Phlebotomy Patient Survey Results

Phlebotomy Patient Survey Results On behalf of Dudley CCG August 2014 Midlands and Lancashire CSU Kingston House 438 450 High Street West Midlands B70 9LD www.experiencecounts.org.uk

Contents Section Page number: 1. Background and Overview 3 2. Method 3 3. Results 3.1 Response Rate 3.2 How often so you have your bloods taken? 3.3 Where do you normally go to have your bloods taken? 3.4 Why do you choose to go to this location to have your bloods taken? 3.5 What do you think works well with the current service? 3.6 What do you think doesn t work well with the current service? 3.7 What changes would you make to the service to make it work for you? 3.8 Would you prefer a drop in service or to have a booked appointment? 4-24 4 5 6 7-10 11 14 15 18 19 22 23-24 4. Conclusions 25-26 Appendices 27-37 Page 2

1. Background and Overview A review is being undertaken of how Phlebotomy services are provided in Dudley. As part of the review, a patient survey has been completed in order find out the views of patients who use the current services and what they would like. The purpose of this document is to provide an analysis of the responses provided. 2. Method Paper copies of the surveys were issued to patients in clinics at Russells Hall Hospital, Corbett Hospital and GP surgeries. Completed surveys were returned to staff in clinics and sent to Dudley CCG for input to Survey Monkey 1. Patients were also given the option to complete online via Survey Monkey. The survey ran from 1 st June to 31 st July 2014 and was advertised through the following channels: Twitter Facebook PPG networks Engagement newsletter Press release Website To GPs via Members News (above repeated at different stages throughout the consultation) Service users were asked the following questions: How often do you have your bloods taken? Where do you normally go to have your bloods taken? Why do you choose to go to this location to have your bloods taken? What do you think works well with the current service? What do you think doesn't work well with the current service? What changes would you make to the service to make it work for you? Would you prefer a drop in service or to have a booked appointment? 1 Survey Monkey is an online survey software tool. Page 3

3. Results 3.1 Response Rate 517 surveys were completed during the consultation period. 19 completed surveys were received after theclosing date (included in final analysis). 536 surveys were received in total. Notes: Some recipients stated that they use more than one location but did not specify if answers to subsequent questions were related to one or all locations used. Some respondents did not answer all the questions. Some respondents gave more than one answer to each question. Over half of the questionnaires completed by service users of phlebotomy services in primary care were from Ladies Walk Clinic. Therefore, the results for primary care have been analysed with and without the feedback for Ladies Walk Clinic to determine if there is a difference in trends. Page 4

3.2 How often do you have your bloods taken? The majority of respondents had their blood taken longer than every 6 weeks or not regularly (80.3%). 300 How Often Do You Have Your Bloods Taken? 250 200 150 100 50 0 Every 1 to 2 weeks Every 3 to 4 weeks Every 5 to 6 weeks Longer than every 6 weeks Not regularly How often do you have your bloods taken? Answer Options Response Percent Response Count Every 1 to 2 weeks 1.6% 8 Every 3 to 4 weeks 11.9% 60 Every 5 to 6 weeks 6.6% 32 Longer than every 6 weeks 50.5% 262 Not regularly 29.8% 160 answered question 522 skipped question 14 See Appendix 1 for a breakdown by location. Page 5

3.3 Where do you normally go to have your bloods taken? The majority of responses were received from patients who attend phlebotomy services based at Russells Hall Hospital (31.2%), Corbett Hospital (24.4%) and Ladies Walk Clinic (30.4%). (Note: some patients indicated that they attended more than one clinic. The percentages in the table below were calculated using the total number of surveys received.) Secondary Care 1 Russells Hall Hospital 167 31.2% 2 Corbett Hospital 131 24.4% 3 Guest Hospital 1 0.2% 4 New Cross 1 0.2% 5 QE Hospital (HF Clinic) 1 0.2% 6 Local Hospital (unspecified) 9 1.7% Primary Care 7 Ladies Walk Clinic 163 30.4% 8 St Margaret's Well 27 5.0% 9 Three Villages 26 4.9% 10 Cross Street 17 3.2% 11 Lion Health 8 1.5% 12 Netherton Health Centre 6 1.1% 13 Limes Medical Centre 5 0.9% 14 Halesowen Medical Practice 3 0.6% 15 High Oak Surgery 3 0.6% 16 Kingswinford Medical Practice 2 0.4% 17 Lapal Medical Practice 1 0.2% 18 Moss Grove Surgery 1 0.2% 19 Priory Clinic 1 0.2% 20 Swanpool Medical Centre 1 0.2% 21 Waterfront Surgery 1 0.2% 22 Woodgate Valley Health Centre (HF Clinic) 1 0.2% 23 GP Surgery / clinic (unspecified) 18 3.4% Other 24 Domiciliary Service 1 0.2% 25 Invalid answer 3 0.6% 57.8% 53% 0.7% Page 6

