The Pharmaceutical Journal
Vol 278 No 7444 p338
24 March 2007

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Patient satisfaction surveys imminent

Annual patient satisfaction surveys are a requirement under the essential services section of the community pharmacy contract. A national template questionnaire is expected this week and the first survey results are likely to be fed to primary care trusts by March 2008. Dawn Connelly (on the staff of The Journal) reports

Annual patient satisfaction surveys to assess NHS services are likely to be undertaken by community pharmacy contractors in England and Wales within the next financial year.A national template questionnaire was expected to be published this week, after The Journal went to press.

Patient satisfaction surveys, or patient experience surveys as some people prefer to call them, form part of the clinical governance essential service. However, pharmacy contractors were advised by the Pharmaceutical Services Negotiating Committee to wait until a national template was agreed before undertaking them. The national template will be issued with an associated toolkit to assist contractors in processing the surveys.

Patient surveys are part of the wider Government drive towards patient and public involvement in how health care is provided. The Healthcare Commission has been running an NHS patient survey programme for several years. In fact, pharmacists are one of the last professional groups to start surveying patients. Acute trusts have had their performance measured for the past five years; a significant part of their score is based on the patient survey. PCTs have been conducting patient surveys since 2002 and GPs have been obliged to do so — at an individual or practice level — since 2003.

Community pharmacy contractors will be required to carry out a patient satisfaction survey annually. The sample size will depend on the average dispensing volume of the pharmacy (see Panel below). The clinical governance service specification states: “The pharmacy should review survey results and consider changes which could improve service provision. The pharmacy will share with the primary care organisation the area where the survey identified the greatest potential for improvement and the action being taken to improve performance, along with the areas in which the pharmacy is performing strongly.”

In terms of administering and analysing the surveys, there are likely to be three options available to contractors. They could print, implement and evaluate the survey themselves. They could print and implement the survey themselves but outsource the analysis of results. Alternatively, they could outsource the whole process. The NPA recommends that contractors choose the last option unless they have the time, expertise and resources in-house to cope with a survey.

Several independent health care research organisations will be offering patient survey packages for pharmacists. These will include sampling support, online and paper questionnaires, data processing, analysis of results and production of quality reports including national benchmarking and patient comments.

Andrew Smith, survey director at Patient Dynamics, a Healthcare Commission-approved survey contractor, has been telling pharmacists more about how to implement patient surveys at several events organised by the PSNC over the past few weeks. He told The Journal that the template questionnaire is likely to cover whether prescription items are supplied promptly, the quality of the facilities and of the services provided, the politeness and efficiency of staff and whether healthy lifestyle advice is offered. In addition, there will be a section for general comments about how services from the pharmacy could be improved and demographic data will also be collected.

Mr Smith explains that patients must be surveyed evenly over the business week. “It is not enough to collect [questionnaires from] the first 50 patients who walk through the door. Pharmacists have to try to collect so many per day based on how long they are planning to do the survey,” he says. He suggests that surveys should be conducted over a two-week period, necessitating five or 10 patients to be surveyed per day, depending on the size of the pharmacy. He adds that pharmacists must also ensure that the distribution of questionnaires reasonably reflects the pharmacy’s business profile. For example, surveys should include patients who have received a medicines use review and an enhanced service, if appropriate.

For pharmacists who are worried that they will not achieve the required response rate, Mr Smith proposes that they allocate a member of staff to take ownership of the survey and make sure they engage patients in the process. Patients are more likely to complete questionnaires if they are directed to a consultation area and asked to fill them in while they wait for their prescription, he argues.

Although questions can be added to the template questionnaire to tailor it to individual requirements, Mr Smith advises that contractors stick to the national template for the first year. “Then, perhaps next year, start thinking about different areas you may want to ask about based on the results of the first one,” he says.

Mr Smith predicts that, at some stage, pharmacists will want to compare themselves with other, similar pharmacies. “As the surveys start to build, companies like us will produce national benchmarks based on all the surveys we are doing for people. Over time, we would like to produce local benchmarks based around local pharmaceutical committee or PCT boundaries,” he explains.

Stephen Fishwick, head of NHS service development at the NPA, explains that carrying out surveys is potentially a useful platform for enriching pharmacists’ relationships with patients and significantly improving their pharmacy practice. “All good business people request customer feedback on their services and all good health care professionals welcome dialogue with their patients,” he says.

Mr Fishwick believes that the most important thing pharmacists can do to improve uptake of the survey is to motivate their staff. “The main thing will be to get the buy in of pharmacy staff because they are likely to be key in promoting and recruiting to the survey to achieve the required return rate,” he says.

The NPA will be offering its members a free resource pack, which shows them how to design, implement, analyse and evaluate the survey. It will also recommend solutions for those wanting to outsource, including a stand alone monitor that conducts the research electronically and analyses the results, and the services of (CFEP) UK surveys, an independent company that specialises in producing patient feedback surveys for health care professionals.

Mr Smith advises pharmacists to get started on patient surveys as soon as possible. “It can take longer than you think. You have to give yourselves or the company time to analyse the survey results,” he warns.

Further information on patient surveys will be published in The Journal following this week’s announcement.