2013 Survey of the Patient Representative Group

The Patients Participation Group asked to review the appointments system.

73 patients responded to our questionnaire.

The results are as follows:

Would you be happy to speak to another member of the team for a non-urgent enquiry?

Yes - 93%

No - 7%

Would you be happy for the receptionists to enquire about the problem when booking routine appointments?

Yes - 71%

No - 29%

Would you be happy for the receptionist to enquire about the problem for urgent appointments?

Yes - 75%

No - 25%

Would you be happy to use the telephone answering system to support this (ie press 1 for medication enquiries, 2 for hospital appointments, etc)?

Yes - 85%

No - 15%

For non-clinical enquiries, would you like to be able to submit enquiries via a form on the website and receive an reply in a couple of days?

Yes - 82%

No - 18%

For non urgent appts could we please still be able to book on-line, and to be able to email a doctor /surgery for non urgent enquiries.

Would it be possible to reinstate afternoon appointments at Carterton on some afternoons of the week to give more appointment slots locally?

I have ticked Yes for these questions but am not entirely happy to discuss health issues with the receptionist though it does depend on the receptionist. I wouldn't like to be 'blocked' from seeing a doctor on the decision of the receptionist. However, I do think something needs to be done to relieve the current situation and I thank you for your written explanation, some of which surprised me. I am a patient of Dr Willby's and do find it very difficult to get an appointment with her. I had reason for a telephone emergency appointment last year over a virus where I couldn't stand up. This needed a follow up appointment a month later. On neither occasion did I see Dr Willby and nor did I make another appointment a couple of days later to see her - though I would have liked to have done! I can't say I am entirely happy about accessing medical help when I need it - either via A&E or a GP.

Do not see how a receptionist is qualified to make a decision on your medical condition

I think it works well considering that a good proportion of the enrolled patients are probably around my age and need a lot of attention

Information is key and knowing how the service is being used and which part is overloaded would allow patients to make a choice. They would know from that if they had made things worse or helped to improve it by their judgment

Has definately gone downhill recently. I know this is the case though with most surgeries.....

I am getting more & more concerned about how long it is now taking to book an appointment either in the surgery or on the telephone. My wife & I are now in our mid 70's with various health problems and it worries us that if we had serious sudden illness would we be able to see or speak to a doctor in time ?.I am recovering from a stroke from 2 months ago and I am afraid I do not feel able to respond to all the various matters brought to light in your very long drawn out report on the Group Results. Also for some unknown reason in printing a copy of your report a large amount of the printing was missing from the right side of an A4 sheet and I was unable to correct this fault. The first page was set up with a wide border on the left to display the picture of the surgery, an index and your addresses and telephone number leaving a reduced amount of space to the right for your "results" information. The second page had a similar blank wide border on the rightwith no text in it and leaving part of the text on the right side missing.

If it works beneficially for the Practice, encourage patients to: 1. Speak or otherwise communicate with a nurse to deal with issues that do not actually demand the professional attention of a GP - e.g. not diagnostic or prescriptive; 2. Encourage telephone appointments with a GP or nurse when a physical presence is not essential; 3. Also, encourage more email communication where feasible, with a reply provided in no more than 24 hours if possible.

I think that both question 4 & 5 are a really good idea, but it may be worth considering an option within both of theses to allow people to state if it is an urgent response is required. Sometimes you need to know something quite quickly but someone other than the doctor can help.

I never wish to discuss any medical problem with receptionist much prefer to send e-mail to Doctor/Nurse

Question 2 & 3 - I do not believe a doctor's receptionist " unless she is also a nurse" should enquire about a patient's medical problems, could I suggest the following- if a patient requests an urgent appointment the request , just as happens in A & E are screened by a practice nurse who would give advice or pass the enquirer over to the duty Doctor.

Regarding Q4: Would this mean that the enquiry is routed to different members of staff with particular experience of the subject ? If so, Yes, as ticked

No coments as it works well for us.

