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At the end of July the Healthcare Commission (HCC) published the results of the National Survey of Local Health Services 2008 which all PCTs had to complete. The survey covered topics such as access to appointments, waiting times and patients’ relationships with NHS staff. 

The aim of the survey was to find out what services really feel like for those using them which would help trusts respond to patients’ concerns. Overall the results have shown that patients are more satisfied with care in practices and health services and are increasingly positive about services. However despite the fact that two thirds of our patients are satisfied with access to primary care services we continue to perform significantly worse than other PCT’s nationally.

The PCT commissioned the Picker Institute to carry out the survey on its behalf.  The report that the Picker Institute provided (Appendix 8) includes benchmarking with the other 68 PCTs that also commissioned Picker and comparison with the last survey held in 2005. Patients were asked 56 questions. These were the same questions used in 2005 which includes the sub-set of 15 core questions which are used by the HCC in their published survey and which will be used as part of the annual health check for 2007/08. The Department of Health will also use the survey for reporting on the PSA target on patient experience.

The local picture that emerged from the survey was that there are positive trends and that patients overall experience of services is better than 2005. HPCT was significantly better in some areas and showed no significant decline in performance in all areas. At least two thirds of patients seen by GPs are reporting that they are getting appointments within 2 working days and felt they were involved as much as they wanted to be in decisions about their care and treatment. The figure was higher in terms of patients’ confidence and trust in their GPs.

All the PCTs had improved overall on 2005 and Hounslow does not compare as strongly against other PCTs.  This is reflected in the HCC report appended at the back where on all indicators the PCT is either in the intermediate or worse performing PCTs categories.  In the Picker Report in just over a third of questions we were below the trust average. The report details a number of questions on which we were significantly worse than the average with more patients indicating that an aspect of care could have been improved.

Examples were: patients waiting more than 2 days for an appointment, lack of courtesy shown by receptionists, not enough information about the purpose of medication, and being put off going to a practice through inconvenient times. As these are the 15 core questions used by the HCC in their assessment it is therefore vital the PCT develops a strategy for improving performance in these areas.  This also reflect the areas that patients send in formal complaints about.

On two questions we scored very poorly in comparison to other trusts. This suggests that these should also be areas where the PCT should focus on improvement.

The first question of concern relates to Out of Hours services.  Nearly three quarters of Hounslow patients reported not being able to get through or waiting a long time compared to the Trust average of 43%. About three out of every four patients added that the reason they had used the Out of Hours service was not dealt with satisfactorily compared to just one in two for other trusts.

The second question of concern relates to GPs providing advice on giving up smoking where the patient wanted advice and did not get it. According to the HCC National Benchmarking, Hounslow was the worst performer in the country. However, this result should be treated with caution as the number of respondents to this question was almost 50% lower than most questions and the confidence interval is so broad that it is also possible that Hounslow could be grouped in those trusts grouped as intermediate performers.  Addressing this issue could support the continued achievement of our stop smoking target.

Using an Action Plan template supplied by the Picker Institute, the PCT has identified a number of objectives to address these issues with the aim of bringing us in line with the trust average when we are surveyed again in January 2009.

Once the Action Plan is finalized work will begin to firm up next steps, actions, monitoring and delivery. A group coordinating survey follow up work will meet quarterly. Regular updates of development will be published including reports on changes to services.  The Patient Survey report and action plan has been considered by the Health Performance Committee.