Key findings and changes to our guidance

There was broad support in responses for the principles in our revised guidance. Many recognised the value of regularly reflecting on patient feedback. Making sure that the process is accessible to a wide range of patients was also recognised.

There were some strong themes arising from the responses. The potential impact of some of the changes on doctors and a healthcare system under pressure in particular. 

We listened to the feedback and balanced the views of doctors, patients and organisations, which is reflected in our updated guidance.

A large proportion of respondents had reservations about applying some aspects in practice. Doctors and some representative organisations said requiring annual reflection on feedback could add to the burden of appraisal. But patients and public said only making doctors reflect on patient feedback once every five years suggests it lacks importance. They also said it limits who can take part. 

There was support for reflection on both solicited and unsolicited (unprompted) patient feedback, but mixed views about how useful unsolicited feedback is for doctors’ professional development. Some said it doesn’t give a balanced view of a doctor’s work. Others (often patients and the public) said that it can be more honest and meaningful than feedback given in a survey.

Patients and their representative organisations welcomed a move to more frequent reflection on patient views. They felt increasing the ways patients can give feedback would encourage people to take part. But some doctors and organisations raised concerns about the resource implications of needing a method to suit each patient. Especially those who need more support to take part.

The proposals on which we consulted were well informed, based on information and feedback from evaluation reports on revalidation. They were tested widely through a programme of pre-consultation engagement across the UK and drafted in collaboration with an advisory group of external stakeholders. Due to the pressures on doctors and the wider healthcare system we recognised that changes would need to be evolutionary, rather than revolutionary. We have sought to move things forward in a way that would minimise burden on doctors, while adding value to the process of reflecting on patient feedback.

So we are:

• encouraging doctors to reflect on patient feedback more regularly, considering a range of available sources. Such as feedback on the team or service, (using ‘should’ in the guidance) - not requiring annual reflection on patient feedback 
• encouraging doctors to reflect on any unsolicited feedback they receive. Such as cards and letters or feedback on their team (using ‘should’ in the guidance)
• stressing the importance of offering patients a way to give feedback that meets their needs. But recognising that the approach needs to be proportionate. 

There was support for increased flexibility in our guidance to allow doctors to collect feedback in ways that suit their patients. Especially for those working in niche areas. Some doctors had concerns about whether employers or responsible officers would support a varied approach.

So we have:

• increased flexibility in the guidance to allow the use of methods other than a structured questionnaire to collect periodic formal feedback. 

Many raised the importance of the role of employing organisations (designated bodies, or other organisations) in supporting doctors to regularly collect and reflect on patient feedback. This was felt to be key in minimising the administrative burden on doctors. But many also felt there’s little appetite in a stretched health service to invest in new systems or to provide additional resources to support any new requirements. 

So we have:

• strengthened messages in our guidance about the responsibility of organisations to support their doctors in collecting meaningful patient feedback and having systems that allow patients to give feedback in different ways.