I think you are doing your best to satisfy everyone

Speaking for myself and friends who are patients of the surgery, the biggest complaint is the difficulty in getting to see Dr, Wilby and Dr, Hancock within a reasonable time. Often one has to wait two weeks and sometimes longer. Having read your report, one can appreciate some of the problems you have explained but when one has been seeing a particular doctor for, in many cases , years, it is natural that you want to talk to the doctor who knows and understands your problems and needs. It would probably be of help if the on line appointments system was rectified. It seems to have been off line for quite some time now. On the bright side, I have to say that the Burford surgery is extremly well run and has a very good ambience. The receptionists are very pleasant and helpful in carrying out a job, which at times, must be quite difficult.

When test results are returned to the surgery and are normal the information should be relayed back to the patient by any competent member of the surgery instead of waiting for the initiating doctor to become available

 

When test results are returned to the surgery and are normal the information should be relayed back to the patient by any competent member of the surgery instead of waiting for the initiating doctor to become available

4. Will only be helpful if the person answering the query has the authority and information to hand.

For 4 above - Options should be limited to max 4, or becomes over complicated for some users. For 3 above - Most patients would prefer to be triaged by someone medically trained. It is important for the urgency level to be correctly assessed; eg: Calling an ambulance may be the appropriate action. If manageable, perhaps a combination of all the above may be practicable.

If i ring the surgery foran appointment with the doctor i do not wish to discuss this matter with a receptionist, however pleasant they all are.

I am happy with the current system

The message on the answer phone is to long

I think that the current system works quite well on the whole. I feel that the practice do prioritise appointments to the best of their ability. Staff always appear to get you seen if it is urgent and follow up with a check phone call. I have always found the surgery to be approachable and staff have responded appropriately. I think that some patients may not consider their problems urgent or alternatively some patients will say it is urgent when it may not be urgent. As to receptionists enquiring about routine appointments I do not wish to discuss personal problems with a receptionist.

a couple of days to reply on a query about medication (mentioned on your intro sheet) is far too long. From experience if there is a problem with medication, eg dosage or reactions, an answer is needed as soon as possible, particularly when a child is involved. I find the current duty doctor system works well - if a problem is urgent enough to contact the doctor then it shouldn't matter which one a person sees as all medical notes are on the system.

The main issue I would have at the moment is that you can be waiting 20 to 30 mins after your appointment time, but are not advised that the doctor is running behind time! I think it would be helpful if a system similar to the the a& e hospital would be an improvement to advise patients how long they may have to wait before seeing a doctor

I appreciate that it is difficult to accommodate everyone, but it is frustrating when one cannot get an appointment with one's Doctor when booking 2 weeks in advance.

At busy times could it not be possible for more than one person to answer telephone calls, or is that already the case?

A key here is that one has at least someone to be able to talk to. The reason for saying yes to questions 2 and 3 is based upon the quality and telephone style of your reception team which is brilliant. If it wasn't then I think many people would say no to those two questions.

I would prefer contacting my GP directly via email, which i do on ocassions and this works very well. I rarely don't need to see him, but need his advice or action in prescribing drugs, referrals etc.

There is a long delay after the initial voice says 'Welcome to Burford Surgery' it need to be re-recorded.

I don't like using forms as they rarely cover what I would want to ask. However I would be happy to send an email setting out my query and for a doctor/receptionist to respond in a couple of days.

Manage appointments as best you can, with the resources you have; the Rest of the World can step into line! Humans, of any age, adapt quickly.

I welcome any of the above procedures that would make it easier and faster to speak to/arrange an appointment with a Dr when that is necessary

My preference is to see (or speak to) my own doctor within 24 hours for an urgent appointment. For routine enquiries, I'm very happy to wait longer, leave messages, see a nurse, speak to reception/admin etc. Examples on the types of circumstances that can be dealt with by the various (non GP) staff would be helpful.

As far as we are concerned, the system as it stands suits us, although this may not be the case for everyone, we have always been able to see someone within an appropriate timeframe taking into account the nature of the problem we have at the time.

