Alton Street Surgery
Local Patient Participation Report 2015
To ensure we maintain the provision of the best possible service, the practice continues to be
committed to seeking the views of our patients. We have an active Patient Participation Group
(PPG) that has been in existence for several years and meets quarterly, and to supplement this,
our virtual Patient Participation Group (VPPG) was formed four years ago. We always have flyers
in the surgery inviting patients to participate in the VPPG, and these are also handed out at our
‘flu day’. We currently have 167 patients (60 male and 107 female). There are 165 British or
Mixed British, 1 Caribbean, and 1 Other White Ethnic Group. The age range is shown below.
To be as inclusive as possible we offered a range of contact methods.
Preferred contact method
150
100
Number of
members
50
0
Email
Letter
Phone
We are continuing with our efforts to recruit members through publicity in the surgery, so that
the VPPG is more fully representative of our patient population and includes a greater number of
younger people, male patients, and migrant workers.
Appointment System Survey Results
A telephone appointment system was introduced in July 2013 in an effort to try to preserve good
access and excellent patient service in an environment where demand for appointments was far
exceeding our capacity to cope.
The results of the survey are as follows:
Q1. We operate an appointment system whereby the doctors call you back and then make an
appointment the same day if needed. Have you telephoned the doctor in the last 12 months?
All 108 patients who took part in the survey answered this first question. A total of 102 patients
had telephoned the doctor in the last 12 months. The remaining 6 patients who had not were
directed to question 8.
Q2. Did you receive a telephone appointment with your preferred doctor?
Of the 102 respondents answering this question 70 (68.6%) did receive a telephone call with their
preferred doctor, 20 (19.6%) did not mind which doctor they spoke to and 12 (11.8%) did not
speak to their preferred doctor.
19.6
Yes
No
11.8
I did not mind which
doctor I spoke to
68.6
Q3. How do you rate the outcome of your telephone consultation?
Answer Choices
Responses
Excellent
49
48.0 %
Good
28
27.5 %
Satisfactory
19
18.6 %
Poor
5
4.9 %
Very poor
1
1.0 %
Q4. If your telephone appointment resulted in you attending the surgery to see the doctor,
how do you rate the outcome?
Answer Choices
Responses
Excellent
48
47.5 %
Good
30
29.7 %
Satisfactory
10
9.9 %
Poor
1
1.0 %
Very poor
1
1.0 %
Not applicable
11
10.9 %
Q5. If your telephone consultation resulted in you attending the surgery to see the Minor Illness
Nurse, how do you rate the outcome?
This question was not applicable for 74 patients and was not answered by a further 12 patients.
Of the 20 patients who had seen the Minor Illness Nurse, 10 patients rated the outcome as
‘Excellent’, 8 patients rated the outcome as ‘Good’ and 2 patients rated the outcome as
‘Satisfactory’
Q6. How would you rate your overall experience?
Answer Choices
Responses
Excellent
43
42.6 %
Good
34
33.7 %
Satisfactory
15
14.9 %
Poor
9
8.9 %
Very poor
0
0.0 %
Q7. Do you feel you have better access to a doctor than with the previous system?
Of the 98 respondents who answered
this question, 28 (28.6%) felt that
access to a doctor was better, 36
(36.7%) said it was the same as before
and 34 people (34.7%) considered their
access was worse than previously.
28.6
34.7
Yes
Same as before
No
36.7
Q8. How easy do you find it to get through to a receptionist on the telephone?
All 108 respondents answered this question.
Answer Choices
Responses
Very easy
48
44.4 %
Fairly easy
52
48.1 %
Not very easy
8
7.4 %
Not at all easy
0
0.0 %
Have not tried
0
0.0 %
Q9. At what time can you receive a telephone call from the surgery?
Answer choices
Responses
Between 8:00am and 10:00am
72
25.0 %
Between 10:00am and 12:00pm
61
21.2 %
Between 12:00pm and 2:00pm
54
18.8 %
Between 2:00pm and 4:00pm
46
16.0 %
Between 4:00pm and 6:00pm
55
19.1 %
Other
Please see comments: below
80
70
60
50
40
30
number of people who
answered
20
10
0
Between Between Between Between Between
8:00am 10:00am 12:00pm 2:00pm 4:00pm
and
and
and
and
and
10:00am 12:00pm 2:00pm 4:00pm 6:00pm
Responses to the Results and Comments:
Question 1 - We operate an appointment system whereby the doctors call you back and then
make an appointment the same day if needed. Have you telephoned the doctor in the last 12
months?
Comments: None
Response / Action: None
Question 2 - Did you receive a telephone appointment with your preferred doctor?
Comments: None
Response / Action: Continuity of care is an important aspect of the service we provide. Of the
102 patients who answered this question 12 (11.8%) did not receive an appointment with their
preferred doctor when they had a preference. This shows an improvement when compared to
last year, when the figure was 20.69%, and is something that we will continue to strive to improve.
Question 3 - How do you rate the outcome of your telephone consultation?
Comments: None
Response / Action: 96 patients (94.1%) rated the outcome as Excellent, Good, or Satisfactory,
with 6 patients rating the outcome as Poor or Very Poor. No system can ever meet every
individual’s expectations, but as always, we will endeavour to provide the best possible outcome
for all of our patients.
Question 4 - If your telephone appointment resulted in you attending the surgery to see the doctor,
how do you rate the outcome?
Comments: None
Response / Action: This question was not applicable for 11 of the 101 patients who answered. Of
the remainder, 88 (86.27%) considered the outcome to be Excellent, Good, or Satisfactory. Nine
patients were dissatisfied with the outcome. See Question 3 above.
Question 5 - If your telephone consultation resulted in you attending the surgery to see the Minor
Illness Nurse, how do you rate the outcome?
Comments: None
Response / Action: The Minor Illness Nurses received very positive feedback from the 20 patients
who answered this question (Excellent 10, Good 8, Satisfactory 2).
Question 6 - How would you rate your overall experience?
Comments - Positive:

