Benefits of using NHS Choices in conjunction with GP consultations

Customer Insight Public information
The Benefits of using NHS Choices in Conjunction with GP
Appointments
November 2012

Contents
• Sample and methodology
• What is the impact of NHSC on GP visits?
• How is NHSC used by the public in relation to GP visits?
• How is NHSC used before and after a GP visit?
• What other health information do NHSC users use?
• Executive summary
• Conclusions & Recommendations

Sample and Methodology
Type of survey Online pop-up survey on selected pages of the NHSC website
Methodology Online survey
Fieldwork dates August 2012
Sample Total sample completes n=2735
Sample distribution General public – self selecting sample of site visiting for themselves
Previous research
conducted
 2010: The Imperial College (commissioned by NHSC). Nelson. P,
Murray. J, Saleem Khan. Muhammad. NHSC Primary Care
Consultation Final Report, Imperial
 2011 survey: which in part replicated the study conducted in 2010
Other information Analysis has been undertaken primarily on those who use NHSC
alongside a GP visit = 1356
Sample & Methodology

Customer Insight Public information 4Base all respondents n=2735
Web pages the pop up survey was placed on Respondents who came
through to the survey from each
web page
Number of
respondents
Per cent (%)
Conditions – Depression (Introduction) 690 37
Conditions – Menopause 273 15
Behind the headlines 245 13
Conditions – Type 2 Diabetes 62 3
Search results 58 3
NHSC Homepage 52 3
Live well – hub 48 3
Service directory 40 2
Conditions – Urinary tract infection 33 2
Change for life 30 2
* A breakdown of web pages on which 1% of the respondents completed
the survey on is available on request.
Main website pages recruiting respondents.

What is the impact of NHSC
on GP visits?

Customer Insight Public information 6
Conclusions
1. NHSC has significantly reduced the frequency of GP visits
since 2011.
4. NHSC is viewed as a valuable source of health information,
particularly when used in conjunction with a GP visit.
5. NHSC and NHS Direct are the main health information sites
utilised amongst current NHSC users.
3. Deciding whether to visit the GP is a key driver for NHSC
usage amongst respondents who use NHSC ‘before’ a GP visit.
2. There is a significantly greater impact on reducing GP visits
when NHSC is used before and during a GP visit.
Key Takeaways
Almost half of the NHSC users use the site in conjunction with
a GP Visit. Amongst these respondents….

Half of all respondents surveyed reported to use NHSC
alongside a GP visit. Over two thirds of users utilise NHSC BEFORE a GP visit &
half utilise NHSC AFTER a GP visit.
All surveyed 100%
(n=2735)
YES 49%
N=1356
NO 44%
N=1194
Before appointment (70%)
N=944
After appointment (52%)
N=707
During appointment (6%)
N=84
Don’t know 7%
N=186
Those using NHSC for GP visit
Female = 80%
Male = 20%
 2%
• Respondents were able to
choose more than one occasion
• Despite an significant increase
since 2011, the propensity for
GPs to use NHS Choices during
a consultation remains low.
 3%
Significant change since 2011  
Have you ever used information from NHS Choices before, during or after a visit to your GP? Please tell us in what
ways you use NHS Choices when considering a visit to your GP?

Four fifths of NHSC users are female & aged between 25-64 yrs.
Two fifths of users have children aged between 0-17 yrs.
Gender
Female
80%
Male
20%
Age1%
4%
7%
21%
19%
21%
16%
8%
2%
Under 16
16-19
20-24
25-34
35-44
45-54
55-64
65-74
75+
Gender?, How old are you?, Do you have children under the age of 18 living with you?
Profile of respondents who use NHSC in conjunction with a GP visit.
Children
11%
14%
11%
31%
41%
Child/children
aged 0-4
Child/children
aged 5-12
Child/children
aged 13-17
None under 18
living with me
No children
36%
Base: All respondents who have used NHS choices
in conjunction with a GP visit 2012 = 1355

9
How does NHS Choices affect the number of visits you make to the GP / Practice Nurse?
25%
62%
6% 6%
27%
69%
4%
Decreases the number of
visits I make
Makes no difference Increase the number of
visits I make
Don’t know
2012 2011
Direct questioning does not reveal a significant decrease in GP
visits since 2011.
Base: Used NHSC in conjunction with a GP visit: 2012 = 1355, 2011 = 925
Only 6% of first time users
reported NHSC makes no
difference to the number
of GP visits in 2012
Impact of NHSC on GP visit.

