Crowds of Patients Get It Right

It was in January 2006, exactly 6 years ago that I asked the question in a blog what the relevance of James Surowiecki’s ‘Wisdom of Crowds’ might be to the NHS. Now we have the data – patients generally get it right when they rate hospitals. The correlation is ‘far from perfect’ in the words of the Imperial College, London researchers who did the study, but their data show that if a hospital performs well as evidenced by clinical measures, patients rate it highly. Perform badly eg on MRSA infections and patients rate the hospital poorly on cleanliness.

Big Crowd, Good Data

Patients have been able to post ratings on NHS Choices since 2008 and the research used over 10,000 such ratings in 2009 and 2010 to compare the consumer views to the clinical data available for those hospitals over the same period. 10,000 patient experiences certainly constitutes a crowd and quite a big one at that. On the other measure we like, 68% of patients were ready to recommend the hospital where they had been treated. So they are ready not just to moan but praise as well.

Try It Out

I tried it out by going onto the NHS Choices site and testing the entry on my local hospital Kings College in South London. 21 out of 23 were ready to recommend, matching a good set of clinical measures – the system has worked. The problem looking at other hospitals is that the patient ratings are not evenly spread – there are some establishments with few patient ratings and where the clinical data is not posted either. That is I suppose a finding in itself. Looking for example at the South West London Elective Orthopaedic Centre where Partner Val Moore recently had a knee replacement operation, there is only one patient reporting and no data from the place itself much beyond the news it has car parking. Not much flesh on that particular bone – if we dare use the orthopaedic metaphor. Val adds:

Although I did not put a comment on NHS Choices site, I did complete a Patient Comment form and it is a pity these comments to do appear to be reported on by the EOC. Also I had to go and find the form in the reception area. As it happens, I and the other three patients in the ward were very satisfied with the clinical care we received both in the operating theatre and back on the ward. All thought the nursing care and the physiotherapy – so important in orthopaedic operations – were first class and – something where the NHS often falls down – special arrangements made for the discharge of two patients were very well handled.

Look Back More in Sorrow than Anger

Looking back at the original Wisdom of Crowds blog, I found the following observation which is worth reproducing –

It was interesting to see in today’s (11/01/06) newspapers the Health Select Committee’s view that ministers should have allowed the trusts (PCTs) “to develop organically and adopt a managed approach to sharing best practice in commissioning” instead of responding to central directives that the committee characterised as “clumsy and cavalier”.

The canny Parliamentarians got it right then and the Committee has plenty to say now. Is there a new phenomenon we have to record – the wisdom of that often vilified beast – the committee?

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