BATH LODGE PRACTICE
LOCAL PATIENT SURVEY RESULTS MARCH 2014
Preliminary Report for discussion at PPG Meeting on 11 March 2014
Following consultation with the Patient Reference Group it was agreed to survey patients on two topics – the
Emergency Appointment system and the Telephone System, both areas having been raised as issues last year. Both
systems have undergone change since the previous patient survey.
The survey was carried out over the period 17 to 28 February 2014. Paper copies were given out in the surgery and
during home visits, and the link to an electronic version of the survey was e-mailed around to the Patient Reference
Group and was also available on the surgery website. In total 278 surveys were completed.
Results
Section 1 – Emergency Appointments
Q1 Have you used our new system
for emergency appointments?
No answer3%
No
41%
Yes
56%
Q2 Did you receive a telephone
call from our Duty Team?
No
14%
Yes
86%
We get a large number of people who do not answer the phone when the Duty Team ring back. We do try up to
three times but if there is still no reply we will not try again. A voicemail message may be left if it is a mobile number
that we are ringing asking the patient to telephone again if they still need to be seen.
Q3 Did the telephone assessment
meet your expectations?
No
7%
Yes
93%
Q4.Do you feel your request was
dealt with in a timely fashion?
No
4%
Yes
96%
No
8%
Q5 Were you satisfied with the
system used to deal with your
problem?
Yes
92%
As can be seen from the replies, the overwhelming majority of people who had used the system were pleased with
it.
Section 2 – Telephone System
Q1.Have you used our new
telephone system?
No answer
3%
No
30%
Yes
67%
Q2. Did you find it easy to get
through to the surgery?
No
21%
Yes
79%
Encouragingly this is an increase on last year’s figures, when only 72% found it easy or fairly easy to get through to
the surgery.
Q3.Were the instructions given
clear?
No
2%
Yes
98%
Q4. Was your call dealt with
appropriately?
No 3%
Yes
97%
COMMENTS FROM PATIENT SURVEY February 2014
Positive Comments
District nurse came in and was followed up well
Good enough
This is better now that a doctor calls you & not a nurse
New phone system very clear
Very thorough
It’s all good already
No complaints
Quicker appointment
Very pleased with overall appointment system and staff were really helpful and dealt with my concerns brilliantly,
thank you
Service seems much better and faster than previous years
Service was amazing
All staff and doctors are polite and friendly
Bath Lodge Practice is well organised, personnel always helpful with smile, reception, nurses, doctors - they are
always ready to help
Thank you
Very polite & helpful
Many thanks to all - you all have a difficult job
Everyone does a great job
Always feel listened to, thank you
Can wait a while, you all have a very busy job
Very happy with all aspects of Bath Lodge surgery, thank you
I feel I am looked after well by the surgery
Thank you for the positive comments. We will feed them back to our practice teams.
Suggested Improvements (The Practice response is in red)
Comments about appointment availability
 Just wish I could see my doctor quicker instead of waiting so long
 The waiting times for routine/non-emergency appts is extremely long - could this be addressed
 Having to wait a month for an appointment is too long
 Need to be able to see doctors earlier than 3 weeks’ time, unless emergency
 It would be nice if you could get an appointment when you need it, not have to wait 3 weeks or sometimes more
to see your doctor
 The waiting time for routine appointments is too long. I believe at present it is around 1 month, this should only
be 1-2 weeks
 Make it easier to & quicker to get regular appts so that we don't have to use the emergency appt system
 When asking for a routine appointment I don't expect to be told 5 weeks’ time - so instead I took an emergency
appointment which could have been given to somebody in more need
 More appointments available on the day of your call
 More doctors
 I think your counter staff are excellent but having no appointments available for a month is awful, must be VERY
stressful for them
It was very obvious from the comments we received on the survey that the current wait for a routine
appointment, which is approximately four weeks, is causing a great deal of frustration, not only for patients but
also for the practice staff and the doctors themselves. .
