| Q1: Does the practice make it easy for you to contact them to arrange to see a doctor or nurse? | Phone is engaged (have to phone again, cost); phone stacking (no indication of where you are in the queue); holding on (cost); competition with others who are physically at the practice – all the appointments are gone; different receptionists: ask personal questions; confidentiality in a crowded waiting room; walk-in clinics are good; booking online might be helpful; parking charges, so make appointment on phone not in person, or don’t live near enough; can’t see GP of choice. Question wording: ‘. . . to see any doctor . . .’ | Some answered Q2 within Q1, i.e. can be a long wait to see your own GP, easier to see any GP (but they can’t always handle complex cases); hanging on the phone then no appointments left; costly (repeated) phone calls (is this why people don’t bother to cancel appointments and there are so many DNAs?); can come in to make appointment but sometimes too ill; administrative errors (duplicate appointments); practice are bound to a telephone contract (0845 number); repeated phone calls then not enough appointments; season and day dependent. Question wording: some answers encompassed Q2, need to separate these more obviously. Suggestion: do the communication systems enable you to get through? | Long time to answer phone; costly (0845); easier to get an appointment in person (Q2?); appointments too far in advance (Q2); one problem per appointment (Q2); no triage, all appointments are 15–20 days in advance (Q2); difficult for working people; fully booked, even for emergencies (Q2); hard to see own doctor – continuity of care. Question wording: surgery not practice; can be interpreted as clinical; need to make it more obvious that it’s not about making the appointment but just getting in contact; suggestion: remove the latter part of the question so it ends at ‘. . . contact them?’ |
| Q2: Does the practice make it easy for you to get an appointment that suits you? | Once you get through, it’s moderately easy; receptionist-dependent; GP might be on annual leave; depends if you have a preference for a particular GP (which depends on the ailment: continuity vs. emergency). Question wording: ‘. . . that suits your needs’. Need extra option of ‘moderately easy’ | See Q1 above. There were no additional points to be made by the time we got onto Q2 | Can sometimes get appointments, it’s a lottery; receptionists don’t explain why there are no appointments; telephone consultations not face to face, just give prescriptions; one appointment, one problem, so have to make another appointment; sometimes told to ring back in case a cancellation becomes available; have to keep phoning back; fully booked, 2–4 week wait, ‘it’s not my fault’; refused an emergency appointment; daytime appointments not good for children at school; no problems for some people, especially in single-handed practices; continuity of care is a problem; so many new doctors, don’t know their names; if not urgent, some patients happy to wait; trial and error medication (clinical). Question wording: surgery not practice, otherwise worked well apart from the odd clinical need creeping in |
| Q3: Does the practice make it easy for you to get into the building and use the facilities? | Automatic doors; slopes for wheelchairs; disabled toilets; car parking (need one, need a bigger one, need more disabled spaces, if can’t get a spot then have to park on street which can mean a long walk in the rain, or the snow, which is tricky for people with mobility issues); need wider doors inside the surgery (auto door to get in, but not wide enough inside for large scooter or wheelchair). Question wording: separate into external and internal | Welcoming; slope up to door is too steep and no handrail; facilities inside are clearly visible; good signage; pharmacy on site; comfortable seating (but not for everyone, some get backache); lighting not good for people with sight problems and the call screen is too small – could use a verbal call from the receptionist for people whose notes are flagged; car park is quite a long walk from the front door; there can be long queues at reception (back problems); disabled parking spaces are misused (want blue badge spaces). Question wording: ‘your personal needs’ instead of ‘for you’; make it clear it’s for your personal situation rather than generic; most didn’t think about parking; most thought of inside the building | No bus, difficult to walk with mobility problems; doctors are upstairs, no lift; difficult to park at busy times; automatic doors; parking too far from surgery; seating, cleanliness, toilets, disabled access, lift. Question wording: need two questions, one for getting to the building and one for inside the building |
| Q4: Do receptionists try to be helpful? | Receptionist-dependent; depends on how busy they are; helps to be recognised and have a good relationship (more helpful); sometimes feel rushed – tricky when you need time to think; can feel like a number. Question wording: fine as is, three options are fine | Depends on the receptionist – some are very helpful, others are very rude; depends on how busy they are; they can assume too much knowledge (don’t explain); [appointment systems, continuity of care]; you need to be assertive to get what you want; rule-driven, lack of flexibility and communication; perhaps lack of training?; don’t smile enough. Question wording: ‘. . . helpful to you?’ | Sometimes busy in morning so have to phone again the afternoon (Q1); they do sometimes try to give you an appointment (Q2?); don’t answer phone if busy (Q1); face to face is more helpful than over the phone; if fully booked then have to phone again tomorrow, can’t help, no reassurance; don’t try to understand; depends on receptionist/their mood/the surgery; face to face is easier as you have body language to help; respect (Q5), listen, give you what you want; good customer service, polite; Gujariti-speaking (Q7?); no interpreters available, tried to help but was not satisfactory (Q7?); depends on expectation. Question wording: what kinds of things do people need help with, give examples, e.g. appointments, hospital reports, prescriptions, medical advice; perhaps two questions: one for face to face and one for over the phone |
