Information is Power – Government Care Ratings or Peer Reviews? Which Would You Trust? comment on the VODG and NCF recently published discussion paper arguing the case for a return to a rating system.

The Nuffield Trust has been asked by the Government to carry out an independent review of whether there should be a single summary score which indicates the quality of care in organisations providing health care or social care – a ‘rating’.

On paper, it seems like a good idea, but realistically can care ratings ever work consistently?

With 12,500 or so separate providers operating across over 25,000 locations, how can the public be sure of any consistency in ratings?  The public themselves, by nature of their very number, provide the most reliable and consistent picture – surely their opinions need to have a platform?

The CQC are a government body and as such any rating system run by them may be suspected by the public of being biased, even if it is not.  If the task of rating care homes is outsourced then the justification for any selection decisions will need to be completely transparent, it is essential that ratings are trusted.

In their report “Empowering consumers of public services through choice-tools, April 2011” , the OFT said,

"The OFT’s mission is to make markets work well for consumers. This includes markets where government is involved as regulator, part-provider, or purchaser. The OFT supports long-term economic growth by ensuring that, where markets exist, empowered consumers and open competition drive innovation and productivity."

The VODG and NCF recently published a discussion paper arguing the case for a return to a rating system. In their paper they discounted peer reviews as being unreliable and moved on to making a case for a rating system. In their paper they say,

“The Good Care Guide, Find Me Good Care and NHS Choices are among the burgeoning websites that provide useful information about care options. Such schemes are laudable and enhance the information available to care consumers. However, they are voluntary, act as portals rather than offering analysis and may require the provider to pay to join.”

They go on to say,

“Are any reviews or judgments completely independent of providers? Even if they are, are they consistent across different providers? Do they cover the less good providers or just the better ones who are naturally keen to showcase themselves? Given the proliferation of websites, which ones should you trust?”

They make some valid comments, but The Good Care Guide, Find Me Good Care and NHS Choices are not the only companies collecting consumer reviews. The Good Care Guide is only one year old this month, and they are the oldest of those websites (review wise) and the first care home review site onto the scene. This is a very young and emerging market so it’s understandable that they have over-looked the work that is being done by Ipsos MORI, who have recently surveyed over 80,000 residents of care homes, nor have they consulted with Reevoo, the UK based World leading social commerce review provider.

Outside of social care, consumer reviews are fairly well established, perhaps the best-known online examples of which are eBay, Amazon and TripAdvisor.  Of course TripAdvisor and Amazon are not without their problems, but the market is mature enough to be solving it’s own issues.  Newer companies are learning from the accusations of manipulation or filtering of reviews and have developed tighter, more reliable models for collecting reliabl and trusted quality consumer reviews.

The VODG and NCF may not have consulted the OFT report - we can however assume that the Department of Health have. In their white paper “Caring for our Future” (published just 15 months after the OFT report), they make strong references to peer reviews, and the creation of the PQP (Provider Quality Profile) – which is fundamentally a collection of reviews pooled from the most trusted of the available review websites. The DoH white paper closely mirrors the conclusions of the OFT.

The OFT, having carried out thorough research and investigating all of the available experts in the field, used Reevoo as their example of best practice.

Of their report, the OFT says,

“We hope the information and case studies it contains will help in delivery and policy decisions facing government departments that use, or plan to use, consumer choice in public service delivery.”

“Increasingly, user-generated data is used to aid choice. Consumers often trust the views of other consumers more than those of firms or even the government, and the use of qualitative consumer experience can make complex decisions and comparisons easier.”

“The information contained within a choice-tool, particularly if it is standardised across service providers, can be helpful to consumers making choices between service providers and stimulate competition between different service providers. As a result, choice-tools can be used to make service providers more accountable to consumers.”

Taken From OFT report,

“Consumer feedback –  Reevoo ( is a consumer feedback aggregation and syndication service that displays over 500 million reviews to consumers each month. Reevoo’s reviews appear across 120 retailer, publisher and manufacturer websites and on its own website.

Reevoo is an example of a feedback tool that links consumers in several ways. Consumers can read other consumer’s verified feedback on products or services through reviews and can also direct questions to product owners. Experience has shown that consumers are very willing to help others in this way, with around 18 per cent of product owners agreeing to answer questions, contributing to a pool of 20,000 opted-in owners in around six months.

Reevoo collects reviews by contacting the customers of their manufacturer and retailer partners. This collection method provides a larger number of reviews than alternative software tools. With this volume of reviews,  Reevoo can offer consumers highly relevant review content and more accurate and genuine ratings.

With a small sample of reviews, or a sample in which the opinions of all purchasers are not accurately represented, it is easy for a vocal minority of dissatisfied purchasers to have a disproportionate impact on the overall verdict.

Proactively contacting consumers ensures that a representative range of opinions is gathered, resulting in a more accurate overall verdict.

The larger number of reviews enables consumers to find information tailored to their particular circumstances: a consumer with a large family may have different considerations when purchasing a washing machine than someone living alone.

Consumer trust in Reevoo is promoted by this collection method, which guards against fake reviews by only allowing verified purchasers to write a review.

Reevoo also ensures its reviews are trustworthy by not allowing companies to remove negative reviews or edit the content of reviews. Reevoo argue that even bad reviews are good for consumers as their research suggests that consumer trust increases when there are both good and bad reviews, and without any bad product reviews, consumers are highly sceptical of positive reviews."

There is a place and a need for both reviews and ratings.  If each social care provider collected Reevoo reviews that feed into the ratings system, perhaps the ratings would be perceived as offering a wider and more reliable picture. Certainly using Reevoo to gather reviews across the whole of social care would provide consistency and make strong financial sense.

Any ratings system will have its critics.  Reviews are a relatively new area for social care and as rightly pointed out the experience so far has not been especially positive. However it is very encouraging that the OFT have identified the value to be gained from promoting trusted customer reviews to help drive up the quality of social care. The creation of the PQP seems to further endorse this thought, especially given recent comments from Jeremy Hunt regarding the friends and family test.  We believe it is a cohesive vision shared throughout the government and we hope that it will continue to gain momentum.

Mark Sadler

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