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1 Purewell Cross Road , Christchurch , Dorset , BH23 3AF
Telephone: 01202 488 486
Fax: 01202 486 724




Practice Questionnaire

Many thanks to all of our patients who took the trouble to complete the recent patient experience survey. Although it can be an inconvenience to take time to complete such a questionnaire, it is very valuable to the practice to know what we are doing well and what can be improved. The partners were very pleased to have 84% of the patient ratings as good, very good or excellent. However, we are always trying to improve our service within our financial and other limits imposed upon us so we will be looking at the three lowest scores which were ‘waiting time’, ‘telephone access; and ‘seeing practitioner of choice’.

As the GP partner linked to the Patient Reference Group (PRG), I will be seeking further opinions from this group as to how we can change the above scores but I thought it would be useful to explain how the surgery is funded and run which may help our patients to understand why things are as they are!

General Practice surgeries in England are funded mainly according to the size of the practice, that is, the number of people that are on the surgery’s ‘list of patients’, or ‘list’ for short. We are paid by the government via the Primary Care Trusts (until the end of March this year) to provide certain essential medical services, such as looking after pregnant women and providing vaccinations and screening tests such as cervical smears and general medical care when you are ill. Some services are classed as extras and paid accordingly, such as the contraceptive coil clinic and others are not paid for at all, such as joint injections and acupuncture for pain relief. Working in a deprived area or with special groups such as asylum seekers or the homeless will attract a slightly higher payment. Essentially, GP’s are treated in the same way as sub-Post Offices; we own the buildings we work in and employ our own staff to run the practice in return for being paid a set amount per year. The amount we get paid at the Farmhouse is worked out on a very complicated formula and looks to change in the near future, probably reducing the money available to employ staff, etc. This change in formula is going to affect all GP’s in England.

The limitation on the money coming in to the surgery is what stops us employing more doctors or nurses, as several patients asked us if we could do. The only way we can make more money is to do more private services, such as life insurance medicals, but these then take the GP away from the NHS work and more and more companies are requesting patient notes for the information needed rather than sending people to see the doctor.

We could take on medical students or GP training doctors as such training is paid for, but space for another doctor to see patients is not easy to find in our beautiful but quirky listed building. This would also reduce the appointments with individual partners as they would be needed to supervise the training doctor or student.

For the moment, we are doing our utmost to make sure we do all the work that the Government have asked us to do and anything else we think is necessary for our patients, particularly making sure that all the people with an ongoing illness, such as heart disease, asthma or diabetes or mental health issues, are seen regularly and necessary health checks made.

With regards to seeing the GP of your choice, it may help to know that there are roughly 6300 patients for the equivalent of 3 ½ full time GP’s in the practice, which is the average for England. We also have a salaried GP who works one day a week. Each of the partners is on duty one day a week, and Dr Blaikley and Dr Dague take it in turns to do 2 duty days alternate weeks. The duty doctor does not have a booked surgery in the afternoons as they need to be free to deal with emergency and urgent visits. This is why the appointments for the emergency surgery on the day are for URGENT medical need only, not because it is easier to be seen that day. If the duty doctor has to go out of the surgery, and the emergency surgery is full, there can be a very long wait to be seen as the other doctors will be seeing routine appointments for those patients who work and can only come at the end of the day.

This means that with the best will in the world, none of us can see all the patients who might wish to see us on a particular day, and never will be able to, along with other GP’s. Waiting times will be longer after one of us has been on holiday or study leave as that tends to create somewhat of a backlog for appointments. However, I do keep an eye on my pre-booked appointments and it is unusual for me to be fully booked for more than 2 weeks ahead. Seeing the nurse practitioner or practice nurse may be more appropriate and you can rest assured that their experience and knowledge is wide and if they cannot help you, they will speak to one of the GP’s or make a follow up appointment for you. We also offer telephone consultations after each morning surgery, where you call in at a stated time and if the GP is not available, they call you back as soon as they can. These are appointments in the same way as face to face appointments, but we do have a much higher level of patients not calling in as planned or forgetting to cancel, which then prevents another patient having that appointment. It is very difficult to answer all the queries that patients phone into us on some days due to lack of time, which is why the staff will advise you that it may not be the GP who phones you back with an answer, if you leave a message, rather than booking a telephone consultation.

With regards to time waiting in the surgery to see the doctor, we do apologise for lengthy delays that can sometimes occur. This can be for a number of reasons, but is primarily due to some patients needing more than the appointment time of 10 minutes to deal with their health problems. If you know your problem is complex, or it is going to take some time to be examined due to disability, please ask the receptionist if it is possible to have a longer appointment, or be prepared to return at a later time for further advice from the GP. We sometimes have to leave our rooms to see a patient for our nurse colleagues or to give advice to our district nursing team, which can then put a surgery behind schedule. We will try to warn patients if there is a particular delay with an individual doctor as we realise you are busy people too.

To avoid congestion on the telephone, please try to avoid phoning on a Monday morning to book a routine appointment. We have approximately 5 weeks of appointments open at any one time and it will much easier to get through in the afternoon. We usually have at least 3 receptionists on duty, but it is not possible to have one person dealing only with the phone so there will be delays in answering at times, especially if the person calling in has a complicated query that requires further advice from a GP or other member of staff. However, I ALWAYS use the ‘enquiries number’ to contact the surgery and therefore do keep an ear on how quickly the receptionists answer me, and therefore you!

Lab results are not usually looked at until after the morning surgeries, so please phone in the afternoon if you need to obtain them. Occasionally, X-ray results are not routinely passed on from the local hospitals and we have to negotiate the Bournemouth Hospital clinical website to get them or to phone other hospitals, which takes time obtaining, so thank you for your patience with these.

I do hope this insight and information helps to explain about your surgery and I will be posting further information about how we will try to improve the troublesome areas shortly. In the meantime, we at the Farmhouse Surgery are very appreciative of your ongoing support and suggestions.


Dr Jeni Worden

March 2013


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