Patient Survey Results & Feedback
Thank you to those of you that completed our recent patient questionnaire. We focused on opening times, booking an appointment and your overall experience at the surgery. Your comments will help us to make decisions in the future as we plan how our services will look in light of the NHS reforms and new contracts.
About those patients that took part
We tried to ensure we had feedback from a representative group of patients. We have over 10,000 patients registered at the surgery and whilst we accept we cannot meet the exact needs of every patient, we do our best to make decisions which benefit the majority.
215 patients (2.15% of our patient list) completed the survey. 56% of respondents were female, 33% were male, and 11% did not say. We have a 51%/49% split in our practice population between males & females so these results were slightly biased towards females, but it is generally accepted that females access health services more often than males, so we felt this was reasonable. The age of the respondents was slightly biased towards our 65 and over patients, but again, it is accepted that this age group generally access their doctors surgery more frequently, so we felt this was acceptable.
49% of respondents said they used our Downend site, 28% said they used our Abbotswood site, 3% said they use both, and 20% did not specify. Our practice population is geographically split to be 2/3rd closest to Downend, and 1/3rd closest to Abbotswood, Yate. We do our best to split our services between them to these proportions and we would like to remind patients that they are welcome to be seen at either site. Our receptionists can book appointments at both locations.
Opening times
We were pleased to see that 85% of respondents were either very or fairly satisfied with our current opening times, and that 85% also said the surgery was open at times convenient to them. However, we acknowledge that there are always improvements to be made and we are currently looking at the options available to us.
We know there has been plenty of press coverage of the government plan for GP’s to work 8am-8pm seven days a week, but whilst this may sound like a perfect solution, it is not as easy or as practical as it seems. We’ll address the reasons for this later in this report.
5% of respondents said they were unsure of our opening hours, or didn’t know if the opening times were convenient to them. Our opening times are on our website are also shown below for your convenience:
Downend Surgery: Monday to Friday 8.00am until 6.30pm except Thursday when the surgery closes at 5.00pm
Abbotswood Surgery: Monday to Friday 8.30am until 6.30pm Closed 1.00 – 2.00pm every day except Wednesday when the surgery closes at 1.00pm
We also have a limited number of GP appointments available on a Monday, Tuesday, Wednesday and Friday evening for patients who are unable to attend the surgery during normal opening hours. At our Yate surgery appointments are available on a Monday evening between 6.30pm and 7.30pm. At our Downend surgery appointments are available on a Monday, Tuesday, Wednesday and Friday evening between 6.30pm and 7.00pm.
Our Yate surgery closes on a Wednesday afternoon to allow for a baby clinic to take place in the waiting room. We unfortunately do not have any other rooms large enough to accommodate this, but our general enquiries line is answered by the receptionists in Downend during this time, should you need medical attention when the surgery is closed.
Our Downend surgery also hosts a baby clinic on a Thursday afternoon, and we face the same issues with space, which is why we cannot run routine clinics during this time. Again, ourgeneral enquiries line is answered by the receptionists in Yate should you need to contact us during this time. In November, once our new building in Downend is open, we will be reviewing these arrangements as we will have dedicated meeting rooms.
Weasked which times you would prefer to access the surgery, and it was encouraging to note that many of you said our current opening hours were your preferred time, or that you had no preference. As we learn more about the government plans for GP surgeries to open longer, we will consider whether we can extend our opening hours to include Saturdays or to stay open later into the evening.
Joint Working
We asked whether you would support joint working between our surgery and another local surgery, to give us the opportunity to combine our resources and make better use of them. Examples of what this might mean to patients include improved surgery opening times, more early morning, evening and week-end appointments, a wider choice of surgery premises where you can be seen, more doctors and nurses with experience inspecific health conditions/areas and better care for elderly patients and patients with chronic long term and complicated conditions.
71% of you said you would welcome joint working, which is reassuring for us to hear. The current thinking amongst many doctors and their governing bodies is that the new NHS contracts and financial pressures faced by practices will challenge the traditional GP practice model, and those best placed for the future will be those ready to work collectively to make the most of their resources and any opportunities available.
From your comments, it seems the biggest anxiety around joint working is that continuity of care will be affected, and you won’t be able to see the doctor who knows you best. This is something we are aware of, and we will bear this in mind when planning services. We are still trying to understand how the NHS proposals to extend GP working hours as well as providing more continuity of care can fit together, and we hope you can understand that some of the decisions we make are driven by our contractualrequirements with the NHS, and not our personal preferences.
Booking an appointment
We asked how you would prefer to book an appointment with the surgery. Just over half of those who responded preferred to book by telephone, with a quarter preferring to use on-line booking. We have recently introduced on-line repeat prescription requests, and will be looking at providing on-line appointments in the coming year.
All surgeries have a limit on their capacity and resources, so we wanted to know how we could help you best if there were no suitable appointments available. 50% of those who responded felt our current way of working was the most suitable, which is that a clinician can ring you to assess your symptoms and find out how else we can help you – this is called ‘triage’. Each morning we have a dedicated clinician who can offer a range of services, from over the phone advice, arranging a prescription to be sent to a local pharmacy, or an appointment with an appropriate clinician in a timescale that fits your medical need.