34%
21%
25%
14%
3%
3%
Every 4-6 months
Less than once a
year
Every 2-3 months
Monthly
At least weekly
Don’t know
10
How frequently do you visit your GP for yourself or a family member?
Frequency of GP visits.
Every 6 months 22%
Monthly 17%
Every 3 months 27%
Less than once a
year
21%
At least weekly 5%
Don’t know 7%
2011
Base: All respondents who have used NHS choices in conjunction with a GP visit 2011= 925, 2012 = 1355
 2%
Note: 2011 and 2012
data is not truly
comparable
Indirect questioning demonstrates NHSC users have significantly
decreased weekly GP visits since 2011.
Represents the
majority of patients
with a long standing
illness.

How frequently do you visit your GP for yourself or a family member?
Base: All respondents who have used NHS choices in conjunction with a GP visit 2011= 925, 2012 = 1355
The average number of GP visits has significantly decreased
since 2011.
Average visits per year
2011 6.39
2012 5.59
 1 visit

How does NHS Choices affect the number of visits you make to the GP / Practice Nurse?
28%
31%
23%
33%
26%
21%
Before During After
2012 decrease in visit 2011 decrease in visits
Those respondents who use NHS Choices BEFORE & DURING
a GP visit show far greater propensity to decrease GP visits.
 5%
 5%
Base: Used NHSC in conjunction with a GP visit: 2012 = 1355, 2011 = 925
Impact of NHSC on GP visit.

14 29
25
26
29
13
12
17
8
6
18
20 30
33 7
Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree
13
NHSC has a significantly better impact on helping users manage
their own symptoms & reducing the need for a GP visit BEFORE and
DURING a GP visit.
To what extent do you agree/disagree with the following statement: I am able to manage my own symptoms instead
of visiting my GP.
Base: Used NHSC BEFORE a GP visit = 994, DURING = 84, AFTER = 707
I am able to manage my own symptoms instead of visiting my GP.
AFTER
BEFORE
DURING
51%
50%
43%
% Agree

14
• Additional site visits using most available data leading up to and during the survey
A total of 1.8 million users have decreased GP visits.
Source: Web trends
6 Million
1.4 Million
2010 2011
Swine flu lead
site activity in
2010.
1.8 Million
2012
12% of all
NHSC users

How is NHS Choices
utilised by the public?

72%
9%
8%
8%
2%
For myself
For my child
For an adult family member
For both professional (health)
and personal reasons
For both professional (non
health) and personal reasons
16
Three quarters of NHSC users visit NHS choices for themselves.
There has been a significant increase in NHSC usage for family
members.
Which of the following best describes the reason why you generally visit NHS choices?
Reasons why NHS Choices is visited.
Base: All respondents who have used NHS choices in conjunction with a GP visit 2012 = 1355
 10%
 5%
 9%
Data suggests NHSC
is a trusted and a
reliable source of
information amongst
users.

75%
57%
54%
51%
46%
37%
32%
19%
9%
4%
To find information on my symptoms / conditions
To learn about my treatment options
To help me decide if I'm going to visit my GP
To help understand information I was given during an
appointment
To look up information about medicines / side effects
To help me ask specific questions during a GP/nurse
appointment
To help me be more prepared before I see the GP /
Practice Nurse
To find information about my GP practice e.g. opening
hourse, contact details etc
Pregnancy info
Other
17
Becoming informed on symptoms/conditions & treatments,
deciding whether to visit the GP top the list of reasons users engage
with NHS Choices alongside a GP visit.
Have you used NHS Choices for any of the following reasons when considering to make a visit to your GP?
Base: Those who have used NHSC with a GP visit ; 2012 = 1355, 2011 = 925
Preparing for GP appointments could
potentially impact on the number &
length of GP visits, potentially
resulting in long term cost savings.
 5%
 4%
 2%
Reasons for NHSC usage alongside GP visits.
An increase in health &
treatment knowledge can
empower users to
manage their own
symptoms and to make
shared decisions with
their GP.