There are many reasons for the delay and no one simple solution. We have more doctor time in the surgery now
than we had last year. At this time in 2013 we had 8 doctors doing 48 sessions between them (a session is a
morning or an afternoon). This year we have 9 doctors doing 56 sessions – an increase of 8 sessions. We now
also have our Physician Associate, who works 9 sessions per week. It is obvious from this that the solution isn’t
just a question of having more doctors in the surgery.
We are extremely aware that this is a problem and one which we have not had previously until the last six
months. We have tried several things to try and bring down waiting times, none of which have had any lasting
effect. Starting in April we are taking part in a programme called “The Productive Practice”, which has been
developed by the NHS to help surgeries examine their systems and functions and to alter the way they work in
order to free up valuable time in all areas. We hope that this will give us a chance of improving the waiting times
for appointments, and this is very definitely an area on which we will be focussing over the next six months.
Comments about the Emergency Appointment System
 Even if doctor is requested to call the next day & this is explained , the assessment call by the nurse means 2x
calls
 I was calling on behalf of an elderly relative and he was prescribed medication rather than a home visit. I think
elderly patients who are very ill should be visited.
 To have the opportunity to see the Dr face to face
 When asking to see a dr or nurse under advisement, to allow for that appt not give a phone app
 Would rather speak to a GP not physicians associate
 Call backs need to be more understanding about the problem
 This system is OK if people are able to explain themselves properly, otherwise an appointment may not be
allocated and the situation could be serious
 I think the patient should be assessed on if they are a regular visitor to the surgery; then if they are not maybe
listened to clearer, not as someone who visits on the least of reasons
We had several comments about problems being dealt with on the phone and not in a face to face appointment.
Not all problems need the doctor to see the patient in person, particularly those that do not require a physical
examination.
All requests for emergency appointments are assessed by one of the Clinical team and they make a clinical
decision as to whether the patient needs to be seen or if the issue can be dealt with over the phone. Our Nurses
and our Physician Associate can deal with many problems, and if they feel that the issue requires a GP to see the
patient they can make the appointment or ask the GP to come and see the patient after they have assessed
them. We treat all our patients equally; whether they have a condition that requires frequent attendance or if
we only see them once a year their request to be seen will be considered purely on a clinical basis and what is in
the best interests of the patient. If there is any doubt we will always err on the side of caution and see the
patient.
When there has been a problem …
 2 different occasions - once a Dr consult - very good, once didn't get past difficult reception
 At busy times I have struggled to get through. More frustratingly I get through & try to get appointments for sick
children to be told there is a 4 week wait or ring back tomorrow for emergency appointments. As a non-driver
with 2 small sick children it is impossible to arrange to get these
 Some confusion as wanted to have a visit but was told to call back another day?
 It is very difficult to get an appointment I see a different Dr each time, always running late. I feel I am rushed
through my appointments
 I understand the pressures on GP surgeries nowadays but feel there is no continuity of care. A Family doctor
would know the patient's history & be able to treat him/her more appropriately, particularly for elderly patients
 Clear communication when being seen. Hygiene procedures followed. Assistant practitioner to demonstrate
confidence.
 Do something to improve the waiting times when in the surgery waiting room
Whenever you have a problem that you feel will need to be sorted out that day it is always more helpful if you
can contact the surgery as early as possible in the day. The later it is left the fewer options there are available
and the more pressure it puts on the Duty Team. Do we need to run a small surgery campaign making this clear
to patients?
This particularly applies to visits. We know that often elderly patients don’t want to bother the doctor and
therefore leave a problem to see if it will get better. However, visit requests after 3.30 pm mean a doctor has to
leave a surgery to come out, and this can make the doctors left in the surgery run late as they have to fit in extra
patients. We would far rather the patients (or their carers) rang sooner rather than later – the doctor can always
speak to them on the phone if they are not sure if they need to be seen. If the patient needs admission to
hospital the earlier they are seen the better for them and the hospital. Maybe a surgery campaign might help?
Clinicians do try to run to time, but not everyone fits neatly into a 10 minute appointment, and it is difficult to
predict sometimes how long an emergency patient will take. The Duty Doctor surgery is specifically for urgent
things that need to be dealt with that day and not additional problems that can be dealt with more routinely.
