Managers have been told to respond more honestly to critical feedback on the internet in order to improve services, following an analysis of online comments.

Ex-GP Paul Hodgkin, who set up the Patient Opinion website in 2006, said managers needed to “relax” and show the “human face” of their organisations.

His comments follow an analysis of five years of comments posted on the independent site, which publishes anonymous feedback about named NHS organisations.

The study found staff attitudes and a lack of “care and compassion” to be prime concerns.

The report urged managers to use this kind of feedback to improve services and said it could act as an “early warning system”.

Online forums such as Facebook and Patient Opinion were “here to stay” and managers needed to change the way they responded, added Dr Hodgkin.

He said: “I can understand why a trust wants to control what is said about it.

“Some will spend ages working on a response that has been drafted by the head of communications and is legally watertight but actually says very little. They need to relax a bit more.”

He said patients preferred more open and honest responses and the chance to hear from frontline staff as well as from managers.

Patient Opinion’s report states that independent websites offer the chance to “meet people on their terms, to hear exactly what they think, and to show the wider world that you’re listening”.

They allow patients to review the NHS in the same way they can rate holidays and consumer goods online.

The report advised managers to ensure staff saw feedback about their services. Other tips included giving more “personal” responses to comments and complaints. Standard responses could appear “insincere and uncaring”, it said.