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How to handle the reputation of your practice in ten steps

18 July 2019

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Virginia Patania explains how the entire workforce can come together to look after your practice’s reputation
In general practice, reputations don’t always match what’s being delivered. There can be grinding 2.5-star reviews for GP surgeries on the NHS website (formerly NHS Choices) and seemingly negative Healthwatch reports for what, in reality, is reliable clinical care. This can be a demoralising drag.

Yet it also means you can improve your reputation without making profound changes. We made minor changes to our practice, such as redecorating the waiting room, and the benefits have been profound – from staff and patient engagement, to the daily reminders that we’re living up to a constantly evolving reputation.
1 Improve accessibility

We’re not talking about seven-day access – we’re talking about a basic necessity and, to those who have special accessibility requirements, an essential.

It is essential for many patients to be seen by a doctor. It is also essential for staff who are less physically able to have a positive experience of navigating their workspace. Ensure ramps are in place for wheelchair users, and that the interior of the consultation rooms is generally considerate of patients with significant health or mobility impairments.

Remember that ‘good for all’ is a better option than ‘great for a few’.
2 Promote realistic appointment lengths

Ten-minute appointments are a prevailing theme in general practice, but the best approach for everyone involved is for appointment lengths to be modified according to the circumstances.

The RCGP recently deemed 15-minute appointments ‘the future of general practice’, but whether they’re this long or just five minutes is irrelevant, as long as the specific health concern is dealt with. This should be taken into account at the time of booking so patients can be given an appropriate appointment. That way, you can give longer appointments without running late.

It is important to be consistent in checking that patients understand the message about realistic appointment lengths.

This flexibility will also require an in-depth understanding of your demand and capacity – which will probably lead you towards universal triage systems, digital and off-site appointments. Manage flow by identifying which work is non-urgent and can wait until demand is lower.
3 Communication nation

GP practices are often the centre of the community, so it pays to be inclusive and keep everyone up to speed. If you haven’t done so already, start a practice newsletter; email bulletins are increasingly popular as effective and cost-efficient ways of sharing news and updates.

Other options include daily printed bulletins in the waiting room or – when priority commitments allow – sending practice representatives to local engagement events.

Of course, the content you’re communicating matters too. If you’re short on inspiration, don’t be afraid to rely on the basics. The main thing is to share how you’ve listened to patients: tell them about the bike rack you installed because of their feedback; display your great immunisation results; or highlight the improvement in your national patient survey results.
4 Stay timely

A noticeboard that still carries heatwave warnings in November shouts one clear message: ‘We’ve given up’. So take the time to stay relevant, but ensure notices are timely and useful for patients; avoid meaningless space-fillers.

This doesn’t have to involve a sizeable time or financial investment. It can be as simple as maintaining an up-to-date social media presence. Popular platforms like Facebook and Twitter aren’t purely for fun – they can offer practices a valuable way to share the latest information with the community.
5 Reply to patient comments

Where patients have taken the time to share an experience – be it online (the NHS website, social media, your practice website), or in person (at the reception desk, in the consultation room, if you bump into them in passing) – it’s only polite to respond.

But don’t fall into the trap of sweetening them with platitudes – be genuine and delve into the issues they’re raising, whether positive or negative.

Seniority isn’t required here. Empower all members of staff to liaise with registered and prospective patients. Addressing patient comments doesn’t have to be an onerous task. See if there are members of staff who would like to be unofficial ‘scribes’ – who can write your newsletter and other responses required.
6 Don’t ignore visuals

Your waiting room says a lot about the state of your practice. Patients will often spend longer there than in their consultation, and it’s probably the first place they’ll see after entering the building.

It makes sense to invest in thoughtful decor: soft seating; colours that complement each other; recent magazines; and artwork by local schools and residents. Although magazines might go missing, bulk subscriptions are inexpensive, so your loss is minimal compared with the benefits to patients.

It’s even better if you can engage your patients in designing and planning the space, as they spend the most time there.

Our practice is fantastic – responsive, purposeful, safe. But until 2009 you wouldn’t have known it at first glance, with its drab reception, wipeable chairs, old magazines and peeling posters. So we redesigned it, at a cost much lower than you might expect and it was a worthwhile investment. We experienced an unprecedented increase in patient satisfaction about access – although there had been no changes to our appointment system or capacity.
7 Use a professional printer

It may be cost-efficient to manage your own practice printing, but the benefits of outsourcing it to a professional can often be worth the outlay. Printed items might include: welcome brochures for new patients; the aforementioned newsletters; leaflets setting out the best ways, days and times to access services; flyers on patient participation groups; and business cards detailing the working hours of individual GPs. The cost of bulk printing can be worthwhile when you take into account the professionalism it adds to your practice materials. 
8 Encourage reviews

The most important leaflet of all, though, is the slip of paper that invites your patients to leave a review of their experience. Promoting feedback is the easiest way to boost your practice rating, but more significantly, it shows you the community’s honest thoughts.
Of course, we’re all drawn to the more positive examples, but healthcare isn’t about feeding egos or glossing over shortcomings. If investigated efficiently, feedback can increase your knowledge of what your target audience think you should be focusing on, improve patient outcomes and encourage new registrations.
9 Engage your staff

Aspire to joy, and encourage your team to achieve all that they can. Staff who love and feel loved by their practice will sell it, protect it and boost its reputation more than anyone else will.

So really invest in your staff and show them the same care you offer patients. This might be as simple as ensuring they have adequate breaks during the working day, or responding with understanding to life events that might bring a last-minute request for leave.

Satisfied staff will naturally come on board when you ask them to adopt a positive approach when speaking with patients. Instead of ‘you can’t book a face-to-face appointment next week’, they’ll say ‘you will be able to speak to a clinician today, they will call you back within two hours’.

Staff who understand the practice philosophy and have co-produced it will be able to credibly sell it.
10 Lead by example

If your own office has five-year-old posters, you take days to answer emails, and you complain that patients just don’t ‘get it’, expect to be surrounded by similarly defeatist attitudes.

But if you’re leading the change you want to see, talking about it and sharing it along the way, you will be creating the culture you want to be known for.
Reputation – a game of cumulative gains

Small outlays helped us improve our practice, says Virginia Patania:
20-30 two-seater benches
400 copies of printed newsletters
500 business cards for one clinician
Two extra hours of admin time per month to update websites and respond to comments
One-year of a variety of magazine subscriptions for the practice

Virginia Patania is the transformation partner at The Jubilee Street Practice in east London. She also sits on the board of the Tower Hamlets CCG, where she leads on urgent, emergency and primary care, and is a director of The Highway Network, a limited company formed by four practices to deliver services locally.