Patient Opinion is your favourite band. Is NHS England the big record company? (Updated)

The Guardian this morning reports that NHS England will be setting up a “TripAdvisor”-style site to capture people’s feedback.

This has a number of implications in lots of different directions, but the one I wanted to briefly comment on is what this says about how markets arise in public services and are then distorted.

In social care, there were 44 care comparison sites at the last count. This “market response” presumably arose because there was a gap in the market: people weren’t getting the information they needed to make judgments about where is/isn’t a good care provider.

In the context of the NHS, and though not exactly equivalent to a comparison site, Patient Opinion has been doing a tremendous job over the last 7 years or so of enabling people to share their experiences of NHS services, aggregating that feedback and supporting NHS organisations to use this information to improve services.

Patient Opinion is a bit like* that really good band only you and a few people know about (a “few” being a relative term, here).

Patient Opinion needed to be created (and was done so very well indeed) because there was a gap in the market. It was an innovator at a time when no one else, including the NHS, was doing feedback particularly well.

Since today’s Guardian effectively says that NHS England is going to replicate Patient Opinion, it could be argued that Patient Opinion’s job is done. When the NHS adopts your idea, you’ve gone mainstream. It’s like EMI signing (or taking over) the band you love, and now all of your other friends and the general public will be listening to the band only you and your friends knew about.

But is this right? Is the presence of government here – in the form of the bizarrely-centralised-though-not-really-centralised NHS – a constructive or distorting market force?

I posed this question to myself when looking at social care comparison sites:

Is it appropriate to think that social care information / comparison sites should be centrally-led, guided more by a visible hand from government rather than by an invisible hand? Or is it ok for information about social care to be provided through the continued emergence of a demand-driven market, reflecting what we see in the film streaming and price comparison businesses around us?

@pubstrat has highlighted the same question using many other examples, such as MyPolice, fishing licenses and Patient Opinion itself, using the metaphor of government as elephant and others as small(er) creatures. He concludes:

I don’t, on the whole, think that government is obliged to leave the field completely clear for others where its own services and information are concerned. But I do think that the asymmetry of power and voice obliges it to take great care where it places its [elephant] feet.

In this case, my initial answer (with explanatory brackets for tortured simile purposes) is that there has to be joint work between NHS England (EMI) and Patient Opinion (your favourite band) to make the most of both unique characteristics they could bring to the question of feedback (your band’s music). NHS England brings scale, significant credibility and brand; Patient Opinion brings the platform, the independence and the learning/innovation of the last 7 years.

If both can work together, then the good music of feedback can be taken to the masses whilst maintaining its integrity. If not, we might end up with another Robbie Williams.

I really hope NHS England / EMI takes the opportunity to work with Patient Opinion.

*I generally don’t like argument by analogy, but make an exception here. Please don’t get too hung up on the band / record company thing.

Update (2 December): Paul Hodgkin of Patient Opinion has written an excellent post here on the topic, and @georgejulian has brought her characteristic “no bullshit” approach to the issue here. Both posts well worth reading.

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Man of letters & numbers; also occasionally of action. Husband to NTW. Dad of three. Friendly geek.

6 thoughts on “Patient Opinion is your favourite band. Is NHS England the big record company? (Updated)”

  1. To push your analogy just a little further, what if EMI also owned the main music review site? How confident would people be that the reviews are disinterested, and even if EMI genuinely ran it at arm’s length, would that help? That’s a genuine question: Amazon manages to do it, correctly seeing greater value in the integrity of the rating system than in making products seem artificially positive. But then that’s not too hard for them, because they are neither publisher nor author (nor band) – their interest is in selling more stuff, not any particular stuff.

    It’s interesting that the comparison being pushed this morning is with TripAdvisor, which is more like Amazon than EMI – it has no real interest in the quality of any specific product, it does have an interest in there being a lot of activity.

    Not sure what, if anything, this adds to the sum of wisdom on this. My instinct remains that it is not intrinsically wrong for the NHS to want to do this; but that it is foolish to charge ahead ignoring what has already been achieved.

  2. Hey, at least the band/record company analogy is fun. Whereas the NHS stealing Patient Opinion’s liberating platform is not at all funny. It is like taking the creativity of our favourite music and taking all the profits from the record sales. Pretty similar to the way EMI treated the Sex Pistols. You know playing along with them for a while, setting them up and then pulling the rug from underneath.

    I think Patient Opinion (PO) will remain the ‘Rough Trade’ to the ‘Factory’ of other comparison sites that offer so much to those patients and service users in the UK who value their services. For service users and patients alike (the fans) the autonomous stature of PO and others is the kudos or creativity they seek – or put another way the only way real transparency can be offered to those seeking the information they need to empower them and their collective or individual voice.
    It is vital they remain independent – but with the support of the major players too but the major labels must not seek to dictate terms.

    Patient Opinion are the Sex Pistols of the Health and Care Industry – the favourite group of so many that challenged the status quo – they represent all that was needed for change and like the Pistols PO was independent.

    But PO hasn’t done anything wrong to deserve the treatment they are getting from the NHS unlike the Pistols who (despite the chat show host asking for it) were very rude on a national TV chat show.

    EMI were one of the big players who tried to override the creativity of the independent labels emerging in the UK in the late 70s and early 80s – I sincerely hope the NHS don’t become the care industry version of the music industry bully boys.

  3. You mean Malcolm McLaren and the great Rock’n’Roll swindle ? That sex pistols ? PO is a full scale income attracting corporate enterprise whose directors draw salaries.. It has corporate written all over it. As John Lydon said ‘Ever feel like you’ve been cheated’ ?

  4. Haha – nice post Eric – but why ? Patient Opinion is is actually a social enterprise where any profit is turned towards making a better empowerment tool for people to play their part in the services they use. If it wasn’t for PO many patients and service users would not get to air their voice to the people who run services. Why would you have a go at the PO Directors who have turned their backs on bigger salaries in their professions to just try and help people make things better. I bet you are one of those people who thought the Clash sold out when they went to America or thought they paid too much attention to their clothes. PO – like the Clash – are just rightly conscious of their appearance – but this isn’t a corporate identity. Good grief sir – they are just a tiny wee company doing good.

  5. IMr Anderson. t’s corporate. Plain and simple. It quite deliberately pretends it isn’t. That’s what corporations do. They lie. Sorry, they market themselves.

    I turned down $8 million dollars and 12 hours in bed to write this post. Honestly.

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