Intro

Over the last year, we have continued to improve our advanced questionnaires feature. This blog post provides an update on changes we’ve made and those still to come.

Released

Answers from questionnaires saved as FHIR Observation resources

Answers collected in advanced questionnaires are now saved as discrete data points in the patient’s record. PKB can configure specific questions or calculated fields to be extracted to FHIR Observation resources when building a questionnaire template. For example, every time a patient completes a GAD-7 questionnaire, the GAD-7 score can be saved as a FHIR Observation in the patient’s record. In this example, the generated Observation resource contains a reference to the patient, a reference to the QuestionnaireResponse it came from, the GAD-7 score, and the SNOMED code representing the GAD-7 score.

Organisations can retrieve these Observation resources from PKB using our FHIR API, allowing them to, for example, track a patient’s GAD-7 scores over time, without having to handle the rest of the questions in the questionnaire.

In the future, we will display these discrete data points in the patient’s record. For example, GAD-7 scores generated from GAD-7 questionnaires will be saved in a patient’s Measurements section, allowing patients and professionals to track how the score changes over time from the PKB UI.

Professionals and patients can optionally edit completed questionnaires

When sending questionnaires to patients via the PKB user interface (UI), professionals can optionally allow patients and other professionals to edit the answers. If a patient edits their answers, the professional who sent the questionnaire gets an email notification to let them know, and the questionnaire displays as ‘Amended’ in the UI. The professional can allow one of the following options:

The patient can edit completed answers.
Professionals can edit completed answers
Both the patient and professionals can edit completed answers

A professional sending a questionnaire that both they and the patient can amend after submission

This feature is useful when a questionnaire includes questions that the professional needs to answer, for example, when they are taking measurements in a clinic.

The thread view of a questionnaire that has been edited after submission viewed in the web application (L) and NHS App (R)

It is not always appropriate or useful to amend questionnaire answers after the patient has submitted them. By default, questionnaire answers will not be editable by anybody after the patient has submitted them unless the Professional chooses to allow editing.

Organisations can also allow patients or professionals to amend completed questionnaires that are sent via the API. Example API calls can be found on the dev wiki.

Professionals get an email notification when a patient responds to a questionnaire they sent

When a patient completes or amends a questionnaire that a professional sent to them, the professional now gets an email notification to let them know. This ensures that clinical teams know when patients have answered the questionnaires that they have sent.

Coming soon (Q3 and Q4 2025)

Patients can start advanced questionnaires via the UI

Later this year, patients will be able to start advanced questionnaires from the PKB UI. After this is released, patients will no longer be able to initiate simple questionnaires themselves. Patients will be able to start questionnaires by clicking the ‘Start consultation’ button, which will only be visible to patients in teams using advanced questionnaires.

After selecting one of the listed questionnaires, the patient will choose a professional from the team to send it to. If the team has team-based messaging enabled, the patient will not need to select a professional. Once completed, the selected professional (or the entire team, in the case of team-based messaging) will see the questionnaire in their inbox.

Clinical teams will still be able to send simple questionnaires to patients via the API or the UI if they have not yet moved to advanced questionnaires. Therefore, only workflows that rely on the patient starting the questionnaire will have to move to advanced questionnaires alongside this release.

If your organisation has clinical teams that rely on patients initiating questionnaires via the UI, please get in touch with your Customer Success PM.

Teams can choose whether their questionnaires can be started by patients

Clinical teams will be able to choose whether patients can start the questionnaires that they use. PKB will configure this when the questionnaire is added to the team. When the questionnaire is visible to patients, the patient will see it when they click ‘Start consultation’. If the questionnaire is not made visible to patients, the patient will not see the questionnaire when they click ‘Start consultation’. This allows teams to use questionnaires that they do not want their patients to be able to initiate themselves.

Advanced questionnaires CSV export: Table view

Professionals and coordinators will be able to export patients’ answers to a questionnaire in ‘table format’ (one row per patient) as a CSV, instead of the current ‘one row per answer’ format.

On the Questionnaires page, professionals and coordinators will see a list of questionnaires that their patients have responded to. They can choose to export the answers with the patients’ national identifiers, organisation identifiers, both sets of identifiers, or no identifiers.

The Questionnaires page, where professionals and coordinators can export questionnaire answers

The exported file will have one row per patient, with the questions appearing as columns. Where the questionnaire contains a calculated score, the file will have columns for the score and a description of the formula. This ensures that the person reading the answers on the CSV can check that scores have been calculated correctly.

Carers can complete questionnaires on behalf of patients

Carers will be able to complete questionnaires that have been sent to patients they care for. When a clinical team sends a questionnaire to a patient via the API or UI, the patient’s carers will also get an email notification allowing them to answer the questions. The carer is recorded as the author of the answers on the QuestionnaireResponse resource and it is clear in the UI that the questionnaire was completed by a carer.

The thread view of a questionnaire completed by a carer

Coming later

Professionals and coordinators can send a questionnaire to every patient in a team

Professionals and coordinators will be able to send a questionnaire to every patient in their team by clicking ‘Send questionnaire’ from the Questionnaires page. After clicking ‘Send questionnaire’, the professional or coordinator will select the questionnaire that they would like to send. They will then see a page that tells them how many patients the questionnaire will be sent to, and they will have to confirm they want to send it.