Intended for healthcare professionals


Collecting data on patient experience is not enough: they must be used to improve care

BMJ 2014; 348 doi: (Published 27 March 2014) Cite this as: BMJ 2014;348:g2225
  1. Angela Coulter, associate professor 1,
  2. Louise Locock, director of applied research2,
  3. Sue Ziebland, professor of medical sociology2,
  4. Joe Calabrese, lecturer in medical anthropology3
  1. 1Nuffield Department of Population Health, University of Oxford, Oxford, UK
  2. 2Department of Primary Care Health Sciences, University of Oxford
  3. 3Department of Anthropology, University College London, London, UK
  1. Correspondence to: A Coulter angela.coulter{at}

The NHS has been collecting data on patients’ experience of care for over 10 years but few providers are systematically using the information to improve services. Angela Coulter and colleagues argue that a national institute of “user” experience should be set up to draw the data together, determine how to interpret the results, and put them into practice

Anyone who has stayed in a hotel, flown in a plane, or bought something online will know that you are likely to be chased for feedback on the experience, usually during or shortly after the event. The NHS has caught the “real time” feedback bug too. By April 2015 all NHS patients attending any type of healthcare facility in England will be invited to report back on their experiences using a variant of the friends and family test (FFT)—how likely are you to recommend our service to friends and family if they needed similar care or treatment? Real time feedback, often gathered on-site using handheld electronic devices, has been introduced into many hospitals over the past few years, and since 2013 it has been mandatory to offer all patients in acute hospitals and maternity services an opportunity to complete the FFT.1 In December 2014 the requirement will be extended to general practice, community, and mental health patients and then to all remaining services over the following three months. This survey is just the latest in a series of government led initiatives to measure patients’ experience (box 1). However, less effort has gone into how to understand and use the data, and there is little evidence that the information has led to improvements in the quality of healthcare. We suggest how the data could be used more effectively.

Box 1: Regular national health and social care surveys carried out in England1

  • Care Quality Commission (CQC) national patient experience surveys—inpatients, outpatients, emergency departments, community mental health, …

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