The government has unveiled proposals to encourage patients to rate GP services on the NHS Choices website as part of its next stage reform of the National Health Service.

Its newly-published public service reform paper Working Together, Public Services on Your Side, suggests that patients should use NHS Choices to provide feedback on the GP services they have experienced, as is seen on consumer websites such as Amazon.

Explaining the move, the government, which has long been working to give more power to patients and increase their involvement in their own healthcare, claims that often the best way to understand whether a particular service is right for a patient or not is to see how it is rated by others.

“This is the experience of millions of customers who use Amazon.com or iTunes, and while these are for simpler, less important services like books or music, the same principle of valuing the opinions and views of others applies in the decisions we make around our health and care as well,” the policy paper states.

Patients are already able to comment on hospital services on the site, and this will be extended to GP services this year with a view to ultimately enabling patients to leave feedback on all factions of the NHS in future.

Also under the mantra of more power to the patient, the government has linked payment to hospitals for services with patient-reported experiences and outcomes, “as one way of driving improved quality and patient-focus across the NHS”, and it has now promised to increase this outcomes-linked allocation every year to foster greater local accountability and further drive quality improvements.

Challenges on the horizon
The new proposals form part of the government’s next stage of reform, as envisaged by Lord Ara Darzi in his review of the future of the NHS, which promises high quality care for all.

Significant improvements to the health service have already been achieved over the last few years, particularly with regard to better access to primary care services, cleaner and safer hospitals, reduced waiting times and better health outcomes, but the government recognises that the NHS must evolve further in order meet new challenges on the horizon.

For example, in just 20 years 40% of the population will be over 50, and “an ever growing proportion of people will have long term conditions, requiring more integrated support across services,” it notes. Furthermore, the government points out that in a recovering economy it will be “critical” to ensure that people unable to work due to health reasons can return to the labour market as quickly as possible.

These challenges require a “21st century NHS”, it says, which should be able to diagnose illnesses more quickly, therefore enabling earlier intervention, as well as place a heavier focus on disease prevention and helping patients to live healthier lives for longer. In addition, the health service must foster closer partnerships between patients and clinicians to promote health, it stresses.

According to the government, handing more control and responsibility for healthcare to patients is absolutely central to attaining its vision for a modern health service able to cope with the challenges ahead.

But Dr Hamish Meldrum, chairman of council at the British Medical Association, argues that the “consumerist approach being advocated by the government is not well-suited to the NHS. Patients are not supermarket customers, and doctors are doing more than providing an easily rated commodity”.

And he adds that while doctors welcome feedback about their services, there is concern about allowing patients to post their comments online. “The suggestion that your treatment in the NHS can be as easily rated as a stay in a hotel is simplistic,” he said, and warned of the “risk that this exercise could reduce NHS care to a meaningless popularity contest, encouraging perverse behaviours and an emphasis on the superficial.”