Transcript: Care Opinion

Podcast Episode: Care Opinion

What follows is a transcription of the audio recording. Due to differences between spoken and written English, the transcript may contain quirks of grammar and syntax.

Michael: On this episode for Iriss, I went to find out about an organisation called Care Opinion. So, I spoke to the head of Care Opinion in Scotland, Fraser Gilmore. Fraser has worked across the voluntary sector and senior management roles for almost 15 years.

So, can you tell us what Care Opinion is, Fraser please?

Fraser: Yes indeed, so Care Opinion is an online platform and it’s run by ourselves, Care Opinion and we’re an independent, not for profit, social enterprise. So, the website is all about giving people a place, so giving the public a place where they can publish their experiences of health and care services. So, the website allows people to tell their story about any experience of health care they’ve had whether that’s been that they’ve gone to the hospital, whether they have used services like the Scottish Ambulance Service, whether it’s NHS 24, any health service that people have had an experience of, they can tell their story about it. And when they tell their story, we make sure that that story is then read by a member of staff on the board. So, we work with all of the health boards in the whole of Scotland and I know today, we’re talking about Glasgow, so that board is NHS Greater Glasgow and Clyde.

So, what happens is, someone tells their story, and they will also be asked questions in the site that are about what was good, what could have been improved and how did it all make them feel. That story is then sent to us and we have a team of people called moderators, now the moderators then read these stories and we tag them to the services that they are about. So, for example, if someone went to the A&E department at the Queen Elizabeth Royal Infirmary, we’ll make sure it’s tagged to that hospital. Once the story is published, we then send alerts out to the board and to all people that work in those departments, they then have the opportunity to respond to the story, so they tell the story and they get a response back. So, the whole idea of it is that people, when they share their stories, can get a response but from the information that the person’s giving the board and the health service can actually learn from what people are telling them and they can even make changes. So, the stories that people tell, they can be positive or negative or they can even have elements of both but by everyone sharing their stories, our idea is that we can all help to improve services by talking about the services that we’ve received.

Michael: So, I know that you’ve been going since 2011 because you’ve been working with different organisations across Scotland and the health service and the third sector in Scotland so why is it important to have this kind of platform for people to give their feedback?

Fraser: Well that’s a very good question. Well, I think it’s all about doing things in the public spaces and things not being done behind closed doors so, there’s lots of different reasons that people will want to tell their story, so it’s about us giving power to people, they often talk about giving people the power to talk to power and because we’re an independent organisation, we’re independent of the health board, that gives the people the support and the knowledge that we’re going to be acting in their best interests and we really want to share the stories.

The reason we exist, as I said, is we want to make sure that we can help improve services for everyone, and giving people the opportunity to tell their story not only means that they’re being listened to but anyone can read the stories on Care Opinion so, they can see what’s happening in their local area. They might even be able to read a story that inspires them because they’ve had a similar situation as well so it is creating that conversation between the public and the health services to make sure they’re always improving, they’re better for everyone.

Michael: And I take it in different health boards, as I say, all over Scotland, are kind of buying into your … I don’t want to say service, in a way, but the public that’s giving feedback because it must be important to hear from the (… unclear) as it were.

Fraser: We actually have our contract with the Scottish government so, we provide our service to all of the territorial health boards in Scotland so, all 14 territorial health boards in Scotland. We also work with the special health boards, so, as I said we work with NHS 24, we work with the Scottish Ambulance Service as well. We also have subscriptions from Health Care Improvement Scotland, and NHS Education Scotland as well. So, there’s lots of people around Scotland, not just the public and not just the services but you mentioned the third sector there so, we do have charities that are interested in different areas so, for example, we have charities that are cancer charities, that are really interested in hearing what people in Scotland are saying about cancer services in Scotland and we have Alzheimer’s organisations so, they want to hear what people are sharing stories about Alzheimer’s but more widely, we encourage MSPs as well to have memberships and subscriptions on Care Opinion so they can see what’s happening nationally in health care but they can see what’s happening locally too.