HOW IS NHSC
USED?
18
Users use NHSC to determine whether a GP visit is required: quotes
Base: All respondents who answered question n=75
In what ways have you used NHS Choices in relation to your GP visit?
“To check symptoms of an
illness for my son before
phoning GP for an
appointment to ensure I was
not wasting their time & his
symptoms were serious
enough to warrant an
appointment ”
“To find information on the GPs
diagnosis and treatment as i often come
out of the consultation thinking i should
have asked more questions but
do not like to take up more of the doctors
time so this web site helps and if i have
issues i can always ring the doctor”
“To consider my symptoms to find out
whether a visit to the doctor is necessary
and what he might diagnose so that I am
prepared to ask any questions”
“I will research symptoms online first and then
decide whether I need to see my GP”
“Using the symptom checker to see if the
symptoms I am experiencing require a GP
visit”
“To find out more information on
diagnosis, easier to browse at my leisure
and digest information.”
“Website narrowed down the cause and at times I
could maybe change diet or something like that,
meaning there was no need to visit my GP...”

How NHSC is utilised
before and after a GP visit?

13%
25%
19%
20%
14%
6%
1%
3%
14%
20%
17%
22%
18%
9%
2%
1%
Under 16
16-24
25-34
35-44
45-54
55-64
65-74
75+
Before After
Base Those who have used NHSC BEFORE a GP visit = 360
Profile of users who use NHS Choices BEFORE + AFTER a visit
to their GP.
AGEGender
81%
19%
80%
19%
Female
Male
• Women appear more
proactive seekers of health
information before & after
visiting a GP
• Younger users are more
likely to demonstrate
health seeking behaviour
before a GP visit and 45-64
year olds ‘after’ a GP visit
Base: Used NHSC AFTER a GP visit = 199

77%
68%
58%
47%
44%
44%
39%
23%
12%
3%
80%
68%
55%
50%
47%
46%
34%
22%
13%
5%
appointment
appointment
Practice Nurse
hours, contact details etc
Pregnancy info
Other
2012 2011
21
Checking for symptoms/conditions & deciding whether to visit
the GP remains the main drivers to use NHS Choices BEFORE a GP
visit.
Have you used NHS Choices for any of the following reasons when considering a visit to your GP?
Base: Used NHSC before a GP visit; 2012 = 944, 2011 = 678
 5%
Reasons for NHSC usage BEFORE a GP visit.
Preparing for GP appointments could
potentially impact on the number &
length of GP visits, potentially
resulting in long term cost savings.
An increase in health &
treatment knowledge can
empower users to
manage their own
symptoms and reduce
GP visits/ length of visits
& make shared decisions
with their GP.

79%
71%
65%
56%
46%
37%
32%
18%
9%
4%
81%
65%
59%
54%
49%
43%
31%
20%
11%
4%
appointment
appointment
Practice Nurse
Pregnancy info
Other
2012 2011
22
Checking for symptoms/conditions & understanding information
given during an appointment are the main drivers to use NHS Choices
AFTER a GP visit.
Base: Used NHSC after a GP visit ; 2012 = 707, 2011 = 507
 6%
 6%
 6%
Reasons for NHSC usage AFTER a GP visit.

