It was a pleasure to Chair the Trip Advisor Debate at the RCOG on April 29th run by Progress Educational Trust. We work in one of the most highly regulated areas of reproductive medicine and the HFEA collects and publishes data on our success rates and other outcomes.
Our patients are asked to fill in feedback questionnaires about all aspects of the care that they receive and the HFEA also sends out anonymous questionnaires, which are discussed at our annual inspection. The question now is whether patients should be able to post their feedback on line and if so the form that this should take. In reality the HFEA have taken the decision to go ahead and so in some respects the debate was superfluous. The HFEA have not, however, decided the form that this feedback should take: should it be a star rating on a number of areas of care? should free-hand text be permitted? how will it be monitored? should there be a requirement for a certain number of responses before the information is visible in order to minimise bias? how can you check that it is a patient and not the clinic itself, or even a competitor, posting feedback?
Muir Gray, who was responsible for the NHS England website was unable to attend as he was unwell, but in preparation for the debate I went onto the NHS England website and looked up my GP: there was one comment and this was negative, so I provided positive feedback, as I have been happy with the care I’ve received; there was no way to tell if I was an actual patient and my comment was anonymised; I then registered a second time and was able to post a second comment! The system therefore is totally flawed! Susan Seenan, from INUK gave the most cogent argument. She is the advocate for patients and opposes the idea of online feedback because of the way it may misrepresent true care and is open to bias. Furthermore IVF clincis are not like hotels – there may be huge competetion in some parts of the country between private units but over most of the UK patients do not get a choice and if they are eligible for what limited funding is out there, they have no choice but to be sent to their local clinic. Of course it is the duty of all to provide high quality care, with good clinical outcomes and in a good facility staffed by empathetic and well qualified staff. At the same time we understand the stresses of fertility treatment and the huge highs and lows and hence the worry that a “trip advisor” approach is likely to attract the extremes of opinion. I do not belive that the HFEA have thought this through properly.
Here is a link to the write-up of the event which we published in BioNews http://www.bionews.org.uk/page_526636.asp