Calling the GP surgery: patient burden, patient satisfaction, and implications for training

Good communication is central to the effectiveness of GP service provision, as well as to patient satisfaction with surgeries, but very little is known about the actual communication that occurs between patients and surgeries. This study was carried out to examine, for the first time, how receptionists interact with patients on the telephone, to identify features of communication associated with efficacy and patient satisfaction. A qualitative conversation analysis of incoming patient telephone calls, recorded 'for training purposes', in three English GP surgeries. Data were analysed qualitatively to identify effective communication, then coded to establish the relative prevalence of communication types across each surgery. Analysis identified a burden on patients to drive calls forward and achieve service. 'Patient burden' occurred when receptionists failed to offer alternatives to patients whose initial requests could not be met, or to summarise relevant next actions (for example, appointment, call-back, or other query) at the end of calls. Coding revealed that 'patient burden' frequency differed across the services. Increased 'patient burden' was associated with decreased satisfaction on published satisfaction survey scores. Patients in some practices have to push for effective service when calling GP surgeries. Conversation analysis specifies what constitutes (in)effective communication. Findings can then underpin receptionist training and improve patient experience and satisfaction.