3.4 Why do you choose to go to this location to have your bloods taken? All the responses received have been categorised. A full break down of categories against location are summarised in Appendix 2. Overall The top 10 categories of why respondents chose a particular location are identified in the table below. 76.3% chose the location because it was convenient (% calculated on number of people who completed a questionnaire). This equates to 68.4% if calculated by location. The convenience category includes the following responses or similar: Near to home Near to work Easy to get to by car Easy to get to by public transport 450 400 350 300 250 200 150 100 50 0 Why do you choose to go to this location to have your bloods taken? Secondary Care The top 6 categories given by respondents who said they used phlebotomy services in a secondary care locations are indicated in the chart below. 59% of respondents stated that they chose the secondary care location because it was convenient. Page 7

200 180 160 140 120 100 80 60 40 20 0 Convenience Why do you choose to go to this location to have your bloods taken? Secondary Care Drop in facility Waiting time Opening times No choice / Already there nowhere else / no option Primary Care The top 5 categories given by respondents who said they used phlebotomy services in a primary care location are indicated in the chart below. 78.9% of respondents who use a primary care location stated that they chose the location because it was convenient. 250 Why do you choose to go to this location to have your bloods taken? Primary Care 200 150 100 50 0 Convenience Appointments Staff/service Waiting time Parking Due to the large number of responses from users of Ladies Walk Clinic compared to other primary care locations, the following chart shows the top 5 categories excluding responses for Ladies Walk Clinic. The trends are similar. 69.4% of respondents who use a primary care location (exc. Ladies Walk) stated that they chose the location because it was convenient. Page 8

90 80 70 60 50 40 30 20 10 0 Why do you choose to go to this location to have your bloods taken? Primary Care (Exc. Ladies Walk) Convenience Appointments Waiting time Parking Staff/service Sample of Quotes: Location used: Wherever can see me quickest Corbett Hospital & Russells Hall Hospital Three Villages Quotes: To be seen as soon as possible. Because I work and there are no appointments outside of working hours available at my surgery, no choice really! Easy access no need to use public transport as back knee osteoarthritis. Because it belongs to our main surgery and you don t have to wait, when you have a fast test. Quicker than waiting in a queue at hospitals. Corbett Hospital Our GP does not take blood samples so this is closest place that does. Need to go early and local because blood test is a fasting one. No alternative, doctor s surgery usually fully booked. Because I'm not sure where else to go. I know you've had notices in surgeries and places, but I only see those when I'm there. I think the information should go on to the request form for the lab, or a letter should be with that, detailing where else we can go. Because you can just turn up. Ladies Walk Clinic Phlebotomists are experts as they do this all day everyday they offer an excellent service. They put you at ease and never fail to find a vein and never leave a bruise. Easy parking, have you tried Russells Hall - it's a joke. Page 9

Ladies Walk Clinic & Russells Hall Hospital Russells Hall Hospital Prefer Sedgley Clinic but use Russells Hall Hospital if cannot book an appointment at Sedgley. Near by where we live - Ladies Walk I try, but usually would have to wait several days (it's just along the way from where I live) 5 minutes. alternatively Russells Hall for quickness Due to a three week wait for appointment at own GP surgery. The service was taken away from the practice. Because I work full time in Birmingham. Having the clinic open until 7.30pm means I can come straight from work (and not lose any 'holiday entitlement'. St Margaret s Well Because they shut the phlebotomy service at Halesowen Health Centre. the alternative at Feldon Lane is like a building from "the third world" I would like the service still to be at Halesowen Page 10

3.5 What do you think works well with the current service? All the responses received have been categorised. A full break down of categories against location are summarised in Appendix 3. Overall The top 10 categories of why respondents chose a particular location are identified in the table below. 22% of respondents said that waiting times were good (% calculated on number of people who completed a questionnaire). This equates to 19.7% if calculated by location. 20% said that they liked various aspects of the appointment system (% calculated on number of people who completed a questionnaire). This equates to 17.9% if calculated by location. 14.6% stated that everything about the service worked well. (% calculated on number of people who completed a questionnaire). This equates to 13% if calculated by location. What do you think works well with the current service? 140 120 100 80 60 40 20 0 Secondary Care The top 6 categories given by respondents who said they used phlebotomy services in a secondary care locations are indicated in the chart below. 20.3% of respondents stated that they liked the ticket system. 14.5% were happy with the waiting time. 14.2% said the drop in facility worked well. Page 11

