Patient perspectives on Brighton and Hove GP Practices 2016

This Healthwatch Brighton and Hove report presents findings from a city-wide review of GP practices conducted between July and September 2015, combining an online survey with Enter and View visits to 12 GP practices. Feedback was gathered from 534 patients, covering all but one GP practice in the city. 

Overall, the report found that patients were generally positive about the quality of care provided by GPs, nurses and reception staff. Most respondents felt that staff gave them sufficient time to discuss concerns, listened carefully, and explained treatments clearly. Patients consistently emphasised that empathy, good communication and being listened to were the most important characteristics of a high-quality GP practice. 

However, access to appointments remained a significant concern. Although urgent appointments were usually available when needed, especially for children, many patients experienced difficulties obtaining routine appointments. Around 22% of patients reported being seen the same day for non-urgent appointments, but 25% said they normally waited longer than a week. Waiting times were reported to be worse than the national average and varied considerably between practices. 

Most patients continued to book appointments by telephone or in person, while only a small proportion used online booking systems. Many patients reported difficulties getting through by telephone and some struggled with automated booking systems. The report noted that efforts to increase online booking had not yet significantly changed patient behaviour. 

Patients generally reported positive experiences of referrals to specialist services, with two-thirds saying the process worked smoothly. However, where delays occurred, many patients felt poorly informed, with nearly six in ten people experiencing referral delays saying they were not kept updated about progress or waiting times. 

Views on telephone consultations were mixed. Over half of patients who had used them felt they were not as effective as face-to-face appointments. Carers were more likely to value telephone consultations, but people with communication difficulties, autism, learning disabilities and those whose first language was not English often found them less satisfactory. 

The report identified concerns around shared decision-making. Although most patients felt treatments were explained clearly, many reported not being offered sufficient choice about treatment options. Patients particularly valued seeing the same doctor regularly and felt more confident when consultations were carried out by a GP who knew their medical history. 

Healthwatch found considerable variation in the availability of information about preventive health services, including cancer screening, smoking cessation and NHS Health Checks. Patient awareness of these services was relatively low, particularly for annual health checks. The report highlighted that uptake of NHS Health Checks in Brighton and Hove was well below the national target. 

Awareness of complaints procedures and patient participation opportunities was also limited. Less than half of respondents knew how to make a complaint, only around a third understood the role of a practice manager, and relatively few knew about Patient Participation Groups or how to join them. 

Observations during practice visits found that most surgeries were clean, accessible and generally well equipped. Most provided health information, disabled toilet facilities and hand sanitiser, although the quality and organisation of information displays varied considerably between practices. Some practices demonstrated particularly good approaches to gathering and responding to patient feedback, including "You Said, We Did" displays showing actions taken in response to comments. 

The report concluded that Brighton and Hove GP practices generally provided good-quality clinical care, but that improvements were needed in appointment access, waiting times, communication about referrals, preventive health promotion and patient involvement. Healthwatch recommended simplifying appointment systems, reducing waits for routine appointments, promoting online booking, improving awareness of health checks and screening programmes, increasing visibility of complaints procedures, supporting patients with communication needs, and adopting a more person-centred approach across GP practices.