Producing information for patients about the quality of general practice services EQuiP open meeting, Brussels, November 2004

The research team Jenny Noble, Rod Sheaff, Martin Marshall NPCRDC, University of Manchester Helen Davies, Glyn Elwyn Department of Primary Care, University of Swansea Kieran Walshe, Manchester Centre for Health Care Management, University of Manchester Heather Waterman School of Nursing, Midwifery and Health Visiting, University of Manchester

Aim To publish information about the quality and range of general practice services which is useful to patients

What do we know? 1.Information can be a useful lever to engage and empower 2.Providing information is an important part of UK policy 3.There are some problems with public reporting 4.There is not a major demand for information from the public 5.The content and presentation format of much of the performance information aimed at the public is poor 6.Minimal information is available about primary care services

Our approach An action research project Flexible Focuses on stakeholder engagement Uses research team expertise Feeds findings back into process

Stages of the project 1.Recruitment of participants 2.Fact finding 3.Feedback 4.Planning 5.Action 6.On-going evaluation 7.Evaluation of outcomes

Results

1. Public engagement Supportive in principle No major demand Reflects general challenges of involving the public Research team driving process

2. Use of comparisons Don’t like league tables Don’t like word ‘report’ More interested in commitment to improve than in relative performance Strong sense of social solidarity with NHS and commitment to practices

3. Targeting the audience Public reporting requires more than putting routine data into the public domain The public have very specific information needs Need to target sub-groups

4. How information is used Information-telling mode: rational decision making egocentric consumerist Knowledge-construction mode: social processes complex, emergent, interactive collectivist

5. Source of information cynical about politicisation desire for independent view demand for partnership

6. Content and presentation Nothing Social marketing Consumerism

6. Content and presentation (1) Hard copy and web-based Present content as hierarchy context structures processes outcomes Beware overload

6. Content and presentation (2) Break up text headings, bullets, FAQs make scanning easy Use visual displays Use narratives

The product: ‘Your guide to general practice’ 1.Service user as sole target 2.Clear purpose – to engage 3.Joint ownership – independent + patient + practice

The product: ‘Your guide to general practice’ 4.Focus on individual practices but standardised format and comparisons with local mean 5.Information presented in hierarchy 6.‘crystal mark’ presentation 7.Hard copy and web-based versions

Summary The public in the UK want to know more about the range and quality of general practice services They do not want to be treated like ‘consumers’ They need to be involved in decisions about the content and presentation format of information