11.9% said that everything about the service worked well. However, a small number of respondents (3.2%) stated that nothing worked well or the service was not very good. 70 60 50 40 30 20 10 0 Ticket system Waiting times What do you think works well with the current service? Secondary Care Drop in facility Staff Everything Opening times Primary Care The top 5 categories given by respondents who said they used phlebotomy services in a primary care location are indicated in the chart below. 34.2% of respondents said the appointment system worked well. 25.4% said they were happy with the waiting times although it was not always clear from the responses if this referred to the waiting time for an appointment or time waited on arrival for the test. 16.2% said the staff were the best thing about the service. 14.4% said they that everything about the service worked well. 120 100 80 60 40 20 0 Appointment system What do you think works well with the current service? Primary Care Waiting times Staff Everything Convenience Page 12

Due to the large number of responses from users of Ladies Walk Clinic compared to other primary care locations, the following chart shows the top 5 categories excluding responses for Ladies Walk Clinic. The trends are similar. 37.2% said the appointment system worked well. 19.8% said they were happy with the waiting time. 50 40 30 20 10 What do you think works well with the current service? Primary Care (Exc. Ladies Walk) 0 Appointment system Waiting times Convenience Staff Everything Sample of Quotes: Location used: Wherever can see me quickest Three Villages At home, via domiciliary service. Corbett Hospital Quotes: Given choice of clinic means usually having an appointment in a maximum of five days Always seen on time. No waiting in long queues that you get at Corbett hospital and no problem with parking The phlebotomist/nurse who takes the blood is competent and efficient. Easy to use and efficient when not faced by large nos. of patients. Ticket system seems to work well, unless early in the morning, there can be a wait due to the number of people. Drop in service is good, but often very congested waiting area. local surgery is much nearer familiar staff, pleasant waiting area, quieter and less busy. I like it because it has long opening hours. It s good you have a choice of points where you can just drop in and it s possible to improve this only if you re-instated more doctors surgeries to offer service although I am aware this would need appointment times. Page 13

Not much! Fasting tests guarantee a long wait without breakfast - not good for diabetics - especially if they drive the car which is the only way to get there unless they can afford taxi journeys. Cross Street High Oak Surgery Ladies Walk Appointments - I have to have fasting blood tests, so I prefer an early appointment a) because I want to eat and b) because I can go into work f because it doesn't take long. The service is quick and efficient and I have my results within a week. Appointments are far better than tickets and queuing, the service is friendly and helpful and very convenient. Staff are on the ball. happy and do a great job. don't have to go to Russells Hall and wait hours. Contact Ladies Walk direct, make appointment to suit. Netherton Health Centre Russells Hall Hospital In and out quickly, very good service withdrawing would make hospital blood tests waiting time EVEN LONGER! (Already terrible without adding to list) Flexibility of either booking or using the walk in service. Both efficient. Current service is better than booking appointment slots. You know you may have to wait but that allows you to suit yourselves, plan around your day. It s good to have later hours to come up and have the blood tests done, Saturday morning are good as well. Most of it apart from the queuing, which is sometimes quite a while. RHH / Cross Street occasionally in week St Margaret s Well Good 'times' of blood tests service at Russells Hall. Would prefer to go to Cross Street, ease of parking. I ring the blood clinic no. 01385 244 330 they fit me in that week or week after and suit time if I m on fasting rest. All in the same building doctors, nurses chemist. Very efficient but in the wrong location for us Page 14

3.6 What do you think doesn't work well with the current service? All the responses received have been categorised. A full break down of categories against location are summarised in Appendix 4. Overall The top 10 categories of why respondents chose a particular location are identified in the table below. 44.4% responded positively to the question by stating that the service works well. (% calculated on number of people who completed a questionnaire). This equates to 39.8% if calculated by location. 20.5% said that they were not happy with waiting times. (% calculated on number of people who completed a questionnaire). This equates to 18.4% if calculated by location. 250 200 150 100 50 0 What do you think doesn't work well with the current service? Secondary Care The top 5 categories given by respondents who said they used phlebotomy services in a secondary care locations are indicated in the chart below. 31.6% of respondents stated that they were not happy with the waiting times. A small number of respondents (less than 10%) were concerned about: - staffing levels - car parking (e.g.charges, lack of parking) - environment (e.g. waiting area, seating) 24.8% responded positively to the question by stating that the service works well. Page 15

