PubMed · 14997796
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Graham Clews. 2004-02-19. Night vision.. https://pubmed.ncbi.nlm.nih.gov/14997796/
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BACKGROUND: The government has proposed a 48-hour target for GP availability. Although many practices are moving towards delivering that goal, recent national patient surveys have reported a deterioration in patients' reports of doctor availability. What practice factors contribute to patients' perceptions of doctor availability? METHOD: A cross sectional patient survey (11,000 patients from 54 inner London practices, 7247 (66%) respondents) using the General Practice Assessment Survey. We asked patients how soon they could be seen in their practice following non-urgent consultation requests and related their aggregated responses to the characteristics of their practice. RESULTS: Three factors relating to practice administration and appointments systems operation independently predicted patients' reports of doctor availability. These were the proportion of patients asked to attend the surgery and wait to be seen, the proportion of patients seen using an emergency surgery arrangement, and the extent of practice computerization. CONCLUSION: Some practices may have difficulty in meeting the target for GP availability. Meeting the target will involve careful review of practice administrative procedures.
The Scottish Executive Health Department approved funding in 2001 for Fife NHS Board to pilot an integrated model of out-of-hours dental services based upon a dental nurse-led triage system during the evenings, weekends and some public holidays. After one year of the pilot project the activity was evaluated by analysing the triage database. Nearly 4,000 calls were received--Fridays and Saturdays were the most popular days to telephone which resulted in nearly half of all callers being referred to an emergency weekend clinic. Thirty-nine percent of callers received advice only or were advised to contact their own dentist during working hours. A further 12% who were not registered with a dentist (n=479) were offered a next-day appointment with a dentist in their area--around half of these callers subsequently attended for an appointment. Only two out of every 100 callers were deemed to require emergency out-of-hours attention and were referred to oral surgery staff in a local hospital.
OBJECTIVE: To compare patients' satisfaction with four types of out-of-hours emergency dental service, including both 'walk-in' and telephone-access services. BASIC DESIGN: Postal questionnaire survey of patients who had attended weekend emergency dental services. Patient satisfaction measured using an adapted version of a questionnaire developed for assessing out-of-hours medical services. SETTING: Two health authorities in South Wales, UK. SUBJECTS: The 411 patients who saw a dentist and completed the patient satisfaction questionnaire. RESULTS: The quality of the dentist-patient encounter was similar across services, with most patients being satisfied with the dentist's attitude and manner, the explanations and advice given, and having to see an unfamiliar dentist. Satisfaction was lower, and differed more across services in relation to service accessibility and delays in getting to see a dentist out-of-hours. The walk-in services were perceived as the least accessible: around 40% said they had problems contacting a dentist when the surgery was closed (compared with 16% and 29% in the other two, telephone-access services). Only 12-14% of telephone-access patients said they would be 'happy with advice plus a reliable appointment when surgeries re-opened', whereas almost half of walk-in patients thought this. CONCLUSIONS: Despite overall satisfaction with the dentist-patient encounter, there was relative dissatisfaction with the accessibility of all services, especially the walk-in services. Out-of-hours dental services should be better designed to reflect patients' needs: the need for telephone advice as well as face-to-face consultations, and greater awareness that theoretically available services may be difficult to access unless public expectations and awareness are raised.