Case study: Patient Feedback in Practice - How NHS Fife's Sexual Health Services Utilises Care Opinion

In recognition of Sexual Health Awareness Week, which began on the 9th of September, we’re excited share an insightful article originally featured in our Annual Review of stories told about NHS Scotland services in 2023-2024, written by Dr. Sue Brechen. In her piece, Dr. Brechen explores how NHS Fife Sexual Health Services have used patient feedback through Care Opinion to identify key themes and implement meaningful changes. The article highlights how listening to patient voices has helped improve service accessibility, staff relationships, and clinic environments. We hope this re-release encourages reflection on how feedback can drive improvements in sexual health services and support more inclusive, patient-centred care.

This article was written Dr Sue Brechin, Consultant in Sexual & Reproductive Health, NHS Fife

Sexual Health Fife is an integrated service including teams across sexual and reproductive health, genitourinary medicine, blood borne viruses, gender based violence and health improvement. We offer a wide range of treatment and prevention to a diverse population in community locations across Fife. We seek feedback from our service users as an opportunity to make improvements to the care we provide. Feedback improves outcomes for patients, is cost effective, increases trust in staff, improves user experience and satisfaction, and improves staff experience.

We started using Care Opinion in 2022 as one way of getting feedback from service users. Now it is business as usual with all staff actively promoting Care Opinion using cards or posters with QR codes across all our clinics in Fife. Our small service trebled Care Opinion feedback between April 2023 and March 2024 with 51 stories received. Moderators for Care Opinion rate the stories for criticality. Those deemed to be not critical increased from an already high 85% to 90% between 2022/23 and 2023/24.

We had two challenges. Firstly, to avoid reflecting only on critical feedback and possibly missing opportunities to look at what we do well and consider how we do more of that. We made a choice to reflect on all Care Opinion stories, identify themes and look for improvement ideas.

Secondly, bridging the gap between getting feedback on the quality of our services then using feedback to focus on what matters to service users and meeting the needs of service users.

We were able to identify themes emerging from Care Opinion stories over time. Themes relative to components in the system: people, service and environment. In particular, same staff – supporting trusting relationships and feeling heard; flexibility in how people can access care - meeting needs of individuals; welcoming safe clinic environment - non-judgemental kind caring staff. These provided us with ideas for improvement direct from service users.

The stories and themes emerging have informed the discovery phase of our project to re-design sexual health services for young people in Fife so we deliver care in a way that gives everyone the same chance of that good experience that was reflected in Care Opinion stories.

Using an improvement model we delivered more options for young people in Fife to flexibly access advice and care: on-line booking; easy and rapidly responsive text messaging; increased booked appointments by 100%; almost doubled the locations across Fife where young people can attend; opened a new drop-in for the most vulnerable young people. We also now have a consistent core team of clinical and non-clinical staff who provide the care for our young people across Fife and ensure a similar environment in all clinic locations.

We plan to continue to use Care Opinion across our service and in addition, seek more in depth feedback. We will do this using the Care Experience Improvement Model (CEIM): undertaking discovery conversations with service users to provide a picture of the quality of care experience over time; and reflecting on these as a team to identify and prioritise improvement ideas that will be planned and tested.