Very happy with the service provided 10/10

Thank you this seems to be a good system and must make it a lot more efficient for the G.P

I continue to receive excellent service from all staff at the surgery- including the
receptionists, nurses and doctors. I have no concerns at all.

Whenever I have used the new appointment system, I have found it very efficient and have
always been able to see the Doctor the same day.

I think everything and everyone is so helpful, and compassionate!

We are fortunate to have a good practice. It took a little bit of time getting used to the new
system. Reception staff are always very helpful

Your reception staff are very kind and polite - even under pressure

Very Good

The whole surgery and Doctors are very helpful

I have found the new system very good and am in favour of it. Sometimes a quick
discussion is all that is needed and this saves the doctor's surgery time and the patient's
time also.

Excellent service

Consider myself to be very lucky having the “services” of such an efficient practice.

I am pleased to complete the survey, my wife and I are most grateful for the help that we
receive from Alton Street surgery and the pharmacy. No Complaints!

First class service in all respects. Thank you.

With all the pressures you are all under, I think that you do a brilliant job and are very
undervalued!! Thank you.

Had doubts about telephone system but have found it to be excellent in all respects with
call backs averaging between 20 minutes and 1 hour. The best surgery one can register
with.

GP referred me to a private eye consultant based on a document I sent to the surgery.
Discussion took place over the phone with no need to visit or spend time in the Waiting
Room.

My family and I have had positive experiences of both needing a see a GP urgently (seen
within 2hrs of the phone call) and not wanting to come into the surgery due to a recurring
poorly foot, therefore a repeat prescription was administered and the tablets delivered by
the pharmacy - perfect!

Although' having a good experience with the present system, I prefer to ring or call in to
make an appointment.

An excellent service
Response / Action:
Although we always take the opportunity to learn from all feedback, it is really appreciated
when we receive positive feedback – Thank you all!
Comments – Positive but . . . :

I still believe that a face to face consultation is the better option but do appreciate the
promptness of the call back and the reduced numbers in the waiting room. Pity we cannot
do the same for the car park!!! Now often do not even try to come in but park in town!!!

Prefer to have a doctor I know whom I can see when necessary... but talking to a doctor on
the phone is usually satisfactory.

Even though this is an excellent service, I still prefer talking to the doctor face to face. The
practice needs to be congratulated on the service it offers to the elderly, it was a highly
efficient experience.

Whilst I'm satisfied with the system I am sorry not to actually see the GP sometimes but I
have confidence that I would if he thought it necessary!

