Saturday, 9 June 2012

The patient at the heart of everything we do? Yes please.

The Department of health has announced that the results of the GP Patient Survey will be published on NHS Choices website shortly. This is a welcomed development but bets are already being hedged by the rider…

‘Important note about the 2011-2012 Survey Results
Please note that due to the changes to the questionnaire design and survey frequency, as well as the change to the weighting methodology, no results from 2011-12, when published on 15th December 2011 (wave 1) and 14th June 2012 (wave 2) can be compared to previous years, even where questions remain the same.’

I guess that means that the results are expected to reflect a growing level of dissatisfaction of patients with their primary care services. As with any of these surveys, we know that it is normally the most unhappy customer that bothers to provide feedback, so I shall read the results with a liberal dose of salt. However, if the whinging masses are increasing in number then this could be significant. I suspect that there will be two major areas of concern – out of hours cover and availability of GP appointments.

Speaking of which - tales from the front line continue to wear a path to my door and I must put on record that for every bad experience that I hear, I’m sure there are literally tens of thousands of examples of excellent care being given nationwide. But…

Here alas I have another tale from the front line. I’m hoping that the reality of this flaw in the service will be reflected in the survey results. As usual, this is a simple story of country folk, subtitled –‘Why can’t things be like the old days when we could see a GP when we needed to?’

A friend, suffering from a bladder infection (or a touch of the Duke of Edinburgh’s as it is now known) called her GP at 4.30pm. It was a Friday afternoon and my friend, let’s call her Elizabeth, who has a history of such infections knew that it would be very unwise to leave this condition untreated over the weekend. She was also feeling very unwell and was in considerable discomfort. She was told by her surgery that no appointments were available although they ‘might be able to fit her in to an emergency session tomorrow morning’.

By 8pm Elizabeth was in considerable pain so she called the out of hours doctor. Some time later, after a 20 minute car journey, she was prescribed the antibiotics she needed by an efficient and kind doctor working with the out of hours contract. She then faced the challenge of finding a pharmacy still open and was advised that she needed to travel another 25 minutes by car to the out of hours pharmacy. Unfit to drive, with a temperature and in bad pain, Elizabeth was only able to make this journey because she was accompanied by her husband.  By that time, she was in desperate need of a loo. Anyone who has had a bladder infection will know the meaning of ‘desperate’ in this case.

While the pharmacist was filling the prescription, Elizabeth asked to use the pharmacy toilet and was told ‘no’ because he wasn’t sure if his insurance covered patients using the facility. Nice.

So – if the GP had been able to squeeze her in, if the out of hours service was closer, a 40 mile round trip in the car and much distress could have been saved.

I hope that the latest patient survey will, like the results from the last one, demonstrate that the area of most concern to patients is accessibility of GP services including extended opening hours and local cover to avoid unnecessary delay or trips to casualty.

Forget commissioning, we need GPs to continue to provide vital front line local services in and out of hours.

Is that really too much to ask?


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