Survey shows care services concern

Dr Andrew Naylor outside the South Harris medical practice. It was rated as one of the best in Scotland for patient satisfaction. Pic: John Maher.

Fewer than half the responses to a question about access to mental health services in the Western Isles via a GP practice reflected positive experiences, a new survey has found.

The concerning statistic emerges from a generally positive bill of health for island services as reflected in Public Health Scotland’s Health and Care Experience Survey. However, responses from carers about the services they are involved in were significantly worse.

The exercise is based on questionnaires sent randomly to people who are registered with a GP. In the Western Isles, 1163 returned the completed forms – 29 per cent compared to the Scottish average of 24.

Not all respondents answered all the questions. However, on virtually all counts, there were higher levels of satisfaction in the islands than in Scotland as a whole.

Asked how overall they would rate the care provided, 80 per cent of islanders gave a positive response; 16 per cent were “neutral” and four per cent negative. The “positive” figure across Scotland was 61 per cent.

Asked how easy it is to contact their GP in the Western Isles, 93 per cent returned a positive response against a 75 per cent Scottish average. This fell to 74 per cent about accessing an actual GP, opposed to 61 per cent across Scotland.

The “positive” rating in the Western Isles dipped below 50 per cent in response to only one question: “How would you rate the arrangements for getting to speak to a Mental Health Professional at your GP practice?”.

Only 105 responded, presumably reflecting the minority with personal experience. Forty nine per cent gave positive answers, 16 per cent neutral and 35 per cent “negative”.

Under this heading, the Western Isles came closer to mirroring the Scotland-wide position, the comparable figures being 44, 18 and 38 per cent respectively.

When the survey turned to care-related issues, islanders’ responses became significantly worse. Asked to respond to the statement “local services are well co-ordinated for the person I look after”, only 33 per cent responded positively, with 36 per cent “neutral” and 31 per cent “negative”. There were 154 respondents.

Similarly, the statement “I have a say in the care of the person(s) I look after” attracted a positive rating of only 38 per cent with 35 per cent “neutral” and 25 per cent “negative”.

The survey also asked about experiences with specific practices. These have been formulated into a “league table” by a national newspaper although the survey report warns against interpreting small numbers.

South Harris Medical Practice and Tarbert Medical Practice were the “league leaders” in the Western Isles, each with over 98 per cent “positive” ratings. All practices in the islands came out at above the Scottish average.

One response which reflects changing times was to the statement: “Experience of your GP practice: I knew the Health Care professional well”. In the islands, this drew a “positive” response of 46 per cent with 27 per cent “negative” and the remainder “neutral”.

Gazette view: Mostly good – but don’t miss the wake-up call

The recent survey of attitudes towards GP services suggests they have come through the pandemic pretty well in the Western Isles, if less so in Scotland as a whole.

The answers about care services were much less positive and this confirms the need for urgent attention from those responsible for their delivery.

It is difficult to see why, within a small population, co-ordination should be so difficult and it is disturbing to find barely a third of those who responded on the basis of their experience agree that “local services are well co-ordinated for the person I look after”. Surely that figure must be capable of improvement.

Another wake-up call which the survey highlights involves access to mental health services, the one aspect of GP provision in which positive responses in the Western Isles drop below 50 per cent.

That statistic needs to be explored, explained and addressed because we know it often involves symptoms which are hidden from view.

It may be that for people with concerns about their own mental health or of someone close to them, it is not immediately obvious that the GP is the first port of call.

But where else would they go? For those who do turn to a GP practice, there needs to be better than a 49 per cent satisfaction rating with the response.

This survey highlights areas of legitimate concern – not least because the statistics are so significantly at odds with other expressions of satisfaction.