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

6 GP Practices - Consultations with Doctors and Nurses

Summary

6.1 The 2013/14 survey results showed that patients were largely positive about their experiences of consultation with doctors and nurses. However, patients were less positive than in the 2011/12 survey.

6.2 Results also suggested that more could be done to involve patients in their care and treatment, over a third of respondents were not involved as much as they wanted to be in decisions about their care and treatment.

Introduction

6.3 The Charter of Patient Rights and Responsibilities was introduced through the Patient Rights (Scotland) Act 2011^[12] sets out what patients can expect when they use NHS services and receive NHS care in Scotland. It also details what the NHS in Scotland expects of patients in return. It aims to support good communication between patient and their carers and health staff to deliver high quality, person centred, effective and safe care, including empowering and supporting people in self-management and self-care where relevant.

6.4 This survey asks a series of questions on experiences of consultation with doctors and nurses, which encompass a number of these aspects of care.

Doctors

6.5 Of patients who had visited their GP surgery in the last year, 93 per cent had seen a doctor.

6.6 Patients were asked how much they agreed or disagreed with six statements about the last time they saw a doctor at their GP surgery:

• The doctor listened to me
• I felt that the doctor had all the information needed to treat me
• The doctor took account of the things that matter to me
• The doctor talked in a way that helped me understand my condition and treatment
• I felt confident in the doctor's ability to treat me
• I had enough time with the doctor.

6.7 In general the responses were positive. The lowest scoring statement, that the doctor 'took account of the things that matter to me', still received a response of 87% positive, whilst the highest scoring statement 'the doctor listened to me' received 95% positive.

6.8 However, these most recent survey results suggest a slight worsening of experience in doctor consultations when compared to the previous survey. Five of the above statements were asked in the previous survey, and of these five, four have got less positive and the other has remained the same (Table 1).

Table 1:Summary results of questions about doctors

Statement	Strongly agree /agree (%)	Neither agree nor disagree (%)	Disagree/ strongly disagree (%)	Change from 2011/12
The doctor listened to me	95	3	2	0
I felt that the doctor had all the information needed to treat me	90	7	4	-1
The doctor took account of the things that matter to me	87	10	3	N/A
The doctor talked in a way that helped me understand my condition and treatment	90	7	3	-1
I felt confident in the doctor's ability to treat me	90	7	3	-1
I had enough time with the doctor.	89	6	4	-1

Nurses

6.9 Of patients who had visited their GP surgery in the last year, 72 per cent had seen a nurse.

6.10 Equivalent statements were asked for nurses as were asked for doctors:

• I felt that the nurse listened to me
• I felt that the nurse had all the information needed to treat me
• The nurse took account of the things that matter to me
• The nurse talked in a way that helped me understand my condition and treatment
• I felt confident in the nurse's ability to treat me
• I had enough time with the nurse.

6.11 As in the previous survey, responses for nurses were highly positive, and as in previous survey nurses received more positive responses than Doctors for equivalent questions (Figure 11).

Figure 11: Percentage of patients strongly agreeing/agreeing with statements regarding doctors and nurses

6.12 The most positive result for nurses was that 96% of respondents agreed that they had enough time with the nurse, 7 percentage points higher than the equivalent figure for doctors.

6.13 This is not necessarily surprising as generally practices allow more time for nurse consultations than doctor consultations. It may also offer a partial explanation for some of the other differences in scores. More time with the patient would allow more time to listen and more opportunity to provide thorough or tailored explanations.

6.14 Results for nurses showed a similar pattern to those for doctors, in that results are less positive than in the previous survey and the 'things that matter to me' statement was rated the least positively (Table 2).

Table 2: Summary results of questions about nurses

Statement	Strongly agree /agree (%)	Neither agree nor disagree (%)	Disagree/ strongly disagree (%)	Change from 2011/12
The nurse listened to me	96	4	1	-1
I felt that the nurse had all the information needed to treat me	93	5	2	-1
The nurse took account of the things that matter to me	90	9	2	N/A
The nurse talked in a way that helped me understand my condition and treatment	91	7	1	-1
I felt confident in the nurse's ability to treat me	94	4	2	-1
I had enough time with the nurse.	96	3	1	-1

Patient involvement in decisions around their care and treatment

6.15 Patients were asked whether they were involved as much as they wanted to be in decisions about their care and treatment.

• 61 per cent of patients stated that they were definitely involved as much as they wanted to be.
• 33 per cent answered they had been involved to some extent
• 4 per cent answered they had not been involved and would like to be
• 2 per cent answered they had not been involved, but had not wished to be

6.16 The subject was covered in previous surveys using a slightly different format of question. Results from these surveys suggested that 88 per cent of individuals were involved as much as they wanted to be. This new format of the question however, suggests that over a third of individuals are not involved as much as they would like. The bulk of these are involved 'to some extent'.

6.17 For more information on the change in question, please consult the technical report at:

http://www.scotland.gov.uk/Topics/Statistics/Browse/Health/GPPatientExperienceSurvey/Survey1314

Discussions on patient's ability to work

6.18 Work is important for keeping healthy and returning to work can help recovery from a condition. If a health condition makes it difficult to keep working, health professionals should offer advice on how a patient can return to work and on what discussions they can have with their employer to support this. Advice on a Fit Note can provide help for patients and employers.

6.19 The statement of fitness for work, or Fit Note, was introduced in 6 April 2010 to replace the Sick Note. With the Fit Note "doctors are able to advise people who are on sick leave for over 7 days whether, with extra support from their employer, they could return to work earlier.

6.20 12 per cent of patients answered they had seen a health professional in the last twelve months about something that affected their ability to work.

6.21 Patients were asked whether the health professionals had discussed their ability to work with them, and how useful their discussion had been. Compared with the previous survey, a similar proportion of patients had discussed work and found it useful (69% this year compared to 70% in 2011/12). As was the case with the previous survey, one in ten individuals who believe that they would have found it useful did not have such a discussion (Table 3).

Table 3: How useful patients found a discussion about their ability to work

Response	%
Had a discussion and found it useful	69
Had a discussion but it was not useful	10
Did not have a discussion, but would have found it useful	10
Did not have a discussion but did not want to	11