Analysis of GPAQ, Ashleigh Surgery
November 2006

A survey was carried out at the surgery in November 2006 using the standard General Practice Assessment Questionnaire (GPAQ). Detail of methodology and full results are available on request.

Immediately after the survey was completed, the data was analysed and printed. The summary of results was shown to all staff. Informal discussions were held about problems with collecting the data and to see if any immediate changes needed to be considered as a result of comments written by patients. A formal meeting was arranged to discuss the survey in greater detail.

•  Summary of the findings

The GPAQ survey is designed so that it is easy to see how scores can be used to improve care. The advice is to look at any areas scoring less than 10 below the GPAQ benchmark. It was apparent that our scores were all higher than the benchmark. This is an improvement from last year when we scored one equal to the benchmark for waiting times in the practice. Introducing an appointment system in September is probably the reason for the improvement from 51 to 66 with a benchmark of 51. This year, 68 % of our scores were 10 points higher than the benchmark.

Last years scores were compared to those of this year.

Specific questions

The question asking about additional hours was looked at (Q3b). It is not possible to state a percentage of people that are happy with the present system because more than one answer is possible. However 52 out of 105 answers were that the respondent was happy with the current hours. 26 out of 105 wanted weekend opening and 19 evenings. As these we are no longer contracted to work evenings or weekends this is not an area that we can do anything about.

Looking at the question about availability of doctors (Q6) it is apparent that people do not always understand questions. Two people answered no to the same day availability of a doctor in an emergency. This is, without doubt, not true as we always prioritise emergencies and would never turn away a patient if they had an urgent problem. The only instance in which this could occur is if a patient did not tell the receptionist that they felt their problem was urgent.

Patient comments are included in Appendix A

No areas of major concern were highlighted by the survey.

•  Summary of the findings of the 2005 survey

 No major concerns were highlighted last year from analysis of the 2005 survey. The area we concentrated on was our lowest scoring area regarding waiting times in the practice. Our score in this equalled the benchmark whereas all others were above. An additional survey was carried out to establish patients' opinions regarding the introduction of appointments. 74% of patients did not want an appointment system. Some useful comments were added by patients and a discussion was held with all staff to discuss the findings of the survey. (Appendix B)

The action point for the coming year was to continue to discuss and review the issue of an appointment system.

•  Activities undertaken over the past year to address patient experience issues

Long waiting times in the practice with an open access system continued to cause us concern. This was despite the findings of our own survey. Also, the need to offer pre-booked appointments for the Access DES became an issue. We finally decided that it was essential to introduce appointments. Much research was done to look at various types of appointment systems used in other surgeries across the country. Retrospective analysis of consultation figures was done to establish how many appointment slots would need to be offered. The proposed system was discussed with all staff (Appendix C). A mixed system of pre-booked and book on the day surgeries was developed.

The appointment system started in September and has been analysed at frequent intervals. The majority of patients seem to be happy with it, even those who had previously voiced strong objections. It is slightly harder for the patient to see the doctor of their choice but no system can be perfect in every way. The distribution of patients between surgeries and between doctors is now significantly more even. We will continue to analyse the system and make changes as necessary. We will take note of any comments received by patients via the suggestion box or on the feedback form on our website.

Satisfaction with phoning the practice was above the benchmark last year but we were aware that at peak times the patients were often met with the frustration of an engaged tone. Because they then used the ring back facility the phone was ringing again immediately thus not giving the receptionist a break between calls. A new telephone system was put in place in July with extra lines, direct lines to the Practice Manager and Doctors and caller display amongst other features. We fell that patients now have a better service although this is not demonstrated in the survey. Some patients may have commented on past experience prior to July.

No other areas were highlighted in the survey that needed improving.

Unrelated to the survey findings we looked at some other areas where we could improve our service to patients. In order to improve information for patients, the practice developed a website. We have already received some very positive feedback from patients about this.
Our most recent innovation has been to set up on-line repeat prescriptions . We are using a service set up by GP initially for his own patients. It was so successful that he decided to open its use to any surgery that registers. It uses a secure server with encrypted messaging and so far we have not had any problems with it. Those patients that are using it have told us how useful it is.

Some improvements have been made to the structure of the building to improve access for people with a disability.

Even though the GPAQ survey is only once a year, patient opinion is continually monitored. Comments received in the suggestion box are read and acted on as they arise. Any changes to improve patient experience are discussed in Practice meetings and implemented as soon as possible.

Is there anything particularly good about your healthcare?

Doctor listens and advises and sends us for further consultations if the need arises.

Excellent care, patient, always clarifies and explains when asked

Excellent, how well the staff and doctors listen to you

The surgery staff are always friendly and helpful

I have a very understanding GP who always has time to explain any problems

I think I have very good health care from my doctor

The surgery is fine, it is the length of wait for hospital treatment that is unacceptable

I am looked after very well

Due to my longstanding illness I feel that the doctors at this practice give me reassurance and medical help when I feel I need it most. Any urgent problems are dealt with immediately

The doctors always have time to listen to my health concerns and are very helpful and give good advice

Friendly doctors and staff at the surgery

At the present time I am very happy with the way things are

Understanding, taking time to explain the condition, willing to listen

Health care very good

Every body doing there best

Yes, children are always a priority

Is there anything that could be improved?

Being able to speak to the doctors in this practice at all times (evenings and weekends included) as it used to be

Evening surgeries would be convenient

Nothing

I wasn't contacted about an abnormal blood result which affected my medication. Perhaps this is my fault for not ringing but having been rung in the past I assumed this was normal

Hospital waiting lists

No, I'm completely satisfied with the care I receive from my GP

Coffee machine

Parking can be difficult

Any other comments?

As a family we are very grateful for the excellent care given by our doctors at Ashleigh Surgery, thankyou

I would like to be able to see a doctor on the same day after 6pm due to working hours

Dr W James is an excellent doctor

I would like to be able to make an evening appointment with a lady doctor.

Dr James and Dr Wendy are very good with my children when they are ill

I feel that we belong to one of the best surgeries in the area, excellent Doctors, nurses and receptionists

Very happy with health care received over the years

Cannot be improved. Quite excellent

In the past with open surgeries I have had to wait over an hour. Today with new appointments I was seen almost straight away – very good

Excellent service

They try there best

In the ten to eleven years I have been coming to this surgery I have found the staff and docs to be helpful,friendly and understanding. Thankyou

Have only been with the practice 10 months but happy so far