Miles Sibley: Hacking through the measurement maze

Last year, a report from the Health Foundation looked at quality measurement—including patient experience—across a range of healthcare services. It described a “measurement maze”, with multiple sources and numerous national bodies presiding over data collection. The potential usefulness of the data for trusts was “limited by the data being hard to locate online, with multiple spreadsheets to choose from and large Excel workbooks to download and navigate.”

To our small team at the Patient Experience Library, the Health Foundation’s analysis sounded all too familiar. The patient experience corner of the measurement maze is a tangle of datasets emerging from the Friends and Family Test, CQC patient surveys, NHS England patient surveys, complaints data, and more.  One recent study identified no fewer than 37 different types of patient feedback “on offer” to staff within UK hospitals.  

So as we thought about the measurement maze in patient experience, we started to wonder whether it might be possible to begin clearing a path through it. The Health Foundation had warned that it is “not clear whether there is a mechanism or organisation that maintains an overview of all the indicators in use across the system.” We saw that as an opportunity: if no-one was in charge, we didn’t need to ask anyone’s permission to make a start.  

Our first step was a challenge to ourselves. We imagined a chief executive of a trust saying “I want all the patient experience data for this trust and I want it now.” We wondered whether we could enable a PALS team to respond to a request like that with just one mouse click. Could a single click provide all the trust’s patient experience data, all in order, all up to date, and all in a format that would enable instant printing, e-mailing or online sharing? We thought that if we could achieve that, we could save people a great deal of time.

Developing the solution took months. We had to trawl endless CQC and NHS England web pages, identifying which contained useful data, and which were out of date, or contained broken links, or were barely navigable. Then we had to download vast spreadsheets and plough through complicated layouts and incomprehensible abbreviations. Finally we had to find a way to organise all the data such that every Trust could get one-click access to everything it might need.

We have now achieved exactly that—but we want to go further.

Putting all the data in one place massively increases the speed and convenience of access to patient experience evidence. NHS staff no longer have to wander, lost, through the measurement maze. But this is not just about access. It is also about insight.  

Having streamlined all the data, we can now start to cross-reference it—looking for commonalities or variances. For example, every national patient survey asks about cleanliness, as does every PLACE visit (Patient-Led Assessments of the Care Environment).  However, they all ask their questions in slightly different ways, and record the answers in different formats. So trying to cross-reference is very difficult.

We dived in again and spent more time going through every single question in every single dataset, to identify cross-cutting themes such as cleanliness, communications, leaving hospital (a known bugbear for patients) and so on. At the end of all that, we knew where all the data was, and how—with one mouse click—we could compare it.

We have hacked our way through the patient experience measurement maze and emerged, blinking, into a world in which it is possible to actually shed light on some of this stuff.  

That word “some” matters. We think there is more to do. We are keen to hear from patient experience staff and patient reps about what they think of our surveys and feedback tool, and whether they think it could do more.  Please feel free to try the tool (open access) and let us know what you think, via .

Miles Sibley is a Director for the Patient Experience Library—the national evidence base on patient experience and

Competing interests: MS is a Director of the Patient Experience Library. The library is entirely self-financing, it receives no grant funding and accepts no advertising.