Howard Croft column: Patient questionnaires ... good for three-year-olds

The NHS is littered with patient questionnaires like this one.
The NHS is littered with patient questionnaires like this one.

A hospital doctor I recently met 
socially made a disparaging remark about the patient questionnaire he and his colleagues are expected to hand out to patients in his hospital, elsewhere in the country. Shortly afterwards I had an appointment at York Hospital for an ultrasound scan where I saw a rack of such a questionnaire; I picked one up to check it out.

I don’t know if this document is an exclusively York production, or if it had been “piloted” elsewhere and then “rolled out” nationwide, but it is a very odd item. It looks to me like the product of someone whose starting point was simply the wish to construct a questionnaire, not to ask what it might be useful to find out and design a questionnaire to elicit that information. The result is something a not very bright fourth former might have produced.

Kuasa pictured at Flamingo Land.

Kuasa pictured at Flamingo Land.

It is an anonymous affair and, after asking me to identify the outpatient clinic I had attended it offered me six options, with tick boxes of course, in response to the question: “How likely are you to recommend our service to friends and family if they needed similar care or treatment?” The options went from “extremely likely” to “extremely unlikely”, followed by “don’t know”. It is rather like a customer satisfaction survey produced by a company selling, say, vacuum cleaners or surgical trusses. I was not asked to give any reasons.

Later (it should have been earlier) I was asked to tick a box against my age category. Age groups, oddly segmented, ranged from 0-7 years to 74+, ten in all. What, I wonder, did the researcher anticipate might come from a three-year old child? I tried to imagine a conversation between my grandson Oscar, who is three, and his friend Mason, perhaps during a finger-painting session at the nursery: “I say, Oscar old bean, I’m thinking of going in for a bit of diagnostic ultrasound. Is there anywhere you can recommend?” ... “Well, Mason, this is not something I’m very up on, but I do know that my granddad had an awfully nice time when he was in York Hospital. It’s a long drive to get there mind, about two hundred miles I think, so you might want to get a recommendation for somewhere a bit nearer. Why don’t you ask your mummy to speak to your GP?”

My own procedure was to investigate my carotid arteries (clean as a whistle, of course) and the operator, having greased up my neck with gel and ready for the off, told me that she wouldn’t be able to talk to me as she would be exploring near my voice box. Talk would interfere with her readings. I asked her if this was a polite way of telling me to shut up and she confirmed this was so. Now, I am a bit of a talker and when I meet someone I like the look of, somehow my tongue gets wagging, but I have never before been told to belt up so courteously. I recommend York’s imaging department for this alone.

Next up I am asked for my gender – Male or Female; no “Not Sure”, “Prefer Not to Say” or other alternatives so popular nowadays. Of course, we may be a bit behind the times here in Yorkshire.

Do I consider myself to have a disability? Yes or No. That’s it. How does that help? I could be a double amputee or be painfully shy.

Finally, there is a free text box inviting a suggestion for one change to improve my experience, this box having its own box that I can tick if I do not want my comment to be made public. Whenever are these things made public, I have never seen it, and as the survey is anonymous why would I care? Some wags might suggest more ash trays in the waiting areas or the provision of a free bar, in which case the NHS might want to keep quiet about it, but surely not the wags. If there were to be an overwhelming demand for somewhere to put your fag ends it wouldn’t look good.

Don’t get me started on the options for self-assigned ethnic groups- all over the place that is. No box for the Cornish, the Scots, the Welsh. Someone in the NHS needs to go on a diversity course, especially as it is the employer of the most ethnically diverse workforce in Europe. They could engage someone to devise a questionnaire to give to their staff. And of course someone else to advise them on the cost/benefit of foolish questionnaires.