Lisson Grove and Woolwell Medical Centre.
Patient Survey conducted Dec 2011 and Jan 2012.
Report
19.3.12
This report is composed of 3 sections:
1) Observations from results and proposed actions
2) Survey results- patient responses as a percentage of total responses to each question.
3) Verbatim comments from Patient survey
A full explanation of the methodology and rationale for the survey is included in the Patient Representation Group Annual Report
1
1) Observations from results and proposed actions.
Abbreviations:
PRGC= Patient Representation Group Committee
PRG= Patient Representation Group
PM= Practice Manager
RM= Reception Manager
LG= Lisson Grove Surgery
WW=Woolwell Surgery
Observation from results/comments / Proposed Action / Responsibility / By WhenNearly ¾ of respondents felt that the reception staff were very helpful.
98% felt they were very or fairly helpful.
Woolwell respondents scored this measure slightly lower than Lisson Grove.
The results are very encouraging but the Practice would like to see continued increase in the score. / 1)Discuss and agree if there are any particular situations which would benefit from training and improvement.
2)Feedback research results to Reception team and gather suggestions about how they would like to change and improve their work style. Identify areas that they find difficult or would like to be trained in.
3)Consider possible reasons for the difference in response between Woolwell and Lisson Grove patients.
4)Prescription management –process review at Woolwell and implementation of any proposed changes.
5)Telephone training update- All Practice staff.
6)Commit to implementing an ongoing programme of adjustments and development. / PM/ PRGC/ RM
PM/RM
RM
RM
PM
Practice / May ‘12
March ‘12
May ‘12
April ‘12
April ‘12
March ‘12
70% of patients do not mind if others hear what they say in the waiting room, 21% would appreciate improved privacy. / 1) Implement “please wait behind the line” at reception desks- like airport check ins and some hospital clinics.
2) Replace the waiting room radio and speakers at Lisson Grove and ensure that it provides background sound at all times.
3) Ensure the TV at Woolwell (a gift from a patient) is always on at a level which provides some privacy to conversation without becoming annoyingly obtrusive. / PM/RM / June ‘12
70% of patients book their appointments by phone, 30% in person. Of those booking by phone, some 30% would prefer to book online. / The Practice has investigated the opportunity to introduce online booking. Unfortunately, at this time the technology available is not sufficiently advanced to be compatible with their clinical system and appointment profile. This will continue to be reviewed as advancements and changes are made. The Practice is aware that some surgeries with different clinical system suppliers are able to provide an online booking facility. / PM / Ongoing
Nearly 60% of L G patients stated a preference to speak to a particular GP. This figure was only 34% for WW patients. 22% of patients liked to speak to a particular GP some of the time.
Nearly 20% of people overall felt their preference was never or nearly never met. 37% of people were unhappy about access to a preferred doctor to a greater or lesser degree. / 1)The Practice recognises that in 2011 in particular it was unable to provide the continuity of care it would have liked to due to GP sickness and retirements. It apologises for the frustration that this caused to a large number of patients.
2)The Practice is in the process of a change in GP Partners. The majority of this transition will be complete in Spring/Summer 2012 which will improve continuity in itself but the Partners and PM are also working together to review staffing levels, work andclinic patterns and clinic content to maximise this benefit.
4)Keep patients informed about changes to doctors, anything that affects our appointment system and ways that they can use the Practice’s flexible approach to their advantage. Communicate via information sheets, posters and website homepage. / PM
Partners
PM / April ‘12
November ‘12
March ’12 and then ongoing
49% of patients are unaware of our text messaging service.
The most common reason for not attending a booked appointment was forgetting ( 41% of respondents)
followed by getting better (26%) and not being able to get away/having something better to do(15%).
Only 7% said that they did not know they had to cancel.
66% of patients felt that text reminders would help them remember appointments and 29% felt that appointment cards would help. / 1) Promotethe text service via poster/ communication campaign.
