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Revealed: BMA's secret talks with DH over online practice ratings

By Steve Nowottny

Exclusive: GP leaders have been negotiating behind the scenes with the Department of Health in an effort to limit the backlash from the launch of online patient ratings of practices.

Correspondence obtained under the Freedom of Information Act shows the GPC has been lobbying for amendments to each of the five multiple-choice questions which NHS Choices is lining up to fire at patients from next month.

The documents also reveal the planned questions, which will ask patients their views on access, appointment availability, ‘respect' shown by staff and involvement in their own care, as well as if they would recommend their practice for overall level of treatment.

The site will allow patients to leave anonymous comments and create mini-league tables to compare surgeries, with the system due to cover every practice in England.

The correspondence shows the GPC is lobbying the DH for a ‘break point' to be introduced a couple of months after the launch of the new service, ‘to assess whether the questions are eliciting appropriate responses' and ‘with an agreement for alternations to be made as appropriate'.

It is not clear if the DH has agreed to this concession.

The documents also reveal how the BMA and DH have been keen to be seen to work closely together on the controversial project, with email exchanges over the summer and a face-to-face meeting scheduled last month.

An email from a BMA official accompanying the suggested amendments to questions, made in June, says: ‘They are nothing earth shattering but it would help us all if you were able to agree to them: you can say you've consulted and we can say you've listened.'

But GPC negotiator Dr Chaand Nagpaul told Pulse major concerns remained over online practice rating, ‘which by its nature is fraught with problems'.

‘Our input has been based on trying to limit the damage that could occur from web-based feedback,' he said. ‘We're not supporting this – this is something the Government has insisted upon and we've had an input to try and ensure there are caveats and safeguards.'

Dr Jamie Macpherson, secretary of Coventry LMC, warned while patient feedback was vital, allowing online comments would ‘leave GPs open to personal attack.'

‘I'm sure the BMA should be party to whatever is delivered, but it must not be complicit with the rolling out of a useless, potentially damaging tool,' he said.

But Dr Andrew Mimnagh, chair of Sefton LMC, said: ‘The BMA had to be involved and the correspondence shows that involvement to have been highly effective.'

Read the correspondence in full

To read the full correspondence between the BMA and the Department of Health thrashing out the wording of questions for online practice ratings, click here.

The changes the BMA requested

BMA suggested amendments (changes in bold)

Overall recommendation

First, patients will be asked to indicate whether based on their overall experience, they would recommend the practice. There will be a choice of three responses:

- I would recommend this GP surgery to a friend
- I would not recommend this GP surgery to a friend
- I have no view

Individual questions

Patients will then be asked to answer four specific questions about different aspects of their experience. In each case, there are three response options as follows:

I am able to contact the practice easily...

- Usually/Sometimes/Rarely

I am able to get an appointment when I want one...

- Usually/Sometimes/Rarely

I am treated with respect by the staff...

- Usually/Sometimes/Rarely

I am involved with decisions about my care...

- Usually/Sometimes/Rarely

Original questions drawn up by DH

Overall recommendation

First, patients will be asked to indicate whether based on their overall experience, they would recommend the practice. There will be a choice of three responses:

- I would recommend this GP surgery to a friend
- I would not recommend it
- I would prefer not to say (default option)

Individual questions

Patients will then be asked to answer four specific questions about different aspects of their experience. In each case, there are three response options as follows:

I am able to easily contact the practice…

- Always/Sometimes/Rarely

I am able to get an appointment when I want one…

- Always/Sometimes/Rarely

I am treated with dignity and respect by the staff…

- Always/Sometimes/Rarely

I am involved with decisions about my care…

- Always/Sometimes/Rarely

The scorecard system for hospitals on NHS Choices, unveiled last month, is a model for the online rating of GP practices The scorecard system for hospitals on NHS Choices, unveiled last month, is a model for the online rating of GP practices BMA-DH correspondence over online practice ratings

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