A look inside Hereford Medical Group Station Medical Centre

Hereford Medical Group (HMG) recently received the "worst" overall ratings in the GP patient survey for this year, conducted by Ipsos on behalf of NHS England.

HMG was critical of the survey, saying that only a very small pool of people actually responded and that it did not accurately reflect patient satisfaction.

When I was invited to spend a morning at HMG's Station Medical Centre, I was keen to go along and see first-hand what challenges it has to deal with.

I'm not registered with HMG myself but I have, like everyone else, been a frustrated patient trying to get hold of my own doctors.

I met several staff members from across the practice to get an idea of how they operate day-to-day.

(Image: Google Maps)

Inside HMG

As well as a team of general practitioners, HMG is home to a women's health team, a complex patient team, an in-house mental health team, dermatology specialist GPs and healthcare assistants, biomedical scientists, a home visiting team, a care home team, a long term condition hub and more. There is also a minor operations theatre.

(Image: Bridie Adams)

"If I die it will be your fault"

One of the challenges faced by HMG is the retention of reception staff. 

Although 23 receptionists have been hired by HMG this year, 17 have already left their jobs, 10 of whom left within three months of starting.

Comments from exit interviews have revealed some of the reasons why they quit, with one former receptionist saying: "Patients can be so unkind and rude, and they think it's okay to talk to us this way."

It is clear that staff at HMG are hard-working and care deeply about their patients, but unfortunately most of them have faced unacceptable abuse.

Some have apparently been told by angry patients, “if I die it will be your fault”.

Care navigation and triage

HMG has had to change in a number of ways to ensure that the most ill people are seen by GPs quickly, while those with less serious ailments are still seen, but by a pharmacist or a nurse instead of a doctor. All requests for appointments are triaged by doctors.

This is part of a new system introduced in July called "total triage", which operations manager Kate Jones and managing partner Ceri Chaplin said has already started to improve efficiency and patient satisfaction.

GPs are based in the same room as care navigators. This means that staff who are not clinically trained can ask the doctors any necessary questions.

Dr Erica Sibley, one of the GP partners at HMG, told me that the key is giving patients the care they "need", not what they "want". 

Kate Jones with Dr Erica Sibley (Image: Bridie Adams)

Face-to-face appointments

One misconception about HMG, and GPs generally, is that it is difficult to see a GP face-to-face.

I was shown data on appointments from September, showing that there were 2,280 phone appointments compared to 10,980 face-to-face.

Shockingly, 918 appointments were missed by patients in one month without being cancelled or rearranged.

Safeguarding

HMG has a dedicated safeguarding team, something very few GP practices in the UK have. 

Vicky O'Donnell and Zara Beddis deal with safeguarding concerns from clinicians and refer patients to social services and other support systems when they are needed.

Mrs O'Donnell said: "Safeguarding is not a happy job, but it is a rewarding one. We also free up GP time by dealing with things they would have previously had to do."

Zara Beddis and Vicky O'Donnell (Image: Bridie Adams)

Complaints

I met with quality manager Bryony Reed and patient advice and liaison officer Elizabeth Morris, said that despite negative social media comments which are "damaging and affect staff morale", there is not a huge volume of formal complaints.

They deal with an average of 24 complaints per month, many of which are regarding car parking or challenges with phone lines.

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Ceri Chaplin (Image: Bridie Adams) Why are people so critical of HMG?

During my visit, I spoke in depth to Mr Chaplin, the managing partner of HMG. He said: "Working with the public is challenging and we understand that patients are frustrated. This is a problem nationwide.

"Some patients do not accept that they have to wait three or more weeks for an appointment. I think this is because we've all become so used to being able to order something on Amazon and it arrives the next day. People want an instant solution.

"What we are focusing on now is continuity of care, but this is harder in a big practice, and the wait time for a routine appointment."