What do you think doesn't work well with the current service? (Secondary Care) 120 100 80 60 40 20 0 Waiting times Nothing, works well Staffing levels Car parking Environment Primary Care The top 5 categories given by respondents who said they used phlebotomy services in a primary care location are indicated in the chart below. 56.3% responded positively by stating that the service works well. The second highest trend was the appointment system with just 5.3% stating that it did not work well. A small number of patients (4.2%) said that they were unhappy with waiting times. However, some comments referred to other locations in secondary care rather than the location used in primary care. 200 What do you think doesn't work well with the current service? (Primary Care) 150 100 50 0 Nothing, works well Appointments Opening times Waiting times Car parking Due to the large number of responses from users of Ladies Walk Clinic compared to other primary care locations, the following chart shows the top 4 categories excluding responses for Ladies Walk Clinic. The trends are similar. 52.9% responded positively by stating that the service works well. The second highest trend was opening times with 8.3% stating that it did not work well. Page 16

Some patients referred to fasting tests in their responses, such as not being able to get an early appointment when fasting. 70 60 50 40 30 20 10 0 What do you think works well with the current service? Primary Care (Exc. Ladies Walk) Nothing, works well Opening times Waiting times Appointments Sample of Quotes: Location used: Three Villages At home, via domiciliary service Corbett Hospital Quotes: At Three Villages the blood testing is carried out on a Monday when surgery opens at 11.00am. This is too late for patients who have to fast therefore more people. From the point at which it is deemed necessary for bloods to be taken to the time the procedure takes place a period of weeks can elapse. The length of time that you need to wait at the hospital. The lack of privacy when blood is being taken. The unpleasant waiting area at the hospital. General lack of organisation. Small waiting room, unable to hear numbers called out when waiting in the entrance lobby. The long waiting time. at peak times, especially if it is a fasting blood test or people have got to go to work everyone goes as early as possible causing this problem. My forms from the GP stated that Corbett started at 8.30am not 8am. not enough people taking the blood (2 until 8.45am) then 3. Parking charges are excessive! Corbett Hospital & Russells Hall Hospital The ticket machine never seems to work. When people arrive at the hospital there is insufficient clear signage/instructions to tell you to get a ticket Poor reflection of time and not able to book later appointments at my surgery (Lion Health). Hospitals are under staffed and I feel existing staff are under strain. Queues are ridiculous, especially when you have to pay for parking 2 an hour, which is how long it usually takes. Russells Hall is not a pleasant Page 17

place to wait - stuffy, cramped waiting area. Guest Hospital Ladies Walk Sometimes a long wait. I have a compromised immune system and sitting in the waiting room leaves me open to catching other people s infections - rather defeats the reason for being there in the first place. Too long to wait for appointment. There is inadequate car parking at Ladies Walk Clinic. Limes Surgery Lion Health Netherton health centre Having to wait at walk in. Early appointments difficult to get, and to wait 3 weeks! You have to ring to arrange an appointment at Dudley first instead of health centre direct. Long waiting at Russells Hall Hospital when I used to go for my blood test. Russells Hall Hospital Difficult to predict when it will be quieter so that car parking isn t a problem and waiting times are not too long. Could routine blood tests be available outside of clinic times? Can I just take this opportunity to say that the phleb's need to show the public evidence that they're washing their hands. Fair enough, I know there is spirigel available for them but In 3 years of having bloods (sometimes as often as every 3 weeks) I have NEVER seen a phleb use it. I only hope they are using it!!it would be great to see that evidence though, like if they could make a show of using it every time a new patient sits in the chair. I could see that their hands would get sore--hence, sadly, I'm not convinced they use spirigel between every patient. St Margaret s Well For me I think it is all good. Sometimes you have to wait a few days for the appointment but to me that is OK. When doing a fasting blood test not always able to get an early morning test. Priory clinic & Russells Hall Hospital I have tried here before without success and had to then go to Russells Hall and when it is a fasting test, that is not good. Page 18

3.7 What changes would you make to the service to make it work for you? All the responses received have been categorised. A full break down of categories against location are summarised in Appendix 5. Overall The top 10 categories of why respondents chose a particular location are identified in the table below. 50.7% of respondents said they did not want any changes made to the current service. (% calculated on number of people who completed a questionnaire). This equates to 45.5% if calculated by location. 11.2% said they would like there to be more capacity (staff/cubicles) at busy times. (% calculated on number of people who completed a questionnaire). This equates to 10% if calculated by location. Less than 5% of respondents asked for better communication such as improved websites, information about where to go for a blood test and opening times. However, it appears from other responses provided that there is a lack of awareness of the scope and availability of phlebotomy services in Dudley. 300 250 200 150 100 50 0 What changes would you make to the service to make it work for you? Secondary Care The top 6 categories given by respondents who said they used phlebotomy services in a secondary care locations are indicated in the chart below. 31.3% of respondents said they did not want any changes made to the current service. 15.8% said they would like there to be more staff/cubicles at busy times. Page 19