2)Implement a MOB number recruitment campaign.
3) Expand the text service to landlines for reminders to chronic illness clinics and flu jabs.
4) Raise awareness of the ability to opt out of the text service for the approx 10% of patients who are aware of the service but don’t like it.
5) Raise awareness of the ability to text back to cancel an appointment.
6) Ensure that patients take an appointment card away with them every time they book in person. / PM/RM
RM
PM
PM/RM
RM / May ‘12 /ongoing
Already actioned.
Ongoing
Ongoing
1)The majority of patients contacting the surgery wanted to see a GP or nurse as opposed to speak to them.
2)Nearly 50% overall wanted that contact to be the same day, with a larger number of LG patients stating this urgency.
Over 80% wanted contact the same week.
Only 10% of patientsdid not have a specific day in mind when they wanted contact to be made.
3)63% of patients were able to get a satisfactory appointment in their first contact but 17% stated they had to contact the surgery again to get a convenient appt.
Of appointments made, only 47% were considered very convenient although a further 44% were considered fairly convenient.
4)20% of patients felt that they could not get an appointment or a convenient appointment. Of these, 40% felt the day was inconvenient.
For WW patients the time of day and appointments available sooner were particularly important while LG patients felt they were unable to see their preferred GP. / Promote the benefits of phone appointments and reassure patients that their problem will be resolved by the duty doctor calling them back.
Practice to purchase notice boards for both surgeries dedicated to “Patient Speak” and run by the PRGC
Consider how phone manner can assist in promoting a positive image.
Consider a whole Practice team approach- review staffing levels, work and clinic patterns and clinic content (balance of phone, pre booked and emergency appointments).
Ensure all staff are informed about individual clinician specialities so that patients are directed appropriately and efficiently. / PM/PRGC
PM
PM/RM
Partners/PM
Partners/PM / July ‘12
June ‘12
Mar/Apr ‘12
Nov ‘12
May ‘12
Only 29% of patients rated our experience of making an appointment as very good. Although 75% rated it as very or fairly good. / Consider how phone manner can assist in promoting a positive image.
Consider a whole Practice team approach- review staffing levels, work and clinic patterns and clinic content (balance of phone, pre booked and emergency appointments).
Re-review observation in 6 month’s time / PM/RM
Partners/PM / Mar/Apr ‘12
Nov ‘12
Sept ‘12
28% of patients were unaware of how our system of making an appointment worked. / Raise awareness- Permanent poster/ patient information board / PRGC/PM / July ‘12
25% of patients thought the system of making an appointment (as described) was to some extent confusing. / Ask patients to explain the system themselves and publicise a variety of these explanations. / PRGC/PM / July ‘12
64% of patients considered feeling very unwell to be an urgent need but 23% stated running out of medication as urgent. A further 7% stated sick notes as urgent. / Consider what measures can be taken to encourage patients to plan their medication requirements better. Promote these on the PRG board.
Consider if sick notes can be managed in an alternative way. / PRG/Practice
PM/Partners / July ‘12
June ‘12
93% of patients were prepared to tell the reception team a little about their condition so that the doctor could assess them quicker. / Incorporate this into the appointment booking process and into our clinical system. / PM/RM / Jun ‘12
6% of respondents stated some sort of special need when using our service. This was only 10 patients so it is difficult to draw general conclusions. Members of the PRG were surprised that no patients identified themselves as requiring special provision due to them being carers. / Raise awareness of alternative language resources available at the surgery.(website, leaflets, translators)
The Practice was recently assessed across its range of provision by “Disabled Go” and reviews its equality policy and provision at least annually.
Raise awareness of Practice ability to “flag” individual requests by patients with special requirements- e.g “patient to be collected from waiting room due to difficulty with vision”. / Pm/PRGC
Practice
PRGC/PM / Jun 12
Ongoing
Jul 12
Respondents were evenly balanced across both surgeries with a good spread of representation across age groups. 66% of respondents were female. / Responses over represent WW and female patients but this is considered a reasonable reflection of those prepared to comment as measured by compliments and complaints made to the Practice throughout the year.
