Patient Perspectives on Brighton and Hove GP Practices 2016

Key findings

• Patients generally felt that practice staff were good at giving them the time they needed to express their concerns.
• Patients felt that an excellent GP practice would have considerate and empathetic staff who ‘listened carefully’. Patients emphasised the importance of interpersonal skills in giving them confidence in consultations, and the ability to see their own named doctor.
• 22% of patents were seen for non-emergency appointments within a day, but 25% still waited longer than a week. Most people saw a doctor in a timely way for urgent appointments especially when the patient was a child.
• Just over half of patients felt that telephone consultations were not as good as face to face appointments. Carers tended to be appreciative but patients with autistic spectrum conditions and patients whose first language was not English found telephone consultations unsatisfactory.
• Many patients reported not being given choices about the treatments that they received.
• Awareness of annual health checks was much lower than should be expected and only small numbers of people were being invited to have a health check by their practice.
• The availability of information on cancer screening, smoking cessation and other preventative health services varied between practices.
• The majority of people gave A&E as their first choice for accessing an out of hours service but also reflected on the need to only attend A&E in an emergency.
• Less than half of patients knew how to make a complaint if they needed to and fewer patients understood the role of a Practice Manager.

Recommendations

Healthwatch Brighton and Hove is keen to work with local commissioners to help improve primary care services provided by GP practices. In the forthcoming year Healthwatch will liaise with commissioners to promote the following changes among GP practices in the city:

Making appointments

Practices should review appointment booking systems and make them as user-friendly as possible. Practices should work to reduce the number of non-emergency appointments that involve a week or more wait for the patient. Online booking should be promoted and made easier, especially for younger people.

Care

Patients should have a named doctor as the norm. • Choices and options about treatments should always be available and be discussed with patients. • Practices should be cautious in their use of telephone consultations. They should be used only for simple issues and for people whose special circumstances make a telephone consultation more convenient e.g. carers. They should not be used with people with communication difficulties or whose first language is not English.

Preventative health checks

• Practices should be proactive in publicising preventative health checks. Information should be visible in waiting rooms and personal invitations sent to patients. Innovative ways of improving awareness and encouraging take-up should be considered including using social media, text messaging and email messages.

Referrals

• Practices should communicate to patients whenever unanticipated delays are experienced in referrals to specialist treatment. This communication should be made by letter or phone.
• Hospitals produce a monthly bulletin that notifies patients of current waiting times for emergency and non-emergency appointments. The bulletin should be distributed to all GP practices and made available in surgery waiting rooms and distributed directly by GPs to patients given hospital referrals.

Equalities

• Practices should accommodate people with hearing impairments who find it difficult to hear their name called out in reception. Practices should encourage staff to use a more personal approach for patients with hearing impairments, personally engaging with the person being called or using a visual indicator.

Surgery environment

• Practices should better publicise complaints procedures and clearly provide complaints information on waiting room notice boards.
• Hand sanitisers should be available in surgeries and their use by patients should be actively promoted.
• Information on notice boards should be well maintained in surgeries.
• Surgeries should provide toys for children in waiting rooms.

Quality standards for personalised and empowered care

• We believe GP surgeries could benefit from a more coordinated approach to monitoring patient experience and developing person-centred practice. We would recommend using co-production to develop city-wide person-centred quality standards. These standards could then be used as a common framework to support personalised practice across the city.