Health services learn from both positive and negative feedback

In his comment for Holyrood last week, Fife doctor John Wilson said: “Care Opinion, widely used in Scotland, is close to pointless as it mostly provides a channel for praise.”

In fact, Care Opinion is website where people can share their experiences of health and care services, good and bad.  People are free to share whatever aspect of their care is important to them and have the opportunity to respond to three questions about their experience: What was good? What could be improved? How did you feel about your experience? 

We’ve also encouraged services to consider the use of other prompting questions like “how could we have made things better for you?”

Currently across health and care in Scotland, people have chosen to share many stories which express their thanks and appreciation. In 2018, 72 per cent of stories shared were positive. Of course, that means there are critical stories too and there is evidence that both good and bad stories initiate change.

We appreciate that some people (outside health services) seem to feel that if Care Opinion is not sharing enough negative stories, then it is not really “telling the truth”. And, as the initial comment shows, some people (inside health services) seem to feel that positive stories can’t contribute anything to the task of improving care.

It’s almost as if people believe that we only learn and improve when things go badly and can make no progress when things go well. But we think that’s a mistaken belief.

So here are a few reasons why we believe that the positive stories on Care Opinion really matter.

First, Care Opinion is citizen-centred, not organisation-centred. It is for people to share the experiences of care that matter to them. If many of those experiences that matter to people are positive ones, then so be it. Listen, and learn what it is that matters, and why.

We think that the 2,533 positive stories shared over the last 12 months are anything but pointless.

Second, these stories have a powerful impact in lifting staff morale – and that is very often exactly what the story donor intends. Online feedback is not just data: it is often an intervention, an act of encouragement, support and solidarity with public service staff. We know from a recent survey that staff really appreciate positive stories.

Staff and patients: both have something to give the other.

As a side-effect, this mutuality of care reminds us all that both staff and patients bring their own needs and their own resources to each encounter. Both have something to give the other.

Third, online stories of remarkable care are shared widely and can become a simple but effective way to share good practice across the UK and internationally. This story of extraordinary end of life care, for example, has been read over 50,000 times to date and has prompted new thinking in services elsewhere.

Fourth, one member of staff explained how receiving so much positive feedback from patients had changed her team culture. “We give each other more positive feedback now”, she told me. Another way that staff are learning from patients.

Fifth, for health/care professionals in training, positive stories of multidisciplinary teams in action can provide important insights into the contribution that each profession makes to good care. The potential for such stories to support interprofessional learning is huge.

by Dr John Wilson

Practical measures to heal the NHS in Scotland

We are involved with Healthcare Improvement Scotland’s person centred health and care team who are encouraging quality improvement based on narrative feedback. 

We feel we are part of a collective approach which encourages authentic sharing of experiences of care and is supporting the development of a culture where we seek to improve from ALL available feedback.      

We agree that it’s up to all of us working together positively to make our health and care services as good as they can be.

As staff use stories of any kind to learn and improve, our goal is that positive experiences will become still more prevalent.  Wouldn’t it be strange to complain about a result which we have all been working to achieve?

Gina Alexander is the director of Care Opinion in Scotland