Patients’ and service users’ use of outcome and quality information

Within a framework of greater choice and personalisation for patients and service users in the health and social care systems, we need to determine the extent to which people do, or potentially might, use outcomes information to inform their decisions about care and support.

The literature suggests that people’s use of outcomes information is modest at present, reflecting in part the limited availability of outcome information resources. People’s perceptions and decisions about their care are more likely to be affected by accounts of the experiences of other people with their condition.

One way that people use outcomes information is via online feedback mechanisms or online rating. Other sources of outcomes information are inspection reports and quality rating results as provided by CQC.

We propose to focus on the potential and challenges of online service quality feedback mechanisms to support service consumption decisions by social care users in Phase II

Aims and methods

Strand 1. Potential and challenges of online service quality feedback mechanisms to support service consumption decisions by social care users

The provision of timely, reliable and accurate information on social care providers and quality is essential to assist users to make effective choices which meet their needs and preferences. Information on social care services in England has typically been limited and difficult to access.

Online ratings, such as those on TripAdvisor or Amazon, have become a part of everyday life for many internet users, and there is considerable policy interest in extending this type of service to the social care area. Gathering and publishing online feedback from users and their relatives and carers is therefore increasingly seen as a way of channelling simple and meaningful information on providers to future social care service users. However, there are a number of issues which affect how successfully online user ratings information systems can be applied in the social care sector. Some of these challenges include achieving a sufficient volume of user reviews so that an accurate picture of the service can be formed. In the social care sector, the low turnover of users and proliferation of small providers can limit the pool of potential reviewers, as do factors such as low internet access and use among service recipients, and issues of cognitive or physical impairment. Added to this is the difficulty of protecting the anonymity of users or their relatives, and the consequences of posting negative reviews. There is also the risk that user feedback, whether accurate or inaccurate, will have a disproportionate effect on decision-making due to a general preference for testimonials over objective and quantitative information on quality.
The proposed analysis will examine the potential for and challenges involved in applying online service quality feedback mechanisms for assisting the decision-making of social care consumers.

Specifically, this research will:

  • Review current major initiatives to capture and publish online feedback
  • Explore the early experiences of each initiative in gathering adequate volumes of feedback and managing the publishing of reviews
  • Review early feedback on social care in terms of its relevance to provider quality and best practice

In terms of methods, the study will gather data through the following means:

  • Interviews and meetings with key individuals involved with the major initiatives (e.g. at the Department of Health, SCIE and Patient Opinion, with others identified as appropriate).
  • Collection of available information on feedback and use. This will rely on each of the organisations providing data, including the volume of reviews (accepted and rejected), number of providers covered and the number of hits on the websites.
  • Reviews of patient feedback posted on the relevant websites. Given the likely challenges of generating feedback, this activity is likely to be limited. However, early feedback will be reviewed to assess how well it meets a number of criteria: for example, the extent to which it covers the broad dimensions of social care, how objective it is, and how valuable the feedback could be in informing future service users.

Timing and outputs

The Phase I work continued into Phase II with publication in 2013. The mainstay of the Phase II work will begin in January 2014. We will provide the Department of Health with a final report (in the form of a discussion paper) and will submit a peer-reviewed article in a relevant social policy journal. The findings from the analysis will be disseminated in appropriate academic conferences, and easy-read versions of the findings produced and shared using appropriate social media.