We are actually ahead of the Government directive that specifies that all patients over 75 will have a named GP
to co-ordinate their care from April 2014. All of our patients, however old or young, have a named GP and we
encourage patients to see that GP whenever possible to try and keep continuity of care. It makes for a much
better experience on both sides. Often the Duty Doctor will realise that the problem you have means it is better
for your own GP to see you and they can arrange this, although it might not be on that day.
It has always been practice policy that if a parent is worried or has a concern about a child they can speak to a
GP that day, and perhaps we need to remind all of our staff of that policy. We will do this.
Comments about the opening times
 More appointment times available (extended opening times)
 The emergency appt system has worked really well, especially as I work over in Salisbury and it can be very
difficult to get to doctors appts. My experience could be improved if there were more late night (6-8pm) or early
morning (before 9 am) appts as I work 1 hr from Southampton. Other than that I have always found the practice
as a whole and the nurses and doctors within it very professional.
We already provide routine pre-bookable appointments on Monday evenings until 8 pm and on Saturday
mornings which are part of the extended hours service. The Duty Doctor can see patients requiring an
emergency appointment from 8.00 am until 6.30 pm which are the normal surgery opening times. We are not
allowed to open the surgery before 8.00 am as the owners of the Health Centre cannot provide adequate
security for the rest of the building before this time.
Comments about the phone system
Comments about the phone system generally came under two headings; the menu and problems in getting though.
Comments about the Menu
 The phone only says No1 emergencies & no 1 should be emergencies & nothing else, for an appointment a
number should be allotted
 The menu takes a long time to listen to before the call is dealt with
 In the end, when I was told to redial & hold
 I am in my 80s and reasonably with it, but think for some people it might be difficult & they would give up, all so
impersonal, like trying to phone your energy company or similar
 Maybe easier to use if appts were press button 1 rather than go through whole list
The menu system was introduced at the end of the summer last year to help patients get through to the right
extension first time, rather than being transferred around the system. This also enabled phone lines to be freed
up more quickly and therefore calls in the queue being answered faster. It had been discussed with the patient
group last year, who felt that menus on phones were very common these days and would not be unacceptable.
We took advice from our phone supplier who felt that in an emergency situation someone phoning in would be
highly stressed and would not hear anything after the first number, which is why we put emergencies as number
1 on the menu. The instruction to hold for an appointment comes at the end and perhaps we need to
reconsider numbering all of the options, with appointments at number 2. We will discuss this with our reception
team and our phone provider to see if it is possible to add an extra option.
Comments about getting through to the surgery
 Long wait, often engaged
 Never call on a Monday cause you can't get through, although polite receptionists
 There should be a dedicated number for appointments that day instead of having to hold for 20mins +
 Improve telephone time - still taking a long time to get through
 Couldn't even get through to talk to anybody on numerous occasions
 Very often it is not possible to speak to anyone as 'all our lines are busy' with determination it is possible to get
an appointment
 Problem on the repeat prescription line when the message about being in a queue is rarely heard and I think is
useful.
At our busiest times, which are Mondays and most mornings between 8.00 am and 10.00 am, we have six people
answering the phone. Our phone system can stack up to 16 calls before the engaged tone is heard. On
Mondays we take well over 150 calls in the morning before 12 noon just for appointments that day – this doesn’t
include calls for routine appointments, prescriptions, test results, visit requests and other enquiries. If the
number of lines were increased we would need more people to answer them, and we don’t have the resources
or the space for this.
The prescription line does not have a queuing message – we would need to install a second line for this to
happen. We have extended the time it is open and you can now phone in the afternoon between 3 and 4 pm for
collection the following afternoon. The afternoons are generally quieter and you can normally get through first
time.
Comments from patients with hearing impairment
 Sorry, I am deaf & don't use the phone
 No clear options for people with hearing problems, ie not hearing the messages.
We will be introducing on-line appointment booking in the next month or two. We also have a text phone for
deaf patients. If there are any issues with communication we will always make an appointment for a deaf
patient and can flag their notes accordingly and we would be happy to explore any other options that would
make communication easier for our patients with this problem.