback can be a double-edged sword, to get the most out of it as clinicians and providers, we really want to hear two things: how well we are doing and constructive ways of doing it even better. Ironically, seeking how to do things better often comes in the form of negative feedback or bad reviews. Facing the music so to speak enables us to improve the way our patients perceive us and ultimately the services we provide. Patient feedback remains a powerful tool to keep us on our toes and seek ways to ever improve what we can offer to our patients, and when taken on board, can be our dance partner to success.
Mr Jeremy Diamond, consultant ophthalmologist and Newmedica Ophthalmology Joint Venture Partner, Bristol.