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How easy is it to give feedback to your GP?

How easy is it to give feedback to your GP?

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In October 2023 we undertook a ‘health check’ of all GP practice websites in Northumberland across seven primary care networks (PCNs). There are 36 practice websites representing 45 individual surgeries. This was to see how easy it was to find information about how to raise a concern or give positive feedback and to see if signposting information for support in raising a concern was up-to-date and factually correct.

Why we did it

Patient feedback is an important part of improving patient experiences and outcomes, enabling the service provider to identify potential problem areas. Having clear processes also gives the opportunity for concerns to be dealt with swiftly to prevent escalation and to avoid undue confrontation with practice reception staff.

In most GP services complaint situations, the appropriate course of action is for a patient to initiate a complaint directly with their GP practice. Patient feedback to Healthwatch Northumberland has shown that many people seem unaware of how to resolve a complaint or concern through their GP surgery and what support options are available to them.

There have been recent changes to advocacy support in Northumberland, with VoiceAbility taking on the NHS Independent Complaints Advocacy Northumberland (ICAN) service, as well as national changes, with Integrated Care Boards(ICBs) now handling NHS primary care complaints – these were previously dealt with by NHS England.

We wanted to explore if these changes had been reflected on GP practice websites. We also wanted to gather evidence of the need for consistent messaging in order to ensure that the process of raising a concern is easy from a user’s point of view, and that signposting information is factually correct, so that patients have a clear understanding of their rights and options.

How we did it

Our staff and volunteers carried out research by visiting each GP practice website to review its complaints information. All of the websites were accessed via desktop computers and, where possible, using smartphones (29 out of the 36 websites) to ensure equal accessibility.

We are aware of other accessibility issues, for example, language barriers, and will carry out further research on this.

What we found

  • Nearly 60% of GP websites were found to be equally accessible from both desktop computer and smartphone.
  • There was a 50:50 split on whether or not information and support for raising a concern was easy to find on the websites – some information was found under different headings on the websites rather than on the main complaints page.
  • Complaints information, support options and signposting information was very muddled. Even where correct support organisation details were given, they weren’t always accompanied by the correct contact details or explanations of how the service could help.
  • In some cases, there were additional steps that needed to be taken when making a complaint online, for example, having to download forms, which could be a barrier to patients making the complaint.
  • There was a lot of variation in information and processes even between practices within the same PCN, for example, within one PCN, two practices have almost identical looking websites, but one practice directs patients to send complaints to NHS England, whereas the other directs them to the ICB.
  • Within another PCN, again, four practices have very similar looking websites, but two of them require the patient to attend the surgery in person to collect a complaint pack, one requires the patient to put a complaint in writing by post and only one practice offers the option of making a complaint online via email.

Read our full findings and recommendations

Getting the most from your surgery

Getting the most from your surgery

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GP surgeries have changed the way they work to meet patient needs and increased demand. There is now a wider range of medical staff at surgeries and different ways to get help such as telephone, video, and online consultations, as well as face-to-face appointments.

Access to GP services is an issue we hear about regularly at Healthwatch Northumberland. In our ‘getting the most from your GP surgery’ booklet we explain more about the range of staff roles at surgeries, different ways to access healthcare and how to make the most of your GP appointment.

Why do I have to tell the receptionist so much about my concern?

Reception staff need to ask enough questions to make sure you get the best appointment with the right person. This may not always be your GP, as there are specialist services that may be more appropriate for your needs, for example, a dietician for
concerns around food allergies or intolerances.

Who might I see at the GP surgery?

Your GP surgery will employ some or all of the healthcare professionals listed below.

Advanced Practitioners: include nurses, pharmacists, paramedics, physiotherapists, occupational therapists, dieticians or podiatrists. They can help with a variety of health conditions and can prescribe medication and make referrals to other specialist services.

Clinical Pharmacists: can carry out medication reviews, particularly for long-term and chronic health conditions. Some can also prescribe medication and manage prescriptions.

