PRACTICE IMPROVEMENT QUESTIONNAIRE FINDINGS

June 2012

Report for Ratcliffe Rd Atherstone Surgery

Overall Summary

This report has been produced as a result of the ‘improving the practice questionnaire’ recently completed by the patients of the Surgery. It is apparent from the survey that the overall satisfaction with the practice is high, however, there are opportunities to raise the satisfaction level still further and improve the overall patient experience.

Primarily, the report pays attention to the opportunities for improvement since this was the focus of the questionnaire and there would be no point in calling the survey an improvement survey if all it was intended to achieve was confirmation of the good service area’s.

Therefore the weaknesses identified should be read with this in mind.

Approach of this report

Consider the questionnaire objectives and using the data derived from the respondents, identify where most gains can potentially be made for the benefit of the patients.

To understand why the weaknesses identified matter, for each weakness identified, the potential impact on the patient or the practice is considered.

To suggest solutions for improvements that will require little or no capital investment and to highlight those area’s that may require a budget and therefore need business priotitisation.

Conclusion, the customer service area’s that require improvement:

• Communication • Access to appointments • Infrastructure improvements Report for Ratcliffe Rd Atherstone Surgery

Yellow indicates that more than a third of the respondents scored the question a 2 or 1 Orange indicates that more respondents considered the answer overall to be less than good

Speed at which the telephone was answered initially Speed at which the telephone was answered if call transferred Length of time you had to wait for an appointment between booking and seeing the Doctor or Nurse Convenience of day and time of your appointment Length of time you had to wait for an appointment to see the Doctor of your choice between booking and seeing the Doctor Length of time waiting to check in with Reception How easy do you find the automated check in system Length of time waiting to see the Doctor or Nurse after your appointment time Opportunity of speaking to a Doctor or Nurse on the telephone when necessary Opportunity of obtaining a home visit when necessary Level of satisfaction with the after hours service provided by Harmony at George Eliot Number of people who answered Combined this question total of all answers Max score if everyone scored 5 % of people who answered this question

% satisfaction score for each question 5 4 3 2 1

339 200 369 383 344 387 226 303 294 130 139 965 581 1199 1387 1032 1441 729 976 1011 390 429 1695 1000 1845 1915 1720 1935 1130 1515 1470 650 695 87 51 95 98 88 99 58 78 76 33 36 8 7 20 26 15 29 19 15 19 18 16 17 20 22 27 22 29 28 23 29 18 22 37 38 29 34 28 28 24 37 35 25 28 30 29 21 10 20 12 15 22 13 24 25 9 7 8 3 15 1 14 4 4 14 9

More than good Good

24 27 42 53 37 58 47 37 48 36 37 37 38 29 34 28 28 24 37 35 25 28

Less than good

39 36 29 13 35 13 28 26 17 38 34 Report for Ratcliffe Rd Atherstone Surgery

The overall satisfaction with obtaining a repeat prescription is overall good to more than good

Prescription ready on time Prescription correctly issued Handling of any queries Number of people who answered Combined this question total of all answers Max score if everyone scored 5 % of people who answered this question 305 296 275 1130 1143 1048 1525 1480 1375 78 76 71

% satisfaction score for each question 5

31 34 32

4

29 32 32

3

24 24 25

2

10 7 8

1

5 3 3

More than good Good

60 66 64 24 24 25

Less than good

15 10 11 Report for Ratcliffe Rd Atherstone Surgery

The overall satisfaction with obtaining test results is less than good and an area of concern given the high number of respondents.

The overall satisfaction with the explanation of the results is good to predominantly very good.

Were you told when to contact us for your results by the Doctor?

Were you told when to contact us for the results by the hospital?

Results available when you contacted us Level of satisfaction with the amount of information provided by the Doctor regarding your test results Where the results explained clearly to you and did you understand the explanation give Number of people who answered Combined this question total of all answers Max score if everyone scored 5 % of people who answered this question

% satisfaction score for each question 5 4 3 2 1

209 184 216 260 260 208 183 215 985 989 1045 920 1080 1300 1300 54 47 56 67 67 0 0 0 30 31 0 0 0 30 31 0 0 0 29 28 0 0 0 8 8 100 99 100 2 2

More than good Good

0 0 0 61 62 0 0 0 29 28

Less than good

100 99 100 10 10 Report for Ratcliffe Rd Atherstone Surgery

The overall satisfaction with the staff is good to predominantly very good

Was the information provided by the Reception staff clear and did you understand it The helpfulness of the Reception staff The information provided by other staff other than reception The helpfulness of other staff Number of people who answered Combined this question total of all answers Max score if everyone scored 5 % of people who answered this question

% satisfaction score for each question 5 4 3 2 1

349 360 304 314 1316 1372 1146 1177 1745 1800 1520 1570 90 93 78 81 26 30 28 27 34 34 31 33 31 24 32 31 7 9 7 8 1 2 1 1

More than good Good

61 65 59 60 31 24 32 31

Less than good

8 11 8 9 Report for Ratcliffe Rd Atherstone Surgery

The overall satisfaction with the last experience with a Doctor or Nurse is good to predominantly very good

Giving you enough time Listening to you Involving you in decisions about your care Treating you with care and concern

Finally

Practice My overall satisfaction with this Number of people who answered Combined this question total of all answers Max score if everyone scored 5 % of people who answered this question 364 365 350 361 1463 1496 1425 1491 1820 1825 1750 1805 94 94 90 93

% satisfaction score for each question 5 4 3 2 1

35 39 38 36 23 20 4 4 0 0 40 43 33 32 22 22 4 3 0 0

More than good Good

73 76 73 75 23 20 22 22

Less than good

4 4 5 3 362 1450 1810 93 35 37 23 4 1 72 23 5 Report for Ratcliffe Rd Atherstone Surgery

Communication Improvement Opportunities

The survey indicated that once booked in to see a doctor and through the door most respondents are highly satisfied with the surgery. However, the patient experience leading up to that point does require some review.

