Brighton and Hove patients wait too long to see doctor, says Healthwatch

Too many patients face too long a wait to see their doctor, according to a report by Healthwatch Brighton and Hove.

The report said that a quarter of patients locally had to wait more than a week for an appointment with their GP (general practitioner).

This compared with a national average of 17 per cent of patients having to wait for more than a week.

The report was presented by Healthwatch evidence and insight manager Roland Marden at a meeting of the Brighton and Hove City Council Health Overview and Scrutiny Committee at Portslade Town Hall this afternoon (Wednesday 20 July).

Dr Marden said: “The findings from the research suggest a mixed picture for GP practices in Brighton and Hove.

“Patient feedback showed high levels of satisfaction regarding the quality of care offered by practices.

“A large majority of patients said that doctors, nurses and reception staff gave them enough time to express their concerns and listened to them properly.

“Similarly, patients largely felt that the GP had all relevant medical information available to them during the appointment and properly explained the treatments the patient was receiving.

“While patients were generally positive about the quality of care when they saw a doctor or nurse they were less positive about the process of arranging an appointment.

“A significant minority of patients – between a quarter and a third – reported difficulties making an appointment. This was true whether the patient made the booking on the phone, online or in person.

“Patients also reported mixed performance on waiting times for an appointment. While emergency appointments seemed relatively easily arranged, non-urgent appointments were sometimes subject to significant delays.

“A quarter of patients waited a week or more – significantly higher than the national average of 17 per cent.

“Average waiting times for non-urgent appointments varied considerably between practices. This variation suggests this is an area individual practices have within their control. Poor performing practices should be encouraged to improve.

“Long waits for a specialist appointment were also commonly reported by patients. While these delays are usually outside the control of GP practices, a more pressing concern was high levels of dissatisfaction with communication about delays.

“More than half (59 per cent) of patients said they were not kept up to date about delays.

“Finally, awareness of preventative health checks offered by GP practices was low. A large number of practices visited did not have information readily available on these health checks (general health, cancer screening and smoking cessation) and patient awareness of these services was often low.

“A quarter of patients had not heard of any of these preventative services. The take-up of NHS health checks in Brighton and Hove is 4 per cent, well below the national target of 20 per cent.

“This is an area of health care that clearly requires improvement in the city.”

In a report to the committee, Healthwatch recommended

Making appointments

• Practices should review appointment booking systems and make them as user-friendly as possible.
• Practices should work to reduce the number of non-emergency appointments that involve a week or more wait for the patient.
• Online booking should be promoted and made easier, especially for younger people.

Care

• Patients should have a named doctor as the norm.
• Choices and options about treatments should always be available and be discussed with patients.
• Practices should be cautious in their use of telephone consultations. They should be used only for simple issues and for people whose special circumstances make a telephone consultation more convenient, eg, carers. They should not be used with people with communication difficulties or whose first language is not English.

Preventative health checks

• Practices should be proactive in publicising preventative health checks. Information should be visible in waiting rooms and personal invitations sent to patients. Innovative ways of improving awareness and encouraging take-up should be considered including using social media, text messaging and email messages.

Referrals

• Practices should communicate to patients whenever unanticipated delays are experienced in referrals to specialist treatment. This communication should be made by letter or phone.
• Hospitals produce a monthly bulletin that notifies patients of current waiting times for emergency and non-emergency appointments. The bulletin should be distributed to all GP practices and made available in surgery waiting rooms and distributed directly by GPs to patients given hospital referrals.

Equalities

• Practices should accommodate people with hearing impairments who find it difficult to hear their name called out in reception. Having a person coming into reception to call out a patient’s name can remedy this and should be routine practice.

Surgery environment

• Hand sanitisers should be available in surgeries and their use by patients should be actively promoted.
• Information on notice boards should be well maintained in surgeries.
• Surgeries should provide toys for children in waiting rooms.

Quality standards for personalised and empowered care

• We believe GP surgeries could benefit from a more co-ordinated approach to monitoring patient experience and developing person-centred practice. We would recommend using co-production to develop citywide person-centred quality standards. These standards could then be used as a common framework to support personalised practice across the city.

Councillor Dee Simson, who chairs the Health Overview and Scrutiny Committee, said: “I’d like to thank Healthwatch for a fantastic and valuable piece of work.”

NHS England South said: “GP practices are responsible for providing appointments in a way that best meets the needs of their patients but we know that across the country GPs are facing challenges.

“The General Practice Forward View, recently launched by NHS England, sets out a plan to stabilise and transform general practice, improving services for patients and investing in new ways of providing primary care.

“We will continue to work alongside NHS Brighton and Hove CCG (Clinical Commissioning Group) to ensure local GP services can meet patient needs.

“We have contacted Healthwatch to identify if there are any local GP practices where particular problems have been identified with patients accessing appointments so that we can look into this further.”