NHSC has a significantly better impact on health & treatment knowledge
When used BEFORE & AFTER an appointment. NHSC has a significantly better
impact on reducing the need for a GP visit BEFORE and DURING a GP visit.
I know more
about my health
Thinking about when using NHS Choices for your appointment, please indicate how much you agree or disagree with
the following statements.
% Agree
I am more
confident to ask
questions
I am more
confident to
express my point
of view
AFTER
BEFORE
39 46
9
10
8
3
1
2
8
2
36
38 39
45 4
DURING
81 %
77 %
85 %
78%
70%
82%
Base: Used NHSC BEFORE a GP visit = 994, DURING = 84, AFTER = 707
I know more
about my
treatment
options 36 46
12
17
12
2
4
2
7
2
32
31 39
46 4
AFTER
BEFORE
DURING
27 44
17
14
19
5
6
4
4
3
31
29 44
40 4
AFTER
BEFORE
DURING
71%
73%
71%
27 44
17
14
19
5
6
4
4
3
31
29 44
40 4
AFTER
BEFORE
DURING
64%
66%
62%
14 29
25
26
29
13
12
17
8
6
18
20 30
33 7I am able to
manage my own
symptoms
instead of
visiting my GP
AFTER
BEFORE
DURING
51%
50%
43%
= significant difference between 2012 sub-segments

How valuable is NHSC to
the public?

Vast majority of users, including first time users, perceive NHSC
information to be valuable in supporting their healthcare needs.
How valuable is NHS Choices information in supporting your healthcare needs?
Before
During
After
8% 1%46% 45% 0%
Very valuable Valuable Unsure of value Not very valuable Not at all valuable
7% 1%48% 44% 0%
4%0%54% 43% 0%
8% 1%47% 44% 0%
Overall
No significant change since 2011
91 %
92 %
97 %
91 %
%
Agree
6% 2%43% 47% 1%First time users 90 %
Base Used NHSC in conjunction with a GP visit = 1355

26 1516 30 7
24 624 39 3
18 528 42 3
26
80% of users agree they are more knowledgeable & confident
about their health and treatment options. Two fifths agree NHSC
enables self management of symptoms and GP visits are not required.
I know more
about my health
(condition/illness)
When using NHS Choices for your appointment, please indicate how much you agree or disagree with....?
I know more
about my
treatment
options
%
Agree
I am more
confident to ask
questions
I am more
confident to
express my point
of view
Base: used NHSC in conjunction with a GP visit = 1355
12 332 46 3
81%
78%
70%
63%
I am able to
manage my own
symptoms
instead of
visiting my GP
9 335 46 3
43%
New question
 4%

74%
45%
61%
60%
53%
41%
31%
17%
5%
4%
74%
62%
53%
44%
39%
34%
32%
21%
13%
3%
appointment
appointment
Practice Nurse
Pregnancy info
Other
Long term disease
Short term disease
27
A significantly greater proportion of users with long term
conditions use NHSC to learn about treatment options and to look up
information about medicines/side effects.
Base: Long term disease = 581, No long term disease = 721
Reasons for NHSC usage amongst users with a long term condition.
 8%
 16%
 14%
 7%
 17%
 8%

31
22
16
15 5
13
19 32
27 8
24
24
7
4 3
25
23 40
38 3
16
20
6
4 3
28
29 40
43 3
28
Little difference in NHSC outcome between users with long term and
short term conditions.
I know more
about my health
(condition/illness)
When using NHS Choices for your appointment, please indicate how much you agree or disagree with....?
I know more
about my
treatment
options
%
Agree
I am more
confident to ask
questions
I am more
confident to
express my point
of view
13
11
3
2 3
33
32 46
46 3
82%
79%
71%
63%
I am able to
manage my own
symptoms
instead of
visiting my GP
10
7
3
3 3
36
35 47
46 3
40%
Base: Long term disease = 581, No long term disease = 721
82%
78%
69%
63%
51%
= Users with a long term condition
 11%

Significantly higher levels of satisfaction with NHSC when used in
conjunction with a GP visit – higher than general site satisfaction.
12%
8% 8%
2%2%
1%
35% 34%
37%
50%
8%
4%
Satisfaction Survey Dec 2012Who use NHS Choices with GP visit (anytime)
Very Satisfied Satisfied Neither satisfied nor dissatisfied Dissatisfied Very dissatisfied Don't know / NA
Low satisfaction
How would you rate your overall satisfaction with the information available on the NHS Choices website to help
you with your appointments?
Base: Used NHSC with a GP visit 2012 = 1355 / 2735
High satisfaction
71% Agree
Source: Quarterly satisfaction survey 2011
Base: 2452
85% Agree
Satisfaction levels with NHSC.

