Confidentiality warning: don't give feedback to NHS website

The new and very web-2.0 NHS website allows you to offer your opinions on the service you’ve received at your local hospital. Having had the opportunity to try it out, I’m just a little worried about its approach to patient confidentiality.

I was recently sent up to my local hospital for an X-ray, and was quite pleased to have an excuse to try the NHS facility out. Each hospital has a page labelled ‘your thoughts’, where you’re invited to write a short note about what you liked and disliked about your experience; and to rate the hospital out of 5 for cleanliness, pain control, staff cooperation, and so on. So I did; and within a day or so, allowing for moderation, the comments were posted on the NHS site.

But there’s quite a serious problem. I’m the only respondent for my local hospital so far. So in terms of the average ‘marks out of five’ by all respondents, my marks are shown exactly as I submitted them, making them directly and very personally attributable. You can see my name, the date I was at the hospital, and what I thought of it. It’s just as well I was nice about it.

It isn’t such a problem with the written commentary: you can write what you want, and self-censor as you go. But you don’t get that chance with a ‘marks out of five’ system. And it doesn’t allow for the rationale behind some of my answers: I didn’t rate them highly for pain control because, at the time, I wasn’t actually in pain.

In a situation like this where data and identity are gathered (and indeed displayed) simultaneously, normal statistical practice would say you shouldn’t publish any numerical results until a certain number of responses are in – five or ten, maybe. I’m actually quite shocked that the NHS isn’t doing this. There’s also a continuing risk, in that – with aggregated scores given (I think) as a round figure out of 40 – it will be possible throughout the early days to keep track of the scores as each new response come in, to work out pretty accurately what the last person said.

Until they sort this out, I’ll have to strongly advise people against submitting their thoughts.