Summary of Malago Surgery Patient Satisfaction Survey Introduction Malago Surgery conducted a Patient Satisfaction Survey during February and March 2013. Questionnaires were made available to all patients who attended both Malago Surgery and BS1 Surgery for any reason. It was also published on the Malago Surgery website for online completion. Members of the Email reference Group were invited by email to complete the survey on-line. Similarly all patients who emailed the practice during the survey period were sent an email inviting them to complete the online survey. The questions in both versions of the survey were the same. Summary of Patient Satisfaction The satisfaction rating shown in the table below relate to the number of patients who expressed an opinion about the topic. Ratings of good to excellent were considered to indicate satisfaction whilst dissatisfaction was expressed by ratings of fair to very poor. Item Topic Results 1. Receptionists Overall there was a high degree of satisfaction with our reception staff. 85% of respondents rated the manner they were treated by receptionists as good to excellent. 84% of respondent were rated the helpfulness of receptionist as good to excellent. 2. Telephones 67%. satisfaction rating. 55% reported telephoning surgery over lunchtime regularly. 3. Opening Hours 72% Satisfaction rating. 31% want evening appointments and 35% want weekend appointments. 4. Particular doctor 60% report having to wait more than 1 week for an appointment with their preferred doctor. This was given a dissatisfaction rating of 75% 5. Any Doctor 73% reported being able to get an appointment with a doctor within one week if they had no preference for which doctor they saw. This was given a satisfaction rating of 48% 6. Same Day Service 64% of respondents report being offered a Same Day appointment. This achieved a satisfaction rating of 86% 7. Waiting Time 77% reported having to wait more than 10 minutes after their appointment time to see a doctor or nurse. This was given a dissatisfaction rating of 78%. 8. Text Messaging service 70% satisfaction rating. 9. Website Only 24% of respondents had visited the Malago Surgery website. Satisfaction rating 83%. Almost all respondents considered that the site should include the facility to make and cancel appointments, request repeat prescriptions and update personal information. 10. Repeat Prescriptions Satisfaction rating 74%
11. Radio Prior to the survey a number of patients had expressed their dislike of the radio being played in the Waiting Room. Only 12% of survey respondents said they did not want the radio on whilst 54% were positively in favour of the radio. 12. 4YP service Only 28% were aware of and expressed an opinion about our 4YP service. Of these 75% expressed satisfaction. 13. Newsletter 52% of respondents comment on the practice newsletter. 61% considered that a newsletter should be published one or two monthly. 14. Overall Satisfaction Satisfaction rating of 84% within only 11% expressing dissatisfaction Due to a change in the methodology for measuring satisfaction ratings it has not been possible to compare this year s ratings with previous satisfaction ratings. Detailed Review of Survey Results The full results of the survey are shown on our website. However, be able to comment on them more easily, the major results are shown below. Receptionists The survey asked who patients rated how they were treated by our receptionists Very poor 0% Poor 1% Fair 13% Good 24% Very good 32% Excellent 25% Don't know 0% No response 5% The survey also asked how helpful our receptionist had been when patients had telephoned for an appointment. Very poor 2% Poor 4% Fair 25% Good 31% Very good 24% Excellent 7% Don't know 2% No response 5% As whole the satisfaction rating for receptionists was 77%. This compares favourably with the rating of 75% last year. Opening Hours We asked whether patients were satisfied with the hours we are open for appointments and what hours in addition to our core hours of 8:00am 6:30pm they would like the practice to open.
