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MOIR MEDICAL CENTRE - PATIENT PARTICIPATION GROUP

Regent Street, Long Eaton Wilmot Street, Sawley Banks Road, Toton

564 Patients Surveyed w/c -16th- 27th June 2014

Please note:- Not every patient answered every question and some gave multiple responses for some questions.

Q1. Which Surgery do you prefer to attend?

Q2. a) When did you last see a Doctor / Advanced Nurse Practitioner (ANP) at a Surgery?

In the past 3 months / 379
Between 3 and 6 months ago / 86
Between 6 and 12 months ago / 60
More than 12 months ago / 35

b) Was this at your preferred surgery?

Q3. a) When did you last see a treatment or clinic staff member at a surgery?

In the past 3 months / 257
Between 3 and 6 months ago / 89
Between 6 and 12 months ago / 84
More than 12 months ago / 110

b) Was this at your preferred surgery?

Q4. How do you normally book your appointments to see a doctor or nurse at the Surgery?

Q5. In the past 6 months how easy have you found the following?

Not needed to do this / Very
Easy / Fairly
easy / Not very
easy / Quite hard / Can’t remember
Using the online services / 307 / 39 / 25 / 22 / 18 / 7
Getting through on the phone / 25 / 52 / 132 / 128 / 201 / 2
Speaking to a Doctor on the phone / 165 / 71 / 124 / 48 / 58 / 21
Speaking to a Nurse on the phone / 258 / 38 / 70 / 30 / 34 / 26
Obtaining test results by phone / 209 / 92 / 105 / 28 / 20 / 18

Q6. In the past 6 months have you tried to see a Doctor / ANP fairly quickly?

By fairly quickly we mean on the same day or in the next two weekdays that the surgery was open.

IF YES, go to part b. Otherwise, go to Question 7.

b) Were you able to see them on the same day or in the next two weekdays that the surgery was open?

IF NO, go to part c. Otherwise, go to question 7.

c) Why was that?

Q7.

Q8. In the Reception Area, can other patients overhear what you say to the Receptionist?

Q9. How helpful do you find the receptionists at the Surgery?

Q10. Are you usually seen at your appointment time?

Q11. How often do you see the Dr / ANP you prefer?

Q12. How satisfied are you with the surgery opening hours?

Q13. Would you like the surgery open at additional times?

IF YES, please state what you would like ……………SEE NOTES PAGES…………………………………………………………………….

…......

Q14. The last time you saw a Doctor / ANP at the surgery, how good was he/she at each of the following - Please put a tick in one box for each row

Very
good / Good / OK / Poor / Very
poor / Doesn’t apply
Giving you enough time / 258 / 176 / 68 / 17 / 2 / 5
Asking about your symptoms / 231 / 178 / 72 / 16 / 1 / 12
Listening / 247 / 159 / 78 / 21 / 1 / 6
Explaining tests and treatments / 215 / 150 / 82 / 14 / 3 / 39
Involving you in decisions about your care / 190 / 151 / 87 / 20 / 6 / 46
Treating you with care and concern / 230 / 163 / 80 / 21 / 1 / 10
Taking your problems seriously / 232 / 156 / 83 / 22 / 4 / 9

Q15. The last time you saw a Treatment or Clinic Staff member at the surgery, how good was he/she at each of the following? Please put a tick in one box for each row

Very
good / Good / OK / Poor / Very
poor / Doesn’t apply
Giving you enough time / 234 / 176 / 32 / 3 / 0 / 50
Asking about your symptoms / 195 / 152 / 49 / 5 / 0 / 66
Listening / 218 / 162 / 41 / 3 / 0 / 46
Explaining tests and treatments / 193 / 146 / 53 / 2 / 0 / 66
Involving you in decisions about your care / 185 / 131 / 57 / 4 / 1 / 85
Treating you with care and concern / 213 / 157 / 45 / 4 / 0 / 48
Taking your problems seriously / 204 / 148 / 52 / 4 / 0 / 59

Q16. In general, how satisfied are you with the care you get at the Surgery?

