Peer and Patient Feedback
In its document, Supporting information for appraisal and revalidation, the GMC makes the following statement:
“You should seek feedback from colleagues and patients and review and act upon that feedback as appropriate. Feedback from colleagues and patients will usually be collected using standard questionnaires that comply with GMC guidance. The purpose of the exercise is to provide you with information about your work through the eyes of those you work with and treat, and is intended to help inform further development. Seeking feedback in this way enables colleagues and patient views about a doctor’s behaviour to be gathered in a more systematic way. It provides the opportunity for patients, non-medical co-workers (including other health professionals, managers and administrators) and medical colleagues (including trainees and juniors) to reflect on the professional skills and behaviour of a doctor”.
Most ophthalmologists work as members of a clinical team and treat patients, so the process of seeking feedback from peers and patients should usually be straightforward.
The GMC provides peer and patient questionnaires which can be downloaded from its website, and it has published guidance for organisations which wish to develop their own questionnaires for this purpose. The questionnaires should normally be administered and collated independently of the doctor about whom the feedback is provided, and the appraiser. In February 2016 the GMC launched a set of case studies and a leaflet for patients, to better support doctors with collecting feedback for revalidation.
When seeking feedback from patients, it is necessary to consider the needs of patients with visual impairment. Reproduction of the questionnaire in a larger font on good quality paper may allow many visually impaired people to complete it without assistance, but for patients with more severe degrees of visual impairment, it may be necessary to enlist the help of an accompanying person or a member of staff such as an Eye Clinic Liaison Officer (ECLO).
Some organisations which undertake refractive surgery routinely solicit feedback from their patients which includes questions about the professional attributes of the doctor who provided their treatment, and this information is used in appraisal. This is an example that should be adopted more widely. Although it requires investment in human resources and information systems, how many clinical governance failures could have been averted had patient feedback been sought systematically and acted upon?
The GMC also requires doctors to discuss complaints at appraisal. It defines a complaint as “…a formal expression of dissatisfaction or grievance. It can be about an individual doctor, the team or about the care of patients where a doctor could be expected to have had influence or responsibility”. The purpose of discussing complaints at appraisal is not to apportion blame, but to reflect on the investigation, response, subsequent actions and opportunities for professional development that have arisen from it. It is also important to discuss compliments at appraisal, because they should also inform the processes of care.
Health care organisations should support doctors by providing information about complaints and compliments and action taken as a result of them.