November 2014 Results

Started 1 November.

Out of our 75 responses, 33 people are extremely likely to recommend us, 25 likely and 8 said they were neither likely nor unlikely. One person didn’t know. 2 people said they were unlikely to recommend us and 1 person said they were extremely unlikely to recommend us. This means that 77% of people are likely or extremely likely to recommend us to their friends and family and only 4% unlikely.

NB The 2 people who said they were unlikely to recommend us declined to answer any of the other questions. The person who said they were extremely unlikely to recommend us was unhappy with the appointments system.

We asked what we could do to make their experience better….

6 people said there was nothing we could do to improve with comments such as “it is fine as it is” or “I love Carlton House”.

3 people said it should be easier to see their “own doctor”. We are absolutely as accessible as we can be. Unfortunately some doctors are more popular than others (mainly because some doctors are newer). We cannot create more appointments with certain doctors. We would recommend that patients develop a relationship with 2 or 3 doctors so they can be more flexible about whom they wish to see.

4 people said that they would prefer a “better” appointment system. We do know and understand that the current appointment system does not suit everybody. NO appointment system is EVER going to suit everybody. However we feel very strongly that we have found a system that works for the majority of patients the majority of the time. We have no plans to change this and would recommend that, if people are really unhappy with it, that they approach a different general practice which may run a system that they are more comfortable with.

3 people said that it is difficult to telephone to make an appointment in the morning. The level of demand means that it is difficult sometimes to get through to the surgery. We understand this which is why all our phones are manned in the morning to try and reduce the time this takes. We have a fixed number of lines and a fixed number of staff and cannot improve this I’m afraid.

2 people said we should finish the waiting room. It is almost finished now. As the contractors can only work outside of our (long) hours it means that this has taken several weeks. However we hope you are pleased with the new look.

2 people said that the doctors should run to their appointment times better. We do work hard to try and see people in 10 minutes. Sometimes people have complicated problems or conditions which make this impossible. Also some patients come with several problems which they want dealt with in the same consultation. Some patients have an emergency requiring them to receive emergency treatment in the surgery or be referred to hospital – all of which takes significantly longer than 10 minutes. Some patients can take several minutes to get undressed for an examination. We make an effort to give each patient the time that they need. In addition the doctors are dealing with phone calls and blood results etc in between seeing patients.

All the rest of these points were made by individual people:

There should be more available appointments. We would be happy to receive suggestions as to how we could improve this – all the doctors and nurses are working to maximum capacity seeing full clinics each day as well as managing high volumes of telephone calls, paperwork and referrals. We don’t think we can create any more appointments. We cannot afford to employ more doctors or nurses. The only way to create more availability is to reduce the number of unnecessary visits to the doctor. Many people do see us who do not need to – eg for a sick certificate, a repeat prescription, a vomiting bug or a cold. We do try to reduce these demands but it is very difficult.

The seat covers should be removed. We have had new plastic seating in the waiting room now for about a month. This is our permanent new seating.

Is it possible to ensure that the same doctor is always available? I’m afraid not. None of the doctors is here full time. This is not going to change. We do understand that this is not how patients like things but everything we are now expected to do in primary care is designed to improve accessibility at the expense of continuity. You may wish to address this with the local MP.

Make better use of the website. Thank you! We would love to use our website more effectively. We firmly believe that the website could improve patients’ experiences of the surgery – both in knowing what to expect and knowing when they don’t need to waste appointments. We would genuinely LOVE to hear people’s ideas for how we could better use the website. It is updated very frequently and we think we use it well but clearly we could be using it better and would love more ideas.

The reception staff lack flexibility. Unfortunately we have to give our reception staff quite rigid rules to follow in terms of booking appointments otherwise some patients can be disadvantaged unfairly. However they frequently use their common sense and discuss any uncertainties with the duty doctor.

The receptionists are rude and unhelpful. I would only book in an emergency or go to A and E. We are sorry that this has been your experience of our reception staff and would be grateful if you would be able to pass on any particular experiences to our practice manager, Jan Swannell, either by letter, telephone or email. However these surveys have shown us that the majority of our patients actually find our reception staff very helpful and kind. Sometimes possibly they can be misconstrued as unhelpful when they are unable to give patients exactly what they want when they want it. Also sometimes they are very busy. You can of course choose to go to A and E but please bear in mind that this is designed for accidents and emergencies, not for routine matters, and that you are likely to see less experienced doctors.

Shorter wait to see the doctor. If this is referring to the time in the surgery then this has already been addressed. If it refers to the time between booking the appointment and getting the appointment then I’m afraid that this depends on who you want to see. Some doctors get booked up far more than others.

The intercom sound should be changed. The noise is annoying. We have already changed to a callboard system rather than using the intercom. The intercom is only used with patients we know to be visually impaired or when the callboard is not functioning properly. We can’t change the noise.

