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Original research
Online patient feedback as a measure of quality in primary care: a multimethod study using correlation and qualitative analysis
  1. Anne-Marie Boylan,
  2. Amadea Turk,
  3. Michelle Helena van Velthoven,
  4. John Powell
  1. Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
  1. Correspondence to Dr Anne-Marie Boylan; anne-marie.boylan{at}


Objectives To ascertain the relationship between online patient feedback and the General Practice Patient Survey (GPPS) and the Friends and Family Test (FFT). To consider the potential benefit it may add by describing the content of public reviews found on NHS Choices for all general practices in one Clinical Commissioning Group in England.

Design Multimethod study using correlation and thematic analysis.

Setting 1396 public online reviews and ratings on NHS Choices for all General Practices (n=70) in Oxfordshire Clinical Commissioning Group in England.

Results Significant moderate correlations were found between the online patient feedback and the GPPS and the FFT. Three themes were developed through the qualitative analysis: (1) online feedback largely provides positive reinforcement for practice staff; (2) online feedback is used as a platform for suggesting service organisation and delivery improvements; (3) online feedback can be a source of insight into patients’ expectations of care. These themes illustrate the wide range of topics commented on by patients, including their medical care, relationships with various members of staff, practice facilities, amenities and services in primary care settings.

Conclusions This multimethod study demonstrates that online feedback found on NHS Choices is significantly correlated with established measures of quality in primary care. This suggests it has a potential use in understanding patient experience and satisfaction, and a potential use in quality improvement and patient safety. The qualitative analysis shows that this form of feedback contains helpful information about patients’ experiences of general practice that provide insight into issues of quality and patient safety relevant to primary care. Health providers should offer patients multiple ways of offering feedback, including online, and should have systems in place to respond to and act on this feedback.

  • primary care
  • qualitative research
  • quality improvement
  • patient safety

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See:

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  • Contributors All authors made substantial contributions to the study design and analysis of the data, were involved in drafting or revising the paper, have approved the final version and agree to be held accountable for all aspects of the work. A-MB designed the study, conducted the literature search, analysed and interpreted the data, drafted the initial manuscript and prepared it for submission. AT contributed to the design of the study, sourced the quantitative and qualitative data and analysed and interpreted the qualitative data and contributed to writing the manuscript. MHvV contributed to the design of the study, prepared the figures, analysed and interpreted the quantitative data and contributed to writing the manuscript. JP contributed to the design of the study, was involved interpreting the data and contributed to writing the manuscript.

  • Funding This research was funded by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care Oxford at Oxford Health NHS Foundation Trust.

  • Disclaimer The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. The study sponsors were not involved in the study design; data collection, analysis or interpretation; report writing or decisions about submitting the paper for publication.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This study was approved by the Medical Sciences Inter-Divisional Research Ethics Committee, University of Oxford (Ref: R53128/RE001).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available in a public, open access repository. All data employed in this paper are available from:, and

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