Collecting data about service user satisfaction

November 4th 2013

Workshop in London

Background

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NIHR

Thank you to National Institute for Health Research, School for Social Care Research for funding.

This presentation presents independent research commissioned by the NIHR SSCR. The views expressed are those of the authors and not necessarily those of the NIHR SSCR or the DH, NIHR or NHS.

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Purpose of research

National Institute for Health Research School of Social Care Research (NIHR SSCR) invitation for proposals:

“People from black and ethnic minority groups report lower levels of satisfaction in both patient and service user experience surveys. If the equalities agenda is to be properly addressed in social care practice it is important to understand what lies behind these differences.”

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2010-11 Adult Social Care Survey Data

Quality of life scores:

White = 18.8Asian = 17.2Black = 17.7

Extremely or very satisfied with care services:White: 63%Asian: 53%Black: 52%Information and advice

very easy to find:White: 26%Asian: 19%Black: 25%

The way I am helped and treated makes me think and feel better about myself:White = 57%Asian = 59%Black = 57%2011, The Health and Social Care Information Centre

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The key question

Are ethnic differences in satisfaction caused by inconsistencies in the way different groups understand and respond to survey questions on satisfaction?

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Research questions

How do respondents understand and go about answering questions about satisfaction with social care services?

Does help from carers in completing questionnaires vary between groups and impact on how questions are answered?

What impact does translation have on how questions are understood?

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Cognitive interviewing

Understanding Recall

Judgement Response

Ask the survey questions and then use probing to explore the question and answer process

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Types of interview

Individual interviews with service usersIndividual interviews with carers or

relativesPaired interviews

Standard and Easy read questionnairesInterviews in English, Urdu and

Bengali/Sylheti

Findings

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There was no evidence that Bangladeshi and Pakistani groups are

systematically understanding questions in

a way which is different from white British people

Satisfaction

Whether needs are being met

What socialservices can offer

Standards of care

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“Social Care Related Quality of Life”

ControlPersonal CareFood and DrinkAccommodationPersonal SafetySocial lifeHow time is spentDignity

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What else we found

Carers’ involvement in answering questions can affect the answers given

Quality of translation does impact on understanding but may not explain differences

Respondents think beyond the specific services being evaluated

Some phrases are hard to understand but not only for BME groups

No evidence of systematic differences in how BME groups understand and respond

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Help with the questionnaire

Questionnaire is addressed to ‘you’.

‘Did you fill in this questionnaire by yourself or did you have help from someone else?’

31% of White complete questionnaire by themselves

22% of Asian complete questionnaire by themselves

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Translation

Adult Social Care SurveyStandard translations availableLow uptake of standard translations15% had translation as type of help (all respondents)36% Asians had translation as a type of helpCognitive interviews“It should be written in proper Urdu, if it is written like that then it would be good. It will be easier to read and understand …If you read it two or three times then you will understand it.”

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More than social care services

Whole social care systemGP, nurse, other health servicesPoliceInformal carers

Or not including social care from direct payments

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Questionnaire issues

Some lack of understanding of terms used:

undermine adequate

Two concepts in one question: Clean and comfortable

Use of smiley faces on easy read

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Recommendations

Consider tweaks to ASCOT questions where appropriate

Revise and test translated versions survey questionnaire and obtain more information on their

use

Encourage all local authorities to provide ethnicity by more detailed breakdown in data

Provide more guidance to carers on how to assist and the importance of recording service user views

Consider what can be learnt from the easy read versions and whether their use can be extended

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If you want further information, please contact

Margaret Blake

Senior Research Director

T. 020 7549 7009

E. Margaret.blake@natcen.ac.uk

Visit us online: natcen.ac.uk

Thank you