| Q5: Do practice staff treat you with respect? | Staff try to use first names; it helps to be known; can feel hurried and rushed (it can be a waste of time if you have to come back for another appointment, and this is expensive – taxi fares). Question wording: what does ‘practice staff’ mean? Everyone, everyone except the doctors, everyone except the receptionists? Could say ‘. . . everyone at the practice, e.g . . .’ | Once you get an appointment, respect is fine (appointment system is the hurdle; continuity of care); lack of dignity in care (clinical); depends on what you want, e.g. follow-up appointments are difficult to book, staff (reception and GPs) can be rushed at the end of the day and try to push you out. Question wording: who are the practice staff: receptionists, everybody, GPs, physios, nurses, district nurses – list who we mean | How they talk to you has improved (used to be bad but more polite now); good systems for prescriptions (Q4); receptionists informing patients that there will be delay in patient’s appointment time (Q4); respectful face to face but not over the phone – they don’t try to understand; polite, always get a good answer (full answer, well explained); smile. Question wording: surgery not practice; do we mean receptionists or everybody; perhaps two questions, one for clinical and one for non-clinical |
| Q6: Does the practice try to support your individual needs? | This was interpreted as a clinical question initially; depends on expectations; depends on the type of need; have to ask/not proactive; had to tell them carer status and disabled status many times (now computerised in notes); communication/continuity/having to start again each visit; plain English; GP-dependent/continuity of care. Question wording: ‘. . . practice staff, e.g. . . .’ | Lack of or conflicting information between primary and secondary care; not working with parents to make (clinical) decisions; GPs don’t admit lack of (clinical) knowledge; patients are prescribed generic medication that can have side-effects (e.g. castor oil) so should be informed of changes (clinical); lack of privacy in pharmacy; [lack of continuity of care]. Question wording: this question was generally interpreted as clinical | Reminders (Q7); make blood test appointments automatically and just phone back to confirm (Q7/8); one GP refused to write a letter to confirm mobility problems prevented a patient from getting a discount on a piece of equipment; supports clinical needs (clinical); one problem, one appointment, not enough time in appointment; provides support (appointments) but not at patient’s convenience (Q2); support with prescriptions (Q7); refused a home visit for an elderly (96 years) parent; no after-clinic appointments (Q2). Question wording: surgery not practice; interpreted as clinical (doctor), or just receptionists, or everybody (need clarity). Answers didn’t really reflect what we were trying to get at. Needs work |
| Q7: Does the practice make it easy for you to keep up to date with your care and treatment? | Have to ask/not proactive (this sums it up); would be helpful to receive a letter that an appointment is due; don’t tell you that checks are necessary, they just give you a repeat prescription and then use ad hoc opportunities to do checks, e.g. when you go in for something else; underuse of IT (e.g. e-mails); text reminders would be helpful. Question wording: more options needed | Some interpreted as clinical (GP answers questions); reminders; fast track urgent test results; automatic checks for 70+ years; younger people must instigate any contact; repeat prescriptions are fine, they can provide in < 48 hours if urgent; can deliver medicines. Question wording: need to make it clear it’s non-clinical | Good proactive communication from doctor (clinical); can be interpreted as clinical; doctor saying (and sometimes phoning to say) need a blood test (clinical); have to ask and be proactive; reminders for blood tests and text reminders for appointments; expectations: been here longer, know how the system works and know what you need, if been here only a short time, tend to be more satisfied; referral to optician (Q8); one practice used to have reminders but not any more – ‘it’s your responsibility to remember’ with no explanation as to why the change happened. Question wording: surgery not practice; hard to answer if haven’t been registered for long or if don’t visit the surgery often; include a not applicable option? |
| Q8: Does the practice make it easy for you to access other health-care services that you need? | What’s available? How do you access it? Word of mouth; fragmentation; need a ‘care officer’ to manage pathways; too many forms to complete (duplication, hard work); isolation/abandonment/vulnerability/voice not heard (even if you had a voice, which you don’t at that time of shock); lack of knowledge about benefits; have to ask/not proactive. Question wording: fine as is | Access is okay but the communication from secondary care back to primary care is not good (takes ages); some GPs are not referring to specialists; lack of knowledge about what services are available. Question wording: should we include a list of possible services? | Can get referral letter for hospital; there is a diabetes nurse at the surgery; it’s easier nowadays; the surgery arranges everything; there are now more facilities on site, e.g. for blood tests, previously had to make appointment elsewhere for 3 weeks’ time; GPs repeat previous prescriptions without examining or listening to you (clinical). Question wording: surgery rather than practice; what does ‘access’ mean; give examples of other health-care services; this question is hard to answer if you don’t need other services; include a not applicable option |
| Other: Is there anything else that’s important for you when you use your GP practice that we haven’t included in our questions? | Length of appointment (one appointment, one problem); length of wait after appointment time – not knowing where you are in the queue or how many people are in front of you | The practice provides a good service, especially the nurses; one patient said that respect wasn’t covered (even though it was), so it couldn’t have registered with her | No indication of when the GP will phone back – tied to the phone; if there were phone queuing systems, people would hang up of they were 15th in the queue; busy phone lines 8–9:30 a.m., have to phone later; when visiting walk-in centre or hospital, need medical card or passport; information provision, e.g. leaflets put forward by interpreter but not an issue for the participants |
