Can digital data capture and improved analysis of comments make patient feedback more meaningful and useful for primary care? Perspectives of staff and patients with long-term conditions

Problem

General practices are required to collect patient feedback but there have been concerns that such feedback is too general and not timely or representative of practice populations. Whilst some practices collect feedback digitally, and via free text, questions remain about the best ways to collect and make feedback useful for service improvement. Additionally, patients with long-term conditions (LTCs) and carers may have specific concerns with implications for safety and quality of care that are not adequately reflected via current feedback mechanisms. We explored perspectives of primary care staff and patients and carers with physical and mental health long-term conditions on the current collection and use of feedback within primary care and on the potential for new digital tools to enhance collection and use of feedback.

Approach

We recruited two primary care practices and conducted focus groups with each team (practice A= 13 staff; practice B= 11 staff). We focused on two specific patient groups and associated carers as exemplars of LTCs: people with musculoskeletal conditions (n=16), and people with serious mental illness (SMI; n=20). Discussions were audio-recorded, transcribed intelligent verbatim and were analysed thematically, drawing on techniques of a grounded theory approach. Findings were used to inform development of a toolkit that will be implemented and evaluated in a final work stream.

Findings

Perspectives of staff, patients and carers are reported in the following themes: 1. Need for change: Current methods of collecting feedback were not considered useful for staff as too generic, based on crude figures, and low response rates. Patients and carers thought current methods do not capture enough of the right kind of feedback.2. Making feedback meaningful: Staff value narrative and in-depth feedback currently collected for professional development; and feedback is needed for specific aspects of services. Patients also think ways to collect meaningful feedback are needed and they need information and guidance on the purpose and how to provide feedback, including the value of positive feedback.3. Enabling capacity for improving the feedback cycle using digital tools: Whilst staff valued more in-depth feedback from a greater number of patients there was a lack of capacity to make this routine. There was a perception that digital tools to support feedback would be necessary, but various challenges to realise this. Patients were enthusiastic to give feedback digitally, but methods need to be simple and some need support to do this. Alternative methods for giving verbal feedback are also needed.

Consequences

The research focuses on a key issue for primary care as collecting feedback is universally required, and connects to key policies and NHS priorities for ensuring quality and safety in services. However, the work is also relevant to a wider audience.