Select Committee on Health Written Evidence

78. Evidence submitted by Patient Opinion (PPI 88)


  1.  Patient Opinion is a not-for-profit social enterprise which was established in 2005 by Dr Paul Hodgkin, a Sheffield GP.

  2.  This submission is informed by our experience over the past two years in developing an innovative web-based approach to patient and public involvement in health services.

  3.  Because of this particular experience, we address here only two of the questions posed by the committee—those for which we believe we can bring a new perspective to PPI.

What is the purpose of patient and public involvement?

  4.  Very broadly, there are two important purposes to PPI. The first relates to issues of accountability, democratic engagement in public services, and social capital (and possibly therefore health and wellbeing) generated by an active and engaged citizenry. Others will have far more to say on this than we are able.

  5.  The second purpose, which is at the centre of our work, is the belief that patients' experiences of using health care provide both the information and the motivation which is fundamental to improving health care. The importance of customer experience has been understood for many years in the commercial sector, but only recently in public services.

What form of patient and public involvement is desirable, practical and offers good value for money?

  6.  The central point which we wish to make in this submission is that the new forms of social engagement, participation and collective action are emerging, based either wholly or partly on the web, which have much to offer in developing new approaches to PPI which are widely accessible, inherently democratic, flexible, scalable, timely and highly affordable.

  7.  Harnessing the power of the web in the cause of PPI brings both advantages and disadvantages. We do not suggest that web-based approaches could ever entirely replace traditional forms of public involvement. But we do suggest that the possibilities offered by the web are so great that to ignore the role it can play would be folly.

  8.  The strengths and weakness of the web are well known. In the context of PPI, perhaps the key benefits of web-based approaches are convenience and accessibility (especially for patients and carers unable to attend public meetings), scalability to large numbers of participants at low cost, and an essential egalitarianism which means that even the quietest voice counts as much as the loudest.

  9.  Among the disadvantages, in this context, are the unfamiliarity of the web to many people, the fact that access is not yet universal, and the lack of face-to-face interaction which means that establishing authenticity and trust may be problematic. But these problems are not insurmountable, and will in any case decrease with time (and perhaps much more rapidly than we imagine).

Patient Opinion: harnessing the web for PPI

  10.  Patient Opinion has created a web-based platform for patient feedback about health services. Our current service launched across England in January 2006, and allows patients, carers or relatives to contribute opinions and ratings about inpatient or outpatient hospital care. We aim to cover mental health care, maternity care and primary care in 2007/8.

  11.  We aim to tag all feedback with the relevant hospital and specialty to enable accessibility. We review all feedback prior to publication on the Patient Opinion web site ( On publication, all feedback is immediately and freely accessible for public benefit.

  12.  We offer reporting, response and data feed services to healthcare organisations to enable them to engage more strongly with patient views, benchmark their patient reputations against others, and ultimately become more patient-focused in their everyday work. This is the source of the income required to sustain and develop the service.

  13.  Feedback can be routed, by email, from the patient directly to the health service manager responsible. Health services are able to respond to feedback online to show what they are doing in response to feedback.

Lessons from Patient Opinion to date

  14.  We have demonstrated through our existing service that the web offers a practical, affordable approach to enabling patient feedback about health care.

  15.  The directness and rawness of patient stories on the web gives them real power to produce change. This directness stands in sharp contrast to the complexity and opaqueness of many existing and proposed PPI structures.

  16.  The public nature of the feedback we publish adds to the pressure for change. It also makes patient experience a national resource which can be easily accessed by anyone to inform local, regional or national debate about the quality health care in specific places, or for specific conditions.

  17.  Healthcare commissioners, elected representatives, LINKS, PALS, scrutiny committees and others can make use of, and in some cases respond to, this patient feedback.

  18.  Healthcare providers are initially cautious about engaging with Patient Opinion. However, we have found that where they do engage, they begin to make small but significant service changes in response to patient experiences and suggestions. We are able to share specific examples of such change.

  19.  For the sake of brevity, this submission has described the existing Patient Opinion platform, development plans and lessons to date only in outline form. There is much more to say than can be included here.

  20.  Accordingly, we would be very glad to provide further information or share more of the lessons from Patient Opinion, either in written or verbal form, if the committee would find it relevant.

Dr Paul Hodgkin

Chief Executive, Patient Opinion

January 2007

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