100 90 80 70 60 50 40 30 20 10 0 What changes would you make to the service to make it work for you? (Secondary Care) No change More staff / cubicles (at busy times) Testing in local GP surgeries Extended opening times Better communication Better parking Primary Care The top 4 categories given by respondents who said they used phlebotomy services in a primary care location are indicated in the chart below. 61.3% of respondents said that they did not want any changes to the service. The second highest trend was for extended opening times for phlebotomy appointments with 7%. 200 What changes would you make to the service to make it work for you? (Primary Care) 150 100 50 0 No change Extended opening times (for drop in and appts) Testing in local GP surgeries More staff (at busy times) Due to the large number of responses from users of Ladies Walk Clinic compared to other primary care locations, the following chart shows the top 3 categories excluding responses for Ladies Walk Clinic. The trends are similar. 46.3% of respondents said they did not want their current service to change. 13.2% said they would like extended opening hours specifically for phlebotomy services. Page 20

9.9% said they would like testing to take place in local GP surgeries with some making reference to having to go to another GP surgery for testing. 60 50 40 30 20 10 0 What changes would you make to the service to make it work for you? Primary Care (Exc. Ladies Walk) No change Extended opening times Testing in local GP surgeries Sample of Quotes: Location used: Corbett Hospital Quotes: An early appointment as I am diabetic and find it hard to last without food for a long period. Perhaps more nurses at start of day or appointments for 1st hour, to make it easier for working people to not lose too much time. Loaded question everyone has an agenda. But for me personally, I would prefer the local doctor surgery maybe 2 or 3 times a week on appointment Corbett Hospital & Russells Hall Hospital Give the patients a list of days and times when the service is busy and quiet, so that they can then choose the most appropriate time to visit. Possibly appointment but think this would not really be viable due to heavy use of the department. St Margaret s Well Three Villages Guest Hospital Kingswinford Medical Practice Blood tests performed for hospital consultations do not seem to be fed back automatically to one's own GPs practice. I would like to be able to book blood tests direct with Three villages practice instead of central booking. Make other sites drop in rather than appointment only and have some late night opportunities 9-5 doesn't suit everyone. Can't GP surgeries offer a facility. To have this facility at my own surgery. Page 21

Ladies Walk No changes to Ladies Walk Clinic but the car parking charges for a minor service is excessive due to the possible waiting time involved. To enable my local doctors surgery to be able to take samples. Early evening appointments for working people Russells Hall Hospital It would be good to have automatic doors for easy access for disable people in wheelchairs. weak arm muscles weak hands, wrists etc. osteoarthritis, arthritis sufferers. Would like shorter waiting time before appointment can be made. Or being able to have blood test at doctor s surgery again. Just to walk in and not have to wait hours and hours Bring the service back to the local GP surgery where it is possible to make an appointment and get to know the phlebotomist. S omewhere that patients know and trust. it would be much easier for disabled patients to get to the surgery without asking friends/neighbours for transport and to pay for parking. Page 22

3.8 Would you prefer a drop in service or to have a booked appointment? A full break down of categories against location attended are summarised in Appendix 6. Preference Number of Responses Booked appointment 288 Drop in service 177 Both 28 No preference 18 Response did not answer 25 question Total number of responses 536 Overall responses: 53.7% would prefer a booked appointment. 33% would prefer a drop in facility. 5.2% would like the option of both a booked appointment and a drop in facility. 3% would like either or didn t mind. The following chart reflects how the respondents answered the questions based on the service they currently attend. Some respondents use more than one location. Would you prefer a drop in service or to have a booked appointment? 350 300 250 200 150 100 50 0 Booked Appointment Drop in Facility Both Either Primary Care Secondary Care Other Currently use a service based in a hospital: 55.5% of recipients who use a phlebotomy service in a hospital would prefer to have a drop in service. Page 23

55.1% of recipients who use Russells Hall Hospital would prefer to have a drop in service. 58% of recipients who use Corbett Hospital would prefer to have a drop in service. 29% of recipients who use a phlebotomy service in a hospital would prefer to have a booked appointment. 29.9% of recipients who use Russells Hall Hospital would prefer to have a booked appointment. 26% of recipients who use Corbett Hospital would prefer to have a booked appointment. Currently use a service based in a GP surgery or clinic: 79.2% of recipients who use a phlebotomy service in a GP surgery or clinic would prefer to have a booked appointment. 8.5% of recipients who use a phlebotomy service in a GP surgery or clinic would prefer to have a drop in service. 84% of recipients who use Ladies Walk would prefer to have a booked appointment (compared with 72.7% of users of other GP surgeries/clinics). 6.1% of recipients who use Ladies Walk would prefer to have a drop in service (compared with 11.6% of users of other GP surgeries/clinics). (Note: the majority of responses from patients using a GP service or clinic came from Ladies Walk Clinic.) Page 24