Care Coordinators: ensure patients have more joined-up care and that their care needs are met, particularly for those who are frail and/or elderly, and people with long-term health conditions

Dieticians: diagnose and treat dietary and nutritional problems, give advice on food and nutrition, and offer support with diabetes, digestive issues, food allergies and intolerances and weight loss/gain.

General Practice Nurses: can do many of the same tasks as GPs. They assess and treat people of all ages, provide wound care, screenings and blood tests, as well as vaccinations. They also offer advice on contraception, women and men’s health issues, weight loss and stopping smoking.

Health and Wellness Coaches: find solutions or lifestyle changes to enable people to lead happier lives. They help people to form a personalised health and care plan to achieve their goals.

Mental Health Practitioners: support people with severe mental health illness to live well in their communities. They can work with patients whose mental health needs cannot be met through, for example, talking therapies, but who may not need care from more specialist services such as psychiatric care. They can often help children and young people as well as adults and can help make referrals to suitable services for support.

Occupational Therapists: work with ill, disabled or injured patients,including those who have returned home following a hospital stay. They help with adaptations to people’s homes so they can continue to live independently.

Physician Associates: work alongside GPs. They cannot prescribe medication but can prepare prescriptions for GPs to sign and can diagnose, order tests and make referrals.

Physiotherapists: work with patients who have joint or muscle problems including those recovering from serious injuries or illness and those with new injuries. They can book scans and tests and are trained to recognise when a joint or muscle problem may be a sign of something more serious. Patients can often make an appointment with a physiotherapist directly themselves (self-refer) or can be referred by a GP or other healthcare professional.

Paramedics: can provide a rapid response to patients with long-term conditions, minor injuries and minor illness. They can supply a range of medicines and support patients who require wound care, have fallen, or have musculoskeletal problems, and can treat some types of infections.

Podiatrists: can diagnose and treat foot and lower leg conditions and provide foot care for short-term or long-term conditions.

Social Prescribing Link Workers: help address the non-medical issues that may be affecting your health and wellbeing. They can connect you to local services and community groups for practical or emotional support.

 

Find out more by viewing our ‘getting the most from your GP surgery’ booklet or download as a pdf.

 

Tell us your experiences of making appointments and visiting your GP surgery.

 

 

 

Share your experiences of GP referrals

Share your experiences of GP referrals

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Have you been referred by your GP practice to a specialist for tests, diagnosis or treatment? Or have you expected or requested a referral but didn’t get one? We’d like to hear about your experiences to help the NHS understand what is working and what could be better.

The survey will only take a few minutes of your time and any information you share will be anonymised.

What is a GP referral?

It’s when a GP or other medical professional at a GP practice sends you to a specialist at a hospital or community clinic for further tests, diagnosis or treatment. Your GP could make a referral for many reasons, such as a hip replacement, MRI scan, physio, mental health services, endoscopy and more. A referral can happen during a phone or face-to-face appointment.

Tell us about your experiences

Share your views about GP referrals

Share your views about GP referrals

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Have you or your loved one struggled to get a GP referral for tests or treatment?

Healthwatch England has been hearing from the public about how hard it can be to get a GP practice referral to another NHS service, and they would like to hear about your experiences.

GPs are the first point of call for many health issues and the gateway to specialist support. But with many GP surgeries stretched thin and under pressure, NHS decision-makers need to understand if people are finding it difficult to get the right help.

Examples of services your GP can refer you to include:

  • Scans or tests for a diagnosis of a condition or health issue
  • Mental health support
  • Surgery for knees, hips and eyes
  • Support like physiotherapy for back pain or arthritis
  • Non-urgent heart problems
  • Wellbeing services, like smoking cessation or diabetes management.

The impact of delayed referrals

GP referrals affect people of every age group, every background, and every region across the country. Some of the things patients have said include:

  • People feel like their symptoms are dismissed
  • They have to try multiple times before they’re successful
  • They are left in the dark about how serious their condition is.

Share your views

As the independent champion of health and social care services, we want to hear your experiences of trying to get specialist NHS support, like physiotherapy, talking therapies, hospital scans and consultations.

