Feedback and quality improvement as part of Standard B6

The Code makes clear that assuring the quality of care provided is central to the protection of patients, and that this requires chiropractors to continually look for improvements to the quality of care they provide. Quality of care is defined broadly: the degree to which care increases the likelihood of desired health outcomes, delivered in a way that is effective, safe, person-centred, timely, equitable, integrated and efficient.

This means feedback is not limited to formal complaints or satisfaction surveys. It can include:

• informal comments made by patients during or after treatment
• outcome measure data collected as part of ongoing care
• patterns noticed across multiple patients over time
• feedback from colleagues, staff or other healthcare professionals
• incidents or near misses recorded through safety reporting systems

Collecting feedback is only the first step. Standard B6 asks chiropractors to evaluate that feedback and use it to drive improvement. For some practitioners this may mean reviewing outcome measure trends across a caseload to spot where care plans are falling short. For others it may mean acting on a recurring theme in informal patient comments, such as confusion about exercise advice or difficulty rebooking appointments.

Small, consistent practices, such as routinely reviewing outcome measure data at set intervals, asking a simple feedback question at the end of a course of care, or holding a regular team discussion about safety incidents, can build a meaningful culture of improvement over time.

As part of your Principle B reflection, you may wish to consider:

• what sources of feedback and data you currently collect, formally or informally
• whether you have identified any patterns or themes in that feedback
• an example of a change you have made to your practice as a result of feedback or outcome data
• how you know whether that change has actually improved the quality of care you provide
• how you will sustain this as an ongoing process, rather than a one-off review

These questions align directly with focused reflection question 2b, which asks how you will review and improve the quality and accessibility of care you provide, and how you will ensure those improvements are sustained.

To support your reflection on quality improvement, you may find the following helpful:

• The Code of Professional Practice - Standard B6 on collecting and using feedback and data, and the glossary definitions of Quality (of care), Outcome measure, and Reflective practice
• RCC Chiropractic Practice Standard: Quality Improvement (2025) - the RCC's dedicated practice standard on this topic, covering patient outcome measures (PROMs), patient feedback and experience (PREMs), clinical audit, and adverse event learning, all mapped directly against B6 and related Code standards
• RCC Chiropractic Practice Assessment Questionnaire (CPAQ) - an RCC-developed online tool for collecting chiropractic patient satisfaction data, adapted from the validated General Practice Assessment Questionnaire
• CPiRLS (Chiropractic Patient Incident Reporting and Learning System) - the UK chiropractic profession's open-access incident reporting and learning forum, useful for the safety-incident-learning dimension of quality improvement