4. Conclusions The majority of respondents had their blood taken longer than every 6 weeks or not regularly (80.3%). There were slightly more responses from users of phlebotomy services in secondary care. Over half of the responses of users of phlebotomy service in primary care related to Ladies Walk Clinic. The main reason given for using a particular location was for convenience (76.3%). This was common across primary and secondary care. Users of secondary care also chose the location for the drop in facility. Users of primary care chose the location because they could book an appointment. There was a high level of satisfaction with current services. Waiting times Overall, 22% were happy with waiting times and this was one of the top categories for both primary and secondary care when asked what works well about the service. However, 20.5% said they were not happy with waiting times. The response was higher for secondary care users (31.6%). Only 6 respondents said they would like waiting times to change to make the service work for them. Ticket system / drop in facility The main response given by secondary care service users when asked what worked well was the ticket system used by drop in services (20.3%). Appointment System When asked what works well, primary care users said gave the appointment system as their top answer (37.2%). Staffing Overall, 11.2% would like to see an increase in capacity (staff/cubicles). Communication A small number of service users said they would like better communication relating to phlebotomy services. Examples quoted were better information on websites, where to go for blood tests, opening times and details of busy times. The responses to questions in general indicated that there is a lack of awareness regarding the variety of phlebotomy services available in Dudley. Page 25

Opening Times 8% said they would like to see phlebotomy services open for longer or appointments offered at different times/days. This increased to 13.2% for users of primary care services (excluding users of Ladies Walk Clinic). Testing in Local GP Services 7.5% said they would like to be able to have blood testing done in a local GP surgery or their own GP surgery. This increased to 10% for users of primary care services (excluding users of Ladies Walk Clinic). Car Parking 9.2% of users of primary care services chose the location because of the parking facilities. This reduced to 6.6% if users of Ladies Walk Clinic are excluded. 4.9% said that car parking was an aspect of the service that didn t work well (charges and availability). This increased to 7.1% for users of secondary care services. 3.2% said they would like to see improvements to parking facilities. Suggestions included free or cheaper parking. 15 out of the 17 responses were from secondary care users. Preference Booked Appointment 53.7% would prefer a booked appointment. Those using a primary care based service (currently providing an appointment system) had a preference towards an appointment system (79.2%). Drop In Facility 33% would prefer a drop in facility. Those using a secondary care based service (currently providing a drop in service) had a preference towards a drop in facility (55.5%). 5.2% would like the option of both a booked appointment and a drop in facility. 3% would like either or didn t mind. Page 26

Appendix 1 - How often do you have your bloods taken? 1 2 3 4 5 6 7 8 9 10 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Tot al Every 1 to 2 weeks 3 4 9 Every 3 to 4 weeks 12 1 1 26 2 4 2 2 65 Every 5 to 6 weeks 10 8 12 1 3 1 37 Longer than every 82 57 1 5 75 17 16 11 4 5 3 2 1 2 9 292 6 weeks Not regularly 52 54 1 3 43 6 2 3 2 2 7 1 2 180 159 130 1 9 160 27 25 17 8 6 5 3 3 2 7 1 3 583 1. RHH 2. Corbett 3. Guest Hospital 4. New Cross 5. QE Hospital (HF Clinic) 6. Unspecified Local Hospital 7. Ladies Walk 8. St Margaret Wells 9. Three Villages 10. Cross Street 11. Lion Health 12. Netherton Health Centre 13. Limes Medical Centre 14. Halesowen Medical Practice 15. High Oak Surgery 16. Kingswinford Medical Practice 17. Lapal Medical Practice 18. Moss Grove Surgery 19. Priory Clinic 20. Swanpool Medical Centre 21. Waterfront Surgery 22. Woodgate Valley Health Centre (HF Clinic) 23. GP Surgery / clinic (unspecified) 24. Domiciliary Service 25. Invalid location Page 27

Appendix 2 - Why do you choose to go to this location to have your bloods taken? 1 2 3 4 5 6 7 8 9 10 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Total Convenience (Inc. near to home, near to work, easy to 90 86 1 6 140 24 19 11 6 5 1 3 1 2 1 9 2 409 get to by car/public transport, location) Appointments 1 3 25 3 4 6 2 1 2 5 56 Waiting time 15 7 13 2 3 2 2 1 49 Staff/service 7 1 24 1 3 2 38 Parking 3 4 18 3 1 2 33 Drop in facility * (Inc, no appointment required, if urgent) 21 5 28 Opening times 15 3 20 No choice / nowhere else / no option 6 4 12 Already there 9 2 11 Sent by doctor/consultant 6 2 1 Preference to other providers / other location 5 1 8 Service no longer or not provided at GP/clinic/previously used location Fasting blood test (suits needs) 3 1 6 3 1 4 Page 28