Q17. Would you recommend the Surgery to someone who has just moved to your local area?

Yes / Might / Not Sure / Probably not / No
310 / 84 / 61 / 37 / 37

Thank you for taking part in our survey and sharing your views.

Notes Pages

A short summary

The Moir Medical Centre Patient Participation Group currently has 13 members and we would welcome some more pro-active members. We aim to represent patients' views, when we meet with the practice staff for 2-way discussions and exchanges of information. For further information please contact the PPG secretary, Elaine Jacklin on 0115 9721721 or email her at .

The previous survey undertaken by the Group (in 2011) covered a very small survey sample (174) however, this survey has covered nearly 400 more patients (564). This is still a small proportion of the total 13,000 patients we serve. (about 5%) We use these results as a rough guide to where our main points of interaction would be best placed.

Those surveyed were not fully representative of our patient range. The majority were patients over 50 years of age. Most of the over 70's were receiving regular health service from both doctors and nursing staff, over long periods. There were less than 10 patients under 20 years old.

Of the 564 responses, 21 patients selected more than one preferred surgery and 21 patients did not select any preferred surgery at the beginning of the survey. For consistency, if the patient selected Long Eaton and Sawley, the surveys were added to the Sawley responses. If Long Eaton and Toton was selected, the surveys were added to the Toton responses. For those who did not select a preferred surgery, their surveys were added to the Long Eaton responses.

The differences between the responses from the 3 surgeries were mainly affected by the size of each and the services offered there. The opening of the new Sawley Medical Centre is expected to have a major effect on where some services are provided. We intend to re-survey patients there to see if this is so.

As was expected, the main points of comment haven't changed since the last survey. These were the opening hours and the appointment booking system, especially when booking by phone.

Many patients have very high expectations and need to be more realistic. There are not enough appointments for everyone to be seen “on demand”. There are many reasons for this and you may be unaware of the following facts:-

There is a national shortage of GPs and less students entering training. Training lasts 9 years, from starting medical school, to be a full GP, which means there is no “quick fix”. The current pressures & the resultant stress levels on GPs are great and long serving ones are retiring early or changing to part-time hours. Newly qualified doctors are often preferring to work in hospitals or abroad.
The practice has a contract to provide NHS general medical services 8.00 – 18.30, Mon-Fri. In this time, staff not only have to cover surgery appointments but also home visits, repeat prescriptions, letters & reports, (reading & acting on those coming in and writing those going out.), training, (for them and by them), and meetings. A GP's working week can be up to 75 hours, which places great strain on the GP's and also their families. Newly qualified doctors don't always see this as desirable!
Several patients may have 'serial' appointments in one week. e.g. 1st with a doctor, who refers them for an urgent blood test; 2nd with a phlebotomist specialist nurse for the test; 3rd back to the nurse for the result and 4th back to the doctor to discuss the next steps. Because this leads to earlier treatment, it is great service for that patient but it may create a shortage of appointment slots for others.

Hospitals are aiming to discharge patients earlier, into Primary Care services. This cuts costs for the hospitals but increases the costs to Primary Care both financialoly and in demand on staff time.

For “Out-of Hours” service, phone the Health Service Helpline on 111

111 provides services, including access to GPs, when the surgery is closed.

A Long Eaton “extended appointment service” is currently planned to start in January 2015,

covering 4pm - 8pm weekdays & 8am – 8pm weekends. These appointments will be held in the Long Eaton Health Centre on Midland Street. The GP you see is unlikely to be one you know but should have access to your records.

If the 111 service doesn't feel you need to be seen by a GP they will advise you of other ways to get advice or treatment.

Even though the 0844 telephone number has been replaced with a local 0115 number and we have a completely new phone & IT system, patients are still experiencing problems getting through to make an appointment.

The surgeries do run slightly different booking systems, as their situations are very different.

There is no way the practice can meet all the patients’ ideal scenarios but we can work together to try and improve some of the concerns.

