Enter and view: Roseberry Practice

Healthwatch Stockton-on-Tees undertook an announced enter and view visit to Roseberry Practice on 21 February 2017.  They spoke to 42 patients and six staff.

Healthwatch were encouraged that the The Practice Manager was positive and welcomed an Enter and View being conducted at Roseberry Practice. The increasing pressure on the practice with reduction in GP’s and difficulty recruiting them to the practice is echoed across the Stockton Borough. 

The Practice Manager felt it was important to share information on the challenges the practice and staff have faced, particularly over the previous 18 months. Healthwatch welcomed the open and transparent approach which was offered in gathering information. The practice has managed to recruit two new GP’s who started in March 2017, although this will increase resources and appointment availability the practice will still be below previous staffing levels while manageing the same amount of registered patients. The commitment by the whole staff team to ensure the safety and service continues to meet appropriate standards is evidenced in the last Care Quality Commission (CQC) inspection where the practice was rated as ‘Good’. The practice have consulted patients with the aim to improve the service a number of times.

Patient choice has been considered and addressed with changes made, an example of this is the adjustments the practice has made to the phone system in an attempt to manage patient calls. Roseberry Practice emanates a calm, relaxed and safe environment which meets patient need. 

Despite negative feedback Healthwatch had gathered regarding waiting times before the Enter and View, on the day Healthwatch visited 74% of patients reported that they found it ‘Very Easy’ or ‘Easy’ to book an appointment and 77% did this by telephone however, when rating the system for booking appointments 45% rated the system ‘poor’ or ‘very poor’. 

It was brought to the attention of Healthwatch that 65% of patients Healthwatch spoke to were not aware of the on-line booking system. 

Negative comments received highlighted the themes of not being able to get through on the phone and not being able to make an appointment in advance. Positive feedback highlighted some patients are accepting of the pressures the practice is under and acknowledged the pleasant, helpful manner of the staff. 

The Practice do not support signposting of patients to the walk in clinics however, 54% of patients asked said they would use this facility if they could not get an appointment at the practice. 70% of patients who completed the survey had used pharmacy services as an alternative to visiting the GP. This demonstrates the education of patients and a positive move towards patients looking for an alternative when ill, thereby alleviating some of the pressure on the practice. 

Although some patients are happy that they can secure a ‘same day’ appointment some feel it a disadvantage that pre-bookable GP appointments are not widely available. The practice do offer pre bookable appointments on a Saturday and one later night per week. The demand for this is high, however, the results show that the majority of patients are satisfied with the current system. 

The ‘Duty Doctor’ will be under increased pressure with this system in operation; when all available appointments have been taken, they are required to call the patient back. Patients could potentially abuse the system by failing to disclose information to the receptionists or by saying the appointment needed is “urgent;” they will indeed receive a call back.

The practice promotes the services of the Nurse Practitioner, educating patients about the conditions they can prescribe for, and encouraging patients to make a prebookable appointment. This helps to alleviate the high demand for GP appointments. Healthwatch gathered positive feedback from the reception team on how they feel about their role and working at Roseberry Practice which demonstrates the practice has the right people in the right roles. Feedback also highlighted the frontline team work to ensure a quality service is delivered consistently.