The pattern of patient responses is not considered to affect the Practice action plan in a biased or inappropriate manner. / N/A / N/A
83% of patients felt their overall experience of the surgery was very or fairly good with 77% stating that they would definitely or probably recommend the surgery to someone moving into the area. The scores were lower for WW patients. / 1)The Practice recognises that the ratings for overall experience and recommendation are comparatively low and aim to work together and with the PRG to improve the service it provides to it’s patients.
2) The Practice will continue to promote membership of the PRG in both the virtual and committee member formats and aims to be actively involved in any way that the PRG requires. / Practice/PRGC / Ongoing
The survey created a clear prioritisation list for service improvements for the PRG committee and Practice team to focus on. / 43%-getting an appointment with a doctor
13%-Time keeping
10%-getting an appointment with a nurse
7%- clinical care
7%- phone answering
6%- opening times
5%- customer service
4%- waiting room facilities
4%-patient information
The Practice aims to focus on “getting an appointment with a doctor” and will review progress via patient feedback in 6 months time. At that point it will agree further work areas with the PRG. / Practice
Practice / Sept ‘12
Sept ‘12
2) Survey results- patient responses as a percentage of total responses
Survey question / Patient Responses-Percentage (%)
Lisson Grove / Woolwell / Total
(All)
1)How helpful do you find the receptionists?
Very helpful / 75 / 71 / 73
Fairly helpful / 22 / 26 / 24
Not very helpful / 2 / 3 / 2
Not at all helpful / 1 / 0 / 0
Don’t know / 0 / 0 / 0
2)In the reception area, can other patients overhear what you say?
Yes, but I don’t mind / 66 / 73 / 70
Yes and I am not happy about it / 22 / 19 / 21
No, other patients can’t overhear / 1 / 2 / 2
Don’t know / 10 / 6 / 8
3)How do you normally book your appointments ?(tick all)
In person / 29 / 31 / 30
By phone / 71 / 69 / 70
By fax / 0 / 0 / 0
Lisson Grove / Woolwell / Total
(All)
4) Which would you PREFER to book appointments?(tick all applicable)
In person / 27 / 26 / 27
By phone / 54 / 52 / 53
By fax / 0 / 0 / 0
Online / 19 / 22 / 20
5)Is there a particular GP you usually prefer to see or speak to?
Yes / 57 / 34 / 46
Sometimes / 20 / 24 / 22
No / 23 / 41 / 32
6a)How often do you see or speak to the GP you prefer?
Always or almost always / 25 / 17 / 22
A lot of the time / 12 / 13 / 12
Some of the time / 48 / 50 / 49
Never or almost never / 15 / 20 / 17
6b)And how do you feel about that?
I am pleased with the service / 37 / 25 / 32
I don’t mind / 25 / 40 / 32
I am very unhappy about it / 7 / 8 / 8
I am quite unhappy about it / 13 / 10 / 12
I am a bit unhappy about it / 17 / 17 / 17
Lisson Grove / Woolwell / Total
(All)
7)Are you aware of our text messaging service?
Yes, I like it / 43 / 47 / 45
Yes I do not like it / 7 / 4 / 6
No / 49 / 48 / 49
8) People do not come to about 10% of the appointments they book. Why do you think that might be? Please X all you feel apply.
Got better / 25 / 28 / 26
Forgot / 42 / 40 / 41
Didn’t know you had to cancel / 5 / 9 / 7
Had no phone credit to call / 5 / 1 / 3
Could not leave the person they care for / 6 / 1 / 3
Could not get away from work / 8 / 13 / 10
Had something better to do / 3 / 2 / 2
Other (please comment) / 7 / 7 / 7
9)What do you think would help people to keep appointments in the future?
