Choosing a GP and NHS Choices data

Customer Insight Public information 1

Choosing a GP & NHS Choices data

May 2012


Introduction

• Investigate how some new measures published on the site would be received with site

users.

• In addition, the data team wanted to understand which of the existing scorecard items

were most important to users as well as to gathering sufficient information to inform future

developments of the scorecard

Research objectives

In order to meet the business objectives the following research objectives were developed;

• Explore whether banding of survey items is considered useful

• Understand the impact of composite measures of GP performance i.e. whether they are

relevant, understood or useful

• Understand the need for general composite scores covering all aspects of care

• Explore reactions to suggestions for composites for GP choices in terms of usefulness when

choosing a GP practice

• Investigate the perceived utility of Choose & Book

• Explore reactions to the Index of multiple deprivation (IMD) data

• Identify the need for immunisation data and information on expenditure on secondary care

• Understand reactions to data relating to A&E admissions, emergency appointments and

1st OP appointments


Methodology & Respondents – Stage 1 (Qual)

• Respondents were recruited from our panel of site users who had all stated an interest in taking part in research. Respondents were invited to our offices for a face to face interview

• The interviews were qualitative and each lasted for 60 minutes

• Respondents were asked about their usage and impressions of the GP scorecard and were also asked for their feedback on the use of composite scores

• The interviews were also used to explore the PIMS GP profile which was part of a different study

• A total of 9 interviews were conducted among men and women from a range of different ages

• All respondents were site users and were using the internet on a daily basis.

• The majority had used the site for GP related information in the past and many had used the GP comparison

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Sample and Methodology – Stage 2

Type of survey Pop-up survey which was placed on the Find Services hub page.

Those not looking for information relating to a GP were screened

out of the survey

Methodology Online quantitative survey

Fieldwork dates 4th – 26th April 2012

Sample Total sample completes n= 301

Sample

distribution

General public – self-selected sample of people who visit the site

looking for information about their GP.

Following on from the qualitative stage of the research a quantitative survey was

completed


Stage 1 – Qualitative interviews


Reactions to composite scores 1/3

Composite Scores

• All respondents received the following explanation of the idea of the proposed composite

scores;

• Overall clinical performance - The proposed composite score would be 1 score i.e. 1 number

which would represent the GP practices performance across 68 clinical measures.

Respondents were given the opportunity to look over the 68 clinical measures to be included

• Respondents were also asked for their thoughts on a composite based on a subset of the

clinical measures e.g. on diabetes and on patient feedback

• In addition, respondents were asked what they would expect from a composite score on ‘quality

of prescribing’

Overall reactions

• Site users have mixed reactions to the idea of using composite scores and are generally

uninterested in seeing clinical data or indicators

• Respondents were more interested in softer measures relating to a GP practice such as

opening hours, car parking, friendliness of staff and patient feedback



× General composite score of practice performance

• Overall a general composite on practice performance was not considered to be a good

use of data, an aggregated score perceived to mean little in terms of the individual

conditions

• Would be even less useful to someone in good health

• Appears to be a measure of the local demographic (and how many people suffer from

different conditions) rather than how the GP handles these conditions and this could be

misleading

• Looks like it could be used as an NHS management tool

• Does not account for variability in the practices competency in different areas, and could

be misleading if it were interpreted in this way

• Furthermore, it is difficult to understand what a composite score is and a detailed human

explanation would be needed



Composite score (based on subset of measures) related to a specific condition e.g. diabetes

• Could be very relevant if the score related to individual conditions

• However, an explanation of its meaning would be necessary

Composite on patient experience/satisfaction

• Patient feedback score would be interesting to most respondents

• Reflects that respondents want to know that other patients are happy with the practice

× Composite score on quality of prescribing

• Respondents are generally unclear regarding what this may tell them

• Is it on appropriate prescribing? Prescribing rates? Is it cost savings associated with prescribing generics?

• The concept of a quality of prescribing score, leads to general confusion as it is widely believed that the patient has the right to assume competence relating to prescribing


Stage 2 – Quantitative survey


Choosing a GP

We would like you to imagine that you have just moved to a new area and you would like to find a GP practice to join, please tell us what information would be most useful for you?

