The GP surgeries with the happiest patients: what’s their secret?

Which GP surgeries are best at keeping patients happy? A recent survey seemed to have the answer, producing a list of the top 10 surgeries in England in terms of patient satisfaction.

Ninth on the list was Porlock Medical Centre in Somerset. Dr Ian Kelham, a GP there, says staff practise family medicine in the old-fashioned sense. Many live locally and they know their patients. ‘We’ve invested heavily in nurses and work as a really close team,’ he says. They make an effort to be welcoming and accommodating.

A key factor is probably location. Porlock Medical Centre, like the other GP surgeries that made the top 10, is in a quiet area, serving a small community. City practices can only dream of getting to know their patients in the same way.

The survey also found that patient satisfaction, though pretty high, appears to be modestly shrinking, with 46.5 per cent of people rating their practice as ‘very good’ in 2012, dropping to 43.1 per cent this year.

So what else can surgeries do to achieve Porlock levels of patient satisfaction?

A good answer to this question is found in a 2013 report commissioned by NHS England.

Its authors, using responses from 512 medical professionals and patients, concluded that most patients did not want choice, but rather high-quality, locally available care.

To make the service work, the researchers said that GP appointments should be extended to a minimum of 20 minutes if doctors were to look after patients who had long-term conditions or complex needs.

Essentially, GPs needed to see fewer patients, for longer, without the fear that their funding would be cut.

Unfortunately, if the key to patient satisfaction is the availability of GPs, then things are unlikely to get better. A study by the King’s Fund released in May found that workload had become more complex and intense over the last five years and GP recruitment had not kept pace with the increase in demand.

The report pointed out that, as GP practices tried to handle the increasing number of consultations, they used other staff, like nurses, to treat the less complicated cases. This left doctors with just the harder cases that could not be dealt with during a 10-minute appointment.

An additional problem is understaffing, with many GPs leaving the profession. The researchers surveyed trainee GPs and found that only one in 10 planned to be working full time and seeing patients five years after qualifying. At the other end many older doctors are choosing to retire early.

With fewer GPs serving ever more patients, the revival of old-fashioned family medicine doesn’t seem that likely.

  • Katabasis

    What’s their secret?

    I think you’ll find its having fluent English speaking staff.

    • Interesting point there. A family member is a GP who works 12 and 13 hours a day without proper breaks. She snatches a bite of a biscuit between patients, and takes the occasional swig from a bottle of water secreted in her desk drawer. Recently, a colleague retired and another left (exhausted). They advertised nationally in the usual way and then did it again at a cost of thousands of pounds (which comes out of the GPs pockets) and only had two applications, both Pakistani trained and weak in English. They had to appoint them both. There are nine GPs and 15,000 patients, many of whom turn up for trivialities, don’t speak English and come about matters like housing applications and other non medical rubbish. The service is collapsing. The money isn’t even good any longer. In 2004, they were earning £100,000. Now in 2016, with 12 years of inflation that salary had it held its value would be £143,000, but they are lucky if they manage £80,000 for a sixty plus hour week, but don’t forget that they must pay insurance of £10,000 out of their own funds just to practice, to protect them against usually spurious negligence claims. This GP I am talking about has now had to cut back to 75% of full time hours, just to stay alive. She will certainly walk away before she is sixty.

  • sfin

    “Its authors, using responses from 512 medical professionals and patients, concluded that most patients did not want choice, but rather high-quality, locally available care.”

    And right there, in black and white is why improvement is impossible.

    Here in France, I pay my GP around £5:00 for a consultation (subsidised by my state health insurance – she gets about £30). That makes me a client, in her eyes and as I am free to shop elsewhere if I’m not happy, she works hard to retain my custom (it’s a city practice – and she knows my name).

    Remarkably, this small, upfront payment frees up availability as the surgery isn’t clogged up with people with a cold, or who need a sick note for work.

    No competition means more management required to impose “improvement” by edict. Competition makes improvement a natural survival strategy.

    • John Smith

      France has a lot of good practices & services
      the one you mention, local testing labs and local non emergency ambulances
      Our national system is a post code lottery

      We should now be adopting the best of european practices but the unions will not let it happen

      • sfin

        Yep! Call for a non life-or-death ambulance and the firemen will come and pick you up (they’re all trained paramedics in any case).

        I used to think that the French were all raging hypochondriacs (the average household medicine cabinet would equip a small UK hospital), but ,having lived here for a few years, I’ve come to realise that they actually take greater personal responsibility for their own health.

        On the corner of my street is a” Laboratoire” and just up the street is a “Radio”. I can walk in off the street, without prescription (although it’s a lot cheaper if you do have a prescription) and get a full blood/ urine test and/or ultrasound exam – I think a blood test is around £25:00. It’s like going into a shop and many French people keep an eye on, say, their blood levels (cholesterol, sugars, lipids etc), without once bothering their GP.

  • John Smith

    More interested in competent GP’s who listen and come up with an agreed diagnosis and way ahead
    Most patients exercise a choice BETWEEN GP’s
    There are some that meet above and some who cannot listen and are therefore poor GP’s