What would you like to change about your GP practice???

[tellmewhatyouthink]

Following on from other threads about having it in for their GP surgeries, wanting to kill GP etc - what things would you like to change about your GP practice (within reason!)? What would increase your satisfaction as a patient?
Can be about doctors/nurses/receptionists or systems etc

Out of interest - but also for a project I'm doing about increasing patient satisfaction, so would really appreciate replies. Also other GPs might read and make changes (possibly)

TIA

Well our last GP practice was horrid, simply horrid. Unimaginably bad. Now we go to a fabulous practice, and I wonder why they aren't all like this. So I'm shocked by the wide variation in standards, and I wonder why they can't be paid in such a way as to link the care and quality of service provided to the amounts that they are paid.

One thing that could be improved even in the super practice is a mix of different types of appointment. In France they had an amazing system whereby the morning was drop in and the afternoon was fixed appointments - and that worked so well.

I think that the most important thing to me is to be able to get children seen by a doctor on the same day if thats what the parent feels is necessary.
My docs have never refused to see my DC (although i have been unable to get appointments myself sometimes). They will tag the child onto the end of surgery despite there being no appointments.

The receptionists are always friendly, polite, and helpful, even if they are unable to actually sort out your problem. It makes you feel like they are trying at least. They have phoned me back with a cancellation appointment after my DS couldn't be seen till 6pm and was crying with earache.
All this gives me confidence in them as I know that, despite being busy, they are doing their best with the resources available to them.

All this is in a town centre practice, with many social problems, and probably many difficult patients. They probably get quite a lot of grief!

One last thing is that I never walk into a GP surgery expecting to be seen at exactly the right time!

No, he's the head guy actually, owns the place and I think he only takes appointments that overspill, so perhaps he really doesn't see many people during long paperwork sessions.

No I wouldn't mind not being prescribed, but if all I am going to get is come back later, then I'd rather just do the come back later bit, without the initial appointment.

Is it true btw that a) gps themselves have a financial insentive not to prescribe and b)they are only allowed to diagnose a certain no. of cronic illnesses per year?

I'm sure my talkative GP mentioned something to the tune of both of these things but I usually switch off, so may have misunderstood.

Last time I was at my local GPs surgery there was a booklet produced showing the results of a recent survey asking what they could do better. Cant remember them all, but the main ones were faster appointments esp for very young or elderly also one early morning or late opening a week for those who work. A special line for emergencies (tho I can see that that could be abused). A little handheld lights/buzzer type thing to alert the hard of hearing or vision impaired when its their turn. Automatic doors as the ones they have are pretty heavy.

In their defence, Ive found the service to be really good. Midwives are always available on phone and a doctor (currently researching rather than practicing) can take calls if no other doctors are available and you need help (like my first panic attack when I didnt know what was happening - if it wasnt for her Id have been calling an ambulance. NHS direct dosent cover NI)

The thing I'd change about my surgery is that I would leave and go and work somewhere that doesn't involve reading 3 threads about how shit general practice is. (I know that sentencs is poorly written but I am starting to take these threads personally!)

Please please don't think we are all like some of these. If you are really unhappy, and if it's possible, please try going somewhere else. You can change GP for no reason as long as you are in a practice's catchment area. (Appreciate that many people don't have much choice if only one local practice).

I totally agree that there are some appauling instances of rubbish service and mean old bags at reception but not everyone is like that.

bradsmissus - know what you mean but think there are also some positive things on this thread too.

snowlight - but your child would need to be assessed in person to see if tey needed treatment. usually it can't be done over the phone, you need to eyeball the child, take the pulse, look at their breathing etc. it ouwld be lovely and convenient if it could be done on the phone/internet etc but medicine isn't like tht. it needs the laying on of hands rto assess adn diagnose. I appreciate it's annoying and illness doesn't slot into nice easily defined categories but hey ho such is life.

no you can diagnose as many chronic disease as you eant - so complete rubbish

and

there is no incentive NOT to prescribe but there is an incetnive to prescribe own brand drugs (termed generic) rather than brand name drugs. they are the SAME drug but the brand name ones are just more expensive. eg nurofen is ibuprofen and they are the same drug but it is cheaper to prescribe ibuprofen. also paracetomol/calpol. In this country, drug companies have had their request declined to advertise directly to patients because of the conflict of interests. in america you see loads of ads to buy such and such a drug, when in truth they are no better than than the generic (non brand name one ) but its all about sales. quite immoral really.

GPs don't actually hold their own prescribing budgets, but it is monitored by the PCT (primary care trust) and Gps are very strong in fighting for using expensive medicines if they think they are clinically justified. (ie evidence that they work!)

I used to think my GP wasn't so goodit was hard to get an appointment, and the wait always seemed far too long. As I hardly needed to visit with DS, it didn't affect us too much. Then came DD, who has global developmental delay, was quite frail in her first two years and has repeat prescriptions. I can honestly say the surgery has been fantastic. My GP is supportive and understandingeven if he does have to google some of the tests DD has had. The receptionists are kind and know me by my first name, they are up to date with DD's various issues, and will always squeeze us in for an appointment. They know I won't say I need an appointment when it's unnecessary.
Having said all that, I would change:
The acoustics in the surgery--in summer when windows are open, you can sometimes hear what patients are saying inside the consultation rooms;
Repeat prescriptions--could you let me know how they could do it online, so I can tell/show them what to do?

Our practice is very good, but there are a few improvements I would like to suggest:

1. I'd like to be able to leave a phone message out of hours, for example to ask them to chase test results that have been overlooked (last lot took four months!) or to cancel an appointment.

