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How the GP ratings site works

After six months of the NHS Choices site going live, Guy Lavis explains how the site is working and how to counter negative or inappropriate comments.

In October last year, the NHS Choices website ( began allowing patients to post online comments about their GP practice.

There were understandable concerns amongst the GP community, with fears only those few patients with an axe to grind would comment, providing an unrepresentative sample of opinion.

Six months on, GPs can take comfort that those early concerns were unfounded. Online practice feedback has proved highly popular with the public with 8,200 comments published as of 1st March.

Of these, 65% of patients state they would recommend their practice to a friend.

Other measures indicate similarly positive ratings, with 77% indicating they are able to get through on the telephone and 64% saying they can get an appointment when they want one.

This article will answer questions on how comments on NHS Choices are moderated and practices can get the best out of patient feedback online.

How are comments moderated?

All comments on the sire are pre-moderated, meaning that every posting is read and checked against the agreed guidelines before they are published.

Moderation is conducted by an external company, Tempero, who specialise in this area, also supporting the feedback services operated by the BBC and NSPCC.

Pre-moderation acts as a filter for comments that are potentially libellous or defamatory, offensive, or simply off topic. For example, one rejected comment was from someone who popped into a practice to ask if he could use its fax machine, and was upset to be told he couldn't!

Comments that stray beyond personal experience, or those of a polemical or campaigning nature are ruled offside.

Moderation also ensures that individual members of staff, clinical or otherwise, cannot be named. This is not about rating individual doctors or other clinical staff. Comments are sought from patients that describe their overall practice experience and which may be helpful to others, such as the two million people who move house every year and need to register with a new practice.

What should I do if an inappropriate comment is posted about my practice?

Practices can ‘alert' a comment if they think it is offensive or inappropriate. Any comment reported in this way is removed from public view, pending further investigation.

The comment is then reviewed again against the moderation rules. After re-examination the comment will either be removed permanently, or if the moderation guidelines have not been breached, the comment will re-appear.

Although an important safeguard, there have been only a small number of cases where a comment has been reported in this way with even fewer found to subsequently fail to meet the moderation standards.

Public comment is by its nature subjective and comments are not removed because they are negative or because the practice or another user considers them to be ‘unfair'. Understanding and dealing constructively with criticism as well accepting praise is central part of the comment process.

Can I reply to comments?

Yes. This is important in recognising the value of the feedback left by patients and enables the practice to defend itself. All replies appear directly underneath the original comment and are able to be viewed by all users.

Currently, few practices are using the reply facility. This is a missed opportunity, as practices can use this feature to engage with patients directly.

The reply facility enables practices to challenge information it believes to be incorrect and deal with any issues raised. It can be used to mitigate any criticism, respond to patients' concerns, or simply thank people for their praise.

Replying to patient comments also conveys a positive approach and by taking the time and effort to respond, practices are seen to engage directly with their community.

The Albion Practice in south east London is one practice that has made a conscious effort to reply to all patient comments. Their replies can be viewed at

What should I do if there are just one or two negative comments?

Encourage feedback from patients. The greater the volume of the comments and engagement leads to more accurate picture of the services offered.

Dr Higson and Partners sought to counter the problem of one or two comments painting a disproportionately bad picture by actively encouraging its patients to leave comments on NHS Choices.

The result is that the practice has had many positive comments with the few negative remarks now placed in the context of a satisfied overall patient group. Dr Higson and Partners' profile can be seen at

Guy Lavis is stakeholder and communications lead at NHS Choices.


• Accept that people's opinions are sincerely held
• Encourage patients to post feedback on
• Use your right to reply
• Suggest that anonymous authors contact the practice where appropriate
• Share positive feedback with staff

• Ignore comments left
• Be defensive to criticism
• Assume negative comments are unjustified
• Reply to comments with an ‘auto' response without personalisation