Moderation principles

Patient Opinion exists so that people can share the story of their care and have conversations with hospitals and staff that improve services. So our editorial policy aims to publish as many of the stories we are told as we possibly can. However, in a few cases we may need to make some changes. Here are the guidelines we use to make sure that this is done sensitively and with minimum change.


Moderation principles

There are four principles, which guide the Patient Opinion editorial policy:


1. Enable a clear, timely, public, constructive conversation about care.

2. Make giving feedback safe and easy for patients, service users and carers.

3. Encourage authentic feedback, based in personal experience.

4. Treat staff legally and fairly.


These principles guide the decisions made by editors. There are guidelines that come from these principles, which help our moderators to decide if and how they should edit a story.


Enable a clear, timely, public, constructive conversation about care

To ensure the conversation is constructive, we will:

(a)  Reject postings which are primarily commercial, obscene or irrelevant.

(b)  Reject postings relating to events which ended over two years ago.

(c)  Reject postings which we suspect may be untruthful

(d)  Remove obscene or offensive language, including racist, sexist, homophobic or other discriminatory material.

(e)  Edit postings to remove words which are capable of defamatory meaning i.e. - imputations which injure the reputation or business of a person or a group of persons or effect how others treat the person or group of persons

(f)   We may limit the length of stories, by heavily editing extremely long postings


To ensure the conversation is clear, we will:

(a)  Consider changes to the story title to make it more helpful to other users.

(b)  Replace upper case (CAPITALS) text with mixed case.

(c)  Make minor changes to spelling, punctuation or layout to improve readability.


Make giving feedback safe and easy for patients, service users and carers

To avoid identifying individuals, we will:

(a)  Remove all patient names from postings, even from positive postings.

(b)  Remove details which might identify an individual, particularly where we suspect there are small numbers of staff or patients in any one treatment area. This may mean linking the posting to generic rather than specific services, e.g. to a hospital rather than a speciality

(c)  Remove mention of specific dates and times.

(d)  Remove details which identify, or allow readers to possibly identify, a health provider entity of less than 10 employees

(e)  Remove details which identify, or allow readers to possibly identify, a group of individuals employed by or associated with the health provider entity. For example, a group of specialist doctors or a specific ward or managers or directors of a hospital.


Where there are postings that are part of a current, formal complaints procedure we will consider the impact of publishing them on the site. We will not publish postings if we become aware it could potentially prejudice any ongoing proceedings, whether they are complaints, claims, police coroner, or any other proceedings or investigation.


If we are concerned that the author of a posting may be vulnerable, we will take appropriate action to protect that person. This may include signposting the person to an appropriate agency for support, not publishing the postings or, in the most serious cases, we may contact the appropriate authority.


Encourage authentic feedback, based in personal experience

To avoid generalisation and speculation in postings, we will:

(a)Make sure that postings directly report the experiences, reactions or suggestions of patients.

For example, we will remove critical assertions about the whole hospital 'The whole hospital was filthy' may be changed to 'those parts of the hospital that I saw were dirty'. In general comments that are measurable ('it was not clean', 'they were 45 minutes late') are more likely to be published unedited than comments that are harder to measure ( 'the service was appalling', 'the whole place was a disgrace').

(b)Generally remove suggestions that indicate others should not visit a service, e.g. ‘Nobody should to go Queens Hospital’, as this is a generalisation based on one individual’s experience.

(c)Remove allegations or speculations about the character or motivations of health care staff or organisations, since authors do not know what motivates particular staff.

For example, ‘I wonder why the government pays these doctors’; ‘the managers were only motivated by money’.

(d)Edit to make clear that experiences relate to some staff, not all staff.

For example, change ‘all the nurses on Ward 15 were lazy’ to ‘all the nurses who looked after me on ward 15 were lazy’.

(e)Sometimes remove references to the care of other patients.    For example, ‘They gave the lady across the way the wrong tablets’. This is because the story should primarily relate to the direct experience of care by the patient themselves.

(f)Sometimes edit direct speech, quoting third parties, to indirect speech.

For example, ‘the nurse said “you’re a nightmare patient and we don’t want to look after you”’ to, ‘the nurse said that I was a nightmare patient and they didn’t want to look after me’.


Treat staff legally and fairly

To avoid defaming individual staff members or specific groups of individual staff members or entities with less than 10 employees, we will:

(a)Remove all staff names from critical comments.

In positive postings about mental health trusts, we will remove all staff surnames. However, in positive postings from non-mental health trusts we will keep surnames.

(b)Generally remove the name or identifying information about a third party.

For example, “Ward 15 cleaner Tracy said it was a disgrace and they had been told to keep costs to a minimum”. We will remove Tracy’s name.

(c)Remove identifying information where we suspect there are small numbers of staff in any one treatment area, and it may be possible to identify individual staff members or specific groups or individual staff members.

Recently read