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Care Connect: there is a better way

Update from Care Opinion

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picture of Paul Hodgkin

Last week NHS England re-launched its Care Connect plans (NHS to launch Tripadvisor-style website), and since then we have been inundated with questions about how this £5.4 million programme relates to Patient Opinion.

The core motivations behind Care Connect – supporting patients to give feedback and to help improve the health service – have our wholehearted support. But we have important concerns because Care Connect (as far as we can tell) regards patients and carers simply as part of a mechanistic feedback loop: report your issue, we’ll resolve it, job done. So Care Connect is a bit like putting PALS online – not a bad thing at all, but unlikely to inspire patients and staff, or transform the culture of the NHS.

As patients and carers, we now want to be more than ‘feedback’. We want to be heard. We want to be reassured. We want to support those we care about. We want to encourage staff we see doing their best, against the odds. We want to know our stories get to the right people. We want to see what others are saying. We want to see real change. And we expect all of this to be transparent, right down to seeing who has read our stories.

The platform we have created at Patient Opinion – over eight years of testing and learning with patients, carers and staff – is already much more than the healthcare equivalent of TripAdvisor. It is about building different relationships and changing culture. It is about involving everyone from providers to CCGs, to Healthwatch, to MPs, in public conversations that really can lead to change, at scale, right across the NHS.

See who had read each story on Patient Opinion

Every day on Patient Opinion we see what happens when you let patients and staff talk to each other. We see stories being transformed into better services. We see staff building relationships with patients and families through warm, thoughtful replies. And because stories on Patient Opinion have already been viewed more than 60 million times, these conversations are powerful. They move beyond ‘data’ into deepening the relationships that underpin care.

In our view this is not just feedback, but “feed forward”. Not about “them and us” but about “us, together”. Not about commenting on the past, but about staff and patients together making things better for the future.

So we’re concerned about Care Connect. We’re concerned that yet another feedback channel will lead to confusion and duplication. And yes, we’re concerned because it makes our survival, as a not-for-profit social enterprise, that much harder. But mostly we’re concerned that Care Connect is built around an impoverished view of what can, and should, be done. Patient voice becomes ‘data’, staff engagement is minimal, central control becomes more important than value-driven independence.

We think there is a better way. We think the Care Connect pilot should be widened to include other platforms, like Patient Opinion. After all, the whole point of being online is to make it easy to share, to connect, to add value to what others are doing. We’ve worked in that spirit with NHS Choices since 2007.

We also think the tax payer would like it if NHS England spent some of that £5.4 million evaluating all of this properly.  So in the next few days we will continue our conversation with the Care Connect team by sending a proposal about what such a mutual pilot would look like (and we will share it here so that you can contribute too).

As citizens, we want to do more than raise an issue, or make a comment. We want to make a difference. And we will.

Let us know what you think. Join the debate here, or tweet us your thoughts @patientopinion.

PS: We will be blogging here about all these issues, in greater depth, over the next few days.

Response from Informationmadeeasy on

I am somewhat concerned that in this economic climate & the NHS financial restraints the Government decides that yet another website is needed.

As a patient I need to feel secure knowing that any concern I have with the NHS will be treated with respect without influencing my care.

Anonymity via an independent organisation can give me this trust. It also helps the NHS with Trust & Transparency so desperately needed for the citizens within the UK.

Why try to undermine a perfectly working system which patients find in Patient Opinion.

We also need to consider the financial implications to the NHS, allegedly costing £5.4 Million. Significant funding which could have gone into patients health & treatment, nursing and care support.

I find having an NHS controlled Patients "Tripadvisor" undermines the fantastic work Patient Opinion has done over the many years & builds no confidence patients have in the NHS. I fact I feel that it may drive the divide between patients & the NHS even further apart.


Response from James Munro, Chief executive, Care Opinion on

@GeorgeJulian has posted a response to this on her blog, which I'm taking the liberty of linking to from here.

I found her response inspiring and humbling in equal measure.

Response from AnneMountjoy on

Why is the Government reinventing the wheel? I think Care Connect will create more confusion.  I don't understand why they don't use an established and recognised  social enterprise solution, rather than run the service as a private business, seeking to make private profits.

Patient Opinion is an independently-certified social enterprise - assessed and verified as being in business to provide benefits to society, by the Social Enterprise Mark

In addition, the Public Services (Social Value) Act was introduced earlier this year, to encourage public bodies to consider the social impact of their buying decisions. Shouldn't the Government take heed of this to involve and collaborate with Patient Opinion, as a certified social enterprise?  Patient Opinion are guaranteed as delivering social value because of their independent certification with the Social Enterprise Mark.

Response from James Munro, Chief executive, Care Opinion on

Felix Greaves has posted a comment on this on the BMJ website:

Response from Jennie Negus, Head of Patient Experience, United Lincolnshire Hospitals NHS Trust on

In the spirit of openness and honesty I must confess that from a personal (as in my own view) and professional (as in my day to day job)perspective the thought of Care Connect being rolled out 'as it is' fills me with dread! It’s not that I don’t agree with the concept and drivers; not at all; I welcome different ways and means and methods and options for seeking and receiving patient feedback - but - has anyone considered what this means on the shop floor? Let me describe a scenario......

  • we have PALS, receiving feedback, concerns, queries, compliments.
  • we have PALS twitter feed.
  • we have the formal complaints process.
  • we have friends & family test and a whole host of local, regional and national surveys.
  • we have listening events and forums.
  • we have executive walkabouts, 15 steps and similar.
  • we have Patient Opinion.

all of the above enable feedback, questions, and concerns - but most importantly they enable interactions, conversations (verbal or virtual) and together give a range of indicators that we can triangulate and gain a good picture of how our patients, their carers and their families feel about their experiences.


We also have NHS Choices - personally I really struggle with NHS choices for feedback - its doesn’t allow a conversation or follow up query and headlines can be alarmist; there are also delays in posting Trust feedback - on one occasion some 3 days after I responded it still said we hadn’t - if I had been that patient I wouldn’t have been pleased. When I e-mailed a query I received an automatic reply telling me they hoped to respond within 3 weeks! Patient Opinion is real time; people are real time...............


We focus on Patient Opinion and use as a single portal - they feed through to and pull back from NHS Choices  - it means as lead for patient experience I don’t have to look at two websites and I choose to use the most human, the most independent, the most responsive, the most interactive; Patient Opinion.


Now, if Care Connect comes online nationally what will that mean to me? It will mean I will need to find resources to check yet another website! It will mean our friends and family test scores will be on at least 3 websites all of which could have comments attached to them or have different headlines and pre-amble; it will mean my PALS team newly designed to be visible and accessible, reaching out as well as receiving in will have to cover this new feed.........


Its nearly Christmas - could Santa not bring us a way to pull things together into one system of some sort - making things easier for patients and public is critically important - can we not make it easier for us on the shop floor too? If we become bogged down in data feeds and swamped with different routes in and formats and responding processes we won’t have time left to do what we need to do.....the power is what we do with the feedback.........and what we do WITH Patient Opinion is make a difference.


Response from LoLo1 on

Late to the discussion - been away - but you are surely right to seek a better solution that harnesses rather than duplicates years of good work by a successful third sector organisations. All power to real stories, real listening,  and real improvement. Louise from Health Experiences Research Group 

Response from James Munro, Chief executive, Care Opinion on

Our Sarah helpfully collected some of the tweets about this issue to Storify:

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