‘Soft’ Intelligence and Online Patient Feedback: Using Care Opinion for NHS Quality Improvement in Scotland

‘Soft’ Intelligence and Online Patient Feedback: Using Care Opinion for NHS Quality Improvement in Scotland

PhD Project - Emma Berry

Care Opinion is a website which gives patients, carers and families the opportunity to feedback on the care they have received. Care Opinion is one of many feedback methods used within the NHS but it is the only method which has been awarded the Scottish Government contract for online feedback.[1]

Care Opinion, and other online feedback posts, provides a rich source of data for NHS improvement. However, like other forms of ‘soft intelligence’[2], this data can be a challenge to process and use for quality improvement. Staff may struggle with how to respond to posts, how to make changes from posts and how to use this data alongside the other feedback methods used within their organisation.

This PhD project started in October 2019 and is funded by The Healthcare Improvement Studies (THIS) Institute. The project will explore how the feedback collected from Care Opinion is used for NHS Quality Improvement within Scotland, as well as exploring staff perspectives on how to increase its impact. In the first year, this project carried out ethnographic research with Care Opinion Scotland. 

More recently, I have carried out case study research with a selection of NHS Scotland health boards, to understand the range of engagement with Care Opinion. This has included interviewing Care Opinion story authors and moderators to better understand their experiences of online feedback. I have also interviewed policy makers and senior leaders to gather their views on this topic. Fieldwork will be completed by the end of December 2022 and the thesis submitted in Summer 2023.

Supervisors: Professor Louise Locock, Professor Marion Campbell and Dr Zoe Skea


[1]. Care Opinion. Care Opinion Scotland: the journey so far. 2018; Available at: https://www.careopinion.org.uk/resources/the-journey-so-far-aug2018-final2.pdf. Accessed 21st October 2019.

[2]. Martin GP, McKee L, Dixon-Woods M. Beyond metrics? Utilizing ‘soft intelligence’ for healthcare quality and safety. Social Science & Medicine 2015 October 2015;142:19-26.





Berry E, Skea Z, Campbell M, Locock L. Using humanity to change systems – Understanding the work of online feedback moderation: a case study of Care Opinion Scotland, Digital Health, vol. 8, pp. 1-13. 2022 https://doi.org/10.1177/20552076211074489