Patient Experience survey of GP and local nhs services 2011/12 Volume 1: National Results

14 Conclusions

Accessing GP services continues to be an issue for many patients

14.1 The survey results again highlighted that patients continue to experience problems accessing GP services. The biggest issues are around the arrangements for getting to see doctors and the experiences of patients have worsened. This year there was a 6 percentage point decrease in the percentage of patients who rated the overall arrangements for getting to see a doctor as good or excellent. Similarly there was a five percentage point decrease in the percentage of patients able to see or speak to a doctor or nurse within two working days.

14.2 Another key finding around access is that there is a lot more variation between GP practices in patients' experiences of accessing services compared to other areas covered by the survey. This suggests that some practices are finding it difficult to improve access for patients.

14.3 The reasons for the deterioration in results for accessing GP services are not clear and to understand them fully would require further detailed exploration; however in the absence of financial incentives targeting 48 hour access, practices may have focused on improving aspects of quality. There was a 3 percentage point increase in the percentage of patients who felt that they had enough time with their doctor which suggests that this may be the case.

14.4 Some of the access problems patients experience have been presented in a report summarising the findings from a review of the patient comments left in the 2009/10 GP survey. http://www.scotland.gov.uk/gp-survey-comments-report-2012

14.5 The largest number of comments related to access, of which the majority were negative. Issues highlighted by patients included: difficulties obtaining on-the day/ emergency appointments as well as advanced appointments; length of wait to see preferred doctor; and lack of flexibility for working patients.

Patients reported slightly better experiences of consultation with doctors and nurses

14.6 There were small increases in most of the questions about consultation with doctors and nurses. As mentioned above, a possible explanation is that practices have focused more on quality and continuity of care rather than providing rapid access.

Patients generally report positive experiences of out-of-hours services

14.7 For the first time we asked patients about their experiences of out-of-hours healthcare when they sought medical help, treatment or advice when the surgery was closed. When they required out-of-hours services, the majority of patients (69 per cent) first contacted NHS 24.

14.8 Patients generally reported positive experiences of out-of-hours services. However they were less positive than they were about their experiences of services at their GP practice. This is to be expected as it is likely that patients will be able form better relationships with staff at their GP practices. Another issue might be that patients may be more anxious about contacting out-of-hours services about something which can't wait until their GP practice reopens. The biggest issue for respondents was the time they had to wait with 15 per cent of patients feeling that it was not reasonable.

14.9 Patients were able to leave comments in the survey about their experiences of using out-of-hours services. These comments will be analysed to provide further understanding of what patients see as important and possible areas for improvement.

Scottish patients report similar experiences compared to UK countries

14.10 Scottish patients generally seem to have similar experiences to those in England, Wales and Northern Ireland:

• Approximately 90 per cent of Scottish, English, Welsh and Northern Irish patients answered positively about the care provided by their GP practice.

14.11 Scotland generally performs favourably compared to other countries included in the 2010 Commonwealth Fund International Health Policy Survey. Doctor patient communication, such as involvement in care decisions and opportunity to ask questions about treatment, were areas where Scotland did well.