Weakness What this means for the patient

The perception is that it takes too long for the phone to be answered by a human.

Transfer of calls appears to take a long time The attitude of some staff, some of the time was commented upon The relaying and management of test results was a major weakness with a 100% of respondents to that question expressing dissatisfaction They are getting frustrated and initial contact with surgery has been a bad experience.

They are already potentially irritated, their perception of time is likely to be distorted and so any delay will feel long. Fixing point 1, may positively impact this. Especially if the operator sets an expectation of how many rings it may take before it is answered and why.

Again its down to perception and not the staff. If their day has started badly and presumably it has because they are at the surgery any ‘slight’ will be exaggerated. Good customer service will recognise this issue and recognise that the patients intention is not to be difficult but to be seen. Anxiety in the first place because people hope for the best and expect the worst! The feeling will also be that if no-one really cares about this early stage, what will it be like if I have to have treatment – they are already in fighting mode. Report for Ratcliffe Rd Atherstone Surgery

Appointment issues

The survey indicated that the overall consultation experiences were excellent and was the highest scoring category.

However, securing the appointment in the first place appeared to cause some frustration a fact supported by some comments.

The survey specifically asked questions on this topic.

Weakness What this means for the customer

The length of time between seeking and getting an appointment with a doctor of choice is perceived to be long.

Home visits are not as easy to obtain as some people would like.

Worry. Not cared about.

These are natural responses when an issue superficially appears to be more important to one person than another. Appointment delays can’t be helped, but some transparency to the customer as to where they are in the queue and why helps. Because it contextualises things and removes the ‘victim’ to some system perception.

The out of hours service at George Elliott had a broad cross section of satisfaction, nonetheless over a third of the respondents were dissatisfied.

Responsibility for their health has been passed over to someone else who knows less about them, however they are grateful that someone is there.

Explanation about the service and the knowledge of what the out of hours service has access to about them may alleviate most of the worries. Also expectations need to be properly managed, maybe a reassurance message about what is an emergency and what isn’t. Telling people to only contact in an emergency means they have to rely on their judgement; this is especially hard if it is on behalf of someone they care about.

Report for Ratcliffe Rd Atherstone Surgery

Infrastructure Issues

The survey indicated that once booked in to see a doctor and through the door most respondents are highly satisfied with the surgery. However, the patient experience leading up to that point does require some review.

Weakness What this means for the customer

The automated booking system wasn’t surveyed specifically but several respondents commented that automated answering system had ‘bugs’ or was unreliable.

The waiting area was commented upon although this wasn’t a specific survey question.

Car parking was commented upon although again not a specific question People only forgive technology replacing a human when it works better than human interaction and saves time. In the context of a doctors surgery technology is already at a disadvantage. Most people want the reassurance of getting the ‘best deal’, in other words they believe that when they speak to a human they have some power of influence over who they see and when, a machine is just pragmatic. They have to listen to it and then still use time waiting to speak to a receptionist.

The survey suggested that if the booking system was bypassed, they got an appointment earlier. I’m already ill, I feel worse. Psychology shows that the environment directly impacts behaviour; Naturally association with the surgery is ‘illness’ and since the surgery exists because of the patients a welcoming environment gives them feelings of being cosseted, brighter or even safer. Its why private facilities spend so much on décor and the environment. People feel optimistic and valued in it.

Report for Ratcliffe Rd Atherstone Surgery

Next Steps

High Level Proposed Plan Time Impact Start

People see more of what they expect to find or focus on; so if the initial experience or expectation from a previous visit is low, typically patients will seek to support this view and find evidence to support it. From the survey it is evident that the last impression of the surgery is usually good if that last interaction resulted in seeing a medical person.

The people we most need to influence and manage the perceptions of are those who last interaction was to either seek information, use the phone system or try to make a booking. These are the people who will be starting from a negative view point and it is important to stress here that the survey shows this is not because the initial front line staff scored badly, they didn’t they scored highly. Unfortunately though, the processes between the non human and human interactions are getting in the way of an excellent overall score.

The relative responses by age category was also considered and even though predominantly more of the age group 25-55 answered the survey, the normalised results indicate consistent perception of the infrastructure/technology aspects of the practice. Agree format and develop feedback to the surgery patients 1 week High immediate Review or develop best practice customer service guidelines. Set customer service expectations : the phone is answered after xx rings, consistent phone greeting, email responded to within etc Review procedures for relaying results to patients and seek to improve these Review automated telephone system I month 1 month 1 week Medium High High After practice agreement Immediate Potential cost Review what ‘cosmetic’ improvements can be done to improve first impressions and waiting experience 1 week medium High Quick win & later cost potential Quick win Develop on going feedback and review process to understand the day to day issues of patients. Manage PR by regularl communication, this will help manage any bad messages, build confidence, support and a feeling of inclusion, most importantly high light all the good things that happen that go unnoticed.

Report for Ratcliffe Rd Atherstone Surgery 1 month