The satisfaction rating with our present ours was 72%. The responses for additional hours this year and last year were: Additional hours requested Percentage of responses 2012-13 Mornings 6% 8.13% Percentage of responses 2011-12 Lunchtime 8% 11.38% Evenings 31% 23.58% Weekends 35% 32.52% None 21% 35.77% The table shows the percentage of patients who answered this question who would like us to offer appointments during the various periods e.g. 6% of the patients who answered this question would like us to offer early morning appointments, whereas 21% were content with the hours already available. The results show that there has been a slight shift toward wanting to be able to access appointments in the evening and at weekends. Telephone Calls to Malago Surgery over Lunchtime Last year we asked patients if the would like us to accept telephone calls over the lunchtime period. As over 32% indicated they would like us to accept telephone calls over the lunchtime period we decide to open our telephone lines between 12:30pm and 2:00pm. To establish what proportion of patients who actually telephone us between these hours, we asked this year how often patients had phoned us over lunchtime. Never 11% Seldom 28% Occasionally 26% Frequently 24% This is the only time I can telephone the Surgery 5% No response 6% It is clear that many patients do telephone us over lunchtime. This is also borne out in pour telephone management data. Availability of routine appointments We asked patients how long they had to wait for a routine appointment with their preferred doctor and if they were prepared to accept an appointment with any doctor and to rate our performance. As summary of their responses How quickly do you usually get to see a particular doctor? Same day 7% Next working day 4% Within 2 days 5% Within one week 17% Within 2 weeks 41% Over 2 weeks 19% No response 7%
How do you rate your ability to get to see a particular doctor? Very poor 8% Poor 35% Fair 21% Good 12% Very good 6% Excellent 3% Don't know 3% No response 12% How quickly do you usually get to seen any doctor? Same day 28% Next working day 5% Within 2 days 16% Within one week 24% Within 2weeks 14% Over 2 weeks 5% No response 8% How do you rate this service? Very poor 5% Poor 15% Fair 21% Good 19% Very good 13% Excellent 12% Don't know 1% No response 14% It is clear that there is a significant level of dissatisfaction with the availability of routine appointments Same Day Service We asked patients if they had been offered a Same Day Service appointment. Yes 64% No 15% Not Sure 16% No response 5% Satisfaction with the Same Day Service Very poor 0% Poor 5% Fair 16% Good 27% Very good 19% Excellent 13% Don't know 8% No response 12%
A significant proportion of patients were unsure whether they had been offered this service. This may reflect the indication that 28% had said that they had been offered an appointment on the same day if they were prepared to see the first available doctor. The overall satisfaction rating for the Same Day service was 86% Waiting Times in Surgery The length of time patients have to wait in doctors waiting rooms before they see a doctor is a source of dissatisfaction nationally. We are not alone in finding that this attracts one of our lowest satisfaction ratings. The response to this question were: Very poor 7% Poor 21% Fair 39% Good 14% Very good 4% Excellent 1% Don't know 2% No response 12% It can be seen that the majority of patients gave a rating of less than good. Last year over 34% of patients rated this as good or better. We offer 10 minutes appointments with doctors. Unfortunately, not all patients problems can be dealt 10 minutes or less and we always try to give each patient the time they need. This almost invariably means that the doctors run late especially when patients wish to discuss more than one problem. We try to structure each session to minimise the effect of doctors over-running. Nevertheless, doctors are finding it difficult to keep to time. We are unable to offer longer appointments as this would reduce the number of patients that each doctor could see and hence mean that patients would find it more difficult to make an appointment. We will provide patients with more information about the length of appointments and advice on how make the most effective use of each appointment. Appointment Text Message Reminders We automatically send text message reminders of doctors and nurses appointments to patients who have opted in to the service and have given us their mobile telephone number. We asked patients to rate their satisfaction with our text message reminder service. The overall satisfaction rating was 88%. This was an improvement on last year s rating of 74% and may reflect a change in the service. Patients are now sent a message as soon as their appointment is made and then a reminder on the day rather than one week ahead and on the day. This year s responses were: Very poor 1% Poor 1% Fair 3% Good 7% Very good 11% Excellent 21% Don't know 39% No response 17%
The text message reminder service is clearly very popular with patients who have given us their mobile telephone number. Practice Website We asked patients whether they had visited our Practice website and, if so, how they rated it. We also asked their opinions on a range of possible website developments. A total of 24% of patients had visited the Malago.Surgery.nhs.uk website. Their satisfaction rating for the website was 83%. Their responses to the question Which present or additional features would you like the website to offer? were: Repeat prescription ordering 39% Make an appointment 40% Cancel an appointment 37% Update your personal details 32% Update your clinical records 27% It can be seen from the table above that the majority of patients who have visited our website would like us to add some additional features to it. Radio Prior to the survey a number of patients had expressed their dislike of the radio being played in the Waiting Room. We had explained that the radio had been introduced as a means of giving a higher degree of privacy to patients talking to receptionists at the front desk and on the telephone in our reception. Nevertheless, we agreed to include this topic in the survey. We asked: Do you like to listen to the radio whilst waiting for your appointment? No, I would prefer the radio off 12% No but the radio doesn't bother me 22% Yes but I wouldn't mind if it were off 37% Yes, I really enjoy listening to the radio 17% Not sure 1% No response 11% Only 12% of survey respondents said they definitely did not want the radio on whilst 54% were positively in favour of the radio. We have already included a message on our electronic Call Display board to encourage patients who would rather have the radio turned off the let the receptionist know. The receptionists have been asked to treat these requests with discretion and arrange for the radio to be switched off. Practice Newsletter For the past 4 years we have published a Newsletter once a year. It had been intended that this should be a quarterly newsletter but the lack of response to the newsletters suggested that it was of little interest to patients. We therefore asked patients to rate
