Predictors of postal or online response mode and associations with patient experience and satisfaction in the English Cancer Patient Experience Survey

Background: Patient experience surveys are important tools for improving the quality of cancer services but the representativeness of responders is a concern. Increasingly, patient surveys which traditionally used postal questionnaires are incorporating an online response option. However, the characteristics and experience ratings of online responders are poorly understood. Objectives: To examine predictors of postal or online response mode; and associations with patient experience in the (English) Cancer Patient Experience Survey. Methods: We analysed data from 71,186 patients with cancer recently treated in National Health Service (NHS) hospitals who responded to the Cancer Patient Experience Survey 2015. Using logistic regression, we explored patient characteristics associated with greater probability of online response; and whether, after adjustment for patient characteristics, online response was associated with more or less critical evaluation of cancer care compared with postal response. Results: 4,635 (7%) of the survey participants responded online. In adjusted analyses, men (OR women vs men 0.50; 95% CI 0.46-0.54), younger (OR < 55 vs 65-74 years old 3.49; 3.21-3.80), least deprived (OR most vs least deprived quintile 0.57; 0.51-0.64), and ethnic minority (OR non-white vs white ethnicity 1.37; 1.24-1.51) patients were more likely to respond online. Compared with postal responders, after adjustment for patient characteristics, online responders had a higher likelihood of reporting an overall satisfied experience of care (OR 1.24; 1.16-1.32). For 34/49 other items, online responders more frequently reported a less than positive experience of care (8 reached statistical significance), and the associations were positive for the remaining 15/49 items (2 reached statistical significance). Conclusions: In the context of a national survey of patients living with cancer, online and postal responders tend to differ in their characteristics and rating of satisfaction; associations between online response and reported experience were generally small and mostly non-significant, but with a tendency towards less than positive ratings, though not consistently. Whether the observed associations between response mode and reported experience were causal needs to be examined using experimental survey designs.Macmillan Cancer Suppor

Role of practices and Clinical Commissioning Groups in measures of patient experience: analysis of routine data.

Recent years have seen an increased focus on measuring how people experience health services to ensure that care and treatment is of the highest quality and safety.1 2 Better patient care experiences are associated with better adherence, clinical outcomes and patient safety, and with lower health care utilisation.3 4 In England, the national GP Patient Survey (GPPS) measures patients’ experience of Primary Care.5 As part of an NHS initiative to improve patient experience and facilitate patient-centred care, GPPS scores are currently reported at the level of general practices, Clinical Commissioning Groups (CCGs) and nationally.Not externally funde

Reliability of hospital scores for the Cancer Patient Experience Survey: analysis of publicly reported patient survey data.

OBJECTIVES: To assess the degree to which variations in publicly reported hospital scores arising from the English Cancer Patient Experience Survey (CPES) are subject to chance. DESIGN: Secondary analysis of publically reported data. SETTING: English National Health Service hospitals. PARTICIPANTS: 72 756 patients who were recently treated for cancer in one of 146 hospitals and responded to the 2016 English CPES. MAIN OUTCOME MEASURES: Spearman-Brown reliability of hospital scores on 51 evaluative questions regarding cancer care. RESULTS: Hospitals varied in respondent sample size with a median hospital sample size of 419 responses (range 31-1972). There were some hospitals with generally highly reliable scores across most questions, whereas other hospitals had generally unreliable scores (the median reliability of question scores within individual hospitals varied between 0.11 and 0.86). Similarly, there were some questions with generally high reliability across most hospitals, whereas other questions had generally low reliability. Of the 7377 individual hospital scores publically reported (146 hospitals by 51 questions, minus 69 suppressed scores), only 34% reached a reliability of 0.7, the minimum generally considered to be useful. In order for 80% of the individual hospital scores to reach a reliability of 0.7, some hospitals would require a fourfold increase in number of respondents; although in a few other hospitals sample sizes could be reduced. CONCLUSIONS: The English Patient Experience Survey represents a globally unique source for understanding experience of a patient with cancer; but in its present form, it is not reliable for high stakes comparisons of the performance of different hospitals. Revised sampling strategies and survey questions could help increase the reliability of hospital scores, and thus make the survey fit for use in performance comparisons.This research was funded by Macmillan Cancer Support (grant number 5995414). GL is funded by a Cancer Research UK Advanced Clinician Scientist Fellowship award (grant number C18081/A18180)

Diagnostic route is associated with care satisfaction independently of tumour stage: Evidence from linked English Cancer Patient Experience Survey and cancer registration data.

BACKGROUND: Whether diagnostic route (e.g. emergency presentation) is associated with cancer care experience independently of tumour stage is unknown. METHODS: We analysed data on 18 590 patients with breast, prostate, colon, lung, and rectal cancers who responded to the 2014 English Cancer Patient Experience Survey, linked to cancer registration data on diagnostic route and tumour stage at diagnosis. We estimated odds ratios (OR) of reporting a negative experience of overall cancer care by tumour stage and diagnostic route (crude and adjusted for patient characteristic and cancer site variables) and examined their interactions with cancer site. RESULTS: After adjustment, the likelihood of reporting a negative experience was highest for emergency presenters and lowest for screening-detected patients with breast, colon, and rectal cancers (OR versus two-week-wait 1.51, 95% confidence interval [CI] 1.24-1.83; 0.88, 95% CI 0.75-1.03, respectively). Patients with the most advanced stage were more likely to report a negative experience (OR stage IV versus I 1.37, 95% CI 1.15-1.62) with little confounding between stage and route, and no evidence for cancer-stage or cancer-route interactions. CONCLUSIONS: Though the extent of disease is strongly associated with ratings of overall cancer care, diagnostic route (particularly emergency presentation or screening detection) exerts important independent effects.This work is supported by Macmillan Cancer Support grant 5995414 for which GAA and GL are joint principal investigators. GL is supported by a Cancer Research UK Advanced Clinician Scientist Fellowship Award (C18081/A18180)

Awareness and use of online appointment booking in general practice: analysis of GP Patient Survey data

Background: general practices are required to provide online booking to patients in line with policy to digitise access. However, uptake of online booking by patients is currently low and there is little evidence about awareness and use by different patient groups.Aim: to examine variability in awareness and use of online appointment booking in general practice.Method: secondary analysis of two questions from the GP Practice Survey data (2018) asking about awareness and use of online booking of appointments. Multivariable logistic regression was used to examine associations with age, gender, ethnicity, deprivation, the presence of a long-term condition, long-term sickness and being deaf.Results: in total, 43.3% (277 278/647 064) of responders reported being aware of being able to book appointments online, while only 15% (93 671/641 073) reported doing so. There was evidence of variation by all factors considered, with strong deprivation gradients in both awareness and use (for example, most versus least deprived quintile OR for use: 0.63 (95% CI = 0.61 to 0.65). There was a reduction in awareness and use in patients &gt;75 years of age. Patients with long-term conditions were more aware and more likely to use online booking.Conclusion: while over 40% of patients know that they can book appointment online, the number that actually do so is far lower. With the constant push for online services within the NHS and the roll out of the NHS app, practices should be aware that not all patient groups will book appointments online and that other routes of access need to be maintained to avoid widening health inequalities.</p

Priestley, Joseph

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