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At the heart of general practice since 1960

How we scored 100% in the GP patient survey

Practice manager Carol Taylor explains why her rural surgery has some of the most satisfied patients in the country

Name Puddletown Surgery, Dorset

List size 4,100

Patient satisfaction The surgery is one of 54 practices that scored 100% in the GP Patient Survey

Full-time equivalent GPs 2.25

A manageable list size is key to providing quality care

Our list is gradually increasing by about 3% a year, and while we are increasing our facilities and services to accommodate, we don’t want to expand too quickly. We control our list by taking anyone who moves out of our area off it, whereas at one time we might have kept them on. We practise in a rural area, which covers about 10 square miles, and so when the list has expanded in the past, neither GPs nor nurses have been able to cope with the strain of making home visits further afield. Now if new patients want to register, we check very carefully where they live.

If we started to get too many patients on our list, the quality of service would fall. Luckily for us, we don’t have the large fluctuations in population seen in other areas and services are improving in other surgeries.

Our access policy has won patient approval

We run an open surgery between 9am and 10.30am, and patients don’t need to book an appointment. Patients can also phone to speak to a GP between 8.30am and 9am, and between 3.30pm and 4pm, although doctors will also ring patients back outside those slots.

If a patient rings and wants to speak to the doctor, we put them through. If the doctor’s already on the phone, the patient is called back straight away.

We have always run Saturday morning surgeries, for which patients don’t need to book an appointment - and they’re not for urgent cases, they’re ordinary open surgery appointments.

We trialled employing nurse practitioners but they didn’t work very well here, because access to the doctors was too good.

Having a patient participation group helps us improve our service

We’ve had a patient participation group since 2004. It’s a mature group that’s very good at harvesting feedback about the surgery. It has arranged education sessions - for example, last year it organised an asthma education session for other patients.

Complaints can help us to make useful improvements to our services - the patient participation group pointed out that evening appointments were hard to get, which prompted us to work to provide extra evening surgeries.

Our integrated nursing team ensures continuity of care

Our nursing team is popular because it delivers excellent continuity of care. The team of four reduces strain on our GPs by looking after patients in the surgery and in their own homes - they do practice and community nursing.

The nurses also have specialisms ranging from respiratory care and diabetes to palliative care and wound management.

Meeting patient needs improves job satisfaction for staff

Our receptionists can mostly say ‘yes’ to patients. This gives them a good sense of being able to give people what they want, which in turn provides job satisfaction. It’s horrible not being able to offer an appointment when somebody wants it, but if you can say, ‘come in and see a doctor this morning’, it makes everybody feel good.

It’s a positive feedback loop. When we’ve needed new staff we’ve been able to recruit quite easily.

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Readers' comments (10)

  • Congratulations, it must be very satisfying to have very supportive GP's who are willing to be flexible in accordance with the Patient need.

    Sounds idyllic, long may it continue and good luck.

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  • Very satisfied patients may get what they want .
    It would be useful to see the cost per patient,prescribing and referral counts.
    It may be the doctors are likeable and working smartly.
    Dissatisfied patients may have a point and I hope we learn from their comments too.

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  • I think you have leadership on quality not quantity. Well done. Bigger is not always better in GP which some seemingly cannot understand in government.

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  • surely the practice area of 10 square miles is a mistake? even 10 miles squared? Our rural practice area using piR2 is about 600 square miles. Now WE have difficulty with home visits near the edges!

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  • Vinci Ho

    All things great and small . Brilliant work, Carol.
    Key word here is 'manageable' , nothing more , nothing less . Something politicians do not understand or choose not to understand.
    'If we started to get too many patients on our list, the quality of service would fall.'
    Clearly , everything of big size is not the answer as perceived by some. It is not rocket science as far as sacrificing quality is concerned. But NHSE is certainly not the same channel and we have stories of rural practices dependent on MPIG got killed off....
    Full time equivalent GPs 2.25 , any of the the GPs are actually full time?

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  • isn't your success due to the fact you are allowed to keep things manageable.

    There has not been large increases in demand with a stable popn.

    Many practices are seeing 10-15% increases in demand associated with 10-20% patient turnover.

    I.e a large part of your success is being lucky ( or from the dr's point of view - clever) about choosing where you work

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  • Well done. General practice as it should be.

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  • this remind me of how i ran practice with 3600 as single handed for 28+ years. it was hard work but very satisfying in the end . being able to see patient when they want is the key to patient satisfaction. if you have to do the job, why not smile and do it. well done. congratulations.

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  • Russell Thorpe

    2K pts 1 FTE I aspire to 100% satisfaction and I congratulate your performance. I applied to close my list to maintain standards and had no support at all from NHS England. You try to provide a better service reduced use of secondary care but it isnt recognised at all you just earn less and get critised for using more medication than yoiur peers. Its a shame that the planned future for GP is the complete opposite of the practice described above.

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  • Just wait when the immigrants come

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