8. Patient and colleague feedback March 2019

• 8.1. Myth: I must use the GMC questionnaire for my patient and colleague feedback
• 8.2. Myth: All my patient and colleague feedback must meet the GMC requirements
• 8.3. Myth: I must do a patient survey every year
• 8.4. Myth: I must find other ways to get feedback from patients every year
• 8.5. Myth: There are RCGP approved colleague and patient feedback questionnaires
• 8.6 Myth: I can use patient and colleague feedback from overseas

8.1. Myth: I must use the GMC questionnaire for my patient and colleague feedback

The GMC questionnaires provide the template on which many appropriate patient and colleague feedback tools are now based. There is no GMC requirement to use the GMC questionnaires. They are not suitable for all patient or client groups, or accessible to all. There may be better tools for your circumstances, such as a very specific scope of practice or a hard to reach group.

The GMC has provided guidance on developing, commissioning and administering patient and colleague questionnaires as part of revalidation. You do not need to use a specific tool, but you should choose one that is appropriate to your patient population. It should be accessible to as many different types of patient across your scope of practice as possible. You should include feedback from at least the minimum number of patients required by the tool you choose to use. Patients must understand that their responses will be anonymous.

For example, you should not collect the responses yourself in such a way that patients think you might be able to read them, or choose only the best. One option is for them to be collected into a sealed box that is opened by someone else who passes them on to someone outside your own practice to collate. You may want to use a professional questionnaire company or service. The results should be externally collated into a report that gives you the feedback you need so that you can reflect on the results in preparation for your appraisal.

8.2. Myth: All my patient and colleague feedback must meet the GMC requirements

You will have many sources of patient and colleague feedback, both unsolicited and formally requested. The guidance the GMC has on developing, commissioning and administering patient and colleague questionnaires specifically applies to the solicited patient and colleague feedback which is required once in the five-year revalidation cycle. Other feedback does not have to meet this guidance. Some of the most compelling feedback is not anonymous.

Some GP roles do not have enough patients or colleagues to meet the numbers required by the feedback tools. Including representation from across the whole of your scope of practice in one survey can sometimes work and provide helpful feedback but some roles are so different that this may make the results hard to interpret. We recommend that feedback is sought across the whole of your scope of practice in ways appropriate to each context and recognise that sometimes this means that some feedback will not meet the GMC requirements.

The main solicited patient and colleague surveys from your clinical work, normally undertaken once every five years, should be GMC compliant. Other feedback does not need to be GMC compliant. You should make sure that any feedback included in the portfolio is appropriately anonymised, which will involve presenting data that is difficult to anonymise separately to your appraiser or redacting it if you wish to include it. The priority is to include your reflections on the feedback, any lessons you have learned and any changes you intend to make as a result, in your portfolio. 

If you are in any doubt about the best way to collect and reflect on feedback you should seek advice and support from your appraiser at an early stage. Where the method that will generate the most meaningful feedback is not fully GMC compliant, it is wise to agree that it is appropriate for your circumstances with your appraiser and your RO before undertaking the survey.

8.3. Myth: I must do a patient survey every year

You only have to do one fully GMC compliant patient survey in the five-year revalidation cycle, like all other doctors. GPs are not required to do additional GMC compliant solicited patient surveys for revalidation.

There are many other sources of feedback from patients. The RCGP recommends that you reflect on any feedback you have had and your relationship with your patients during every appraisal. This is not about formally collecting additional feedback. This is about reflecting on feedback that is available about you.

8.4. Myth: I must find other ways to get feedback from patients every year

We recommend that GPs, who have many patient contacts every day, should reflect on their feedback from, and relationship with, their patients during every appraisal. You are not required to do additional patient surveys or actively seek feedback every year but we recommend that you consider the feedback that you already have.

Patients have told us that they expect you to reflect on all the sources of feedback that already exist, not that you should do more surveys than other doctors. You should take the opportunity once a year at your appraisal to discuss your reflections on your relationship with your patients and any feedback that you have had during the year. This can be from:

• informal unsolicited comments or cards
• formal feedback from ‘Friends and Family’ or the national patient survey
• complaints or compliments.

You are not expected to do any extra work in actively seeking additional feedback, unless you want to seek targeted feedback on a specific area.

8.5. Myth: There are RCGP approved colleague and patient feedback questionnaires

The RCGP stopped recommending any particular questionnaires several years ago.

In the past, there was an attempt to collate a list of questionnaires that met the GMC standards and were appropriate for GPs to seek feedback on their performance. It proved impossible to keep up with the development of more and more questionnaires, or to avoid the appearance of bias, and so this has not been maintained for some time.

The GMC are clear that it is important to choose a tool that is appropriate for the type of feedback that you are seeking and the people that you are asking and set out some principles for the choice of questionnaire. The review by Sir Keith Pearson points out how essential it is to reach the ‘hard to reach’ groups and to seek meaningful feedback from all patients, including those who cannot access written forms.

We recommend that you choose the most appropriate colleague and patient feedback tools for your circumstances. You are advised to review the GMC standards for such tools and agree, in advance, with your appraiser or responsible officer that they are happy to accept your choice.

8.6. Myth: I can use patient and colleague feedback from overseas

The GMC issues a UK licence to practise. Your revalidation recommendation will depend on supporting information that relates to your work in the UK. Although your RO has discretion to additionally consider supporting information from overseas, where the relevance to your UK practice is clear, your main patient and colleague feedback should be gathered from work in the UK.