Text or phone Reminders / 70 / 62 / 66
Appointment cards / 28 / 30 / 29
More information in different languages / 1 / 3 / 2
Other-Please comment / 1 / 5 / 3
Lisson Grove / Woolwell / Total
(All)
10)Last time you wanted to see or speak to a GP or nurse
a) what did you WANT to do?
See a GP at the surgery / 65 / 67 / 66
See a nurse at the surgery / 16 / 18 / 17
Speak to a GP on the phone / 12 / 11 / 12
Speak to a nurse on the phone / 1 / 2 / 2
Have someone visit me at my home / 0 / 0 / 0
I didn’t mind/ wasn’t sure what I wanted / 5 / 2 / 4
11) and when did you WANT to see or speak to them?
On the same day / 54 / 39 / 46
On the next working day / 9 / 14 / 12
A few days later / 16 / 33 / 25
A week or more later / 7 / 6 / 7
I didn’t have a specific day in mind / 12 / 8 / 10
Can’t remember / 1 / 0 / 1
12) Were you able to get an appointment to see or speak to someone?
Yes / 65 / 61 / 63
Yes but I had to call back closer to or on the day I wanted the appointment / 19 / 15 / 17
No (go to Q15) / 16 / 24 / 20
Cant remember (go to Q16) / 0 / 0 / 0
Lisson Grove / Woolwell / Total
(All)
13) What type of appointment did you get?
To see a GP at the surgery / 63 / 61 / 62
To see a nurse at the surgery / 20 / 20 / 20
To speak to a GP on the phone / 16 / 20 / 18
To speak to a nurse on the phone / 1 / 0 / 1
For someone to visit me at home / 0 / 0 / 0
14)How convenient was the appointment you were able to get?
Very convenient (go to Q 16) / 57 / 37 / 47
Fairly convenient (go to Q 16) / 38 / 49 / 44
Not very convenient / 4 / 9 / 7
Not at all convenient / 1 / 4 / 3
Lisson Grove / Woolwell / Total
(All)
15) If you weren’t able to get an appointment orthe appointment you were offered wasn’t convenient, why was that?
There weren’t any appointments for the day I wanted / 38 / 40 / 39
There weren’t any appointments for the time I wanted. / 9 / 20 / 14
I couldn’t see my preferred GP / 26 / 10 / 18
The appointment offered was not soon enough / 13 / 26 / 20
I couldn’t book far enough ahead / 9 / 2 / 5
Another reason / 6 / 2 / 4
16) Overall, How would you describe your experience of MAKING an appointment?
Very good / 35 / 24 / 29
Fairly good / 47 / 44 / 46
Neither good nor poor / 8 / 19 / 14
Fairly poor / 8 / 9 / 8
Very poor / 2 / 4 / 3
17) Were you aware of the system before you read this statement
Yes / 74 / 71 / 72
No / 26 / 29 / 28
Lisson Grove / Woolwell / Total
(All)
18) Do you understand the system?
Yes, very clearly / 79 / 73 / 76
Yes but it is a bit confusing / 16 / 22 / 19
Not really, it is a bit confusing / 4 / 1 / 3
No, it is very confusing / 0 / 3 / 2
19)What do you consider an urgent need? Please X all that apply
Run out of medication / 26 / 21 / 23
Need a sick note / 8 / 7 / 7
Have felt unwell for a while and now feel a lot worse / 43 / 46 / 44
Woke up feeling dreadful / 19 / 21 / 20
Woke up feeling off colour and wanted some advice on what to do eg have a really sore throat but am not changing my plans for the day. / 2 / 1 / 1
Couldn’t get a routine appointment at a convenient time. / 2 / 4 / 3
Other (Please state) / 1 / 1 / 1
Lisson Grove / Woolwell / Total
(All)
20)When calling the surgery for an urgent appointment, would you be prepared to tell our reception team a little about your need so that the doctor can assess you more quickly?