Base respondents n=1203
Reason driving satisfaction Per cent (%)
Base: 1084
Accuracy and reliability 33
Clear and understandable 22
Finding information 20
Ease of use 15
Amount of information 8
Accuracy & reliability, clarity of information and ease of
finding information are the key reasons driving
satisfaction amongst NHSC users.
Reason driving dissatisfaction Per cent (%)
Base:119
Finding information 33
Accuracy and reliability 25
Technical issues – broken links 21
Amount of information 12

Base: All respondents who answered question n=75
“It is useful to go to a trustworthy site to get
facts so I can think about the matter with
good information”
Half of your links are broken I am a
student trying to find some work
experience/advice in therapy to
develop a career and I am just going
around in circles!”
“NHSC gave me the facts in simple terms I
can understand. The recommendations and
advice is clear and warnings are
appropriate. ”
“It sends me to a broken link on NHS
choices, where it seems surprisingly
hard to look up hip pain specifically
without getting suggestions for all the
other pains i might have instead.”
“Concise, user friendly, easy to understand
information which has helped me to focus on
which symptoms to discuss with my GP and to
ask appropriate questions about those
symptoms and about treatment”
Clear and understandable/finding info
“Clear concise information, easy A-Z index”
“Very easy to find the information
you need and to determine whether
a GP visit is necessary if you are
unsure”
So that we can help improve our site experience, please can you say why you
were satisfied or dissatisfied with the information available on NHS Choices in helping you with your GP appointment?
At times the site is not available, this is
very frustrating when looking for
information”
“Make website easier to read and
understand it takes me an hour to
find what I want.”
SATISFACTION
WITH NHSC
NHSC satisfaction/dissatisfaction quotes

What other health
information sites do NHS
users utilise?

49%
41%
18%
16%
15%
13%
13%
NHS
Choices
NHS Direct
BBC
Health
Wikipedia
Facebook
Boots
WebMD
Netdoctor
Utilisation of NHSC and other alternative health information sites
has significantly decreased. Supports users have increased their health
knowledge.
Do you use any other internet sites when thinking about your health or visiting your GP practice?
20% of respondents
use NHS Choices in
isolation
11%
10%
7%
7%
7%
7%
6%
6%
6%
5%
5%
5%
5%
31%
Patient UK
Direct Gov
British Heart Foundation
BUPA
Arthritis Research UK
Cancer Research UK
Diabetes UK
Yahoo Answers
Mind
Asthma UK
Macmillan Cancer Support
Thyroid UK
Other
None
Base: All respondents who use NHS Choices in conjunction with visit 2012 N=1355, 2011 N = 925
 3%
 4%
 8%
 7%
 2%
 3%
 2%
 2%
 2%
 5%

GPs & Practice nurse tend to refer a significant greater number of
patients to Patient.co.uk than NHSC.
15%
65%
6%
2%
11%
15%
Don’tknowcant
remember
No
Other
BootsWebMD
(www.Webmd.boots.com)
NHSC
Patient
(www.patient.co.uk)
Has your GP or practice nurse ever printed materials or referred you to any other websites?
New question for 2012 survey

8%
71%
12%
9% 9%
68%
13%
10%
Don'tknow/
Can't
remember
No-itwasnot
mentioned
Yes-I
mentionedit
Yes-theGP/
ParacticeNurse
mentionedit
2011 2012
35
Approximately two thirds of users reported NHSC has not been
mentioned during a GP/Practice nurse visit.
Has NHS Choices ever been mentioned
during a visit to your GP or Practice Nurse?
Has your GP or Practice Nurse ever printed
materials or referred you to the NHS Choices site?
• Don’t know / Can’t remember = 8 per cent
Yes - referred me to
the site
Yes printed materials
from the NHSC site
Yes – gave me the website
address and refer to it in
own time
No, never printed materials
or referred to the site
38%
15%
12%
40%
Base: Those who used NHS Choices + had NHS Choices mentioned = 311

