How to improve your patient survey scores
Having achieved top scores in the patient survey for all areas of access, Dr Stephen Parnell passes on the secrets of his practice’s success
Having achieved top scores in the patient survey for all areas of access, Dr Stephen Parnell passes on the secrets of his practice's success
Dr Stephen Parnell is a partner at the 13,000-patient Moss Grove Practice in Kingswinford, West Midlands – a twice-winner and current holder of the RCGP's patient participation award.
In the latest GP Patient Survey results it scored 93% in indicator PE7 for patients able to obtain a consultation with a GP within two working days – worth £2,979 in QOF points to the average practice.
The practice scored 92% in indicator PE8, covering appointments booked more than two days ahead, worth £4,437 to the average practice. Here he gives tips to practices on how they can improve their results in each question area.
Getting through on the phone
Q5. In the past six months, how easy have you found the following?
– getting through on the phone
– speaking to a doctor on the phone
– speaking to a nurse on the phone
– getting test results on the phone
Q7. Which methods would you prefer to use to book appointments at your GP surgery?
• Grasp the nettle on the issue of telephone access. Doctors at our practice phone in to check for themselves how long it takes to get through and it's something we've still got work to do on.
• Give out leaflets promoting other ways of obtaining prescriptions – such as online or via a pharmacy – to relieve phone pressures.
• Use touch-screen systems to allow receptionists more time to answer telephone calls quickly.
• Work with your PCT on developing your website to include information and interactive services. Making more use of the internet can free up phone lines.
• In future there will be a big extension of email consultations but it must be handled carefully with safety at the forefront.
Seeing a doctor
Q9. Were you able to see a doctor on the same day or in the next two weekdays the GP surgery was open?
Q10. If you couldn't be seen in the next two weekdays, why was that?
Q12. Last time you tried, were you able to get an appointment with a doctor more than two full weekdays in advance?
• Sit down and talk about how your practice is doing on these questions on at least a monthly if not a weekly basis. They are very important questions because, in the case of indicators PE7 and PE8 (questions 9 and 12 in the survey) they are linked to your QOF funding.
• As well as these regular meetings, our practice has two or three major meetings about access each year.
• Get the balance right between making appointments available on the same day and appointments in advance. Involve patients in the decision. Ask your patient panel what they prefer and if they would be willing to have restrictions on advanced appointments if it meant more available on the day.
• Allow for the fact that every practice is different. At our practice the feeling among patients was very strongly that they didn't want restrictions. But my wife works in a much poorer area nearby and her patients wanted to be able to have appointments on the day. They weren't so concerned about booking in advance.
• Make alterations to the balance of appointments but avoid stopping patients booking in advance if they want to. We created more same-day appointments by shifting the balance slightly but patients can still book with a doctor of their choice three months ahead.
Waiting time at the surgery
Q15. How long after your appointment do you normally have to wait to be seen?
Q16. How do you feel about how long you normally have to wait?
• Have a system in place to allow appointments to be swapped to other GPs in case GPs are running late with their consultations.
• Make sure you get communication right – always advise patients what is going on if there are long waits or if appointments have to be moved to another doctor.
Seeing the doctor you prefer
Q17. Is there a particular doctor you prefer to see at your GP surgery?
Q18. How often do you see the doctor you prefer to see?
• Put your hands up to patients and say that if a doctor is so overwhelmingly more popular than others, then they will have to wait longer. Of course in an ideal world all the GPs will be equally brilliant, but we don't live in an ideal world. And there is no way to square things completely because the more you have continuity of care, the more difficult it is to hit access targets.
• Manage holidays effectively. At our practice we have six partners all with schoolaged children and we have a three-year rolling rota for holidays. I already know when I'll be off in 2012. It is fair to all the partners and gives patients the notice they need to continue to see the doctor they want.
Q19. How satisfied are you with the hours that your GP surgery is open?
Q21. Would you like your GP surgery to be open at additional times?
• Offer extended hours – it's political suicide not to. I'm a supporter of the extended hours strategy but it may not have been handled very well by the Government.
• Seek the advice of patients. We met with our patient panel to get their views about when extended-hours surgeries would be more valued. We now offer three extended-hours sessions a week.
Indeed, in all aspects of access, it is important to involve patients when you can – although it's not always easy. We have got the top whack on all these access targets, and one of the reasons is that we have a lot of patient involvement.
But we are also lucky that our patients have good negotiation skills – we are from a relatively well-off area where most of them come from affluent backgrounds and are good communicators. At my wife's surgery the patients just shout. That makes it much harder for GPs to improve their patient satisfaction scores.
Dr Stephen Parnell is a GP in Kingswinford, West MidlandsPatient survey