Patients are increasingly exercising their right to make choices concerning their healthcare.
Following in the footsteps of websites that enable individuals to rate and review services such as restaurants, hotels or schools, some patients are turning to the internet to inform their decisions about doctors and hospitals.
There is a wealth of information available online, including data from NHS England, NHS Choices and the CQC, which allow patients to review their practice or doctor.
The friends and family test is an online feedback system that asks patients if they would recommend hospital wards, A&E and maternity services to their friends and family if they needed similar care. At the end of 2014, it was rolled out across 8,000 practices, with the results published periodically on NHS websites.
Monitoring and responding to online references to an individual doctor or practice could be time-consuming and may be impractical. For some practices, such information may only come to their attention on an ad hoc basis, while other organisations are actively seeking to engage with online patient feedback as a way of improving services.
Changes to access to practice lists mean that patients can shop around for a GP and may base their choice on other patients' online comments.
The twice-yearly GP patient survey is one of the ways in which patients can provide feedback on their experience of a GP practice.
While some doctors may be concerned that websites rating individual doctors and practices will result in negative feedback, particularly from disgruntled patients, research shows that most patient feedback is positive.
Negative feedback, however, is a useful learning tool and GP practices can use the feedback they receive as an opportunity to open a dialogue with patients.
Encouraging patients to comment online can be helpful. If there is a broad spectrum of comments, any less favourable ones may be balanced by the positive ones and present a more representative view of the service provided.
Ensuring there is clear guidance for patients on how to make a complaint to the practice, and giving prompt attention to any complaints received, may reduce the chance of patients airing grievances online.
Where there is an option for the practice to respond online to a negative comment, it may be appropriate to do so.
This could take the form of an acknowledgment of the patient's concerns, an apology if there has been a failing, and details of what steps will be taken to investigate, rectify and/or learn from this.
The practice may also wish to respond to positive comments, thanking patients for taking the time to provide feedback and reassuring them that this will be passed on to the team.
If specific patient problems are raised, care must be taken to avoid inadvertently breaching confidentiality and it may be worth limiting any such response to an invitation to raise the matter directly with the practice (and details of how to do so), with an expression of regret for any concerns the patient may have.
If a patient posts something abusive or offensive, it is usually possible to ask the site moderator to remove such comments.
It is not usually appropriate to remove posts that are simply critical of the practice, because this may inflame the situation and prompt the complainant to take further action. A better approach would be to acknowledge the concern and invite the patient to contact the practice to discuss this further, or to reassure them if you take any action.
It may be worthwhile for a member of the practice management team to monitor online activity, to identify and act when patients raise concerns.
Right to be forgotten
After a ruling by the Court of Justice of the European Union in 2014, individuals have the right to request search engines to remove results that include their name, if they can show these results are inadequate, irrelevant or excessive. If there is historic information that may damage your reputation, this may be an option.
Ultimately, the best way to secure a positive online reputation, reflecting the quality of the service provided, is to focus on communication with patients and other service users, be reflective and learn from feedback.
- Dr Tisdale is a medico-legal adviser at the Medical Protection Society
- How to manage online feedback medicalprotection.org/uk/practice-matters-issue-7/how-to-manage-online-feedback
- Use of social media medical protection.org/uk/resources/factsheets/england/england-factsheets/uk-eng-use-of-social-media