1. I'd really welcome a Saturday morning routine surgery, particularly for kids' injections and so on. I did write to the practice manager suggesting this, after being urged to by a doctor in the practice, and some other working parents, but all that happened was the one hour emergency clinic that used to happen on a Saturday morning was abolished when the new contracts came in.

1. I'd like to be able to email a simple question, eg 'Can you organise my repeat prescriptions?' or 'Can I have an appointment any time at all on Friday?' That kind of thing.

Apart from that, I'm really happy.

It's strange how across the NHS as a whole, everything still needs to be on paper, when it could all so easily be emailed--eg test results, prescriptions, x-ray/scan images.
Information tends to get passed on efficiently from one hospital department to another, but if I needed my GP to chase one of DD's test results from a hospital, it would have to be done by phone rather than the test results being automatically copied to my GP...

I'd actually like a doctor to come out to the home 'out of hours'.

Had a DD1 with gastroenteritis and not being able to get the bus / take a cab etc. Not all of us have a car, or access to extra help in the home to help with looking after other kids that are sleeping!

Wasn't really well one day, and hadnt been feeling right for ages. The whole floor was swirling beneath me. Made appt, but that was for 1o days time. Anti d's not working. Went to Samaritans which was closed. Somehow in a hazy suicidal blur, I ended up at the docs begging to see someone.
Saw a doc for 5 mins after closing. Told him I'd been unsuccesful in seeing samaritans and that I was close to going up the tube station and just walking off the platform.

'Oh, come back next week and we'll see how you are then' he said. He gave me more anti d's and some Valium.
Came home and tried to take the lot...

My faith in Gps are totally shot. I take the kids and me up the A+E unit at the hosp now and just wait if it's desperate. Better chance of being seen that way.

To answer one above point, the reason you can't leave a message after hours is that some people may not understand that no one will be listening or checking the messages that night/weekend, and might leave a message saying, for example, 'I've got chest pain, can someone come please', then wait at home with their heart attack, instead of phoning 999. I agree it's frustrating, but that's why.

Also, music in the waiting room is to allow some privacy to patients talking to the receptionists or to people on the phone at reception.

Polite and pleasant receptionists!

cass66, why not just state on the answerphone when messages will next be checked?? That's what I do with my voicemail at work (I don't deal with life and death things but I do deal with wobbly students and so on who need referrals to other professional).

Thanks for your responses tellmewhatyouthink and take your point about child needing to be assessed first.

My current GPs ALWAYS see you that day if you insist, but you have to go in after normal appointments have finished and then wait. You will usually get the talkative head guy (who tries to convince you that materity exemption certificates are an out of date requirement or something and until you aree with him you aint going nowhere).

I think it is a decent system actually, and you area always asked if you want to see a particular doctor and can usually if you are prepared to wait (although I usually say no and wonder if I'm gonna get the least preferred that way) but grrrrrr at the receptionists.

And I could well have got it wrong about the insentives to prescribe and diagnose as I#m usually unwell when I'm trapped in his office.

boffinmum, quite simply it is not worth the risk, medicolegally. if someone died, the practice could be sued. sad but true.

I want to change everything except the location, no wait that too. Mine wins the worst GPs practice in the land.

For me it's practical things - being able to wheel pushchair into actual appointment would be great. At our surgery you have to park your pushchair in lobby so have to lug one or more children into surgery room. This can make appointment tricky if you have to manage unshackled children exploring medical equipt. The appointment is not necessarily for them so having them locked down snug in pushchair can be a real help.

Also ensuring waiting area is not boiling hot would be hugely helpful. Have felt faint numerous times when pregnant and had to wait a long time. Same goes for having drinking water available.

I would like to know what the particular areas of interest of the GPs are so can try and 'match' ailment to GP. Some are clearly interested/extra experienced in children's health (and don't say things like 'Well that's what I used to do with my children but that was twenty years ago so I s'pose it's all changed now' ) or have an interest in reproductive medicine that makes them more helpful than your average.

I would also like the opportunity to go back into reception and give instant 'feedback' after appointments - say through some sort of electronic suggestion box as there is always something that you think 'Wouldn't it have made all the difference if they'd...' Granted there would be some ranting but I do think it would also reveal real strengths and weaknesses of the practice.

I would love:

• to be able to book appointments online
• to wheel the buggy into the surgery, not have to leave it in the lobby
• automatic doors
• weekend / evening opening

The receptionists at my surgery are lovely btw!

Re my own GP surgery I would like to see the following changes made:-

1. A chance to actually see my own registered GP for once rather than the other two charlatans who happen to "work" there.

1. GPs who actually look at you rather than tapping away at a computer whilst talking to/at you. The only one in my practice who does not do that is the good and hard working GP (see above). No wonder therefore he's always booked out weeks seemingly in advance. Had faith that he would have diagnosed my recent skin condition; the other doc had no idea at all what it was!.

1. The previous system whereby appointments on Saturday morning were first come first served was first rate. Pity it was taken away - that is outside the surgery's control though.

1. The receptionists to be just a bit more caring and less snippy towards patients of all ages. I do not want to be asked upon phoning if my visit is urgent and or necessary!.

GPs surgeries can be okay if there is good staff and patient communication. I had occasion to visit another surgery (a friend had an appt at this surgery) about 1/2 mile distance from this one which was worlds apart in both efficiency and calm. Wonderful receptionists!. Can't go there unfortunately as am outside their practice orbit.