Roberta Dempster Helen Webb

Chairman Member & Survey Statistician

Moir Patient Participation GroupOctober 2014

The Main Topics – Some Survey Comments

(The figures in brackets show the number of responses for each type of comment)

We can't answer everyone but have added our responses to some. These are based on the PPG knowledge and are not from the medical staff.

Q13: Opening Times

More weekend appointments (45), Saturdays / Saturday mornings (50), Bank Holidays (3)

More evening appointments, as late as 10pm (106)

Open earlier (5)

Doctor on duty every day (16)

Blood tests available not just in the mornings (1)

Wednesday afternoons always seems to be closed for a meeting (1)- Sawley

This actually only happens once or twice each mont. Wednesday afternoon is traditionally when NHS training and meetings take place at local, county and national levels. Sometimes this leaves the Practice too short to operate a service, especially at smaller surgeries.

See notes about National GP shortages, on page 4

Best thing about your surgery

There were a huge range of responses, although the most common were:

Local (95)

Complimenting the doctors, nurses and receptionists e.g. helpful, friendly, professional

(some naming a specific doctor) (145)

Nearly always see a doctor on the same day / can see a doctor fairly quickly if you don't mind who you see (17)

Convenient pharmacy (13) - Long Eaton

The new Sawley Medical Centre shares the building with Manor Pharmacy.

Care provided (11)

Cleanliness (9)

Ability to call another Branch if no appointments at first choice (6)

Comfortable chairs and plenty of space (5) – Long Eaton

also at the new Sawley Medical Centre

Signing in on appointment screen and not having to wait to see a receptionist (3)

also at the new Sawley Medical Centre

What could be improved

Again, there were a variety of responses and the most common were:

Opening hours / appointments:

See notes about National GP shortages, on page 4 & 111 service on page 5.

and also see comment ondifferent appointment allocations in the “Brief report on the PPG patient survey 2014.”

Easier appointment booking system / telephone system / prefer to make appointment at any time instead of having to call at specific times to book an appointment, as telephones are often engaged (97)

Additional opening hours / increased doctor presence for appointments (92)

Shorter waiting time to be seen for appointment (22)

To be able to see the same GP all the time / doctor of my choice (13)

Not having to queue up outside the surgery to make an appointment (8)

Being able to pre-book appointments when specifically told to come back a week later (6)

This can be done by the person requesting this before you leave the room but they only have a couple of slots in each session, which they can book.

Have telephone appointments at all times as they are difficult to get (5)

Sort out those people who miss appointments (e.g. make people pay) (3)

3 missed appointments, without reason, results in the offender being asked to transfer to another practice.

Open more telephone lines at peak times especially in the mornings (3)

The number of staff using the appointment booking system is restricted. Telephone staff and desk staff have an equal allocation of slots.

Keep patients informed when doctors are running late (3)

This would need the person who is running late to notify the IT system & keep updating it, slowing them down even more. Running later than 15-20 minutes is quite rare and you couldn't do anything about it anyway, other than cancel the appointment.

Attitudes:

Have friendlier appointment staff who are not rude, sharp or impatient (5)

Doctors who are not rude / unconcerned when you see one and have better manners (4)

Both of these could apply to patients too. We are all human and are not perfect.

Doctors who have better knowledge, are better at diagnosing and more understanding (3)

Where would the new GPs go to get experience? Patients need to show understanding too.

Better communication between GPs (1)

Prescriptions:

Issue repeat prescriptions on time (1)

Get prescriptions to Tesco at Toton more easily (1)

The new (August 2014) GP & pharmacy online link is more secure and much faster but relies on patients registering their pharmacy choice at the surgery and also ensuring repeat prescriptions are requested at least 48 hours ahead.

Synchronise repeat prescriptions (1) Your registered pharmacist can do this for you.

Online repeat prescription system often faulty / unavailable (1) Not needed, if you have a registered pharmacist who can do it for you. (We'll still pass on your comment to the website manager.)

