Aug 24 2012

Could TripAdvisor-style reviews work for social care providers?

by Lisa Trigg

In the recent White Paper Caring for our Future, the government announced its intention to support comparison websites which assist users in choosing providers in England. With the popularity of websites such as TripAdvisor, it seems like an obvious solution to solving the problems of limited information in the social care sector. This has already been applied with some success in health care with NHS Choices and other independent websites. However, a new PSSRU discussion paper Using Online Reviews in Social Care explores the potential challenges involved in setting up this type of website for provider quality in the social care sector.

The opportunity for health care users to post reviews of doctors and hospitals has been the subject of some debate in the medical profession (Trigg 2011). Much of the discussion centres on whether patients can be competent reviewers of complex medical care and the extent to which they will use the internet to post malicious comments on what they perceive as inadequate care, for example, where doctors have refused to issue prescriptions. Despite these objections, NHS Choices has a facility which allows feedback to be posted on hospitals, GPs and dentists. The site has received 85,000 comments on various services over the last three years (NHS Choices 2011). Services such as www.iwantgreatcare.org and www.patientopinion.org.uk also allow patients to provide reviews on both clinicians and hospitals. Research on the insight of patients is mixed – while a recent study identified a relationship between patient ratings and clinical quality (Greaves et al. 2012), other research suggests that patient feedback tends to be more useful for the non-technical aspects of care (Chang et al. 2006).   

For social care, at least at first glance, the opportunity to use online reviews appears less controversial, at least for personal care. It seems comparatively safe to assert that a user of social care can form a more comprehensive view of how well their provider is performing. For example, a user – or their carer – can form views on the extent to which they were treated with dignity and respect, and whether the service fully met their needs. The idea of publishing feedback from users is gaining ground – as well as the development in England, the Australian government has recently announced plans for a government-run comparison website, My Aged Care.

However, this application faces a number of issues in the social care sector. To begin with, it might prove difficult to deliver user feedback in sufficient volumes for users to gain an accurate picture of the service. For example, for older people in the residential care sector, with the average length of stay at approximately 1.6 years (Forder and Fernandez 2011), there is simply not enough turnover of residents to generate a large number of reviews – from either residents or carers. Add to this the fact that many residents are living with dementia, and may not have the mental capacity or skills to post feedback on the internet.  For those users or carers who can generate reviews, the threat of reprisal for already fragile or vulnerable users may be too great.    

The new discussion paper Using Online Reviews in Social Care attempts to document the range of challenges for using online reviews in social care. It discusses the barriers for generating reviews in the sector, as well as the potential difficulties for information-seekers and for providers who might be interested in using reviews to address quality issues. The paper stresses the importance of consolidating information into a single site, facilitating peer-to-peer contact (that is putting potential users and their carers in contact with current users and carers), and also the opportunity to gather information from professionals – or even collect feedback from users and carers for publication. This is the approach taken in the Netherlands and Sweden, where both users and carers are surveyed on a regular basis, with the results published on central websites (on www.kiesbeter.nl and www.aldreguiden.se respectively). 

While the benefits of providing information on providers to social care users are undeniable, the strategy for collecting and delivering appropriate data and feedback needs careful thought and planning to ensure that the effort behind these initiatives is not wasted.  

References

Chang JT, Hays RD, Shekelle PG, MaClean CH, Solomon DH, Reuben DB, Roth CP, Kamberg CJ, Adams J, Young RT, Wenger NS (2006) Patients’ global ratings of their health care are not associated with the technical quality of their care, Annals of Internal Medicine, 144, 665-72.

Forder J, Fernandez J (2011) Length of Stay in Care Homes. A report commissioned by BUPA, Personal Social Services Research Unit, London.

Greaves F, Pape UJ, King D, Darzi A, Majeed A, Wachter RM, Millett C (2012) Associations between web-based patient ratings and objective measures of hospital quality, Archives of Internal Medicine, 172, 5, 435-436.

NHS Choices (2011) Improving Health, Improving Lives, NHS Choices Annual Report 2011, NHS, London.

Trigg L (2012) Using Online Reviews in Social Care, PSSRU Discussion Paper 2836, Personal Social Services Research Unit, London.

Trigg L (2011) Patients’ opinions of health care providers for supporting choice and quality improvement, Journal of Health Services Research & Policy, 16, 102-107.

See also:

Age UK Guest Blog: Using Online Reviews to Choose Care Homes by Lisa Trigg, 25 July 2012.

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5 Responses to Could TripAdvisor-style reviews work for social care providers?

  1. Mark Randall says:

    It is a really great discussion you are suggesting. As a social worker in the field in both the medical model (public system) and in private practice I think it is really necessary to have such a review system. This way consumers are able to make greater choices if the information was made available to them.

  2. Claire Gordon says:

    Working in the social care sector has allowed me to gain a greater understanding of the barriers service user’s face when trying to access information about providers. I think it is essential for individuals and service user’s to be able to access information about social care providers and services available. Making a decision on what services to use has to be an informed choice to ensure individuals get the best possible service available to them. Being able to access reviews on social care providers may well support individuals to make a much more informed choice as it is often a difficult task when it comes to choosing a provider of social care.

    Although this type of reviewing system does have its advantages, I think it would be necessary for social care providers to recognize that not everyone has internet access and individuals requiring social care services may not have the skills to use computers and access these types of sites. Therefore other methods to access information must be made easier by social care providers.

  3. Amanda Goodwin says:

    Having experience in the social care services field I am aware of the pros and cons in relation to this blog.

    Firstly, when making a choice of what social care provider and services to go with is crutical to the care that you will recieve. It is a personal choice that should not be taken away as it does create independence and allows you to be in control, and it would be useful to have critical feedback of services that you are considering as it may influence your choice.

    A form of feedback would be useful for individuals who are looking to seek help and information on services as they are wanting a positive and effective experience. But should it be open to the public? Many people are often quick to complain but not praise ( from experience) so, how do we know that people will go and leave positive feedback? We also do not know if the comments that will be left are correct.

    Who will be commenting on the care they have been provided by services is another question, as many individuals who seek further assistance do not have the capability to create a comment, therefore the individuals doing it on their behalf could get confused with their own beliefs of this service.

    Finally, not everyone is able to gain access to the internet – so how would they be able to comment?

  4. L Carr says:

    By working in the social care sector I can see both the advantages and disadvantages with this type of system.

    I believe it may be beneficial for services to receive reviews as it would provide them with the opportunity to improve elements that are criticised. However, as with any complaint made an investigation would have to be carried out to determine the accuracy of the reviews, and as stated there is the possibility that reviews will be made with the intention of harming the reputation of a service. If negative reviews are factual the reviewers confidentiality must be protected otherwise the system will be unusable. The reviews will also depend upon the experience the service users had, and whether they can remain objective.

    By implementing this type of system it would allow service users, their families and carers to make an informed choice regarding the service they chose, and it is imperative that service users are enabled to do this. However, this would depend on individual’s access and ability to use a computer, which could prevent them making a valued contribution.

    Will the implementation of such a system and the possibility of unfounded negative reviews affect the funding received by the service? And how would the system be monitored?

  5. Pingback: Friday afternoon reading: July 12, 2013 | The Democratic Society

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