The future is already here. It's just not very evenly distributed

“We’ve been using Care Opinion at Rampton,” a service user volunteer told me last week. “It’s been a breath of fresh air.” The occasion was an event celebrating a decade of working with online feedback at Notts Healthcare NHS Trust. Rampton is a high-secure hospital.

In Glasgow last month, the Care Opinion team joined 3,400 quality improvers at the IHI/BMJ Quality Forum. Scotland’s national clinical director, Jason Leitch, has written that “the use of Care Opinion is the most important single thing we’ve done around person-centred care in the last three years”.

Improvers from across the world wanted to know more. Was Care Opinion really used by almost all Scottish NHS health boards? How did that work? What were the impacts?

At both events, online patient feedback was seen as “the new normal”. We were quizzed on what we had learned and where we should go next. How might we create more value for feedback donors and the wider health system? How would we scale further? What about use in education, QI or revalidation?

For a brief moment, it felt as if the whole world had changed. But only part of it has.

On our live responsiveness chart, I see many organisations are now responding to over 90% of feedback - but I also see three English NHS trusts still responding to no feedback at all, despite our prompting.

On our live staff chart, I see many providers with senior staff across the organisation receiving alerts to patient feedback and responding in real-time – but there are also very many NHS trusts with just a handful of staff engaging with online feedback.

Some healthcare CEOs see online feedback as a core to their culture change or service improvement strategies

I speak with some healthcare CEOs who see online patient and carer feedback as a core part of their patient experience, culture change or service improvement strategies – and others who remain unaware that public online feedback about their services even exists.

And I’ve seen some organisations spending scarce public money on building their own, primitive, online feedback system when they could use Care Opinion to create greater impact at a fraction of the cost. Why do this, I wonder. Control?

I understand change in healthcare is slow. It is sometimes said that it takes 17 years for evidence from a randomised controlled trial to change routine clinical practice. So I am not terribly surprised that while some organisations have gone three times round the track, others don’t seem to have left the starting line.

As William Gibson, the American/Canadian writer, famously commented: “The future is already here — it's just not very evenly distributed.”