What Patients say about the NHS Experience


Why is it that patient feedback in the UK finds significantly lower rates of satisfaction for GP practices than for hospitals and also that NHS patients prefer being treated at private hospitals for NHS treatment? The work - by NHS Choices - has not been made public, but is based on a study of more than 100,000 ratings and comments posted on its public website.

Findings included:

  • Criticism of GP practices tended to focus on customer service issues such as booking appointments, whilst practices generally scored better on involving patients in care.
  • GPs were considered less likely to respond to comments from patients compared to hospitals, however.
  • Hospitals themselves were most likely to be criticised over cleanliness, with all of the top eight with the best ratings for cleanliness being run privately.
  • Patients also tended to criticise hospitals on issues such as parking, food and staff attitudes.

According to the report by the respected Health Service Journal (HSJ), BMA GP Committee deputy chair Richard Vautrey said 'people posting on NHS choices were "self-selecting" and tended to comment only when they had specific issues to raise'.

However such scepticism flies in the face of the wider statistics regarding the broader use of social media. Currently, over 100m consumer reviews are made in the UK every year where, for the vast majority, they receive no personal benefit. Over 50% of reviews are positive, suggesting that this is not about anger or vendetta. Instead, it's a willingness and acknowledgement that the 'crowd' helping each other as a community in an organised place can benefit decision-making and even redress.

Perhaps the most disappointing thing (or the most encouraging, depending on your point of view) about this patient feedback is that it highlights challenges within the patient experience that have little to do with clinical excellence.

As an example, for a patient and their friends or relatives, car parking is an important aspect of a hospital visit. Too few spaces add stress, whilst punishingly high parking charges can discourage patient visits altogether. Clinicians may not feel that car parking is even part of the NHS "patient pathway", but such thinking is too inward-looking. Only by understanding the holistic healthcare experience from the perspective of patients and those around them will issues such as this ever be properly addressed.

As for cleanliness (a subject we have previously highlighted in a previous blog), our own research with patients suggests that their perceptions of cleaning are typically based upon 'everyday hygiene' that they can directly relate to - such as clean toilets, floors, bed linen and so on. It's unsurprising then, that patients have little confidence in sterile medical equipment and devices, if the ward they are staying on is visibly unclean.

As customer experience designers, we see world-class airports, shopping malls, restaurants and leisure centres all tackling issues such as car parking, cleanliness, appointment and reservations and food service with a dedication and passion for excellence. Most of all, these firms instill an attitude into their employees that, if a customer  cares about it, then they should too, and are empowered to act.

Having captured so much valuable patient feedback through the NHS Choices website, an opportunity now exists to demonstrate that it's purpose was to act and improve, not simply dismiss that the insight is unrepresentative......

Editors Note:

In May 2006, an Extended Choice Network was launched within the NHS.. This allowed patients to choose from NHS foundation trusts and independent sector treatment centres, in addition to local options. Examples included non-emergency operations, such as hip and knee replacements, and though only 3.5% of operations are done this way today,  the government's shake-up of the health service plans this volume to increase.