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

5 GP Practices - consultations with doctors and nurses

Summary

5.1 The 2011/12 survey results showed that patients were mainly positive about their experiences of consultation with doctors and nurses. In most areas patients reported a better experience compared to the 2009/10 survey.

5.2 Patients' experience of their involvement in decisions around their care and treatment remained very positive, with over 8 out of 10 patients being involved as much as they wanted to be. More information on these results and other questions relating to the consultations with doctors and nurses are described in the following sections.

Introduction

5.3 This survey asks a series of questions on experiences of consultation with doctors and nurses, which explores some of the key features of patient-centred care. An important element of the NHSScotland Quality Strategy⁴ is to support person-centred care. Similarly, delivering person or patient centred care is one of the six core competencies required to be a trained general practitioner. It is based on the concepts of autonomy, human rights and choice.

5.4 The Charter of Patient Rights and Responsibilities is currently being introduced through the Patient Rights (Scotland) Act 2011⁵. It an information document for patients and members of the public and sets out what they 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.

Doctors

5.5 Of patients who had visited their GP surgery in the last year, 92 per cent had seen a doctor.

5.6 In the following section of the survey 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 six statements were

• The doctor listened to me
• I felt that the doctor had all the information needed to treat me
• The doctor was considerate and understanding
• 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.

5.7 Patients were most positive about doctors listening to them, with 95 per cent agreeing or strongly agreeing that their doctor listened to them. This is a one percentage point increase from the 2009/10 survey.

5.8 The largest increase from 2009/10 (3 percentage points) comes from patients responding positively to having enough time with the doctor.

5.9 'The doctor talked in a way that helped me understand my condition and treatment' is the only statement showing a decrease (1 percentage point) from the 2009/10 results.

Table 1: Summary results of questions about doctors

Statement 1	2011/12	Change from 2009/10 in positive %3 4
	Disagree or strongly disagree (%)		Neither agree nor disagree (%)	Agree or strongly agree (%)
The doctor listened to me	2	3	95	1
The doctor was considerate and understanding 2	3	5	92	n/a
The doctor talked in a way that helped me understand my condition and treatment	3	7	91	-1
I had enough time with the doctor	4	6	90	3
I felt that the doctor had all the information needed to treat me	3	7	90	2
I felt confident in the doctor's ability to treat me	3	6	90	0

Notes:

1. Statements sorted by percentage of patients strongly agreeing or agreeing.

2. This statement was changed from last survey and therefore results are not comparable.

3. Positive percentage results are based on agree and strongly agree answers.

4. All changes in this table are statistically significant

5. Totals may not add due to rounding

Nurses

5.10 Of patients who had visited their GP surgery in the last year, 69 per cent had seen a nurse.

5.11 The next question in the survey asked about the same statements for nurses as for doctors. The six statements were

• The nurse listened to me
• I felt that the nurse had all the information needed to treat me
• The nurse was considerate and understanding
• 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.

5.12 Overall patients expressed a more positive experience this year than they had done in the previous survey, with results increasing or staying the same for all questions that could be compared.

5.13 96 per cent of patients agreed or strongly agreed with three statements: patients had enough time with the nurse, the nurse listened to them and the nurse was considerate and understanding.

5.14 The largest increase from 2009/10 (3 percentage points) comes from patients responding positively to 'I feel that the nurse had all the information needed to treat me' (Table 2.).

Table 2: Summary results of questions about nurses

Statement 1	2011/12			Change from 2009/10 in positive %3
	Disagree or strongly disagree (%)	Neither agree nor disagree (%)	Agree or strongly agree (%)
I had enough time with the nurse	1	3	96	1
The nurse listened to me	1	3	96	0
The nurse was considerate and understanding 2	1	3	96	n/a
I felt confident in the nurse's ability to treat me	2	4	95	2
I felt that the nurse had all the information needed to treat me	2	4	94	3
The nurse talked in a way that helped me understand my condition and treatment	1	6	93	0

Notes:

1. Statements sorted by percentage of patients strongly agreeing or agreeing.

2. This statement was changed from last survey and therefore results are not comparable.

3. Positive percentage results are based on agree and strongly agree answers.

4. All changes in this table are statistically significant

5. Totals may not add due to rounding

Patient involvement in decisions around their care and treatment

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

• 88 per cent of patients stated that they had been involved as much as they wanted to be. This has remained unchanged from the previous survey in 2009/10
• 7 per cent answered they had not been involved enough
• 3 per cent answered they had been involved more than they wanted to be
• 1 per cent answered they had not wished to be involved.

Patient's ability to work

5.16 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.

5.17 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."

5.18 We introduced new questions on patient's ability to work in this year's survey. Patients were asked

• whether they had seen any health professionals in the last twelve months about something that affected their ability to work, and
• whether the health professionals had discussed this with them and how useful their discussion had been.

5.19 17 per cent of patients answered they had seen a health professional in the last twelve months about something that affected their ability to work.

Of these,

• 70 per cent of patients answered that health professionals had discussed their ability to work with them and they had found it useful;
• 9 per cent of patients answered that health professionals had discussed their ability to work with them and they had not found it useful;
• 10 per cent of patients did not have any discussions with health professionals but would have found it useful;
• 11 per cent did not have any discussions with health professionals but did not want to.