Michael: You know, it must be good to see that people are feeding into services that are really not working at the moment and what they could be doing better to improve the service, so it must be good to see that you’re making a difference but also that you’re giving people a voice as well.

Fraser: Well my whole background has always been in engagement, I’ve always worked in engagement and this is why coming to work for Care Opinion. As you know from our previous conversations, I actually started this job two weeks into the first lockdown and I think it’s such a powerful tool because anyone in the country can use it and you’re right just now, it’s been very, very difficult for health services, a lot of the stories that are coming through are mentioning covid 19. So they’re talking directly about people who’ve been affected by it, they’ve talked about, they’ve talked about the vaccinations and they’ve even, in some instances talked about how covid has changed how they’ve accessed services or it’s how it’s changed how they’re visiting people.

So, there’s definitely a lot that you can see coming through in the stories. Interestingly enough, as I was saying, people can say positive and negative things in their stories, or a bit of both, but last year we had over 69% of the stories coming through were purely positive. So, people have a lot of really nice things to say about health services and we totally feel that the health services can learn just as much from positive feedback as they can negative feedback because you want to know what you’re doing wrong but you also want to know what you’re doing well as well.

Michael: I suppose it is a feature question now when I do my interviews about – I can’t really do an interview without asking about COVID-19 – so, how has that like impacted on people’s services from all across Scotland? Have you heard kind of like different stories or services that could get better but at the moment they’re not?

Fraser: A lot of the evidence on Care Opinion, as I was saying, it really does mention COVID-19 a lot, whether it’s directly or indirectly. Like whether they’re saying, ‘oh I caught COVID and I went into hospital’ or whether they’re saying, ‘I went to A&E and I had a different experience because of the fact that everyone has to wear PPE’ or ‘it’s slightly different’ it feels slightly different’. So, there definitely is a lot of that and we can see that in the story numbers as well because at the start of last year when all of this kicked off, our story numbers did go down but then the health services realised that a lot of the other engagement that they do, not just with us, the other engagement they do, face to face with patients was much, much harder to do.

So, a lot of the boards were really promoting our service, they say, well we really want to hear from you but some of the more traditional methods that they had of engaging with patients had completely gone away, they couldn’t do them during the lockdown periods, so we started seeing story numbers creeping back up again so, we totally felt the impact but we’re now seeing higher story numbers like the first two months of this year, so April and May, we actually saw the highest story numbers at the start of a financial year that we’ve ever seen before.

Michael: And also Care Opinion is not just in Scotland, you’re all over the UK as well …

Fraser: Yeah.

Michael: … so that must be good.

Fraser: Care Opinion actually started in England and last year we launched in Northern Ireland. Care Opinion Northern Ireland works in a very similar way to the way that it does in Scotland. We work with the whole health and social care system over there and we also have Care Opinion in Australia so, my colleague Michael, works in Western Australia so, it’s really become embedded in their practice as well.

Michael: So, basically, if people are listening to this interview and they wanted to give, you know, feedback about a hospital appointment or even the doctors or even the dentist or that and other health providers available, you know, but they’re too big to list, how can people get on your website to basically review the service?

Fraser: So, there’s a few different ways that people can do it. The main way, more than 95% of people go straight on to the website. So the website address is: www.careopinion.org.uk. You literally click the button on the screen that says ‘Tell your story’ and it takes you through the process of telling your story. There’s questions that come up on the screen about what the story is about, the main body for the text is in there as well and as I said, it takes you through it, you press a button and it publishes it.

We’ve got lots of things on the site to make the site itself more accessible as well. The site itself is designed around the W3C web content accessibility guides to make sure that the website itself if accessible for people with visual impairments, all of the images have descriptive tags and using a screen reader it’s easy to follow the information on Care Opinion.

