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Practice receptionists more likely to receive negative patient feedback due to ‘role bias’

by Costanza Pearce
10 May 2019

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Practice receptionists are more likely to receive negative feedback from patients than other healthcare staff due to ‘role bias’, a new study has shown.
A team of Lancaster University linguists analysed 29 million words from 228,000 patient comments submitted to NHS Choices between 2013 and 2015.
The project found that positive words were used to describe receptionists only 57% of the time, a significantly lower percentage than for other healthcare professionals.
Surgeons were described with positive words 98% of the time, dentists 96%, midwives 93% and nurses 90%, according to the study.
Even the level of positivity within good feedback differed, with surgeons referred to as ‘outstanding’ and ‘brilliant’ while nurses and receptionists were described with less impressive words, including ‘lovely’ and ‘pleasant’.
Receptionists were also the group most likely to be labelled with negative terms such as ‘useless, rude, unprofessional, unhelpful, arrogant, patronising, aggressive and terrible’.
The study, published in a new book, found that this had little to do with whether receptionists were good at their job or not. Rather it was linked to the nature of their role.
Lead researcher Professor Paul Baker said: ‘Jobs that involve saving your life or delivering a new life are seen as more impressive than the more support-based work carried out by nurses and receptionists. Feedback has a role bias in other words.’
‘Linked to expectations’
Professor Baker added: ‘Rather than suggesting that receptionists need retraining or that surgeons deserve pay rises, we instead noted that feedback is very much linked to expectations and constraints around different staff roles.’
Co-chair of the Practice Management Network Steve Williams agreed that negative comments often relate to factors beyond the receptionists’ control.
He said: ‘Very often receptionists are not able or authorised to affect the expected outcome without reference to another individual and this can create a barrier.
‘Patients are not always aware of these constraints and see this as the receptionist failing to make a decision or being obstructive.’
Mr Williams added that patient participation groups could help counteract this by offering patient education around the limitations on receptionists’ ability to impact the services provided.
One of the reasons dentists receive positive feedback is, Professor Baker said, that ‘a significant proportion’ of patients have a dental phobia and are then pleasantly surprised when their negative expectations are not met.
He added: ‘While this is good for dentists, it raises a dilemma if we simply measure NHS success in terms of patient ratings.’
‘Bigger systemic issues’
According to the study, the poorer evaluation of receptionists was ‘strongly linked’ to patients taking offence when the receptionist was required to ask them personal questions to conduct triage.
Some practices have tried to pre-empt concerns that receptionists are ‘nosey’ by providing a recorded message explaining why they need to ask personal questions on the phone.
The research found that patients were also inclined to take it personally when receptionists could not give them an immediate appointment.
Professor Baker said: ‘[Receptionists] are often taking the flak for things that are not their fault but actually are indicative of patient frustration at bigger systemic issues – fewer appointments and longer waiting times are more likely to be the result of funding shortages that are beyond the receptionist’s control.’
Professor Baker told Management in Practice that things are likely to have continued to deteriorate since the data was collected.
He said: ‘The NHS is even more over-stretched than it was five years ago, which [probably] means that appointments are even less likely to be available and receptionists are even more likely to bear the brunt of the anger around this.’
Last week, a BMA report revealed that month-long waits for a GP appointment have increased by 15% in the last year, due to the ‘continuing shortages in the number of GPs working’.
Alongside waiting times and appointment availability, the majority of patient complaints were focused on ‘staff rudeness’, the research showed.
The study found that patient feedback was ‘overwhelmingly’ based on the social skills of NHS staff rather than their technical ability, even when the comment seemed to evaluate the technical aspects of a patient’s care.