How can online feedback make a difference in commissioning?

I am Head of Engagement & Experience at Bradford District and Craven Clinical Commissioning Group. We have been using Care Opinion for 3 years now and it is one of the ways, we bring together feedback in order to gain an understanding of what local patients, users of services, carers and stakeholders are saying about their experiences of local NHS and other providers across health and social care.  We pull together feedback from a variety of different sources and use this information to ensure our commissioning decisions are informed by insight about peoples’ experiences. All the information is collected into a database which enables us to analyse themes and trends in people’s experiences and generate reports.  We call this system ‘Grassroots’

By pulling people’s feedback on experiences of care into one database it allows us to see patterns and trends emerging alongside.  In this way we are able to put people’s experiences at the heart of the commissioning process.

Having human eyes on every piece of feedback that is submitted, especially when serious or critical issues are flagged up with providers is a big advantage.   Care Opinion allows us to see if providers have already responded to these issues and tried to resolve them and make changes to improve.

Using the ‘Grassroots’ system we can embed and promote the experiences of patient’s and carer’s within NHS culture and build into our processes around Quality.

Gathering a range of sources for feedback is really important to us, it allows us to see not only the extremes of complaints & compliments but also we can see the ordinary everyday feedback, the patients who want to thank staff and show their gratitude. Care Opinion gives us a balanced view of what people thought was good and what could have been improved……..‘the nurses were lovely BUT…’

Care opinion is one part of the data, but it provides rich insight & lots of different perspectives. Feedback generated from our Patient Support & Complaints team shows the most commonly identified emotion is ‘fear’, in Healthwatch data it’s ‘frustration’ however the feedback generated via NHS Choices & Care Opinion it’s ‘delight’.

Bringing these different data sources together gives a more rounded picture of healthcare within our commissioning area.

Development of system approach to Quality & Experience. 

These developments represent an exciting opportunity for patient feedback to be addressed collectively by partners in our health and care system.  In the past, patient experience reports have sometimes felt like a stick used in the commissioner vs provider conversation, where the commissioners are holding providers to account - “what are you doing about this?”

Bradford District and Craven Clinical Commissioning Group is committed to a different way of working, turning commissioning into conversations and not contracts.  This is a shared resource to help us listen and learn from public experience. 

When we bring people’s experiences together through Grassroots, it tells a story of the challenges and opportunities we share as a system and the question becomes “how can we make this better for people, together?”

For example, we are working with the Chief Nurse at a local Hospital Trust to develop a system approach to patient experience – first step is that leads have agreed to sharing the data they collect, through Friends and Family Tests and other feedback routes so that we can build an even better picture. We want to collectively identify some common questions and metrics, so that we can better measure our joined-up-ness as a system.

Our Voluntary Sector providers and partners are sharing feedback too, and this is often a very rich source of insight.  One example is some work we are doing with the local Maternity Voices Partnership.  We encourage providers to promote a range of feedback routes including Care Opinion and more actively seek out feedback from under-represented groups.

Bradford District and Craven CCG is doing this, not just because we feel it represents a better way of working in the here and now, but we feel that this better prepares us for the changes that will affect how care is delivered and funded in this country.  See here for an overview of some of these changes  https://www.england.nhs.uk/integratedcare/integrated-care-systems/  as we move towards a more integrated way of working.  Finding better ways to look at care experiences across a population will be a key part of planning for all future health.