The site itself uses, what’s known as, style sheets for visual layout and we try to use as few tables as possible. People can change the text size on the website so, you can make it bigger, you can make it smaller but you can also change the contrast of the screen as well into different colours to help you read it. We’ve got a specific page that is for BSL users, so we’ve got some videos up there for people that they can look at those videos. We work with an organisation called Talking Mats, so you can actually tell your story through pictures as well so, there are pictures that you can use to represent different things in health and care and you can use that in your story.

We have a section of the website, you can change the language that you’re looking at the website in and the same if you’re inputting it in a different language, it would be translated as well. For some reason, they don’t have access to the internet, or for any other reason, we also have a free phone number that people can use which is 0800 122 3135 and that’s where people can do the same thing. If they haven’t got access to the internet, they can phone up, tell their story over the phone and we’ll actually input that story on to the site for them and all of our health boards as well, we give them free post leaflets. So, all of the health boards have copies of these where people can physically write, old school pen and paper, to tell their story too. And in Greater Glasgow and Clyde, there are always, in the different wards and the different service areas, they have … not at the moment because of covid, but we train up the boards on how to use volunteers and how to use patient representatives to help people to tell their stories. So, we’ll offer a whole host of training for the health boards. So, yeah, as you can see there’s tonnes of different ways and there’s lots of different support there for people to tell their stories.

Michael: I just wanted to ask you, I know we were talking about how people use your Care Opinion to give feedback but I wanted to maybe like touch on the kind of organisations that the mental health services and third sector services as well. I wanted to find out how beneficial that was for them, so what has the feedback been like from them to Care Opinion about the service that you run?

Fraser: So, interestingly, talking about mental health there because we look at lots of different service areas and what people say and how they say it and what their story content is, is always very, very different based on what condition they’re talking. So, if they’re talking about a physical condition, if they’re talking about mental health, it can be quite different.

We’ve had a lot of feedback from people about our service, one in particular I remember talked about how freeing it was, that they had a space that they could tell their story publicly but also that they had a space that they could tell their story publicly and be completely anonymous. So, one of the biggest things on the site is giving people anonymity. We don’t allow people to put their names up on the stories, we don’t share any information about the person and we also help people edit the stories if they’ve left some of that information in there. Especially for mental health services, it’s about giving that person the opportunity but also helping the boards, the health boards and the health services to recognise that there might need to be a different response depending on the type of condition that someone has and what it is they’re asking for.

So, we always say to the board, don’t just look at a story and give a corporate answer, respond to exactly what the person’s saying, what are they asking from you? Are they asking you specific questions? Respond to those specific questions and show that you’ve really read the story and that you’re really taking it on board so you can help improve your service. So, we have had very positive feedback from third sector organisations as well who use our data. They use our data for policies, so they’ll take lots of stories about their particular area of interest, so it could be learning disability, it could be cancer services, it could be asthma, it could be Alzheimer’s. So they can find stories on Care Opinion, and then use what people have said to help develop policy at a national level.

Michael: And I take it when people put a kind of a review up on Care Opinion, does that organisation then email the Care Opinion website back or do they just send their reply straight to that person?

Fraser: Well everything happens through the site. So, what happens is: someone puts their story up or they send it through the site, the site automatically emails them when we publish the story and then when they get a response from the health board or whatever service that they were talking about, as soon as they get a response, they get an email as well to tell them that there’s a response, so they just click on the email and it takes them straight to the site where they can see that response that’s from the service. And some people have it, they may tell their story, they may get a response from the board, or the health and care service and they can respond again, and the board can respond again. But a big thing is people can talk about multiple services in one story. I’ve seen it before where someone has said, ‘Oh, I phoned up NHS 24 for advice, I then had to get an ambulance in to Glasgow Royal Infirmary and in Glasgow Royal Infirmary, I was in all these different wards’. And I’ve seen it where someone has said that and that’s been three different services with a few different wards and they’ve got lots of response from all the different areas. So, that’s one of the fantastic things as well, you know, it’s not just one. You can talk about lots of services in your story too and you would hopefully get responses from all of them.

Michael: Okay, thanks Fraser.

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