The role of patient experience surveys in quality assurance and improvement: a focus group study in English general practice

Abstract

Background: Despite widespread adoption of patient feedback surveys in international health-care systems, including the English NHS, evidence of a demonstrable impact of surveys on service improvement is sparse.

Objective: To explore the views of primary care practice staff regarding the utility of patient experience surveys.

Design: Qualitative focus groups.

Setting and participants: Staff from 14 English general practices.

Results: Whilst participants engaged with feedback from patient experience surveys, they routinely questioned its validity and reliability. Participants identified surveys as having a number of useful functions: for patients, as a potentially therapeutic way of getting their voice heard; for practice staff, as a way of identifying areas of improvement; and for GPs, as a source of evidence for professional development and appraisal. Areas of potential change stimulated by survey feedback included redesigning front-line services, managing patient expectations and managing the performance of GPs. Despite this, practice staff struggled to identify and action changes based on survey feedback alone.

Discussion: Whilst surveys may be used to endorse existing high-quality service delivery, their use in informing changes in service delivery is more challenging for practice staff. Drawing on the Utility Index framework, we identified concerns relating to reliability and validity, cost and feasibility acceptability and educational impact, which combine to limit the utility of patient survey feedback.

Conclusions: Feedback from patient experience surveys has great potential. However, without a specific and renewed focus on how to translate feedback into action, this potential will remain incompletely realized.

Keywords: patient experience; primary care; qualitative research; quality improvement.

Figure 1

The ‘Utility Index’ of patient experience surveys in primary care – perspectives of practice staff.