“Why should anyone want to make things better for me particularly?” – A qualitative exploration of Care Opinion and NHS care improvements

Care Opinion is an online platform which enables people to share anonymous feedback (known as “stories”) about their experiences of UK healthcare. In Scotland, this platform has official government backing, though healthcare organisations are not obliged to use it. Care Opinion staff review and edit these stories, acting as moderators. Healthcare staff are invited to respond to stories and are encouraged to use it for healthcare improvement. However, the number of changes made and registered on the platform is relatively small. This paper brings together findings from interviews with story authors (those sharing experiences), NHS staff and Care Opinion moderators to explore their experiences of online feedback and its use for improvement. In-depth semi-structured interviews were undertaken with 10 NHS staff, 10 authors and 6 moderators during 2022. The interviews were based on a sample of Care Opinion stories about services from two National Health Service Scotland organisations. Transcripts were analysed thematically. The findings demonstrate the emotional impact for those involved in online patient feedback. Stories add to a growing online repository, which Care Opinion uses to encourage improvement. As our participants highlight, changes and impact from feedback can be indirect. Online feedback can be used in different formats for different purposes. The external platform captures stories which may have been missed. However, change relies on the engagement of healthcare staff.