the newsletter and suggest how frequently we should publish it. Only 23% of patients responded to this question. These patients gave the newsletter a satisfaction rating of 91%. Monthly Quarterly Twice a year Annually Preference % 8% 12% 16% 16% The majority of patients who responded to this question would like us to publish a newsletter no more than twice a year. Overall Satisfaction with Malago Surgery Completely dissatisfied 5% Very dissatisfied 3% Fairly dissatisfied 2% Neutral 12% Fairly satisfied 28% Very satisfied 27% Completely satisfied 12% No response 11% The satisfaction rating for the surgery is 84%. This is an improvement on last year s 74% rating and is similar to the National mean of 84% Conclusions In some critical areas, patient satisfaction with the Malago Surgery appears to have reduced since we ran our survey last year. In an attempt to minimise the number of appointments that patients do not attend, we only release routine appointments for up to two weeks ahead. We are aware that a consequence of this is that patients find it difficult to make an appointment to see their preferred doctor and that there are often no appointments for any doctor available in this timescale. We then find ourselves in the position of having to ask patients to telephone again the following day when more appointments will be available. However, the appointments released that day are often booked very quickly after 8:00am and patients can sometimes make several calls before being offered an appointment. Our Same Day Service ensures that patients who really need to see a doctor quickly are offered an appointment on the day they contact us. To try to ease this situation, we analysed the demand for appointments and set a target level of routine appointments that should be available each week. Doctors agreed to offer extra appointments sessions when forward plans indicated that the target would not be met. The point at which appointments became available for booking was also altered to ensure that there would always be appointments available within 48 hours at 8:00am each day. To start with the new appointments arrangement was very successful, with lower demands for the Same Day service from patients who felt they could not wait for the next available routine appointment. However, we were soon swamped by an unusually high demand for appointments throughout the winter period and many patients were disappointed by the availability of routine appointments once again. We were also affected by an unprecedented level of sickness within the clinical staff that meant that appointments had to be cancelled and rearranged at short notice, thereby reducing the availability of appointments. To try to help doctors to keep to time, we need to give patients more information about the length of their appointment with doctors and nurses and advice on how to make the
most effective use of each appointment. This should include advice such as telling the doctor at the start of the consultation what they would like to discuss and which they think is the most urgent. The doctor can then gauge which problems are clinically most important and deal with them first. They may then be able to suggest making another appointment to discuss the less important issues. We will include this advice in our patient leaflet and information about appointment length on our call-display board in the waiting room. We have become increasingly aware that we have in the past attempted to solve problems like appointment availability and waiting times in isolation and have only achieved marginal short-term improvements. We have, therefore, decided to participate in the NHS Institute for Innovation and Improvement Productive General Practice programme. This will involve the whole practice team in analysing every aspect of our performance and working with patient to improve our efficiency and responsiveness to patient needs and aspirations. The programme will take us around a year to complete. Our first meeting to set our practice strategic direct will be on 22 April 2013. Patients interested in finding out more about this venture may like to follow the link to the programme website: http://www.institute.nhs.uk/productivegeneralpractice The conclusions we are able to draw from the specific questions we asked on the occasion are: - Opening Hours. Most patients continue to value evening and weekend appointments. We will, therefore, continue to offer booked appointments on a Wednesday evening and a Saturday morning. We will also explore the possibility of offering some early morning and lunchtime appointments. - Lunchtime telephone calls. A significant proportion of the patients completing the questionnaire would like us to accept telephone calls over the lunchtime period. We will continue to leave our telephone lines open over lunchtime. - Text Message Reminders. A large majority of patients rated our text message reminder service very highly. We will, therefore, continue to fund this service from Practice income. - Practice Website. Although our website has only been visited by a minority of patients, it is clear that these patients would like the opportunity to make use of it to book and cancel appointments, make prescription request and update personal and clinical information. Our clinical database provider makes most of these features available. We have made these feature available on our new website and will assess the impact of these facilities on appointment availability and staff workload and then actively promote the most effective of the features to all patients. - Patient Newsletter. Few patients have actually read our newsletters and of those who have there is little demand for more than two editions a year. We will continue to publish a newsletter and make it available to patients who attend Malago and BS1 Surgeries. We will also publish it on our website so that it is accessible to patients who do not come to see us. We plan to publish at least two newsletters a year. Action Plan No. Action Timescale 1. Telephone lines to remain open to enable patients to Immediately talk to a receptionist from 8:00am until 6:30pm each weekday. 2. Continue to offer extended hours appointments on Wednesday evenings and on Saturday mornings Immediately
3. Malago Surgery will participate in the NHS Institute for Innovation and Improvement Productive General Practice (PGP) programme. This will enable a through review of all aspects of organisation and management of the practice. Particular attention will be paid to modules on appointment scheduling in an effort to improve satisfaction with availability of clinicians 4. Review doctor timekeeping as part of PGP and improve communication of delays to patients 5. Continue to fund appointment text message reminder service. 6. Promote the practice website in newsletters and encourage patients to use the facilities linked in to the website 7. Continue to play radio programmes in the waiting room but provide patients with opportunity to request it be turned off if they so desire. 8. Publish newsletters at least quarterly. The newsletter will be available in the waiting rooms of both Malago and BS1 Surgery and published on the practice website Commence PGP programme in April 2013 Commencing April 2013 Immediately June 2013 Immediately Commencing June 2013 John Gibson Practice Manager