Patients' voices in danger of drowning in paperwork
Patients could be put off taking part in NHS outcome measurement by overwhelmingly long questionnaires, market researchers fear.
Health service market research specialists are divided on proposals for survey documents up to 15 pages long when patient reported outcome measures are introduced across the service in April.
BUPA Foundation group medical director Andrew Vallance-Owen said: "We think it will be difficult to get a high response rate with a document of that size. I worry it could set back the cause of [patient reporting] if the response rates are low."
The size of the questionnaire is revealed in a Department of Health tender document for running parts of the reporting process.
Under DH proposals in the 2008-09 operating framework, hip and knee replacement patients and those having groin hernia and varicose vein surgeries will complete questionnaires before and three months after the procedures.
Out of touch
CHKS head of market intelligence Paul Robinson said: "I can see no reason for the questionnaires being that long." The proposals reflected "a researchers' view of doing things", he said.
CHKS and BUPA have worked with patient reported outcomes measurement privately for several years.
The plans are based on a 2,400-patient London School of Hygiene and Tropical Medicine pilot. Professor of health services research Nick Black said the system had been proved effective.
Around 81-90 per cent of eligible patients opted to complete a pre-operative questionnaire and of those there was a 75-91 per cent response rate to the post-operative survey. Response rates of 80 per cent and above are considered acceptable.
Technical issues
He said: "The questionnaire is one we developed for the DH and it works. These are technical issues - they are a complete distraction."
Professor Black said it was right that the system was based in research, but agreed practical issues such as the length were important.
The London School of Hygiene and Tropical Medicine with the Royal College of Surgeons, CHKS and BUPA-owned Outcome Technologies have shown interest in the tender, which envisages pre-operative surveys of 10-15 pages and post-operative ones of up to 11 pages, each expected to contain around 30 questions.
A DH spokeswoman said patients will not be expected to complete a set of questions "that stretch over 10-15 pages. This includes covers, patient information and consent forms". She said the DH was confident of good response rates.
HSJ's Performance Management conference is on 11 November.
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Readers' comments (1)
Ginette CAMPS- WALSH | 17-Oct-2008 6:45 pm
A 15-page patient questionnaire would be far too long. Response would be low and be skewed by the bored and unhappy! Research subjects are more motivated than the general public and response rates will be higher.
The questionnaire should be shorter and kept strictly to the most important data that can be used and acted upon. There is no point in collecting lots of interesting data that cannot be used.
Should it not also be anonymous and confidential? Patients will not be honest if they feel their comments could be fed back to staff.
Market research professionals should be involved and there should be a number of pilots to look at optimum questionnaire length, formats and timeframes.
2 very important criteria are time back to work & time to feeling completely well. Full recovery takes much longer than is generally acknowledged, so 3 months will not be long enough for some treatments.
Ginette Camps-Walsh, Chairman Medical Marketing Group CIM and formerly marketing manager for all BUPA's hospitals responsible for patient surverys
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