October 2014 Results

Started 1 October.

Out of our 79 responses, 30 people are extremely likely to recommend us, 36 likely and 7 said they were neither likely nor unlikely. One person didn’t know. Four people said they were unlikely to recommend us and one person said they were extremely unlikely to recommend us. This means that 83.5% of people are likely or extremely likely to recommend us to their friends and family.

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

 

7 people said there was nothing we could do to improve.

6 people said it should be possible to see their “own doctor” within a week. 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 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.

3 people said you should be able to book appointments a month in advance. You can book appointments 4 weeks in advance.

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.

2 people asked for better seating in the waiting room. Hopefully you have seen that this is being upgraded currently.

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

 

Keep doctors more than 7 days. All our doctors are now long term with the exception of the training doctors, Dr Gordon (who is covering Dr Wolff’s maternity leave) and Dr Friel who is here for 7 months whilst also lecturing at the university. We have acknowledged that we went through an extremely difficult 18 months when we used a lot of locums which is something we have not experienced before now. We are no longer needing to use locums except for maternity cover.

I don’t like having to tell the receptionist why I want to see the doctor. Our September survey demonstrated that this was unpopular and we have stopped this now (except for emergencies and home visits).

I want to be able to book an appointment with my own doctor in advance. You can book an appointment with any doctor for up to 4 weeks in advance. If they are here and not already fully booked you can book with your own doctor.

There should be regular blood tests for the over-60s. People with certain conditions are asked to have regular blood tests regardless of their age. People who think they may need a blood test can discuss this with a doctor or a nurse.

I want to be able to see my own doctor more easily. As has already been said, some doctors are much more popular than others. Those doctors get booked up very quickly. We cannot change this.

Have a larger reception area. We are limited by the building as there is no way to extend this. However our updated reception should be ready soon and will hopefully use the available space in a better way.

I want to have an allocated doctor not any doctor. You do have an allocated doctor but all the doctors work “part time” and are not therefore available every day. It is not possible for people only to see their preferred doctor although we would encourage people to try and see the same doctor for chronic conditions.

Polite stress-free reception staff. Some are friendlier than others. We would hope that all our staff are always polite although it is not always possible to reduce their stress completely! Please inform the practice manager if there are any specific concerns.

Fewer doctor changes. As already mentioned we have gone through a difficult period of change. We are very happy now with our team of 11 permanent doctors. We hope very much that this will be a stable team for several years – however in the modern NHS and the current primary care difficulties we cannot guarantee that.

Seats with arms in the waiting room. We are ordering some of these and hopefully will have these shortly.

Adopt patient choice service in January 2015. We are awaiting further advice and information from NHS England and the local Enfield CCG.

Get an English doctor as we English people are not entitled to an interpreter which is wrong. All our doctors speak excellent English and all have done most of their training in the UK. If you have any specific concerns then please raise these with the practice manager where they can be addressed appropriately.

Online appointments. They will come. Hopefully it will be possible to book some appointments on line by April 2015.

Sort out prescription issues – may go missing or have errors. We do try to manage these as well as we can. Several hundred prescriptions are dealt with by the staff daily. These all have to be signed by doctors as well as printed by the staff. Online prescription requests reduce errors and you are welcome to use these. Electronic prescribing has been rolled out in this region but unfortunately caused a large number of problems and is currently suspended.

One person made a specific mention of a particular issue which was clinical – this has been dealt with but you are welcome to raise it with the practice manager if you wish to do so.

 

What do we do now that is good or excellent?

 

5 people said we had good reception staff.

5 people said it had always been a good surgery

4 people said the availability of appointments was good.

5 people said the availability of telephone consultations was good.

2 people said the GPs and nurses were good.

2 people said they received excellent care.

 

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

 

  • Very well run practice.
  • Doctors call back if there is no appointment.
  • Blood tests at the practice.
  • Amazing GP!
  • Our receptionists Angie and Carol, and Dr Larkin were singled out for praise by 2 respondents.
  • Doctors seem knowledgeable.
  • Flu jab reminders.
  • The sign in the waiting room to call patients.
  • Waiting times are very good.
  • I am glad the waiting room is being revamped.

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

 

What changes would you like to see?

 

6 people said they didn’t want anything to change.

3 people wanted “our own doctor like we used to”. We know that a lot of people liked the service we used to be able to give where patients could always see their own doctor. However this is no longer always possible. This is partly because the doctor’s workload has increased significantly due to the complex nature of some patients’ needs. Some doctors would therefore be overwhelmed by very demanding patient requirements. Also many patients want to choose their own doctor and are not happy to be “allocated” a doctor. Therefore the more popular doctors would not be able to cope. In addition all the doctors are now part time. We think it is better to have 2 or 3 doctors that you feel comfortable seeing for any ongoing problems and try to see one of those. For an acute one-off problem it does not matter who you see.

Please note as well that many of the doctors who have been here longer (for example Dr Amarin, Dr Vincent and Dr Dresler) are seeing fewer patients due to doing more managerial work and this is unlikely to change in the near future.

2 people said we should redecorate and change the waiting room/surgery which looks dirty and unkempt. The waiting room is being updated currently. The surgery is obviously cleaned daily. We accept it looks quite shabby in many areas but we cannot afford to do all the work necessary to make it look better everywhere.

These were all individual responses:

Regular doctors. Hopefully this has already been answered.

Tell people if their appointment is delayed by more than 10 minutes. Thank you for this suggestion. We will look at whether this is possible.

Change the way appointments are allocated. We know we can’t please everyone and there will always be people who are unhappy with any appointment system. However this current system is working better than any we have tried before and we have no plans to change it.

Finally run health check MOTs for 40-74 age groups. We have been doing these for over 2 years. Do book an appointment if you would like one.

Offer later appointments. We do currently offer appointments until 7pm every evening.

Have the facility to make appointments 1 month in advance. You can book 4 weeks in advance.

Inform patients when their named GP changes. Each GP has approximately 1,200 patients. We simply cannot afford to write to them all every time a doctor leaves the practice. However we update the website every time there is any change and this is the best place to find out what is going on.

More full-time doctors. We have no full time doctors. It is no longer possible to be a GP full-time without causing burn-out. Most practices are the same. The doctors working 3 days a week are currently working around 33-36 hours a week, many of them more.

Clearer announcements in the waiting room. Hopefully the board makes that easier instead of relying on the tannoy system.

 

Commuter question – extended hours

 

18 people responded to this of whom 4 admitted to not being commuters/workers. Only 8 gave their ages (37-65) and 9 gave their place of work (Herts, North London, Hendon, London, Euston, Hoddesdon, Enfield, Edmonton)

Of the 14 people who may be commuters: 4 wanted either evenings or Saturdays and 1 was happy with any of these times. 4 preferred Saturday mornings (8-11am), 3 preferred evenings (6.30-7.15) and 1preferred early mornings (7.15-8am).

2 people 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