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Guidance in brief

New guidance shows how trusts can use patient feedback to improve care delivery

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Outlining the main points from Department of Health guidance on using patient feedback to change and develop services to meet patients’ needs


Keywords: Patient experience, Patient feedback, Services, Quality care



Health secretary Alan Johnson said last autumn that he wanted to see NHS trusts collecting and using ‘immediate feedback’ from patients to drive service improvement.

As a result, the Department of Health (2009) published guidance last month on using patient feedback to transform services. This outlines best practice in terms of collecting, analysing and using feedback to improve care.

The guidance outlines the policy context, including Lord Darzi’s High Quality Care for All report, which makes patient experience a key driver of quality and therefore quality improvement (DH, 2008).

Specifically, the health secretary asked the NHS to broaden the use of real-time techniques to collect patient feedback.

The guidance says that all hospitals will be expected to start using – or extend the use of – ‘near real-time techniques’ to collect patient experience feedback in 2009, and demonstrate that they are using this to improve services.

PCTs should consider widening their plans to include primary and community care settings.

The guidance points out that technology is available that can support information collection that is measured in near real time and report results quickly.

This technology includes bedside terminals, kiosks, hand-held devices and web-based surveys.

Commissioners and providers should work together to establish an agreed local framework.

The feedback cycle

The guidance explains that the process of collecting and using experience feedback can be shown as a cycle (Fig 1). It then outlines each part of the process in detail.

In terms of clarifying the purpose and business context for using feedback, the guidance points out that collecting feedback by itself has no value.

It needs to help clinical and management teams to identify aspects of their service that need to improve, so the team can take appropriate action. To do this, trusts should establish clear organisational processes.

The guidance adds, however, that negative feedback, while useful, can be uncomfortable for staff and managers. This can be overcome by making patient experience feedback an essential feature of everyday practice.

Staff should have – or be able to develop – the skills and knowledge needed to analyse and interpret feedback and translate it into improvement activity.

A range of issues to consider are outlined, including being clear about what is being measured, deciding how it will be measured and reaching the full range of people who use the service.

Particular consideration should be given to gaining the participation of different types of patients – this involves deciding how feedback will be collected from vulnerable groups such as children, or people with mental health problems or learning disabilities.

Analysing and using feedback

When analysing feedback, data needs to be examined carefully to produce useful information that can help to identify necessary actions.

The guidance says clear presentation of results is crucial in helping busy clinical teams to understand the messages from feedback.

When it comes to using feedback to design and implement service improvements, the ultimate test is how information is used to bring about change. This cannot happen piecemeal in reaction to specific feedback, but should be part of the organisation’s wider approach to quality improvement.

Finally, to show how feedback has transformed services, several trusts have used display boards in wards and outpatient departments to show what patients have said about their experience.

For examples of using patient feedback and a list of tips, see the full guidance (DH, 2009).

Author: Nerys Hairon, is assistant practice editor, Nursing Times


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