I have attended the surgery for a check-up and blood test which I arranged by phoning or
attending in person to make the appointment. I would not mind expecting the doctor to
ring me back but worry that the call may come at an inconvenient time when I could not
talk confidentially. Other than that worry I think it is a good scheme. I continue to think
that it is very important to see the same doctor as usual (if not an urgent situation) for
continuity of care. The NHS is coming back to thinking this is important again, I hope! I like
the Taurus Health Care Scheme!

Sometimes it ties you because you have to wait in for the call, but overall a good system.

I like the telephone system but if I need to come in I need enough notice so I can arrange a
taxi. It is difficult now I have no car. But no complaints at all.

Call back has worked very well for me, however I have slight concern that something could
be missed without direct contact. Overall I am very satisfied with the service provided by
the Surgery.

18 months ago my answers would have been very different. 18 months ago my answers
would have been 'excelled'. Standards of administration have dropped - Doctors still
excellent.

This system has worked very well for me now that I have retired and can make and receive
a phone call at any time. However, were I still working as a senior secondary school
teacher I would not be able to make or receive phone calls at most times in the day, or
with any degree of privacy. I assume that Alton Street has a protocol that deals with this
scenario, but if not, then I might have scored the above questions with a lower mark. At a
time when access to primary care is under considerable stress, a telephone contact is a
very acceptable way of utilising the time of the medical staff. In my experience, Alton
Street does this well.

This system has made very little difference to me. I hope things are better for you.
Response / Action:
Please refer to the red box below.
Comments – Negative

This system is still not acceptable to me. If it were an acute illness which required
immediate treatment it is fine. If it is an ongoing chronic condition, I put off, and off calling
for an appointment as I don't know when my appointment will end up being and I cannot
fit this uncertainty into my daily schedule. I have never just had a phone call, I always end
up coming into the surgery and this takes far more time, effort and upheaval than just
logging in and making a convenient appointment. Please find some option of going back to
the old system. Or at least an email alternative.

I think the telephone call back system is fine for emergency/same day appointments to
make sure the right people get them BUT I (and quite a few people I know including
members of my own family) DO NOT like it generally. There are times when you want to
see the doctor face to face and would be happy to make an appointment say a few days or
a week in advance to discuss something which you MAY NOT want the third degree on the
phone first! Sometimes you have something niggling at the back of your mind which you
would like to bring up in person - but the thought of having to go through the rigmarole of
getting a face to face appointment puts you off in case it is thought to be trivial and
wasting the doctors time (i.e. something like an odd shaped mole which you then convince
yourself is nothing so not worth bringing up). Since this system came in I feel I have lost
the positive relationship I had with my Doctor and I have definitely been put off trying to
get an appointment unless I feel at deaths door! I feel the doctors are now in an ivory
tower and don’t want to see patients face to face unless absolutely necessary - which is a
shame. I would like an option introduced to book a non-emergency appt a few days in
advance. I REALLY liked the old option to book appointments on line with a preferred
doctor and feel the current system is a step backwards

I do find it difficult waiting for the call as I would not want to discuss health issues on my
mobile phone if I was out because of confidentiality. I would not like to be overheard.

Trying to explain, to a doctor, over the phone is awkward and if you do then have to see
the doctor afterwards surely this is wasting time because when you then see your doctor
you have to explain everything again. Myself I think the old system was better.

Previous system with many appointments was excellent enabling patients to make them to
see a doctor the same week convenient to both parties. For those of us with long term
problems, and restricted travel opportunities was far better than now. Limited public
transport for those with mobility problems who do not drive means we are reliant on the
goodwill of friends to take us to the surgery.

I regret the inception of this telephone scheme and also the fact that I have never met my
named Doctor in the practice.

Find it embarrassing talking over the phone can't contact my usual doctor to discuss
mental health problems Positive side: very good system for minor problems common
ailments colds flu chest etc.

As a working person it is very difficult to find somewhere to discuss personal medical issues
over the phone when the doctor calls back, standing in the street in the rain discussing
contraception is not a pleasant experience, from 9am to 5pm is not convenient

I do not respond to withheld numbers which is the system the surgery uses. Furthermore I
do not have an answering machine. I rely on caller display on my phone. Therefore unless
a specific time when to expect a call is given the conversation with the doctor does not
happen.

