Scottish GP Patient Experience Survey 2009/10, Volume 3: Findings from the Analysis of Patient Comments

10 Conclusions

10.1 This report is based on collective analysis of the 42,042 legible patient comments from the Better Together 2009/10 GP Patient Experience Survey. The main survey findings were reported nationally and locally in 2010. GP practices have already received their patients' comments and have used them, along with the survey results, to reinforce service achievements and make improvements locally.

10.2 The analysis of the patients' comments at a national level has allowed us to understand in more depth some of issues which are important to patients. In some cases the analysis has provided better insights into the main quantitative survey results reported in the national report. The analysis has also identified other issues not covered by the survey, for example referral processes to other health professionals or services and concerns about treating mental health problems.

10.3 One of the most noticeable things about the comments was that on balance there were more negative comments than positive ones. However this does not seem to reflect the overall statistical survey findings as these were, in the main, positive. It may be that patients, who were less positive in answering the quantitative survey questions, were more likely to leave a comment which was negative. Further analysis of the relationship between the survey responses and the patient comments is required. Another reason is that we assigned some comments as negative if they included suggestions or if they were predominantly negative but still contained positive points. It is noticeable, however, that where the survey results were less positive, for example around access, the proportion of negative comments was higher.

Patients generally praise their GP surgery

10.4 A large number of comments left by patients were general praise for their GP surgery. This is reflected in the findings from the national report which showed that nine out of ten patients rated the overall care provided by their GP surgery as good or excellent.

Patient comments on access generally corresponded with access problems reported in the main survey

10.5 While the results of the national survey were generally positive, the main areas for improvement identified in the national report related to access. The survey suggested that a sizeable minority of patients experienced problems with access, particularly around being able to book in advance; getting an emergency appointment; and seeing preferred doctor or nurse. These results may explain why the largest number of comments left by patients related to access. The analysis of the comments showed that these areas were also highlighted by patients, particularly around the ability to book emergency and advanced appointments and seeing preferred doctor/nurse.

Patients reported views about referral to other services or health professionals

10.6 One area which the 2009/10 survey did not cover was referral to other services or health professionals. However we found that a large proportion of patients commented on this element of their care. While some reported that the referral process worked well for them, others suggested that the time between the first appointment with a GP and being seen by another health professional was too long. Patients also reported problems relating to coordination of care between GP and other services and vice versa. We have included a question on patients' experience of the arrangements to see another health professional in the 2011/12 survey.

Patients generally praised the quality of service provided by doctors

10.7 The majority of comments about doctors were positive which corresponds with the main findings presented in the national report. Most of the comments left by patients related to: general praise for doctors; the quality of service provided by GPs; GPs taking time to listen to patients; and GPs commitment and efforts to accommodate patient needs. Concerns raised tended to identify the opposite of this. There were also problems identified by some patients around the treatment of mental health problems, for example a perception that some doctors may be too quick to prescribe medicines rather than look into causes and consider other treatments.

Patients highlighted the need for better explanations for medicines and reviews of long term medication

10.8 Although the main survey results for medicines reported in the national report were very positive, many of the comments left by patients on medicines were negative. Some patients highlighted a lack of understanding about their medicines, while others suggested that there should be medication reviews carried out by doctors for those on long-term prescriptions. Finally there were a large number of patients who commented on repeat prescriptions. While some suggested that arrangements for repeat prescriptions worked well especially electronic facilities, others suggested that they were restrictive and/ or there were lengthy waits.

Patients suggested problems with privacy at reception desk

10.9 Another issue raised by some patients related to privacy at the reception desk, with comments suggesting that patients felt uncomfortable discussing health matters in front of other patients. This finding corresponds with the finding of the national report where - 37 per cent of patients worried sometimes, most of the time or always because other people could overhear them talking to the receptionist.

It is important to view national results alongside patient comments

10.10 Using the comments made by those who responded to the survey has allowed us to understand in more depth some of issues which are important to patients. While it has helped to reinforce some of the main messages from the national report, it has also highlighted other issues not covered by the main survey. In carrying out this analysis, it has reinforced the importance of viewing, both nationally and locally, the main statistical survey results alongside patients' comments to gain the best insights into the main areas for improvement.