By sharing your story, we can use your feedback to help the NHS better understand your challenges and improve how people access the care they need.

Find out more about GP referrals

This piece of work has now ended.

Brockwell Surgery relocation

Brockwell Surgery relocation

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Earlier this year we helped Brockwell Medical Group to hear from patients their thoughts on the proposal to relocate Brockwell surgery to a new build located on the site of the Northumbria Specialist Emergency Care Hospital. We held three online forums during February and March 2022 for patients and residents.

Pauline Ironside, Business Lead from Valens Medical Partnership and Dr Aamir Munir from the surgery were at the sessions to provide an overview of the proposal and answer any questions. Jen Coe from Northumberland Clinical Commissioning Group Engagement also attended and Shari Kelly from Valens Medical Partnership joined us for one of the online sessions.

Feedback on the proposed relocation

In total eight people came to the forums and all were patients of Brockwell Surgery. We also received some feedback via social media, email and telephone. A summary of the areas of feedback we recieved are outlined below.

Read detailed questions and answers from the forums in Appendix A.

1. Travel to the new surgery

One of the primary concerns we heard was around travelling to the new site for appointments, particularly as public transport did not appear to be readily available and taxis would be expensive. Concerns tended to be for elderly people or others who may be unable to drive. One person mentioned her elderly parents could rely on her for lifts, but others would not necessarily have that same family network. Another person said that she was currently unable to drive due to a health issue and would struggle to get to the new site.

There was a general feeling that the current surgery was a ‘community’ facility serving its patient location and demographic well and that a move would detract from that. A query was raised about whether a postcode analysis of current patients had been completed. Two people mentioned that the current site was walking distance for them. However, we also heard from one person that the new proposed site was closer to travel to and a suggestion that this would also be the case for others.

Related travel concerns and questions are outlined below:

  • Alternative options to proposed move

 There was some acceptance about the need for improved premises and services, but a question was raised by two people about whether expansion on the current site was possible as an alternative and another two people about whether the current surgery could be kept open as a ‘branch’ surgery alongside the new proposed site.

  • Environmental and cost implications

 Due to the observation that most patients would likely have to travel further to access the new site a concern was raised at one forum and via social media about the environmental impact of people having to drive to appointments who are usually able to walk. Alongside the concern about taxis being expensive for those who cannot drive, the costs of public transport for those who could use it to get to the new site and increased petrol costs for those driving to the new site were also raised.

  • Alternative transport options

There was general support for the proposal of a free transport solution in partnership with Age UK Northumberland. We heard that this would not only be for the elderly community but also younger patients who were struggling with transport to the new site. However, there was a concern raised about ensuring the transport available was safe and accessible for frail elderly people who may not be able to step up into a mini-bus or be safely seated before it moved away. One person told us that her autistic son who is also non-verbal potentially may struggle with this type of transport solution.

There was also a concern that any transport solution should be sustainable, and a query was raised as to how this would be and continue to be funded in the future particularly given Age UK’s charitable status.

2. Parking concerns

 Another primary concern raised in relation to the new site was around parking. Several queries were raised about whether this would be free parking and there were concerns around how parking would be managed at the new site and if hospital patients would be prevented from using it.  We did however, also receive feedback from someone at a forum and another via social media about the difficulties parking at the current site and how the new site could improve parking concerns.

Other considerations

The engagement process

There was some concern raised about the engagement process itself following unexpected delays in patient letters being received. However, it is noted that some more online sessions were arranged and the survey date extended due to this delay.

Concerns were raised about ensuring the voices of those who may be digitally excluded, whose first language is not English, and those with protected characteristics were heard as part of the engagement process. We also had a suggestion from one person that the survey appeared biased in favour of the proposal, and another was concerned that the proposal was like a move proposed several years ago and therefore felt contributions made from patients as part of that process should also be considered. A few people were keen to understand whether the proposal was a ‘done deal’ regardless of patient views.

Miscellaneous

We received a couple of comments that the move appeared more beneficial to staff than to patients and a related query about whether there were financial incentives for medical partners for the move.