Sorry but I still prefer the old system.

When you have either a blood test or appointment with a consultant or particular tests it is
often difficult to get the results even if there is no need for a follow up. Waiting causes
anxiety. Results should be given out as soon as possible – good or bad

Previous system with many appointments was excellent enabling patients to make them to
see a doctor the same week convenient to both parties. For those of us with long term
problems, and restricted travel opportunities was far better than now. Limited public
transport for those with mobility problems who do not drive means we are reliant on the
goodwill of friends to take us to the surgery.

Preferred doctor was unavailable and I was not able to book an appointment with him for
the next day

I was told by the Receptionist when I called at 8.00am Friday morning on the 20th February
that all the senior partners/doctors i.e. Dr. Clayton, Dr. Lennane, Dr. Gallagher, and
Registrar Dr. Calderbank were not there that day for any appointments. I was then advised
that I would receive a call from a Dr. Medlicott - whom I have never met - to discuss my
problem. When she returned my call she said that she would book me an appointment
later in the afternoon but it would not be with her but a Dr. Oakley - whom I have also
never met. I was NOT told that Dr. Oakley is a Trainee at the Surgery specifically there to
gain experience in GP practice, neither was I asked if this would be acceptable. As an
elderly patient I was unimpressed with being shuffled off by Dr Medlicott to a young,
inexperienced Registrar whom I had also never met - with obvious limited experience in GP
practice.