Yes / 93 / 93 / 93
No / 7 / 7 / 7
If “no”, why is that?(please state) / 0 / 0 / 0
21) Do you have any special requirements when using our service?
No (go to Q24) / 91 / 97 / 94
Yes / 9 / 3 / 6
22) If “yes” could you give a little more detail please?
I have special requirements because:
English is not my first language / 0 / 67 / 20
I care for a family member/friend (and I am not paid for this) / 0 / 0 / 0
I Look after dependents / 0 / 0 / 0
I have hearing difficulties / 0 / 0 / 0
I have impaired sight / 14 / 0 / 10
I have a physical disability / 43 / 0 / 30
I have a mental disability / 14 / 0 / 10
I work full time / 14 / 0 / 10
Other (please state) / 14 / 33 / 20
Lisson Grove / Woolwell / Total
(All)
24) Are you male or female?
• Male / 36 / 33 / 34
• Female / 64 / 67 / 66
25) How old are you?
• Under 18 / 0 / 3 / 2
•18-24 / 7 / 11 / 9
•25-34 / 10 / 13 / 12
• 35-44 / 9 / 18 / 14
•45-54 / 24 / 17 / 21
•55-64 / 28 / 20 / 24
• 65-74 / 16 / 15 / 16
• 75-84 / 5 / 2 / 3
• 85 or over / 0 / 0 / 0
26)Which surgery are you registered with?
Woolwell / 0 / 99 / 49
Lisson Grove / 100 / 1 / 51
27)Overall, how would you describe your experience of the GP surgery?
Very good / 54 / 38 / 46
Fairly good / 33 / 41 / 37
Neither good nor poor / 4 / 14 / 9
Fairly poor / 7 / 5 / 6
Very poor / 2 / 2 / 2
Lisson Grove / Woolwell / Total
(All)
28) Would you recommend the surgery to someone who has just moved to your local area?
Yes, would definitely recommend / 49 / 39 / 44
Yes, would probably recommend / 34 / 33 / 33
Not sure / 8 / 16 / 12
No would probably not recommend / 5 / 8 / 7
Lisson Grove / Woolwell / Total
(All)
No would definitely not recommend / 4 / 3 / 3
Don’t know / 0 / 1 / 1
Which of the following services should we focus on?
Getting an appointment with a doctor / 43 / 43 / 43
Getting an appointment with a nurse / 9 / 11 / 10
Clinical care / 6 / 8 / 7
Telephone answering / 5 / 9 / 7
Waiting room facilities / 5 / 3 / 4
Customer service / 5 / 4 / 5
Time keeping / 11 / 15 / 13
Patient information / 6 / 2 / 4
Opening times / 8 / 4 / 6
Other (please specify / 1 / 1 / 1
4) Verbatim comments from Patient survey
As far as I am concerned, I cannot fault the services provided and the treatment that I receive.Handed in some paperwork, they said it would be ready in a week, takes nearly five weeks,
I wish they had told me straight not fobbed me / off and told to stick to the subject I had made / the appt / about.
Thank you for everything - no need to change a thing - I can find no fault.
My comments are more for the Woolwell service you receive - there are more options at Lisson Grove, you can never get appointments.
You are made to feel as if you are wasting time. No one ever seems to have time for me. As a buisness person, I am surprised that you are still in business.
Get a telly for Lisson Grove - change the way that patients are called as the beep is very irritating.
I would like to be able to book my appointment directly with my registered surgery.
I am concerned that the surgery is becoming so big that a personal service is lacking.
Not often a problem, but occasionally it is as you're always seeing different people and locums all the time. Service needs to be kept personal don't turn it into an outpatient's dept.
On a positive note, really like computerised renewal of prescriptions, it is an excellent service.
Dr/Patient relationships need to be improved.
Need a clearer definition of an emergency appointment, as if the next appointment isn't for two weeks, something may not be an emergency on that day