Primary and urgent care survey - suggestions for improvement in primary care

Respondents made a range of suggestions for improvements in primary care which included more investment in the health service and recruiting more GPs and staff, other ways to communicate and keep in touch, bringing out of hours contracts back into GP surgeries, improvements in appointments, having more local clinics, having more specialist services available in GP surgeries.

More investment, more GPs

Over 300 people mentioned the need for more clinical staff – doctors and nurses - and 150 of these were talking specifically about primary care. Other comments related to hospitals in general. This was often described with the need to reduce the numbers of administrators/managers. There was also a call for more training.

More doctors & staff available at our doctors surgery

Allow a surgery to recruit sufficient GP staff to reflect the high increase in population covered (due to developments in the area). The GP staff are doing a fantastic job but are under increasing pressures.

Keep enough Doctors and Nurses working for NHS (They are all wonderful) even if it means a small fee for the public to pay for NHS services.

More information about services/helplines

Suggestions included providing a helpline, more information displayed in doctors surgeries and available to patients. This is expanded in the section on urgent care below, but some pertained directly to GP services.

A helpline at local practice might help save having to make an unnecessary appointment and avoid wasting my time and the doctors time.

A full list of NHS services in the West Sussex group area, displayed in doctors surgeries, would be helpful, rather than the odd leaflet here and there.

Some comments were about information about the surgery, for example timing of surgery sessions, which doctors were available and their specialisms and any changes and to raise awareness of the surgery website.

Local doctors doing urgent care at the weekend on rota basis

When people are ill they wish to see a Dr. We have 5 surgeries in our area and it would be a good idea to have one open at weekends on a rota basis. Drs have families too they need days off.

Walk in clinic

Some comments were about having walk in clinics, or open un-booked clinics in the morning.

A walk in clinic in Worthing with extended opening hours, similar to the one at Brighton Station Health Care.

ALL GP practices should have a three-hour walk-in service, every morning Monday to Friday, from 0900 to 1200 with three or four doctors available for examination, diagnosis and assurance of a patient. Appointment surgeries can then be from 1430 to 1900 dependant on the availability of the remaining doctors at the practice

Training and improvements with reception staff

When phoning for an appointment not to have the receptionist being officious and asking why you need an appointment, this is between the doctor and myself, not an unqualified person.

Improvements in appointment system

Change the way appointments are made. It should be possible to make an appointment today for tomorrow or the next day and not have to make it on the day. Many of us work with conditions that need treatment but our working hours make it difficult to make a phone call. If we could phone on our days off to pre book an appointment for when we are next off it would help. Shift work is now common place and we can't afford to miss work.

Adopt a system telephone consultant with own GP before being give an appointment many problems could be dealt with this way without the need for an appointment . Doctors could decide who they needed to see, so patients to talk to their own doctor.

Invest in telephone services, I have benefits from telephone conversation in another part of the UK . Preferable to text or email as it is an easier two -way exchange of information for certain circumstances it could be more appropriate efficient. Also all GP practice should have a telephone queuing system e.g.: “press 1 & stay in a queue or hang up to try again later”. Constantly having to waste time re-dialling in this age is ridiculous especially if you are trying to calm a sick child.

Ability to book an appointment ASAP preferably the same day as am prepared to return to GP surgery. More GPs so the appointment system is not full up by 8.30am. Two receptionists on all the time when busy. A copying machine for info obtained.

A significant problem is when your doctor has said 'come and see me again in 'x' weeks', or 'after test results are back', and you cannot get a booked appointment when he said to. […] It would be better if the surgery could be prompted at the right time and an available appointment offered in those circumstances.  It seems to work with hospital appointments, so it should work for GP surgeries.

More information about waiting times

Some suggestions were about getting information about appointment times and waiting times, so that they could adjust their activities accordingly. For example finding out if they could get an appointment with another GP faster or to inform if the actual session is running late which is particularly pertinent if waiting is difficult for example with small children or with anxiety disorders.