We also heard a query around pharmacy services and whether these would remain at the current site or move to the new site, showing a potential concern about disruption to services.

Summary

The feedback we received about the proposed relocation centered mainly around two key issues which were travel to the site, particularly for those who do not drive, and concerns about parking. Due to these concerns people were keen to know if other options closer to the current site had been considered or whether some provision could also remain at the current site should the move go ahead.

Recommendations

  • Ensure continued meaningful engagement on the proposal if approved. For example, develop and deliver a communications plan with patient representatives that provides regular updates to all patients, highlights when key milestones are reached/achieved and identifies when and how feedback will be sought on key issues.
  • Given the queries received about whether the current site could instead be expanded, further information should be included in the FAQs about the reasons that this is not possible, to improve transparency and patient confidence in the process.
  • Whilst alternatives to travel to the site for those who do not drive are being considered, these options need to be both transparent and viable and communicated fully to patients to help alleviate concerns. Information about available bus routes should ideally be published or at least be offered to affected patients prior to any agreement on the proposal to allow for further feedback. At a minimum this could be via a Traveline ‘plan your journey’ link on the website.  A travel impact assessment focusing on those with protected characteristics under the Equality Act should be completed, including an Environmental Impact Assessment.
  • Should the proposal go ahead, parking solutions at the new site should be fully and clearly communicated to visiting patients.
  • Given potential difficulties in travel, further consideration should be given to how multiple frequent surgery visits within one day would be managed, for example, stool and urine sampling cases.

 

June 2022: Brockwell Surgery relocation approved

The Brockwell Surgery relocation has now been approved. The practice was given the final approval at NHS Northumberland Clinical Commissioning Group’s Primary Care Commissioning Committee held in May 2022. You can read more about the move at Valens Medical Partnership’s website.

 

Tell us about using GP Services

Tell us about using GP Services

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We are helping the NHS in our area to find out more about your experiences of using GP services in Northumberland. We’d like to know which healthcare professional at your GP practice you prefer to see, how quickly you would like to be seen and how far you would be willing to travel for an appointment.

We’d also like to know if weekend and evening appointments are useful to you and if you prefer a telephone or video consultation or a face to face appointment with your GP, nurse or other healthcare professional at your surgery.

Your views are really important as they will be used in decisions about any future changes to the way people access GP services in Northumberland.

You can , over the phone by calling 03332 408468 or texting 07413 385275 for a callback, or ask us for a postal copy with freepost return.

There is the chance to enter a prize draw to win a £100, £50 or £25 High Street voucher as a thank you for sharing your thoughts. Please leave your views or send any paper copies back to us by Friday 25 February 2022.

This piece of work has now finished.

To keep up to date with all of our work and how you can get involved, sign up to our monthly newsletter.

Menopause Day: A tale of two Tinas

Menopause Day: A tale of two Tinas

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World Menopause Day: A tale of two Tinas

On World Menopause Day this year we wanted to highlight the differences in treatment from healthcare services in Northumberland that two women have experienced as they go through the menopause.

‘A tale of two Tinas’ is two women’s experience of healthcare treatment for perimenopause and menopause, told from their own point of view.

Given that almost half of the population of Northumberland are going to go through the menopause at some stage in their lives, we would hope that Tina R’s story, outlined below, would be the most common experience.

A Tale of Two Tinas: World Menopause Day 2021

Read more about the symptoms and treatment of menopause at the NHS website.

Miss Menopause is a Facebook group for working women in the north east.

 

Why don’t you tell us your story of the healthcare services you have used during the menopause, and help us build a picture of what’s happening across the county.

Virtual appointment Hubs Northumberland

Virtual appointment Hubs Northumberland

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Virtual Appointment Hubs for Northumberland

Patients across Northumberland and North Tyneside are being encouraged to make the most of digital hubs, set up to help them access online healthcare.

Community hubs are being set up across the county by the Public Health Team at Northumbria Healthcare NHS Foundation Trust in partnership with Northumberland County Council and North Tyneside Council to offer confidential spaces for individuals to access virtual appointments who may not have the technology or don’t feel confident in doing it themselves at home.

