Monday, 13 January 2014

The GP Patient Survey 2014: a recipient's view

Early in the New Year a bulky envelope found its way through the letterbox. The accompanying letter gleefully told me that I was being asked for feedback “to help improve local healthcare and other services” by answering questions about my experiences of my local GP surgery and other local NHS services.

Wondering if the answers would be truly anonymous and confidential if any recipient chose to cross-check the 10 digit reference on both the letter and the form, I turned the page. I was advised that my name had been selected randomly then and invited to apply for any necessary assistance in 13 different languages, or to request a copy of the questionnaire in Braille via a special phone number. (Yes, I know…..)

I flicked through the questionnaire to assess the task ahead of me, and saw fifty box ticking questions. The first section was about “accessing GP services”, which was fancy talk for making appointments and speaking to staff and doctors. The old cliché about whether other patients can hear what you say to the receptionist was dusted down again, closely followed by a question that appeared to presume that some people make GP appointments by fax or would prefer to do so.

Over to the “making an appointment” section. “Last time you wanted to see or speak to a GP or nurse from your GP surgery, what did you want to do?” One of the six options was “I wasn’t sure what I wanted.” Oh, come on. To order a large cod and chips, perhaps? Or a pint? Or just seek a few kind words? (Maybe this was an option for the Alzheimers’ sufferers.)

Now for the GP and nurse appointment section, all about assessing time given, listening, explaining, involvement and caring, all on a sliding scale from very good to very poor. All options fairly covered, you might think, but how interesting it might be to see the GP completing a parallel patient focused questionnaire on such issues as lateness, paying attention, courtesy (e.g. not interrupting a consultation to answer the mobile) and respect for the opinion of a trained professional who might not be giving the advice the patient wanted to hear?

The focus then switched to the patient’s personal circumstances. Questions were asked about long term medical conditions before moving to mobility, ability to wash and dress, usual activities, pain, discomfort, anxiety and depression. Curiously, none of them carried a “mind your own business” (or should that be “prefer not to say”) option. The questionnaire went on to ask if the patient had a “written care plan” before ending up at question 50 via out of hours services and a brief set of enquiries about NHS dentistry.

Now, it’s perhaps not entirely unreasonable to conclude that out of the brave souls who began to complete the document, a fair few would have given up out of boredom, frustration or annoyance before the last of the 62 questions bore a ticked box. It may be equally accurate to conclude that those who were sufficiently motivated to fill the whole thing in and return it would comprise more than a fair share of the complaining classes, leaving the silent majority to nurse their adjective of choice. So how representative would the answers be, and how sensible or otherwise in turn would it be to allocate resources in order to address perceived shortcomings evidenced only by those answers? Debatable. But it’s hardly likely to bring the questionnaire mania to an end, even if its sole practical purpose is to demonstrate that “garbage in, garbage out” is as true a principle as ever.

Wait a minute. Did I just say 62 questions when I started off with 50? Indeed I did. Well, a government questionnaire would hardly be the same without the usual collection of diversity questions about personal characteristics. The normal range was spiced up on this occasion with a few more covering such topics as how long your work journey takes, your smoking habits, and your time spent giving support for the infirm. Interesting to note that while the “male or female” question did not provide a third option, thereby inexcusably discriminating against the hermaphrodite community, the orientation question included a curious “other” alongside straight, gay, bi and prefer not to say. It would perhaps be wiser not to comment further, save perhaps to note the potential deterrent value of this closing section upon the incentive to return completed questionnaires. Or to decide whether to laugh or cry at the thought of the poor souls in the survey brainstorming session struggling with the duty to report that 26% of the respondents who were both Buddhist and heavy smokers used their written care plans to help manage their health day to day and had trust and confidence in their GP surgery nurse despite not being happy that other patients could overhear what they said to the receptionist, having made their appointment booking by fax.

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