Summary

Executive summary 1: What is the impact of NHSC on GP visits?
What is the impact of NHSC on GP visits?
• Direct questioning in regards to the impact of NHSC on the number of GP visits
revealed no change in the decrease of GP visits since 2011.
• However, indirect questioning uncovered these NHSC users (those who use NHSC
in conjunction with GP visits) have significantly decreased the average number of
GP visits per year and weekly GP visits since 2011.
• Discrepancies between what respondents say they do and what they actually do is not
uncommon
• 40% of these users agree NHSC enables self management of symptoms and GP
visits are not required.
• Those respondents who use NHSC BEFORE & DURING a GP visit show far
greater propensity to decrease GP visits.
• 70% of NHSC users utilise NHSC before a GP visit and 10% utilise NHSC during a
GP visit.
• NHSC has a significantly better impact on helping these users manage their own
symptoms & reducing the need for a GP visit BEFORE and DURING a GP visit vs.
those using NHSC AFTER a GP visit.
Findings correspond to the 49% users who use NHSC in conjunction with a GP visit (N = 1355)

How is NHSC used by the Public in relation to a GP visit?
• 75% of these users visit NHSC for themselves, however, there has been a
significant increase in usage for family members. This indicates NHSC is perceived
as a trusted and reliable source of health information amongst current users.
• Overall, becoming informed on symptoms/conditions/ treatments and deciding
whether to visit the GP top the list of reasons for NHSC use.
• Checking for symptoms/conditions & deciding whether to visit the GP remains the
main drivers to use NHSC BEFORE a GP visit.
• Checking for symptoms/conditions & understanding information given during an
appointment are the main drivers to use NHSC AFTER a GP visit.

How valuable is NHSC to the public?
• Vast majority of these users, including first time users, perceive NHSC information
to be valuable in supporting their healthcare needs.
• 80% of these users agree they are more knowledgeable & confident about their
health and treatment options.
• There is a significantly higher level of satisfaction with NHSC when used in
conjunction with a GP visit – higher than general site satisfaction.

What other health information sites do NHSC users use?
• Use of NHSC and other health information sites has significantly decreased since
2011, indicating that perhaps NHSC users have increased their health knowledge.
• Majority of NHSC users also use NHS Direct as an health information site.
• Approximately two thirds of users reported NHSC has not been mentioned during a
GP/Practice nurse visit.
• A significantly greater proportion of NHSC users reported GPs & Practice nurses
tend to refer or print materials from Patient.co.uk than NHSC, 15% vs. 11%
respectively.

Conclusions

Conclusions.
• Data supports NHSC has had a positive impact on increasing health knowledge and self
symptom management amongst users who use NHSC in conjunction with a GP visit.
• As a consequence there has been a significant reduction in the frequency of GP visits
amongst this group. Extrapolation suggests 1.8 million users have reduced GP visits as
a consequence of NHSC use.
• This research study has revealed NHSC has a greater impact on reducing GP visits
when used ‘before’ and ‘during’ a GP appointment rather than ‘after’ a GP appointment.
However an increase in health knowledge occurs when using NHSC ‘before’ or ‘after’ a
GP visit.
• It is worth noting NHSC has become a trusted and reliable source of information
amongst users who use NHSC in conjunction with a GP visit. Data shows these users
have decreased usage for themselves, reflecting the increase in health knowledge, but
have increased NHSC usage for family members.
• It is fair to conclude the use of NHSC alongside GP visits can potentially result in long
term cost benefits by
• Increasing health knowledge amongst the public
• Empowering patients to self manage symptoms and reduce frequency of GP visits
• Encouraging shared decision making between the GP and patients and enhance GP and
patient relationship
• Reducing length of GP visits

Questions and comments to:
thechoicesteam@nhschoices.nhs.uk
please quote “Slideshare” in subject line

Benefits of using NHS Choices in conjunction with GP consultations

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