Since the start of 2021, the Ashington hub has supported 70 outpatient appointments online and the trust is putting arrangements in place to support people from other areas too, including Wooler/Glendale, Belford, Blyth, Longbenton, Meadow Well and Wallsend.

Already, 35% of all appointments per month at the trust are via telephone or online, saving unnecessary hospital visits, travel and parking costs and the need for people to make work or childcare arrangements.

There are also huge environmental benefits. Over the past year, patients at the trust travelled over two point six million fewer miles than the year before.

Marion Dickson, executive director of nursing midwifery and allied health professionals and executive director of surgery and community at the trust said “I’m so pleased we are able to offer this support closer to home for our patients.

“Since the start of the pandemic we have seen a huge shift to online appointments which can be hugely beneficially for both our local residents and our staff. Less footfall in our hospitals also means less opportunities for infections to spread – which will help keep our patients and staff safe.

“But we know not everyone is able to readily access the internet and there are lots of people who struggle to get online. This can be for a number of reasons such as living in an area with poor quality broadband or personal situations which make it difficult.”

According to The Good Things Foundation, nine million people in the UK are unable to use the internet independently and seven million people do not have the internet at home. These hubs aim to tackle these inequalities in digital literacy, digital poverty and digital connectivity to improve health outcomes for local populations.

Marion continued “We are now operating at a level where the most appropriate type of appointment can be offered to a patient, and they can be safely seen in the outpatient department when necessary. We want to make sure everyone has the ability and the skills to access their healthcare in a way which works for them.”

Clinic details

  • Wooler/Glendale area, Cheviot Centre, Monday – Friday, 9am-5pm, 01668 282406.
  • Ashington, Being Woman at YMCA Northumberland, Tuesday – Thursday, 0778647233. or 0800 9991876. Please note: this service is not just available for women.
  • North Northumberland, Belford, Bell View, 01668 219220.
  • Longbenton, Oxford Centre, 0191 643 2750.
  • Wallsend, LD: North East, 0191 262 2261 Please note: this centre is for people with learning difficulties and learning disabilities only.
  • Meadow Well Connected, call 0191 341 0033 between 9am – 3pm to arrange an appointment.
  • Blyth Horizons North East, Community Lounge, 01670 359465 (option 4) 9am – 5pm Monday – Friday.

Please note: patients need to call in advance of their appointments to book in and all premises have been COVID-19 risk assessed.

 

If you or someone in your family has used one of these hubs, tell us about your experience.

Click and Connect: GP online services report

Click and Connect: GP online services report

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GP online services report

GP online services can cover a range of different functions, for example, booking appointments online, ordering repeat prescriptions and viewing medical records, test results and medicines. Many people find it more convenient to register for online services rather than having to rely on telephone or in person contact with their surgery. This has been magnified by the Covid-19 pandemic, due to social distancing restrictions.

We were contacted by someone who told us about the difficulties they had experienced trying to register for GP services online. They found the process complicated, particularly as they were asked to visit the practice in person with ID, in the middle of the pandemic. We decided to do some work to look at how people in Northumberland could register for online services at GP practices across the county.

Click and Connect: GP Online Services Report

Do It For Yourself

Do It For Yourself

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We are supporting the #DoItForYourself initiative which helps raise awareness around the symptoms of lung cancer and the importance of early diagnosis. If you’ve noticed any signs of lung cancer, such as breathlessness or a cough lasting for more than three weeks, contact your GP practice to get checked out.

Lung cancer can affect people of all ages, but the risk increases as you get older. The campaign specifically targets men and women over the age of 50 as lung cancer most commonly affects people of this age group.

Before the pandemic the early diagnosis of lung cancer was challenging, with many patients presenting with a late stage cancer when curative treatment is not an option. Covid has added the complication of potentially disguising the signs and symptoms of lung cancer. If you have any concerns, your GP practice is there to help.

Read more about the symptoms and treatment of lung cancer