1 2 3 4 5 6 7 8 9 10 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Total Hassle free / easy 4 Access 1 2 3 Always have done 2 1 3 Better options than local facility 2 1 3 (accessibility) Environment 2 2 Housebound If wait for appointment too long elsewhere Inconvenient to go to local hospital Refreshment facilities available (required for test) Warfarin clinic 183 127 1 3 9 226 38 32 24 10 8 4 4 4 3 2 1 20 1 3 705 * Drop in - may refer to different location to one stated 1. RHH 2. Corbett 3. Guest Hospital 4. New Cross 5. QE Hospital (HF Clinic) 6. Unspecified Local Hospital 7. Ladies Walk 8. St Margaret Wells 9. Three Villages 10. Cross Street 11. Lion Health 12. Netherton Health Centre 13. Limes Medical Centre 14. Halesowen Medical Practice 15. High Oak Surgery 16. Kingswinford Medical Practice 17. Lapal Medical Practice 18. Moss Grove Surgery 19. Priory Clinic 20. Swanpool Medical Centre 21. Waterfront Surgery 22. Woodgate Valley Health Centre (HF Clinic) 23. GP Surgery / clinic (unspecified) 24. Domiciliary Service 25. Invalid location Page 29

Appendix 3 - What do you think works well with the current service? 1 2 3 4 5 6 7 8 9 10 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Total Waiting times 22 23 48 6 4 2 2 2 4 18 Appointment system 3 5 52 13 11 9 2 3 1 2 1 3 107 Staff 19 17 34 3 3 2 2 1 85 Everything 22 14 1 30 2 2 3 78 Ticket system 34 28 1 63 Drop in facility 22 2 1 2 47 Convenience 4 7 2 10 3 5 2 1 3 37 Efficient / organised 2 7 14 2 1 26 Location 7 1 6 3 3 1 23 Opening times 11 7 22 Results - received quickly * Nothing works well / service not very good Parking (inc. free parking) Environment / waiting area Choice/flexibility (of locations, booked appointment or drop in) 4 6 16 6 4 2 14 2 3 2 2 2 11 3 1 2 8 2 2 1 7 Staffing levels 2 2 4 Bus route 2 Arranged by District Nurse Page 30

1 2 3 4 5 6 7 8 9 10 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Total Clinic size (small) Easy access Refreshment facilities (after fasting) Takes pressure off hospitals 164 146 3 3 0 6 205 32 31 22 10 6 5 2 4 1 2 2 2 3 673 1. RHH 2. Corbett 3. Guest Hospital 4. New Cross 5. QE Hospital (HF Clinic) 6. Unspecified Local Hospital 7. Ladies Walk 8. St Margaret Wells 9. Three Villages 10. Cross Street 11. Lion Health 12. Netherton Health Centre 13. Limes Medical Centre 14. Halesowen Medical Practice 15. High Oak Surgery 16. Kingswinford Medical Practice 17. Lapal Medical Practice 18. Moss Grove Surgery 19. Priory Clinic 20. Swanpool Medical Centre 21. Waterfront Surgery 22. Woodgate Valley Health Centre (HF Clinic) 23. GP Surgery / clinic (unspecified) 24. Domiciliary Service 25. Invalid location Page 31

Appendix 4 - What do you think doesn't work well with the current service? 1 2 3 4 5 6 7 8 9 10 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Total Nothing, works 46 27 4 96 16 12 10 5 3 4 3 1 9 1 238 well Waiting times 49 48 1 4 2 2 110 Staffing levels 14 1 28 Car parking 10 12 2 2 26 Appointments 4 4 9 2 1 24 Opening times 5 3 2 5 3 18 Environment 4 9 13 Location 4 8 Fasting 2 6 8 Ticket system 8 8 Opening times 6 1 7 Access 1 5 Communication 2 4 Staff attitude 2 2 Service no longer provided 2 at own GP Drop in (unable to make appointments) Hygiene Clinics using same system Communication Refreshment facilities Time taken to receive results Page 32