We were surprised by how many felt the best way of helping you would be to ask you to try again later, as we feel this has caused frustrations in the past. Equally, over a quarter of respondents felt that coming up to surgery and sitting and waiting to be seen was the best option. Many surgeries have used this system in the past, and whilst it meant a patient was guaranteed to see a clinician, the long waits frequently caused frustration for those who worked, or had other commitments such as childcare, so it is not commonly used in local surgeries in South Gloucestershire. We are pleased to see our current arrangements appear to be the most popular option.
To help us to ensure we have enough appointments for those patients who need them, we ask that you consider other local health care services which you can access quickly. Your local pharmacist is qualified to give advice for many conditions such as coughs, colds, aches and pains, minor ailments and allergies as well as giving you advice about your medication and any side effects you may be experiencing.
We also have two minor injuries units within South Gloucestershire which are best placed to deal with wounds, strains, sprains, minor head injuries and other similar conditions. One is based at the Westgate Centre within Yate Shopping Centre (open Mon-Fri 8.30am – 7.30pm, Sat & Sun 10am – 2pm) and the other is based at Southmead Hospital (open 9am – 9pm every day).
To evaluate the usefulness of our triage system, we asked how many people had used it, whether their medical needs were addressed, and whether the outcome was convenient to them. 50% of the patients surveyed had used the triage system in the past six months,and our team were absolutely delighted to hear that so many of you had had a positive outcome.
Were your medical needs addressed appropriately by our triage system? / %Yes / 94
No / 5
Don't know / 1
Was the outcome convenient to you? / %
Yes / 92
No / 7
Don't know / 1
Your experience at the surgery
We asked you to rank the following statements in order of importance to determine what you value most at your surgery. We have listed them here in the order in which you said you valued them most:
1.Getting advice on the same day I need it
2.The doctor/nurse giving me the time I need with them
3.Getting a convenient appointment
4. Seeing the doctor/nurse of my choice
5. Being involved in the decisions about my care, treatment and support
6.A receptionist who is able to help me
7.The doctor/nurse running on time
We know all of these things can be important, but with limited resources we often have to prioritise what we do. We wanted to be sure we knew what you appreciated most, so we can try to protect and improve these areas.
We will continue to provide and build on our triage service, as we can see advice on the day you need it is the biggest priority for many of you. However, we do have to balance this against those patients with long term conditions who need to be monitored and reviewed on an ongoing basis.
Our frustrations and the challenges GP practices face
In analysing this feedback, it seems your frustrations echo some of the issues we face as a small business operating within sweeping health service reforms. We want to have an honest dialogue with you, our patients, so you can understand the difficulties all GP practices face in the current economic climate. We want to offer you the best service we can, but we know that we don’t always do that, and often our hands our tied. We don’t want this to be a political message, but we believe it is only fair to explain how it feels from ourperspective.
According to figures from the Royal College of General Practitioners (RCGP), In England, 10.55% of the NHS budget was spent on general practice in 2004-2005. By 2011-2012, this had fallen to 8.5%. The decline in funding for general practice comes despite the fact that general practice carries out 90% of all contacts across the NHS. Put simply, we are being asked to do more and work harder, with less funding to pay for the staff, services, and equipment that you deserve.
Dr Sarah Jarvis, a GP who regularly speaks on the One Show and the Jeremy Vine Radio 2 programme has written an article which sums up how many GP’s across the country feel, and we wanted to share her words with you, to give you an insight into the challenges GP practices are facing at the moment.
“In the 25 years I've been a GP, average life expectancy for women has increased by five years and for men by even more. Older people have far more complicated medical problems, and they're being discharged earlier and earlier after hospital admissions. When I became a GP 25 years ago, almost all my work with patients was checking them out when they were ill and making them better. The workload on behalf of most patients has almost doubled in the last couple of decades, because so much of our work now is about disease prevention and treating conditions likehigh blood pressure,type 2 diabetes and raised cholesterol, to stop them causing life-threatening illnesses in the first place.
In the hours between (and before and after) the surgeries where GPs see patients, they're checking patient blood test results (I can deal with up to 100 a day); following up letters from consultants (all of them have to be checked against the patient records and changes in medication etc, and put into place); liaising with hospitals, district nurses and social services; doing home visits for housebound patients; and spending more time than ever ticking all the right 'quality assurance' boxes to prove they're doing what they're already doing.
While people with long-term health problems make up a minority of the population, they make up the majority of the patients GPs see. If GPs end up working shifts, these patients are less likely to see their regular GP - which makes a mockery of the welcome plans introduced in this year's GP contract, to give every patient over 75 a named GP.
We can't just get the existing GPs to work longer hours - the average working week is 50 hours+ already, and working any longer would frankly make them unsafe to make life or death decisions. So it means we need more GPs - but it takes 10 years to train one of those, and there is a recruitment crisis in general practice as it is. A recent survey suggested that 60% of GPs are feeling so overwhelmed with bureaucracy and increasing demands that they're considering taking early retirement.”
That’s the reality many doctors across the country, including ours, are facing right now so please be patient with us if we can’t always give you everything you need at the time you need it.
That aside, we are really excited about the opportunities our new premises in Downend will bring, and we will be using the feedback you have given us to plan new services and influence the decisions we make across the practice.