Quite often I have to see a locum. Apart from Dr Gordon who is covering Dr Woolf’s maternity leave (and who is an excellent doctor), we haven’t had any locums for 4 months and, now that we have a full complement of doctors, we have no plans to employ any locums in the future.

Have electric doors for wheelchairs or at least a bell so disabled people can ring it. We did have electric doors. They constantly were broken by people being too impatient to wait for them to open (they open slowly) and we cannot afford to keep replacing them. However we have always had a bell on the wall outside and there is a notice advising disabled patients to ring this and they will be helped to access the surgery.

All appointments should be available on the day and certainly not more than 2 days away. Some patients like very much to be able to book in advance. This is what we meant when we said that no appointments system would suit everyone. If we had this system then there would be lots of complaints from people who choose to book in advance.

What do we do now that is good or excellent?

6 people said we had friendly helpful reception staff who made them feel better.

3 people said it had always been a good surgery (and someone said it was “superb”).

3 people said everything was fantastic and thank you.

3 people said it was a friendly and caring surgery.

5 people said they could always get an appointment when they needed it.

2 people said the GPs and nurses were good.

3 people commented on the good telephone contact from the doctors.

These were other individual responses as to what we do well:

  • A sincere thank you to everyone.
  • Phone assessment on the day for emergencies.
  • Dr Vincent, Dr Dresler and Dr Matloob were singled out for praise by individual patients.
  • Doctors are helpful.
  • Doctors call back if there is no appointment.
  • Generally very happy.
  • Easy to see a doctor on the day.
  • The nurses are good.
  • The new waiting room is great.
  • Excellent customer service
  • Prompt prescription service.
  • You are improving.
  • It has been nice to see different doctors with different ideas.

Thank you for all the positive comments. They are always lovely to hear!

What changes would you like to see?

2 people would like it to be easier to get appointments. As already discussed I don’t think we can improve this but would be happy to hear practical ideas if patients have them.

2 people would like us to roll out electronic prescriptions. We were part of the first wave of this locally and were very pro-active. We were keen to be a part of this as it is likely to reduce staff time significantly. However it has been a disaster as the software did not seem to work. We have stopped doing it currently as it caused more headaches than it solved. We are very keen to take part in it again if the problems can be solved.

2 people would like more appointments after 5pm. We cannot employ more doctors purely to work later in the day. We have the same number of doctors working between 5 and 6pm as at any other time of the day. We also do extended hours.

2 people wanted less waiting time for advance appointments. This depends on who you want to see. You will be able to get an advance appointment for some doctors for next week. For others it will be four weeks. This is down to more patients wanting to see certain doctors. We cannot police this.

These were all individual responses:

Another phlebotomy session to avoid a wait of over a week. We could look into this. However this is funded externally and I am not sure we will be given this as urgent blood tests can still be done the same day at Chase Farm Hospital.

I would have liked to have been informed when my GP left and when my new GP started. I’m afraid this is neither practical nor affordable. However every change is put on the website as soon as we can so it is worth checking this regularly.

Have a separate room for the BP machine. I’m afraid we don’t have any spare rooms. However this is not something that needs to be private as it does not read out your results or require any undressing.

Appointment times to be more flexible. I’m not quite sure what this means. We cannot open longer hours than we currently do.

More opening hours. We are currently open from 8am to 7pm five days a week. We are not planning to alter this in the immediate future.

Have a specific doctor even if you can’t always see them. You do have a specific doctor.

Online booking. This will come by April 2015.

Commuter question – extended hours

18 people responded to this, all of whom were commuters/workers. Ages ranged from 20 to 49 and places of work were mainly in London with some in Hertfordshire.

Of the 18 responders: 8 wanted either evenings (6.30-7.15) or Saturday mornings (8-11am) and 3 were happy with early mornings (7.15-8am), evenings or Saturday mornings. 1 preferred evenings only and 6 preferred Saturday mornings only 1 person specifically stated that they didn’t want us to offer extended hours as they would rather take time off to see us in normal working hours.

For the PPG

For everyone who wants more appointments on the day someone else wants them to be more able to be booked ahead. We can’t please everyone all of the time but our complaints about appointments are relatively low and we probably have reached the optimum appointments service for our population group.

Many patients are unhappy that they find it difficult to see “their own” doctor whenever they want to. Primary care in the modern NHS simply cannot manage to run this type of system any more. We would think it better for patients to find 2 or 3 doctors that they are comfortable seeing and try to see one of these. Perhaps the PPG could find a way of running a campaign to encourage patients to feel comfortable with this?

Suggestions for the PPG:

  • Upgrade the toilet facilities
  • Upgrade the automated arrivals machine
  • Online appointments booking
  • Re-visit extended hours from April 2015 – with proper mail out to commuters finding out what they really want
  • Help us manage patient expectations of seeing “my” doctor
  • Consider ways in which the website could be more effectively utilised.