# GTD-Managed Practices Review Report For PPG Discussion

This report is a fresh read of the Google review corpus for `GTD`-managed practices only.

It does not summarise the wider reports. It starts again from the GTD slice alone and asks the same broad questions:

- what patients mainly complain about
- what they say about staff and care
- what happens with digital routes
- where the strongest warning signs of harm appear
- how people talk about trying to leave or being stuck
- how practices respond in public
- what seems to have changed over time

All examples in this report come from GTD-managed practice reviews only.

## The GTD Slice

The GTD-managed review set in this rebuilt index still contains `830` reviews across `13` practices:

- `Ashton Gp Service`
- `Charlestown MD`
- `City Health Centre`
- `Droylsden Medical Practice`
- `Gordon Street Medical Centre`
- `Guide Bridge Medical Practice`
- `Hattersley Group Practice`
- `Lindley House Health Centre`
- `Millbrook Medical Practice`
- `Mossley Medical Practice`
- `New Bank Health`
- `Simpson Medical Practice`
- `The Smithy Surgery`

The overall rating shape is harsh:

- `602` reviews are `1` star
- `25` are `2` star
- `18` are `3` star
- `33` are `4` star
- `152` are `5` star

That means `627` reviews, `75.5%`, are `1` or `2` star.

This is not a balanced-looking slice. It is a strongly complaint-heavy one, sitting inside the rebuilt `40,506`-review corpus but staying tightly focused on GTD-managed practices only.

## Headline

The main GTD story is not one single bad thing. It is a repeated patient feeling that the front door is hard to get through, hard to trust, and often pushes people somewhere else.

Access dominates the GTD review set, but it does not stop at access. The complaints spill into:

- rude or blocking reception
- missed follow-up and prescription drift
- online systems that feel like another barrier
- feeling dismissed when unwell
- being sent to walk-in centres, hospitals, or `A&E`
- very weak public responses when patients complain

The heaviest public complaint load falls on `New Bank Health`, `Guide Bridge Medical Practice`, `Charlestown MD`, `Gordon Street Medical Centre`, `Simpson Medical Practice`, and `Droylsden Medical Practice`, but the slice is not completely flat. There are a few clearer positive pockets, especially in `City Health Centre`, `The Smithy Surgery`, and parts of `Mossley Medical Practice`. There are also some positive reviews in more complaint-heavy practices where patients praise a specific doctor, nurse, or receptionist.

So the picture is not "every GTD practice is identical". It is more that the negative weight is very strong, and it falls on a familiar set of problems.

## 1. Access Is Still The Core Problem

Using a simple fulltext pass over GTD reviews, I found:

- `366` GTD reviews mentioning appointment problems
- `289` mentioning phone access
- `278` mentioning reception
- `137` mentioning follow-up, referrals, results, or prescriptions
- `71` mentioning online or website routes

If I narrow those to `1` and `2` star GTD reviews only:

- `304` low-star GTD reviews mention appointment problems
- `259` mention phone problems
- `218` mention reception
- `120` mention follow-up or referrals
- `60` mention online or website routes

This is the main GTD pattern. Patients are not usually writing about one isolated bad moment. They are writing about a route into care that feels blocked at several points at once.

Examples:

> "Booking an appointment is an impossible task."  
> Chloe Bradshaw, `Gordon Street Medical Centre`, `2 days ago`

> "Every question that you have go online. Avoid"  
> John Apetri, `New Bank Health`, `4 years ago`

> "I have never been able to get an appointment in less than a week and usually have to use the walk in centre."  
> Butterfly Effect Transformation, `Guide Bridge Medical Practice`, `8 years ago`

> "Worst experience. Weak staff."  
> John Apetri, `New Bank Health`, `4 years ago`

The GTD access problem is not just high demand in the abstract. In the reviews it is described as a chain:

1. the phone is hard to get through on
2. appointments are gone
3. reception pushes people elsewhere
4. the online route is confusing or shut
5. follow-up does not land cleanly afterwards

## 2. Reception And Staff Tone Matter A Lot

The GTD slice is full of complaints about being spoken to badly, brushed off, or made to feel like a nuisance.

I found `188` GTD reviews mentioning staff-attitude language, `177` of them in `1` and `2` star reviews.

This is not just a manners issue in the reviews. Patients often describe tone as part of being denied care.

Examples:

> "Reception have an awful attitude problem."  
> dale garbutt, `Gordon Street Medical Centre`, `a year ago`

> "the admin/reception team here are something else"  
> Hafsa Bakari, `New Bank Health`, `2 years ago`

> "The receptionist is useless and unhelpful."  
> Siem, `Simpson Medical Practice`, `a year ago`

> "The receptionists are the worst I have ever experienced."  
> Kirsty M, `Hattersley Group Practice`, `a year ago`

That said, the GTD reviews also show that patients notice individual staff who make things easier.

Examples of positive staff experience:

> "Thea is an amazing doctor who follows up appointments and makes sure she’s treating problems correctly"  
> Belinda Bayley, `Ashton Gp Service`, `3 years ago`

> "Very accessible, I was able to get an appointment quickly. Staff and doctors were friendly and very helpful."  
> Shehab Samaha, `City Health Centre`, `2 months ago`

> "Kathryn on reception is always very helpful when I phone"  
> Angels, `The Smithy Surgery`, `Edited 2 years ago`

So one thing the PPG should keep in mind is that patients are not writing as though every member of staff is the problem. Quite often they separate "the system" from the one or two people who still help them through it.

