How was your appointment? At your Salford GP practice

Healthwatch Salford wanted to find out best practice in GP services as well as areas where they needed to improve.  They undertook a survey to which 1,715 people responded and a survey of staff to which 71 people responded.

For some people, telephone appointments were a convenient way to access GP appointments. Patients also talked about how they had embraced online and app services before the pandemic and sorely missed the ability to contact the surgery remotely or book appointments in advance throughout the day. Nearly a quarter of the comments talked about appointments in a negative light with people talking about the barrier that speaking over the telephone presents, rendering some patients unable to convey their problem to the doctor or nurse.

There were many responses who shared positive experiences of doctors, nurses and receptionists. Respondents valued polite, courteous, friendly, and approachable staff; staff were frequently described as caring and empathic, and many patients felt that they were listened to with understanding and patience. There was an overall impression across the feedback that receptionists are viewed as the appointment gatekeepers and that once a patient accesses clinical staff their issues are appropriately resolved.

Generally speaking, when it came to the surgery premises, patients were understanding of the safety restrictions that COVID-19 had imposed. Patients said that they felt safe and secure, acknowledging the efforts staff had made to negate the spread of infection. Some patients talked about the physical barriers presented to them with main reception doors being closed and only accessible by pressing an intercom button.

For some patients, referrals into secondary care or other services went well. Patients talked about some GPs being proactive in contacting them following health concerns with others saying that their surgery had a dedicated COVID monitoring team. Where patients were kept informed of their position on waiting lists, this allayed their fears of being ‘missed off’ and forgotten. Where people had talked negatively about referrals, their comments seemed to stem from lack of information and communication.

Patients said that the facility to order prescriptions online was a valuable service to them. Some patients also spoke of how GP practice staff went out of their way to support them in ensuring they could access the right medication, with one commenting that their receptionist rang around many pharmacies to get the medication that was needed. Many comments to do with medication mentioned that doctors and nurses do not follow up after prescribing, with some patients telling us that they had been given the wrong or conflicting medication.

In some practices, staff would demonstrate care and patience with people who have mobility issues. For example, during lockdown when the main doors were kept shut, some staff would come to the door and help the patient into the building. Some practices were happy to print off medication instructions and test results to those people who requested the information on paper. Others felt that the digital uptake of services was detrimental to people who did not have the access or knowledge to make use of online services.. Some patients whose first language is not English felt that their practice did not do enough to be inclusive, commenting that many forms and procedures were only provided in English.

The staff survey found that staff workload had increased and there had been a huge increase in patient demand. Practice and business managers talked about how they had a bigger role to play in supporting staff who were stressed due to the sheer volume of workload, exasperated by incidents of sickness, low morale and staff vacancies.

Over half felt that their wellbeing had been affected due to their workload. Practice and business managers said that they were working longer hours and missing breaks to support staff and patients, whilst implementing new systems to accommodate the changing directives from the government and commissioners.

Over two in five staff felt that patients’ access to appointments had improved since the pandemic. GPs explained that the introduction of telephone triage meant that patients were often contacted quicker, but there was still dissatisfaction from patients as they wanted to be seen face-to-face.

Almost all staff let that patient attitudes towards them had deteriorated since the pandemic. Many felt that the negative press in the media was fuelling patient dismay with the service.

All staff commented on how technology had enabled their service to adapt and improve their services to patients. Enabling patients to be able to send in pictures of their medical conditions where appropriate was also championed as a way of cutting down waiting times and allowing more access to clinical support.

The report contains five recommendations and responses from providers.