• There are many factors which contribute to the decision to join a GP practice

• Patients are particularly interested in the practicalities of visiting a GP surgery as well as the

friendliness of staff and GPs

Base n=714 comments

3%

4%

5%

5%

6%

7%

8%

9%

11%

13%

0% 2% 4% 6% 8% 10% 12% 14%

Ease of appointment booking

Referral to clinics/specialists

Appointment booking system

Patient feedback

Waiting times

Gender of GP

Services available

Friendliness of staff & GPs

Location

Opening hours

% of comments

What kind of

hours of service

is offered

How far is it

from where I

live? A Dr who is not

rude

Friendly and

helpful

receptionists

and Drs


Using information to choose a GP

Q. On a scale of 1-5 where 1= not at all relevant and 5 = very relevant, please rate the following information in terms of how relevant it would be to you if you were choosing a new GP

21%

34%

16%

7%

6%

6%

7%

4%

4%

12%

10%

9%

5%

6%

4%

4%

3%

2%

22%

15%

23%

15%

17%

17%

14%

8%

7%

20%

15%

21%

26%

20%

20%

20%

25%

18%

26%

27%

30%

47%

52%

53%

55%

60%

70%

Proximity to public transport/busroutes

Car parking facilities

GP special interests

Services/clinics offered

Patient feedback

Distance from home/work

Availability of evening/weekendappointments

Availability of appointments 2 days inadvance

Availability of same day/within 48 hourappointments

1 = not at all relevant 2 3 4 5 = very relevant

• Flexible appointment times, distance from home/work and patient feedback information are

particularly relevant to users when choosing a GP.

n=301

88%

Score 4&5

85%

75%

73%

72%

73%

51%

42%

46%


Different measures to compare GPs

Q. It is also possible to compare GP practices in terms of a number of different measures, we would like you to tell us whether you would be interested in seeing the following

measures/information (some of which already appear on the site) when choosing a GP

3%

5%

7%

9%

6%

66%

56%

53%

45%

44%

31%

39%

40%

46%

51%

Number of patients receiving

seasonal flu vaccinations

Number of patients admitted to

hospital in an emergency

Number of patients who

attended A&E from the

practice

Number of patients using

choose and book, online

hospital booking service

Number of patients referred for

an outpatient appointment

Don't understand this information Not useful/would not use Yes, I would be interested in this information about the practice

• Of the suggested measures relating to attendance at hospital, it is not clear which respondents would be most

interested in seeing. For example, 51% of respondents would be interested in the number of patients referred for an

outpatient appointments, but 44% would not find this useful

• Furthermore, 66% of respondents would not find the number of patients receiving seasonal flu vaccinations useful.

n=301


Users were shown an image of the Index of

Multiple Deprivation scores on scorecard

26%

9%

19%

12%

15%

20%

0% 5% 10% 15% 20% 25% 30%

1 not at all useful

2

3

4

5 very useful

Don't know

How useful is this information on a scale of 1 (not at all useful) to 5

(very useful?)

Have you ever looked at this score before?

11%

86%

3%

0% 20% 40% 60% 80% 100%

Yes

No

Don't remember

• There is no real consensus as to how useful this measure was. However, only 15% of respondents rated

it as ‘very useful’ and 86% had never looked at this score before, suggesting that site users are unsure

what the score will mean for them

n=301 n=301


Expenditure on secondary care

14%

7%

13%

19%

39%

9%

0% 10% 20% 30% 40% 50%

1 not at all

interested

2

3

4

5 very interested

Don't know

Q. We are considering including a measure which relates to the level of expenditure on secondary care, by secondary care we mean healthcare that is not provided by the first Dr that you see e.g. referrals to a hospital or

clinic. Each GP practice spends a certain amount of their budget referring patients to secondary care. How interested on a scale of 1-5 where 1 = not at all and 5 = very interested would you be in seeing this type of

information?

• 58% of respondents would be very interested or somewhat interested in measures relating to the

expenditure on secondary care

• Many respondents agree that this measure will provide and indication of the level of care they

may receive

n=301

5%

6%

7%

12%

16%

24%

0% 10% 20% 30%

Indicates whether patient

gets the best treatment

Indication of level of

service

Just interested

To see how budget is

spent

Shows positive GP

attitude towards patient

care

Shows willingness to

refer

Q. Why do you say that

n=151 comments

58%


Patient Survey Data


Users were shown two images of how patient

survey data could be presented on scorecard

Banded survey data

Unbanded survey data


Patient survey data presentation

21%

52%

4%

23%

Unbanded data Banded data shown with icons

Neither, I would prefer something else I don't have a preference

Q. Which of the two presentations of data do you prefer?

n=301

• 52% of respondents preferred the banded data shown with icons. However, there was still a

significant minority that preferred the percentages displayed (21%) or had no preference (23%)

Base n=235 comments

35% – Ease & clarity

31% – Prefer visuals

18% – Easier to understand the

data

Base n=93 comments

37% – Easier to understand the

percentages

32% – Prefer data/percentages

20% – Dislike visuals, could be

misleading

Percentages are

clearer and

easier to

understand Better to view

at a glance

The colours

make it easier

to spot what is

what

Graphic image is

more powerful

and translates

into any

language

Why?

Banding is too

generic, would

prefer to see the

% and the number

Icons look

more user

friendly


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Choosing a GP and NHS Choices data

Health & Medicine

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