1 2 3 4 5 6 7 8 9 10 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Total No drop facility at GP surgery Delays caused by doctor running over 147 135 6 117 23 26 7 6 5 3 2 509 Car parking - includes charges, lack of parking Appointments - includes no early/sufficient appointments for diabetic fasting patients, can t have test at GP surgery without appointment, waiting time for appointment, insufficient appointments) Environment - includes waiting area, seating, temperature Ticket system - includes signposting Access - includes disabled access, more centres closer to home Waiting time - may refer to service used previously/elsewhere such as drop in 1. RHH 2. Corbett 3. Guest Hospital 4. New Cross 5. QE Hospital (HF Clinic) 6. Unspecified Local Hospital 7. Ladies Walk 8. St Margaret Wells 9. Three Villages 10. Cross Street 11. Lion Health 12. Netherton Health Centre 13. Limes Medical Centre 14. Halesowen Medical Practice 15. High Oak Surgery 16. Kingswinford Medical Practice 17. Lapal Medical Practice 18. Moss Grove Surgery 19. Priory Clinic 20. Swanpool Medical Centre 21. Waterfront Surgery 22. Woodgate Valley Health Centre (HF Clinic) 23. GP Surgery / clinic (unspecified) 24. Domiciliary Service 25. Invalid location Page 33

Appendix 5 - What changes would you make to the service to make it work for you? 1 2 3 4 5 6 7 8 9 10 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Total No change 55 38 4 118 9 13 5 4 1 2 2 1 8 1 272 More staff / cubicles (at busy 30 19 7 60 times) Extend opening times (drop in 10 4 10 3 2 1 43 and appts) Testing in local GP surgeries 12 12 1 3 7 1 2 40 Better communication 10 7 1 20 Better parking (Inc. free/cheaper 6 8 7 parking charges) To have appointments 5 4 2 11 Environment (more seating/ temperature/ 3 7 10 drinks machine) Separate/early fasting blood tests from other 2 5 1 2 10 blood tests Shorter waiting 3 2 1 6 Clinics use separate 1 2 1 4 facility/time Numbering system (more visible/audible/ to work) 4 4 Page 34

1 2 3 4 5 6 7 8 9 10 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Total Results - made available between surgery 1 3 & clinic systems Results - returned to GP 2 sooner Shorter wait for appointments 2 Use peel off plaster instead 2 of cotton wool Improve help provided to patients having 2 blood tests More locations (inc. drop in) 2 Staff attitude 2 Better disabled access Refreshments on site Better planning around busy times Home visits Phlebotomist in each department More time spent on patient care Nearer home Results - Patients to have copy Page 35

1 2 3 4 5 6 7 8 9 10 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Total More appointments Improve/speed up domiciliary service All district nurses able to take bloods Ticket machine to be available before opening Better access by phone Better access for wheelchair users Book direct with GP practice (not central system) Anticoagulation test at local surgery Drop in facility 148 121 2 8 142 20 23 17 7 6 2 2 3 0 16 3 1 529 1. RHH 2. Corbett 3. Guest Hospital 4. New Cross 5. QE Hospital (HF Clinic) 6. Unspecified Local Hospital 7. Ladies Walk 8. St Margaret Wells 9. Three Villages 10. Cross Street 11. Lion Health 12. Netherton Health Centre 13. Limes Medical Centre 14. Halesowen Medical Practice 15. High Oak Surgery 16. Kingswinford Medical Practice 17. Lapal Medical Practice 18. Moss Grove Surgery 19. Priory Clinic 20. Swanpool Medical Centre 21. Waterfront Surgery 22. Woodgate Valley Health Centre (HF Clinic) 23. GP Surgery / clinic (unspecified) 24. Domiciliary Service 25. Invalid location Page 36

Appendix 6 - Would you prefer a drop in service or to have a booked appointment? Secondary Care Primary Care Other 1 2 3 4 5 6 7 8 9 10 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Total Booked 50 34 1 5 137 20 19 15 6 4 5 2 3 1 9 3 318 appt Drop in 92 76 1 3 10 3 2 1 2 4 196 facility Both 12 10 1 5 1 2 2 2 37 Either 4 6 5 1 3 1 20 158 126 9 157 25 26 17 8 6 5 3 3 2 6 3 571 1. RHH 2. Corbett 3. Guest Hospital 4. New Cross 5. QE Hospital (HF Clinic) 6. Unspecified Local Hospital 7. Ladies Walk 8. St Margaret Wells 9. Three Villages 10. Cross Street 11. Lion Health 12. Netherton Health Centre 13. Limes Medical Centre 14. Halesowen Medical Practice 15. High Oak Surgery 16. Kingswinford Medical Practice 17. Lapal Medical Practice 18. Moss Grove Surgery 19. Priory Clinic 20. Swanpool Medical Centre 21. Waterfront Surgery 22. Woodgate Valley Health Centre (HF Clinic) 23. GP Surgery / clinic (unspecified) 24. Domiciliary Service 25. Invalid location Page 37