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

8 Facilities/Buildings

8.1 A small proportion of patients left comments about the facilities / building at their GP practice. In total 1,624 comments (4 per cent of all comments) related to this theme which covered all aspects of the physical surgery itself along with any other facilities available, for example an on-site pharmacy. Among the comments were several around whether patients felt safe in the waiting rooms as well as being heard in reception. There were more negative then positive comments.

8.2 There were no direct questions in the survey asking about cleanliness of the GP practice or buildings. However there were two questions which may in part be related to GP surgery facilities or building:

• I was worried because other people could overhear me talking to the receptionist - 37 per cent of patients worried sometimes, most of the time or always because other people could overhear them talking to the receptionist. (14 per cent of patients were worried always or most of the time).
• I felt bothered or threatened by other patients - 97 per cent of patients rarely or never felt bothered or threatened by other patients.

8.3 Within the group of positive comments, the themes identified were:

• General praise for cleanliness and overall comfort and atmosphere of the surgery.
• Praise for availability of specific facilities and services on site such as pharmacy, x-ray machines, etc.
• Praise for facilities for adults and children - e.g. reading materials, toys/play area for children.

8.4 Within the group of negative comments the recurring themes were:

• Concern over lack of privacy in the reception area;
• Lack of parking facilities generally and for disabled people;
• Complaints of buildings felt to be no longer fit for purpose e.g. surgery too small, surgery needing to be refurbished;
• Poor access for wheelchair users/disabled patients (and also parents with prams);
• Feeling uncomfortable in the presence of drug users and methadone patients in surgery and linked pharmacies;
• Complaints about the cleanliness and hygiene of their surgeries;
• Suggestions around the need for refreshments in surgery especially for long waits;
• Some finding choice of music in waiting rooms irritating and upsetting when ill - especially if it's radio;
• Lack of additional facilities on site e.g. pharmacy;
• Use of technology like touch screen check-in and tannoy to call patients is dehumanizing, difficult for elderly and those hard of hearing/sight, etc.

8.5 The main positive comments relating to 'Facilities/Buildings' centred on the overall appearance, cleanliness, etc. of the practice. A lot of these were positive comments:

"Nice purpose built practice, light and spacious also clean."

8.6 However there were a large number of negative comments suggesting the opposite; that the surgery was not up to standards and not fit for purpose.

"The conditions of waiting room and surgery are in a bad condition badly in need of refurbishing painting and cleaning."

8.7 Other positive comments in this area related to the availability of reading materials and toys in the waiting room which was appreciated by some patients as a welcome distraction.

"The waiting room is always clean & tidy and the leaflets & magazines are reasonably up to date!"

8.8 Although a few suggested it was not very hygienic to have magazines, books, toys, etc. as they may spread infection.

8.9 There were also a few suggestions which called for refreshments to be available at the surgery, particularly if waiting times were long.

8.10 This also links with comments about music being played in the surgery; some patients liked it and commented that it was a good way to prevent people from over hearing private conversations. However, there were others who did not particularly like the provision of music; a particular problem was the type of music being played.

"The only negative I have is in the waiting room it is difficult to gather ones thoughts due to the loud 'radio-one-type' music in the loudspeakers. Some gentle inoffensive 'classic FM type' gentle Mozart would be less intrusive. Get the impression what the receptionist likes!"

8.11 Probably the most frequent negative issue raised was the matter of privacy at reception. The comments suggested that many people did not feel comfortable discussing matters at the reception desk as it was felt to be within earshot of the waiting room and other patients. This is an issue that is reflected in the national results of the survey, with 37 per cent of patients worried sometimes, most of the time or always because other people could overhear them talking to the receptionist.

"There is not enough privacy at the reception desk because far too many patients can hear all that is being spoken. That is wrong thing to happen."

"There is no privacy when speaking to receptionist. I quietly mention the (…) clinic but always have to repeat that and my D.O.B."

8.12 Physical access to the GP practice was another theme which arose in this group of comments. This is not always in control of the GP practice. One of the issues highlighted was availability of parking spaces at the surgery, and in particular disabled parking spaces.

"Parking at surgery is an absolute nightmare even more so for a disabled patient whose ability to walk is greatly reduced."

8.13 Some patients commented on disabled access to the building itself, suggesting that the facilities were inadequate.

8.14 A final access related issue within 'Facilities/Buildings' is the use of technology in the surgery.

"I strongly resent being expected to book in using an electronic machine. I'm a technophobe, technology is de-humanising. I expect to be able to talk to a real person at reception…"

8.15 There were a number of comments relating to the presence of other patients who were drug users e.g. those attending methadone clinics. Many suggested that they felt threatened by the presence of such patients and were unhappy with behaviour in waiting rooms, particularly in front of children.

"I hate having to sit in a room with my children with bad language from patients and having to sit beside people that have drug problems. Not fair on my children."

8.16 Some comments also explained that people were not comfortable with the arrangements in pharmacies for people who were receiving a methadone prescription as it was being taken openly in front of others, and again, in front of children. It was also pointed out in some comments that this was not fair on the patients taking their methadone prescriptions either as they had no privacy.

"People who receive methadone should have their own privacy and dignity respected, people and children should not be in same small proximity, (E.g. pharmacy waiting room) waiting on medication as it is not fair on both methadone patients as well as other patients waiting for prescriptions. (anxiety can arise causing problems)."

Summary

8.17 'Facilities/Buildings' was one of the smallest thematic groups within the comments, representing 4 per cent of all comments left by patients. The main issue which arose in 'Facilities/Buildings' comments related to the cleanliness and overall presentation of the surgery, both positive and negative. Another issue related to privacy at the reception desk, with comments suggesting that patients felt uncomfortable discussing health matter in front of other patients.