Our recent work on NHS.UK has revealed that users are often confused about giving any kind of feedback about GP practices. For example, they sometimes aren’t sure about the difference between leaving a review and making a formal complaint, and they don’t know where to go to get the response they want from feedback.

This is important because a significant number of users come to NHS Choices to read or leave feedback. Our research suggests 17% of visitors to GP profile pages want to leave feedback or make a complaint, and 10% want to read what other people say about a specific surgery.

Patient feedback is important at a policy level

The NHS Constitution sets out patients’ right to complain about NHS services, and the NHS.UK programme aims to ‘improve patient experience’. Additionally:

  • the NHS Five Year Forward View says that ‘we need to engage with communities and citizens in new ways, involving them in decisions about the future of health and care services’
  • in 2015 an NHS Report (Improving Experience of Care) stressed the importance of having effective feedback mechanisms in place so that the NHS can listen and learn from patients

How we currently meet the needs of these users

NHS Choices lists ‘facilitating feedback’ as part of its current service proposition, and it allows users to leave ratings and comments about NHS services, including GP surgeries.

This service receives around 70,000 comments annually on GP surgeries, and another 100,000 comments across other types of NHS service, such as hospitals.

We found that users don’t always use the feedback service in the way intended, so we started exploring how users interact with it.

Mapping out the user journey

Working with our colleagues in the team that run the existing service has been invaluable. We all got together for a day where the excellent Trilly and Brooke ran a workshop to map out the current user journey through the NHS Choices feedback mechanism.

We started by hypothesising about the different motivations for leaving feedback, and soon arrived at a long list of reasons, based on the type of feedback we’ve seen submitted.

Some motivations for leaving feedback

We mapped out on the wall the journey for users of the current service, pausing to look at the different screens that a user might interact with and the messages they might receive.

As we stepped through the journey, we identified pain points. These are points where the journey seems difficult for:

  • the patient
  • the GP surgery receiving the feedback
  • the team that moderates the comments that are submitted

Hearing about the variety of situations that the moderators deal with was fascinating.

Part of the journey map for leaving feedback

What we learned

One of the headline findings is that people are using this service to submit many different types of feedback. Formal complaints and comments relating to possible clinical negligence are much better served by other channels. But it would seem that many people don’t know where to go, or have tried and failed to feel heard through other channels, so they use the NHS Choices service as an outlet.

What next?

It’s early days, but we anticipate being able to make improvements to the existing journey, providing users with clearer signposting to the most appropriate channel for the type of feedback they have. There are also business benefits to be had, if we can reduce the amount of comment moderation required by the service team.

We recognise that there are a number of different types of user involved in this process. We want to work with our colleagues across the NHS on this, so next up we’ll be talking to a number of different people to understand their experiences and needs:

  • patients who’ve left feedback or complained, via any channel
  • GP practice staff who receive feedback and complaints
  • Policy stakeholders in NHS England
  • People in other parts of the NHS that deal with feedback and complaints (such as the Care Quality Commission)

And of course, we’ll continue to work closely with the existing service team.


  1. Comment from Felix Greaves

    Great to hear you are doing this. Please also do look at the academic work funded by NIHR on this: https://www.nihr.ac.uk/05-development/newsroom/blog-DO-NOT-DELETE/inquire-improving-nhs-quality-using-internet-ratings-and-experiences.htm

    • Comment from Joe McGrath

      Thanks Felix.

      We’ve been trying to track you down actually, to find out about some research you conducted. We’ll be in touch!

  2. Comment from Ben Rusholme

    Glad to hear you are looking into this, looking forward to seeing your work on clearer signposting

  3. Its very nice to hear that you are doing this. Patient feedback is very valuable and necessary. We are looking forward into this. Thanks for sharing this with us.


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