Patel, Salma (2016) Online patient feedback : awareness, usage and attitudes among patients and general practitioners in England. PhD thesis, University of Warwick.

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Abstract

In the UK’s National Health Service, there has been an increasing emphasis on patient and public involvement, formal measures of patient experience, and public reporting of performance measures. This, as well as the emergence of the ‘digitally engaged patient’, has shifted the traditional paternalistic doctor-patient relationship. There has also been an increase in consumers more generally using rating websites. These factors together led to the formation of online patient feedback (OPF) websites, where patients can choose a healthcare provider based on patient reviews, and give feedback about healthcare providers. Academic research has been conducted on OPF websites, especially to ascertain whether patient ratings online are associated with other measures of quality. However, very little is known about patients’ and healthcare professionals’ attitudes towards OPF websites.

A multi-phase mixed method design was therefore used in this research to explore patients’ and GPs’ awareness, usage and attitudes about OPF websites as a mode to give feedback about GPs in England. In Study A, twenty GPs were interviewed to explore their awareness, usage and attitudes towards OPF. The findings highlighted GPs’ concerns about OPF, and produced recommendations for OPF website providers. In Study B, eighteen patients were interviewed to explore their awareness, usage, preferences and attitudes towards OPF websites and other methods of feedback available in general practice. The findings from this study helped develop a questionnaire, which was then validated in seven-stages. The questionnaire was then implemented nationally across England in Study C using face-to-face interviews with a nationally representative sample of members of the public (n=844).

The findings from this research produced evidence both for and against OPF websites, suggesting that GPs are highly concerned about the impact of these websites on them, on their professional practice, their reputation and their patients, and are not currently using OPF for improvement. Patient usage and future intention to use OPF websites was also found to be extremely low when compared to other methods of feedback, suggesting that unlike direct methods of feedback, OPF websites currently only appeal to a very small minority of patients. However, there was evidence to suggest that OPF websites fulfil a ‘feedback gap’ for patients, and unlike other feedback methods, span age, social and regional divides.

The key contribution of this research is that the majority of GPs and patients are not convinced of the value of OPF websites as a mode to leave feedback about GPs in general practice. Rather surprisingly, OPF websites cannot be used currently for patient choice in general practice, nor as a measure of quality, because OPF is biased towards negative experiences, and not representative of patient experience overall. This research provides suggestions on how this could be rectified. However, the NHS should also consider channelling its energies towards providing more direct and private methods of feedback in general practice in England.

Item Type:	Thesis or Dissertation (PhD)
Subjects:	R Medicine > RA Public aspects of medicine
Library of Congress Subject Headings (LCSH):	Great Britain. National Health Service -- Evaluation, Medical care -- England -- Evaluation, Patient satisfaction -- England, Patient participation -- England, Physicians (General practice) -- Rating of -- England
Official Date:	December 2016
Dates:	Date Event December 2016 Submitted
Institution:	University of Warwick
Theses Department:	Warwick Manufacturing Group
Thesis Type:	PhD
Publication Status:	Unpublished
Supervisor(s)/Advisor:	Cain, Rebecca ; Neailey, Kevin ; Hooberman, Lucy
Format of File:	pdf
Extent:	xiv, 363 leaves : illustrations, charts
Language:	eng

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