GP surgeries with poor access told to improve
BMJ 2007; 335 doi: https://doi.org/10.1136/bmj.39287.410822.4E (Published 26 July 2007) Cite this as: BMJ 2007;335:174
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The GP patient survey 2006/2007 results will be interpreted to make
different
judgments about general practice. The Department of Health response is to
impose local action plans to make practices provide more same day
appointments. The belief that the survey results reflect reality must be
questioned. The results only present a perception of reality that must be
investigated locally to be understood.
Our practice (www.horfieldhealthcentre.nhs.uk) scored above average
on all
the questions except in answer to one question: ‘Think about the last time
you tried to get an appointment with a doctor fairly quickly. Were you
able to
get the appointment on the same day or on the next 2 days the surgery was
open?’ Our practice only scored 82% yes (in England the average score was
86%, and in Bristol 87%).
This is a puzzling result because we have always had a policy of
providing an
appointment for any patient who says ‘I want to be seen today’, and we
ensure that we supply enough unbooked appointments each day to meet the
likely demand. We audit our performance and have never been aware that
patients had a problem accessing same day appointments. The only
complicating factors are that we try to promote continuity of care and
personal care by directing patients to make routine appointments with
their
personal GP, and that irregular users of the service may be unfamiliar
with
booking appointments.
In our practice the survey does not demonstrate that there is a
problem with
access, it demonstrates there is a problem with perception about access.
The
survey report did suggest that if patients are older, white British, live
in least
deprived areas, a rural area, or are more frequent attenders, attend a
smaller
general practice then they are more likely to say they succeeded in making
an
appointment for within 48 hour.
If we want to improve the service and the patients ability to use the
service,
then the survey results must direct us to be not only confident that we
supply
enough same day appointments, but to find better ways how to help patients
unfamiliar or uncomfortable with a service to use the service.
Competing interests:
I am a NHS general medical
practitioner
Competing interests: No competing interests
GP Surgeries
Dear Sir
Last month saw headlines in the media about the ‘vast majority of
patients’ being satisfied with their GP's opening hours. This followed
publication of results from a GP Patient Survey conducted by the
Department of Health. The results were taken by some as proof that GP
practices are open at times to suit the vast majority of patients.
However, the picture is not as clear cut as some have made out. They have
conveniently forgotten a Healthcare Commission report that came out in
January of this year that contained a rather different message. This
survey, also based on a large sample, showed that 25 per cent of people
said specifically that inconvenient opening hours had actually put them
off going to the GP within the preceding 12 months. Furthermore, only 28
per cent of people said that additional opening hours were not necessary.
Although the two surveys contained questions put in different ways, the
Healthcare Commission study suggests that we cannot afford to be
complacent about this very important issue, especially when considering
the needs of groups, including men, which have historically under-used GP
services.
Relying just on the last set of statistics is always an unwise path to
tread.
Yours
Regards
Peter Baker
Chief Executive
Men's Health Forum
Competing interests:
None declared
Competing interests: No competing interests