One patient said that they have very often been given someone else's repeat prescription and had to return it. On a more positive note, another said that the prescription system is very easy using the Internet.

Surgery:

Parking should be better (x5) and disabled parking (x1) – Long Eaton & Sawley
The practicecannot afford to provide major parking in Long Eaton and the public car park is close by. There are a large number of Disabled badge holders in Long Eaton and the Moir practice cannot reserve spaces outside the surgery just for its patients.

Better seating in waiting room (x9)

Privacy at reception – should be more discretion and it is not right asking symptoms in front of other people (x4)

It was suggested that there should be some music playing or radio, so patients don't have to hear others' issues.

Water dispenser should be available / free tea / coffee / biscuits (x4)

& More toys and books for children(x2)

Costs and Health and Safety regulations, (which are stricter for surgeries than other places), make these both unworkable. If you need a cup of water, because you are feeling faint for instance, you can ask for one at reception. Please bring your own child's books or toys but ensure you take them away with you.

Surgery could do with a facelift and paintwork needs to be brighter (x2) – Long Eaton

It has been redecorated, since this comment was made at the last survey.

Costs and Health and Safety regulations, (which are stricter for surgeries than other places) make this unworkable.

Clearer PA system in waiting room / doctors to shout your name clearer (x2) – Long Eaton

We looked into this. Firstly, some patients don't like having their name called out at all. The new Sawley Medical Centre has a scrolling text system but it is quite expensive and funding is currently not available to repeat this at Long Eaton.

Front door closer is too strong – I use a tri-rollator walker (x1) – Sawley

New Sawley Medical Centre has automatic sliding doors, with sensors.

Wheelchairs for less able patients (x1)

We looked into this but its not practicable - How many would be needed, where would they be stored and how do we stop them being stolen? There is however, one avialable for staff to use for patient emergencies.

Website (x1) More detail required, to be able to respond.

General comments

See notes about National GP shortages, on page 4.

The appointment system is inflexible and does not accommodate those who work further away from the surgery or patients' varying working hours. How would you recommend it is revised? Will the new 111 system help you? (See page 5)

The large quantity of patients calling at the specified times (8am and 1.30pm) is frustrating to many patients as they are having to call numerous times (as the line is engaged) to often find no appointments are left for that day. Responses suggest that more telephone lines should be open and patients would prefer to be able to call a few days earlier to book a non-emergency appointment.

Patients appear to be confused as to why there are sometimes no appointments left shortly after the surgery opens (i.e. surgery doors open or surgery appointments start?), especially when they have been told that they cannot pre-book appointments. These tend to be patients who want to see a specific person. Some appointments can be pre-booked. Ask reception to explain this.

Patients are hoping that getting an appointment will be easier when the new Sawley surgery opens and that the PCT will employ more doctors, with less turnover of doctors. However, one patient expressed their worry that when the new, larger surgery opens, the personal touch will go and be like the Long Eaton surgery where, “you're no longer a person and just a number”.

See notes about National GP shortages, on page 4.

Several patients were pleased that the 0844 telephone number had been replaced by a local number.

Responses show that patients are not happy with waiting times – one patient said that they had waited longer than an hour to be seen past their appointment time twice in the last two years and another had a telephone appointment where the doctor called them one hour after

the appointment time. Only the medical staff person who was running late can explain the reason for this.

Many patients say that they rarely get to see the same doctor and so it is almost impossible for the doctor to gain familiarity with an individual case. GP shortages mean Registrars and Locums are needed to fill in. This is considered better than having no service.

One patient said that since the building alterations at Long Eaton the room numbers should be clearly signed with directions to rooms out of view from the waiting area.

We looked into this and signposting is now done.

A difference of opinionis evident in 'best thing'and'needs improving' comments on opening hours, appointment time keeping, waiting room seating and general staff attitudes.

Some ideas for improvements are ‘in the pipeline’ and some of them may take some time to come to fruition. Please have patience with all concerned.