78. Evidence submitted by Patient Opinion
(PPI 88)
BACKGROUND
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
(www.patientopinion.org.uk). 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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