Creating a patient-friendly surgery

Simple changes and feedback can improve relationships with patients, says Dr Judith Harvey

The NHS's patient and public involvement scheme is about doctor and patient partnership. Sustainable patient involvement cannot be one sided and practices should aim to improve procedures that are a problem for both patients and staff. Acknowledging a shared problem and a shared frustration goes a long way towards making everyone feel better.

Consultation skills

You can start with your own consultation. When you call a patient you do not know from the waiting room, try to introduce yourself. Similarly, if you are overrunning, a good idea might be to go to the waiting room and explain to the waiting patients that you are running, for example, 35 minutes late. Not only will the patients appreciate your action, but it will also take the strain off you and the receptionists will be grateful too.

Patient surveys

The GMS contract measures public involvement in terms of access and surveys. Surveys have provided some useful information and it is good practice to find out about the surveys that your practice has done, what their aim was, how they were carried out, what their outcome was and, most importantly, if there was a change in practice following the results.

Try to find out if the survey were completed by a representative group of patients and if not, why not and what could be done about this.

The results of its surveys and any changes made to the system as a result of the surveys, should should be shared with the patients.


Find out whether there have been any complaints to your practice and what is the practice policy on complaints.

Be aware that patients who are not happy with the practice will not necessarily file a complaint. Does your practice go out of its way to capture these patients and to hear their views? The natural temptation is to ignore what can be ignored, but if receptionists are trained to pick up the comments and invite the patient to have a chat with the practice manager about a problem, it may well avert a future outburst of pent-up resentment, which could escalate into a situation that could easily have been avoided.

Patients from abroad may be used to a very different set-up. For example, one of our foreign patients was irritated by the fact that he could not see the doctor at the time he chose. The receptionists alerted the practice manager, who talked to the patient about his concerns.

It turned out that, as an American citizen, the patient assumed that the service in the UK was private and he therefore was expecting a bill at the end of the quarter. When he realised that the service was free, he was more than happy to accept the appointments system and wait his turn.

Information leaflets

Some patients continually seem to use the emergency surgery rather than booking an appointment. It may, however, be that they do not understand the purpose of the emergency surgery.

Think about what leaflets are being offered in the surgery and how easy it is for patients to understand them. If there is a gap in the information going out to patients think about what can be done to improve the situation. It is not uncommon for patients to be unaware of changes in procedures, so keep them informed.

Patient-friendly practice

Being patient friendly does not mean pandering to consumer whims. It is about starting with courtesies and looking at the potential sources of friction. Small changes can make a lot of difference and improve the experience for everyone.

For example, one practice highlighted that single mothers from a council estate did not bring their babies in for check-ups. Eventually the practice manager raised the matter with one of the patients and she confided that the bus often drove past without stopping. A phone-call to the bus company from the practice manager was all that it took to improve attendance.


  • Talk and listen to patients to get constructive feedback.
  • Put yourself in the patient's shoes: think about your own experience as a patient.
  • Patients want to be respected and listened to.
  • Becoming more patient friendly starts with small things that can mean a lot.
  • Look for the areas where patients' interests and staff interests overlap and try to enlarge them.
  • Pick up on patient comments and surveys and identify problems to be solved.

Dr Harvey is a GP in London

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