Why all doctors should use Patient Opinion.

As the Clinical Lead for Acute & Elderly Medicine it is my responsibility to ensure that the Departments that I lead are safe, effective, caring, responsive to need and well-led. This is how the CQC will judge us and rightly so. But how do I prove to myself, my teams, the wider NHS and the public that we are doing the right things? Or if at times we are not, how can I show that we have learned?

One of the most important ways that we can assure ourselves that we are all of those things is by listening, really listening, to our patients, their loved ones and carers. It follows that we can give others assurance by doing our listening in public.

It is a long-held tradition in medicine that research is conducted in public. This allows peers to review the research and to agree, disagree or make suggestions. It also allows the world to see that there is nothing to hide.

I see patient feedback in the same way.

Patient Opinion takes the control of the publication of information away from those of us that run the service. It made me uncomfortable at first, because when we didn't do our best it was plain for all to see. In fact I told our Chief Executive that I was concerned about morale when he decided to put patient opinion's feed on our intranet homepage. Every day when you opened your computer the feedback was staring right at you. This didn't feel great when we were struggling to run a busy emergency service with too few beds a few years back. However it suddenly occurred to me that with a very sick patient I wouldn't want to ignore an abnormal blood test result so why would I want to do the same with feedback when the hospital was under stress? I changed my view from the feedback being criticism to seeing it as an indicator. Sure there is a personal reason to make sure each patient gets a response to a concern, but the bigger picture is even more important. The pattern is key.

As a Physician I like gathering information and making a diagnosis. I love watching patients get better on the right treatment. But you can only give the right treatment once you have the correct diagnosis.

I see hospitals like I see patients now. If the results look abnormal, you need to diagnose the problem and give the right treatment. And if the treatment doesn't work, guess what, the results don't get better. Patient Opinion is like one a the hospital's physiological observations - like a blood pressure chart. And when we made our hospital's diagnosis and put in the right treatment the results stabilized and got better and better. That was the best feeling in the world.

Is it a problem that Patient Opinion is anonymous? Absolutely not. If it was not "blinded" then patients may not be honest. Some patient fear telling the truth as there may be consequences. I hope that our work proves to our patients that this will never be the case, however anonymity definitely allows everything that needs to be said to be said. The site then allows us to respond and offer a more personalized response if the patient would like to give us their details via email, etc. and this works well for me.

So do I feel comfortable being so transparent? Putting myself out there on Patient Opinion, Twitter, etc. Well so far I do, because following the Francis report I believe that this is what is expected of me now. I feel that the NHS and Government would defend doctors like me if I do slip up whilst trying to do the right thing for the hospital, the patients and the NHS. I hope that this is true, but everything I hear tells me that it will be. I also hope that those who follow us are reassured by what they read.

I suppose the important thing is that I now feel confident that if there was a problem, or a patient had a concern, then I would know about it. It feels liberating to know that everything bad that can be said, almost certainly has been. And its amazing that the majority of patients have taken the time to write lovely comments as well. Both of these things give my team and I a huge boost. I'd always rather know than not know. If I know, I can fix it. And as our Chief Executive presumably had planned, our morale improved as the feedback got better. He knew that doctors love nothing more than fixing things.

I hope that my colleagues will feel the urge to dive in and see for themselves, because Patient Opinion has made me much more confident about the care that we deliver and that makes me happier.

So when the CQC come to visit and ask me if my departments are safe, effective, caring and responsive to need I will be able to use Patient Opinion as evidence to assure them that the answer is most certainly yes. I will leave "well-led" to the team to decide (fingers crossed).

Dr Ben Mearns

Clinical Lead for Acute & Elderly Medicine