Health and Care Experience Survey 2013/14 Volume 1: National Results

4 GP Practices - Accessing Services

Summary

4.1 As in the previous survey, results relating to accessing GP practice services are generally less positive than results relating to the actual care received at the practice.

4.2 Amidst a set of results which, taken as a whole, are slightly less positive than the previous survey, 72 per cent of people rated the overall arrangements for getting to see a doctor as good or excellent. This is down 3 percentage points compared to 2011/12 and follows a decrease of 6 percentage points from the 2009/10 survey.

4.3 One in seven patients reported that it was not easy to get through to the GP practice on the phone. A positive finding however, was that 94% of patients found the person who answered the phone helpful.

Introduction

4.4 Often a patient's first and only contact with the NHS is through their GP practice. It is vital, therefore, that every member of the public has ready and appropriate access to their local primary medical services to ensure better outcomes and experiences for patients^[6].

4.5 In recognition of the importance of providing appropriate access, a toolkit was developed in 2010 by the Royal College of General Practitioners (RCGP) Scotland, the Scottish Government and other partners to help practices improve access to appointments, treatments and information and the Scottish Government made available to practices supporting material via the Productive General Practice website^[7].

4.6 A review of patient access to GP services across the country in partnership with the British Medical Association (BMA) has also been included in the GP contract agreement for 2014/-15, in order to support practices and NHS Boards to both better understand the challenges and to make any necessary improvements to Access.^[8],^[9]

GP practices - getting to see or speak to someone

4.7 Ninety per cent of survey respondents had contacted their GP practice in the last 12 months.

4.8 Of those people who could remember how many times they had contacted their GP practice:

• 57 per cent contacted it up to four times during the last 12 months;
• 43 per cent contacted it five or more times during the last 12 months.
• These results show an increase in the percentage of patients contacting their GP practice 5 times or more in the last 12 months (Figure 1).

Figure 1: How often patients contacted their GP practice in the last 12 months for 2011/12 and 2013/14

4.9 Patients were asked how easy it was for them to get through on the phone the last time they contacted their GP practice.

4.10 Of those patients who remembered their last experience of phoning the practice:

• 83 per cent found it very or fairly easy (40 per cent responded very easy and 43 per cent fairly easy);
• 17 per cent responded they did not find it easy.

4.11 This is a slight shift in responses from the previous survey, with less people responding that it was very easy to get through on the phone. The results now suggest that one in six find it difficult to get through to their practice on the phone (Figure 2).

Figure 2: Getting through on the phone in 2011/12 and 2013/14

Helpfulness

4.12 Patients were asked 'The last time you phoned the GP practice, how helpful was the person who answered?'.

4.13 Of the patients who remembered their last call, a very high percentage were positive about the person that answered the phone:

• 94 per cent found the person who answered very helpful or fairly helpful (64 per cent responded very helpful and 30 per cent fairly helpful);
• 6 per cent found the person was not very helpful or not at all helpful (Figure 3).

Figure 3: How helpful was the person who answered the phone at the GP practice?

Two working day access to see a doctor or a nurse

4.14 Each territorial NHS Board in Scotland is required to meet a HEAT^[10] standard that monitors the percentage of patients able to obtain access within two working days and to book an appointment in advance to an appropriate healthcare professional. GP practices are expected to provide reasonable and appropriate access for their patients as part of their services.

4.15 In the survey patients were asked, when they had needed to see or speak to a doctor or nurse from their GP surgery quite urgently, how long they had to wait.

4.16 Of those patients who were able to remember

• 85 per cent could see or speak to a doctor or nurse within two working days, the same figure as in 2011/12.

4.17 Fifteen per cent were unable to see or speak to a doctor or nurse within two working days. Of these:

• 46 per cent said they had not been offered a chance to see or speak to anyone within two working days;
• 36 per cent reported that the person they wanted to see was not available in the next two days;
• 12 per cent reported that the times available were not suitable for them;
• 6 per cent were unable for another reason.

4.18 For the HEAT standard we count patients as being able to obtain two working day access if they were offered an appointment, but turned the appointment down due to the person they wanted to see being unavailable or the time not suiting them.

4.19 Considering the results in this way, 92.4 per cent of patients were able to see or speak to a doctor or nurse within two working days, or were offered an appointment but either the person they wanted to see was unavailable or the time was not suitable. This is very similar to the figure for 2011/12 (92.6 per cent).

Booking an appointment in advance

4.20 Patients were asked if their GP practice allowed them to make an appointment with a doctor 3 or more working days in advance. Twenty-three per cent of patients said they did not know.

4.21 Of those people who did know, 78 per cent responded that their GP practice allowed them to book an appointment three or more working days in advance. This is a slight decrease (2 percentage points) in the positive answers to this question compared to 2011/12. (Figure 4)

Figure 4: Booking an appointment with a doctor 3 or more working days in advance

Preferred doctor

4.22 The survey asked patients if they usually saw the doctor they preferred when making an appointment.

4.23 For patients at GP practices where there is usually more than one doctor, 22 per cent of patients indicated that they do not have a preferred doctor.

4.24 Of the patients who have a preferred doctor, 76 per cent reported that they are usually able to see the doctor that they prefer. This is a 3 percentage point decrease compared to 2011/12 (Figure 5).

4.25 The ability of patients to see their preferred doctor is likely to be affected by the workforce of each individual practice. GP contractual arrangements are generally practice based with an emphasis on patient care being provided by the whole clinical team.

4.26 A recent workforce trend nationally is an increasing proportion of female GPs. As female GPs are more likely to work part time, this may have an impact on the ability of patients to see their preferred GP^[11].

Figure 5: Can patients see their preferred doctor at their GP practice?

Opening hours of the GP practice

4.27 Since 2008 an enhanced service arrangement has been in place to extend GP surgery opening hours beyond core hours. Participation in enhanced services are optional for GP practices and more flexible scheme arrangements, introduced last year to encourage more to offer extended hours, have increased practice participation in the scheme.

4.28 As part of the 2014/15 GP contract settlement the Scottish Government have an agreed commitment to an annual review of GP access, the results of which will be shared with patients and Health Boards and be used as the basis for discussion to make any necessary changes/improvements.

4.29 Patients were asked what they thought of the opening hours of their GP surgery.

• 78 per cent were happy with the opening hours;
• 12 per cent found it too difficult to get time away from work during opening

hours;

• 3 per cent responded that the opening hours were not convenient for

another reason;

• 7 per cent were not sure when their GP practice was open.

4.30 Compared with the previous survey, an increased percentage found that the opening hours were not convenient, either due to difficulty getting time away at work or for another reason (15% compared to 13%).

Overall arrangements to see a doctor or a nurse

4.31 Patients were asked to rate the overall arrangements for getting to see a doctor or a nurse in their GP practice.

4.32 72 per cent of patients rated the overall arrangements for getting to see a doctor as excellent and good. This is a drop compared to 75 per cent in 2011/12 and 81 per cent in 2009/10 (Figure 6)

Figure 6: Overall arrangements for getting to see a doctor in 2009/10, 2011/12 and 2013/14

4.33 82 per cent of patients rated the overall arrangements for getting to see a nurse as excellent and good. This has also dropped compared to 84 per cent in 2011/12 and 87 per cent in 2009/10 (Figure 7). As in previous surveys, patients rated the overall arrangements for getting to see a nurse more positively than getting to see a doctor.

Figure 7: Overall arrangements for getting to see a nurse