4. Patient feedback

NASGP AppraisalAidYou must undertake a patient feedback survey once in every 5-year revalidation cycle, usually needing to collect at least 34 responses.

Which questionnaire to use

Neither the GMC or RCGP now specify which questionnaire to use. Many questionnaires are provided by the various toolkit providers and locum chambers.

The GMC has developed their own questionnaire and instructions on how to administer it. Whilst these instructions are specific to their own survey, there are key features that all questionnaire providers have to note:

  • Questionnaires should be based on GMC principles of Good Medical Practice, follow GMC principles of good questionnaire design and have been piloted and validated.
  • They should be completed anonymously by consecutive patients from the full scope of your work. For locums, this may mean carrying out your survey in different practices and clinical settings.
  • The response should be handled and collated independently of the doctor, appraiser or RMO.

The RCGP suggest checking with your Responsible Officer (RO) whether they recommend any specific feedback questionnaires. Given the key role of your appraiser and RO in your revalidation, it might make your life easier to use a tool that is not too alien. However, if you have used a questionnaire that has been designed and administered in accordance with GMC guidance, then you should be able to justify your choice.

Tips for a smooth patient feedback survey

Engage with the practice staff

  • You are going to need some level of cooperation from the practice staff in distributing your patient questionnaires and collecting completed responses.
  • Make it part of your Terms and Conditions that practices offer you the same support as a fellow healthcare professional that they would give to their own practice team.
  • Consider politely forewarning the practice manager that you are carrying out a survey and seek their advice on how this would work best in their practice.
  • Arrive early for your “survey” sessions. Check that the staff on duty understand the survey process. Lots of charm, gratitude and perhaps making a cup of tea might help!

Make it easier for the patient to complete the survey

  • Willing patients may be deterred from completing the survey if they have no pen, nowhere to sit and then have to join a queue at reception to hand it in. Likewise, if they take the survey away to post themselves, you may see a drop in response rate.
  • Overcome these obstacles by investing in some clipboards with pens attached; ask the practice staff if a chair can be placed in a quiet corner; make a clearly labelled postbox for completed responses which can be placed in reception.
  • Wear a professional name badge, use removable doorplates with your name on and even carry mini patient-friendly personal profiles to hand out to patients so they can identify you when giving feedback.
  • Some locum chambers have developed their own GMC-approved patient feedback, and have invested in several plastic post boxes, pens and clipboards to share amongst them, and there’s no reason why other groups couldn’t do the same.


Pitfalls in interpreting patient feedback for locums

The GMC feedback surveys were piloted and researched by Professor John Campbell of Peninsular college of medicine in 2012. Appraisers should be familiar with his guidance on interpreting feedback surveys. Some of the key findings that pertain to locums:

  • Locums tend to receive less favourable feedback than doctors in permanent positions.
  • Doctors who obtained their primary medical degree in a non-European country tend to receive less favourable feedback than those who qualified within Europe.
  • Beware benchmarking. Interestingly the GMC does not currently see comparison with other colleagues as an essential feature of the feedback process. Nonetheless, many survey providers do include benchmarking but it is very rarely locum-specific. So for your own sanity and in preparation for your appraisal, it is good to be aware of the rating bias against locums.

The NASGP, with our experience of locum work, think that below the surface of these GMC findings there are probably many granular factors at play which affect how locums are perceived. Read on for some examples which could serve as reminders and talking points with your appraiser when reflecting on your feedback. Unless your appraiser is also a locum, they may not fully appreciate the context in which you work, so be ready to tell them!