Inform the patient via text/phone call if appointment running late.  I have waited over an hour before with hungry, screaming toddlers, other patients even offering me their appointment, with different doctors. Being informed in advance means patients can arrive later for their 'delayed' appointment to avoid such situations.

make available on line the waiting times at any surgery within 10 miles radius. Make sure all GPs post their availability times on the online service so I am book an appointment online for the next 7 days

When you do go to a clinic whether it be GP, other provider or Hospital. That you are kept informed of your waiting time and any other options eg running 1+ hours late rediarise appointment.

Agreed time for call backs

Some respondents described the problems of waiting for call backs from the GP, and this has been also highlighted in focus groups with disabled people as they often found it hard to get to the phone in time. In addition, in research conducted by the Young Foundation, this was a particular issue for those who were relying on relatives to help interpret for them, when English was not their first language. Working age people also identified that it was difficult to be available to take calls.

I would like to be able to ring for an appointment and get one instead of the new “the doctors will ring you back” system, because I cannot do anything else waiting for the call. I am 92 and can’t get to the phone quickly. I don't know if I can leave  the room to get food in case I miss the call. I also need my son to give me a lift to the GP , he can't just wait to know if I need him so we are both waiting in. He lives 8 miles away.

Pairing GPs

In view of the great difficulty in getting an early appointment with one's own GP - why not give patients a choice of TWO specified GP's, i.e. "PAIRING”, which would give patients the opportunity of seeing either GP who was conversant with their medical history, rather than seeing a locum or GP who had to plough through the history - wasting about half of the allotted 10 minutes.

More specialists in local centres

Several comments were about wanting more specialist appointments or services in local centres. Some referred to having these at GP surgeries, others with more local clinics.

I would like to see GPs subscribe to a "Centre of Excellence" model whereby GPs have a specialist expertise and interest.

We need to provide more hospital service at GP surgery.

More immediate blood tests and practice nurses taking blood pressure. Test for diabetes at each visit when patient has not been seen in past 3-6 months. It's time consuming and difficult for older patients to have to return to the GP practice or attend phlebotomy at a local hospital. So each practice could have someone phlebotomy trained (+ BP and sugar tests) - needn't be nurse band. Also for MSK - more access to physiotherapy services.

A minor injuries unit in Chichester - Bognor is a long way to go with a broken ankle or arm! Why not close OP clinics in hospitals but re-site them in the community with more available slots for GPs to refer direct? Why not have MORE diagnostic services for tests ie blood, specialist tests, x-rays, CT scans, MRI scans in the community rather than send patients to hospital for a definitive diagnosis when this could sometimes be done by a GP then dealt with by the GP or sent to the appropriate specialist direct?

Make more multi clinics available, the surgery I attend is excellent with fantastic services but I know it's the only surgery in the area that opens outside of the 9-5 I can get an early morning a late evening and a Saturday appointment if I need one.

Ability to pick up more than a month’s prescription at a time

When I get a prescription for a long term condition, I can pick up 3- 6 months of tablets etc. not just 1 month! NHS spends 90p on each prescription; if this was adopted across the UK it would save a) GP practice admin, b) chemist admin c) paperwork staffing bags etc. plus £0.5bn in savings prescription costs.

Use other local resources community sites for consultations, for example pharmacies and village halls

I would like to walk to my GP surgery rather than travel to the next village (Storrington or Steyning). It seems bizarre that the whole of my village has to travel to another village to see a doctor. I think my current surgery should run a clinic in my village (Ashington).

Make people pay for missed appointments

Wasting appointments is a well recognised problem. A system similar to the dentist's where patients missing an appointment must pay a fee would reduce the incidence, making the system more cost effective.

Charge those that don’t bother to contact the surgery to cancel their appointments! Give a telephone reminder and/or text prior to all appointments. We all have busy lives and when you’re waiting 3 weeks to see a doctor you can forget the actual appointment which ruins it for you and everybody else.

Improved registering for GP practice

To be able to register at a GP with only proof of NHS entitlement e.g. a valid NHS number

More choice should be available to sign up for a GP. I tried and was told only 1/4 miles with home visits being done differently to years ago. I don't think there is need to have a catchment area.

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