MSc Dissertation: How do GPs use NHS Choices feedback?

I was lucky to have been able to do the MSc in Health Informatics at UCL CHIME, and finally (after much procrastination) submitted my dissertation in December 2012. I've tried not to think about it since, but now that I have the degree certificate in my hand, I reckon I'm not going to jinx anything by posting the dissertation here now. I have good intentions to do some more interviews and work it up into a publication, but procrastination is a key skill of mine, so I wouldn't get my hopes up...

Many thanks go to Dr Henry Potts for his supervision and gentle motivation.



Since 2009 patients of English GPs have been able to post comments and ratings about their care on the NHS Choices website. This could represent a valuable source of data for clinical governance and quality improvement (QI), but little is known about how general practices might use such patient feedback in their QI processes.


Semi-structured interviews with four practice managers and one GP, at four practices with a high rate of engagement with NHS Choices patient feedback. Interviews were transcribed and analyzed using a coding frame developed using a Grounded Theory approach.


Practices seemed aware that NHS Choices feedback was a potentially useful quality signal, but struggled to integrate it with other sources of performance data. Factors specific to online feedback, including anonymity and publication, often acted as barriers to optimal use of the data in quality improvement. There was frustration caused by the application of an unsuitable investigative paradigm to comments which, because of anonymity or other issues, were effectively uninvestigable.


Suggestions for practices and the NHS Choices system are made, which may improve the utility of the feedback functionality. Further research into the validity and generalisability of NHS choices feedback, and into the processes used by general practices in responding to it, would help to identify more areas for optimisation.


Clinical Governance; Quality Assurance, Healthcare; Internet; Patient Satisfaction; General Practice; England; Medical Informatics.

Download as a PDF (475k)

Introduction and background