GPAQ Questionnaire Results

The GPAQ Patient Satisfaction Survey has been an annual part of our Quality and Outcomes Framework (QoF) work for several years now.

Each year patients fill in a questionnaire after seeing the nurse or doctor in the practice. The results are then analyzed to see if there are any areas which can be improved.

This year we are very pleased to report that our patients continued to rate the practice very highly. Most of the scores were equal to or above the benchmark, some significantly so. Also, most of the comments were favourable. The majority of negative comments were about OOH or concerns with ambulance availability which we have no control over (these comments were passed on to Viv Smith, the Health Board localities manager).

2009 was the last year that this survey will be carried out within GP surgeries themselves - in future the questionnaire will be sent out and collected by the Health Board. (One such questionnaire was already sent out at the end of 2008).

We discuss the results of the questionnaire at a practice meeting and set goals for the year to come to continually try to improve our service. The following information comes from our most recent GPAQ discussion:

Last year’s GPAQ - 2008

A patient survey was carried out in the Practice during January and February 2008.

Completed questionnaires were received as follows:

Dr Robbie Coull 43
Dr Rosemary Wright 32
Kate Paton, Practice Nurse 33

Dr Wright analysed the responses for all three. Both GP’s scored above the benchmark for the majority of questions. Kate Paton’s scores were equal to or above the benchmark for all questions.

The main area of patient dissatisfaction revealed by the data analysis concerns waiting times (between the time of their appointment and the time they are actually called into the consulting room) and continuity of care by the same GP. Some patients also expressed a wish for easier telephone access to clinical staff.

Regarding patients’ comments at question 18, most were positive. However, several patients expressed concern over out-of-hours provision.

Last Year’s Priorities - 2008 to 2010

As a result of the GPAQ carried out in January/February 2008 the following

Priorities were agreed:

* to reduce the time patients wait once they arrive in the practice;
* to dedicate time for patients to contact clinical staff by ‘phone;
* to allow patients to see the same doctor more easily.

Changes Implemented in 2008

* Dr Wright’s morning surgeries now start at 9.20am instead of 9.00am to allow time for her to check emails, etc before seeing patients;
* Dr Coull has a short break half way through his surgeries to allow some ‘catching up’ time;
* Five minute telephone advice slots have now been included at the end of morning surgery for patients wishing to speak to clinical staff over the telephone.
* Since July 2008 we have had a second salaried GP at the practice and has surgeries from Wednesday to Friday each week. Dr Wright is at the surgery on Mondays and Tuesdays. This allows patients who wish to see the same doctor to do so more quickly.

GPAQ 2009

A patient survey was carried out in the Practice during January and February 2009.

Completed questionnaires were received as follows:

Doctor 19 + 23
Practice Nurse 26

Response rates were not as good as last year; many patients were unwilling to complete a questionnaire at the surgery after seeing the doctor, preferring to take it away with a stamped addressed envelope for completion at home. However, many of these were not subsequently received in time for inclusion in the analysis. Several patients who attend surgery frequently to see the doctor and the practice nurse may have grown weary of filling in more than one questionnaire. Similarly, some patients have already taken part in the Access Survey carried out by Highland Health Board in November 2008.

Dr Wright analysed the responses for all three.  The scores were equal to or above the benchmark for all questions. The score indicating satisfaction with the receptionists was also well above the benchmark.

Regarding the priorities set last year for 2008 to 2010:

* Waiting times – satisfaction with waiting times has improved this year with both GPs and Kate scoring above the benchmark. This was the main area of dissatisfaction last year.
* Telephone Contact – patients expressed a high degree of satisfaction in this area with all scoring significantly above the benchmark.
* Continuity of care – this is not relevant for Kate and has not improved significantly for the GPs since last year in spite of the new arrangements whereby both doctors are available every week (apart from annual leave, etc).

Although one provider scored well in the area of patient autonomy, two providers scores were not as high as would have been expected. This may have more to do with the layout of the questionnaire than anything else; for the patient autonomy questions the tick boxes indicating the best scores are aligned to the left whereas for all other questions they are on the right. Not all patients may have realised this.

Patients appear to be satisfied with the practice’s opening hours. However several expressed a wish for evening or weekend opening hours. This may be connected to the unfavourable comments made by some patients about NHS24 and the ambulance service. There seems to be little doubt that patients would prefer to have an out-of-hours service run by the practice.

One comment criticised the music played in the waiting room.

Apart from criticism of NHS24, the comments at question 18 were very positive and show that patients value the service provided by the practice and appreciate the caring way in which they are treated by all the staff.

Priorities for 2009 to 2011

As a result of the patient survey carried out in January and February 2009 the following priorities have been agreed:

* to emphasise to Highland Health Board the widespread dissatisfaction with the current arrangements for out-of-hours care;
* to maintain the high standards of care currently provided;
* to change the music played in the waiting room.

In order to achieve these priorities Sue will carry out the following:

* contact Viv Smith, Locality Manager, regarding out-of-hours provision quoting comments made in the survey and other verbal feedback received at the surgery;
* ensure that all staff remain motivated to provide high standards of care;
* load a new selection of music onto the ipod in the dispensary. If this is not well received the Practice will consider asking patients for their suggestions.

Reporting Findings to Patients

The outcome of the survey will be reported to patients as follows:

* [This document will be posted on the practice] blog at;
* Members of the community council will be invited to a meeting to discuss the results of the survey.

Additional Information

It was not felt appropriate to widen the survey to collect additional material. The Practice provides medical care for about 900 patients. A survey designed to target a specific group, eg relating to a particular condition, would be unlikely to produce meaningful results as the numbers in each group would be too small, and in a small, close-knit community, such as Strachur these discussions are a constant feature of practice life.

The Practice may consider asking patients to suggest music they would like to hear in the waiting room.

Quality and Outcomes Framework (QoF) points 2008/9

We're delighted to announce that Strachur Medical Practice scored 998.5 out of 1,000 in this year's QoF.

QoF is the Quality and Outcomes Framework that every NHS General Medical Services GP Practice has to complete each year. It measures quality care over a wide range of areas such as blood pressure, cholesterol, diabetes care and so on.

You can view Strachur Medical Practice's QoF points score and disease prevalence rates online and compare it to other practices in the area, and to the Health Board and national averages. (This year's figures are not available online yet, but previous years are.)

We only missed two points of the 1,000 - one was because we decided not to collect ethnicity data on our patients because we had an ethical objection, and a half point because one of the staff vaccination certificates went missing.

I'd like to thank all of the staff at the practice for their hard work at acheiving this excellent score.`