Telephone calls from GP very difficult to schedule when you work. Receptionists not very
forthcoming with information about late phone calls, only when I spoke to a Doctor was I
told that they could ring later, i.e. after 5. Had been told that no need to rush to ring in to
the surgery early on the morning then when did ring in mid-morning was told should have
rung earlier as telephone slots were only available between certain times and I had missed
them! Difficult to book appointments in advance, often told need to ring back nearer the
time, not convenient when you work yourself and you need sufficient notice to arrange
time off etc. would be interested to know how many appointments have been saved by the
new system, how many issues are resolved at the telephone call stage etc.
Response / Action:
We understand that many patients would prefer a return to the old system whereby it was
possible to book a face-to-face appointment with their doctor of choice. The system worked
well in the past, and we were proud of our excellent access. However, rising demand meant
that we were no longer coping, and had to consider an alternative system.
Our patient list has risen by 34% since we moved here, and demand for appointments has
meant that access to a doctor had been deteriorating for some time. Additionally, car parking
had become extremely difficult at peak times, and the waiting room often overflowing with
patients waiting to be seen. It became clear that we would need to review the way the service
was provided if we wished to maintain the level of service we would like.
Following an extensive period of research, consultation and consideration, we introduced a
system that we believe has the potential to improve the service to patients who need to be
seen by a doctor, whilst having the benefit of being able to more efficiently deal with the
remainder of patients. Evidence suggests that approximately one third of patients asking for
an appointment can be dealt with over the phone, and a further third directed to an
alternative element of the service such as a Health Care Assistant for routine checks prior to
seeing a doctor, or a GP with a special interest in, for example, dermatology for skin problems.
All of the doctors have received specific training in telephone consulting, and two of our
Practice Nurses are qualified to conduct minor illness clinics. This increases the options
available to our doctors to ensure each patient’s needs are met appropriately.
Our aim is to “do today’s work today” and we analyse appointment data by hour of the day
and day of the week to enable us to ensure we have sufficient doctors available to meet
predicted demand each day. However, there may be significant peaks and troughs in demand
for appointments that cannot always be attributed to a particular cause, and these may still
have an adverse impact on our ability to meet demand on some occasions
We are also analysing call-back times, conversion rates for telephone/face to face
appointments, and the continuity of the service to patients, i.e. whether a patient is able to
see the same doctor each time if they wish, the latter being very important in patient
satisfaction terms.
From August 2014 to January 2015 our doctors undertook 16,333 telephone consultations,
and the majority of those patients who were identified as needing a face-to-face appointment
were seen the same day. The responses to Question 2 indicate that the vast majority of
patients either spoke to the doctor of their choice, or did not mind which doctor called them
back. We believe that access is better than previously – few surgeries are able to offer such a
prompt service, and waits of 2-3 weeks to see a doctor of choice are not uncommon
elsewhere.
We appreciate that patients who work may have particular issues with regard to call-back.
Telephone appointments are available from 08:00 Monday to Friday. Alternatively, we have
extended opening hours on Tuesdays and Wednesdays each week when telephone
appointments may be available up to 19:20. We are open alternate Saturday mornings, and
call-backs would be possible then also.
We also offer “timed telephone appointments”. These are booked at a time identified by the
patient as convenient, and the doctor will do their best to ensure they do telephone the
patient at that time.
Once it has been decided between the doctor and patient during a telephone consultation that
a face-to-face appointment is necessary, then that appointment may be made at a time and
date to suit the patient, thereby making it possible to organise transport in advance, etc.
We are keen to utilise the benefits of new technology and one doctor has been offering email
consultations to some of his patients with chronic disease. This is something that we are
currently reviewing and actively discussing with a view to making this facility more widely
available.
With regard to results, these are always available to the patient concerned on enquiry once
they have been received from the laboratory and checked by the doctor concerned.
We are a committed training practice, and usually have three GP Registrars working here.
These are fully qualified doctors who are intending to become GPs themselves – this is an
essential function to ensure the current decline in GP numbers does not become an increasing
problem.
It is essential that the GPs book appropriate patients in with the Registrars to ensure they are
exposed to the full range of conditions a GP may encounter. However, it would be preferable
if patients were informed that their face-to-face appointment will be with a Registrar, and
given the option to choose another GP if they wish. This will be implemented immediately.
Our ultimate aim is always to provide the best service we can to our patients, and feedback
such as this is appreciated and of immense value when we are reviewing service provision.
Question 7 - Do you feel you have better access to a doctor than with the previous system?
Comments:
 I think you are doing very well with the system but saying things over the phone is very
difficult. So hard to say, as I do like to see the doctors.
Response / Action: Of the 98 respondents who answered this question, 28 (28.6%) felt that
access to a doctor was better, 36 (36.7%) said it was the same as before and 34 people (34.7%)
considered their access was worse than previously. This is a small improvement on last year,
when 41.18% of respondents considered their access was worse than previously.
Please refer to the red box above for further comments.
Question 8 - How easy do you find it to get through to a receptionist on the telephone?
Comments: None
Response / Actions:
108 patients answered this question, and 100 considered it very easy or fairly easy to get through
to a receptionist on the telephone.
The receptionists deal with a very high volume of calls on a daily basis (between 600 and 700 each
Monday, and approximately 400 each day Tuesday to Friday). Analyses of statistics from our
telephone system show that there is an average ‘drop out’ rate of 1.8%. Of these 1.1% is ‘short
waits’, i.e. the caller hears they are, for example, 4th in the queue and decides to call back later,
and the remainder are long waiters who then choose to abort the call. There is always room for
improvement, but we believe the receptionists do an extremely good job.
Question 9 - At what time can you receive a telephone call from the surgery?
Comments:

Not working so able to take calls anytime when needed.

Any time as long as the Doctor calls my mobile number

I can receive a phone call at any time on a Tuesday or Friday

To state the time is very difficult, as it would depend how urgent the reason for the call.

I leave the house at 6.30am and do not return until 5.30pm so unless they call my mobile I
cannot receive phone calls.

Times to receive calls depends upon my availability with work commitments.

It varies from day to day, according to when I am working.

Most times on the mobile

I am retired so anytime

After 5.00: I cannot take calls during the working day which is why the booking of
appointments online was ideal for me. When I am travelling, reception is intermittent so
even calls on journeys to and from work are unsuccessful.

Availability varies from day to day. I am often in areas with no mobile reception.

We are usually at home.

Time to receive a telephone call varies from day to day. I'm not available all day every day
but restricted availability when I last needed an appointment did not cause a problem.

As I am retired I can usually receive a telephone call at any time. There was 1 instance
when I rang at lunchtime & wasn't able to speak to my doctor until the next day as she was
so busy. However it wasn't an emergency & I was able to speak to her first thing the
following morning.
Response / Action: None required, but see the response to Question 6 (red box) relating to
‘Timed telephone appointments’.