I think it is very difficult to get a balance between speaking to a doctor because it is urgent or speaking to someone else when it is not. Would it be possible to have a triage system with maybe one of the nurses taking calls and then either offering advice or booking an appointment either telephone or visit with the on call doctor. Like they do in a hospital. i think that anyone who is anxious would benefit from the security of talking to a nurse. i really believe that it is not an efficient use of resorce to have a doctor sorting out hospital appointments and we are very lucky in our surgery that we have really pleasant receptionists who are more than capable of sorting out hospital appoints and loads of other non medical issues. We also have a really great person and system for medication that most other surgeries do not have. i think that anything that releaves medical staff to concentrate on patients who require urgent medical care is a good thing. i do appreciate that some of the patients are elderly and may find a phone tree and internet system confusing so maybe you could trial all these things. I am sure that every patient would rather have a doctor available rather than be tied up on the phone sorting out appointments. Sorry if this seems like a rant but it really isn't.

Crucial to retain some sort of duty doctor system for when patient feeling 'only talking to/seeing a doctor' will do. I really value this but am more than happy to discuss with receptionist etc how urgent it is .. you are all so lovely.

1) I would be happy to speak to another appropriate member of the team for non urgent enquiries. For example, I wouldn't expect to discuss clinical problems with a receptionist. 2)As stated, I would be happy with this but not for them to make valued judgements based on no medical training. Also, if I said I was not happy to discuss something with them, that would be acknowledged. 3) Same applies as section 2. 4) Although happy to use this system, wouldn't it prolong the agony of getting through to somebody with all the options this would entail? 5) Although I already use email, which I prefer, I would be happy to try this option. Your system would have to be compatible though with all the available media, i.e. smart phones, iPads, etc, that people use these days.

The phone call back system is good but it would be helpful to have appointments earlier or later in the day for people who work away from home.

I have to say, I love coming to Burford Surgery as everyone is always so helpful

The entire appointment system would be more efficient if there were more than one duty doctor on call in the mornings.

I thought it was working well!!! I have to use E-mail as I have hearing difficulties.

Generally I think the Practice copes well with appointments, but anything that streamlines the system and reduces Doctor involvement when not really required, should be tried and then assessed.

My experience is of the system overseas. In europe and elsewhere the local chemists are used to a much greater degree as professionals to whom one can go for advice. There is a wide range of questions (particularly to do with medication) that can be referred to a chemist which would aleviate the pressure on doctors. Similarly the practice nurses could be made more easily contactable by telephone at specific times of the day. The final point is harder to unravel: Most of us would like to be seen by 'our' doctor. That is by the same doctor eon each occasion. The current system obviously makes that almost impossible but were your computer system to hold that information and the receptionist to have access to it, telephone consultations would be quicker (no re-run of the history) and it might save some appointments where otherwise the 'duty' doctor feels he/she has to see the patient to find out about him/her.

It is good when it is working

It seems very hard to get an appointment these days!!!!!!!

I find the time between enquiry and telehone/actual consultation should have a failsafe of a maximum of 24 hours and No More!

 

Proposals

We are aware that our current duty doctor system has paradoxically made it more difficult to make an appointment with your usual doctor. We do want to improve continuity of care for our patients and plan to introduce the following changes to the appointment system:

A prebooked block of appointments in the morning.
The available doctors will then work as the duty doctor for the rest of the morning (more chance of seeing usual doctor).
Continue a single duty doctor system in the afternoon to deal with urgent enquiries that cannot be dealt with in the morning.

If your enquiry is about medication or hospital administration then one of the administrators may be able to deal with this - if you are happy to deal with them please let the receptionist know.

Perhaps we could send you blood results via text or email rather than using a surgery appointment for this?

We will continue to fight our corner at the local commissioning meetings to protect the service - increasingly we will be expected to take on more which will affect the routine service.

Are you happy with the suggestions?

Any comments or alternative suggestions