## 3. Follow-Up, Prescriptions, Results, And Referrals Drift

This is one of the clearest secondary themes after access.

I found `137` GTD reviews mentioning follow-up, results, referrals, or prescriptions, including `120` low-star reviews.

What patients describe is drift:

- prescriptions not landing
- results not coming back
- referrals being delayed or doubted
- no callback after a promised contact

Examples:

> "Sent repeat prescription request via patches and got wrong medication prescribed 3 times in a row(!)"  
> Ewelina Hartung, `Gordon Street Medical Centre`, `4 months ago`

> "There have been multiple mistakes in my notes and results recently, and no one has responded to the patches I raised."  
> Kierron Byron, `Gordon Street Medical Centre`, `6 months ago`

> "it took them 3 months to get my results"  
> A E, `Charlestown MD`, `2 weeks ago`

> "lost a important letter from hospital and if i'd not chased it up a really important referral to another hospital wouldn't have occurred"  
> Stephen Brewster, `Hattersley Group Practice`, `a year ago`

In the GTD slice, this follow-through problem is important because it often appears after the patient has already fought through the first access barrier.

## 4. Digital Routes: More Generic Website Complaints Than Named Platforms

The GTD digital picture is surprisingly narrow by name.

After stripping practice-response text, I found:

- `49` GTD reviews mentioning a generic online or website route
- `8` mentioning `PATCHS`
- `3` mentioning the `NHS app`
- no meaningful patient-side GTD mentions of `AskMyGP`, `Accurx`, or `eConsult`

That means the GTD digital story is mostly not about branded platforms. Patients mainly say:

- the website
- online
- the app
- the system
- the online form

This matters because the lived experience is not "I dislike vendor X". It is "the only route left to me is a web route that does not work well enough."

The GTD-specific digital ranking also lines up with that reading. In the wider digital appointment pass, `Guide Bridge Medical Practice`, `Hattersley Group Practice`, `New Bank Health`, `Droylsden Medical Practice`, and `Simpson Medical Practice` all sit on the weaker side of the digital-access table rather than the stronger side.

Examples:

> "they keep referring go online book online that's the procedure you have to follow"  
> mediawise TM, `New Bank Health`, `4 years ago`

> "The Patchs system you have to use to make requests is awful"  
> Mark Gambon, `Hattersley Group Practice`, `3 months ago`

> "The online app always says no appointments"  
> Simon Thomas, `Hattersley Group Practice`, `8 months ago`

> "The AI was asking me follow up questions ... and it's \"amazing\" advice was to go to A+E"  
> Theodore Morrissey, `Ashton Gp Service`, `10 months ago`

The GTD-specific digital issue buckets are not huge in raw count, but they are sharp:

- `5` GTD reviews about usability or instruction failure
- `3` about triage burden or self-diagnosis
- `2` about no reply or lost request
- `1` about forms being closed or filled up
- `1` about explicit digital exclusion

There are also a few positive digital reviews in GTD practices, mostly where online contact leads quickly to a same-day result.

Examples:

> "My appointments are getting way easier when I request online! Quick response when you do online."  
> Naga Manickam, `Charlestown MD`, `Edited 3 years ago`

> "The patches system is very good and easy to use"  
> Fiona Simpson, `Simpson Medical Practice`, `4 months ago`

But in the GTD slice, positive digital stories are clearly outweighed by the feeling that online is replacing access rather than improving it.

## 5. Exclusion: Patients Try To Leave, Or Find They Cannot

The GTD slice also shows what happens after patients lose trust.

Examples:

> "Register elsewhere."  
> Siem, `Simpson Medical Practice`, `a year ago`

> "I’ve changed doctors as this place is nothing short of a joke."  
> Genuine Bloodshed, `Guide Bridge Medical Practice`, `2 years ago`

> "I was deducted from the practise due to my postcode being out of their catchment area without my knowledge"  
> Hafsa Bakari, `New Bank Health`, `2 years ago`

> "there is no option but to register elsewhere"  
> HG, `The Smithy Surgery`, `Edited 4 months ago`

The main point here is not just that some patients leave. It is that some feel trapped until they can leave, or are moved around by catchment and postcode rules rather than by successful care.

## 6. Clinical Warning Signs Are Present In The GTD Slice

Using the same harm-signal scan as before but only on GTD low-star reviews, I found `48` flagged GTD reviews with a self-reported clinical warning sign.

Within those GTD harm-signal reviews:

- `22` mention hospital or urgent escalation
- `14` combine dismissal or not being listened to with a bad outcome
- `10` link delay or postponed care to harm
- `5` mention misdiagnosis or wrong diagnosis
- `3` mention wrong or unsafe medication
- `3` mention a serious condition or near miss

The GTD practices with the most flagged harm-signal reviews are:

| Practice | Harm-signal reviews |
| --- | ---: |
| `Ashton Gp Service` | `6` |
| `Guide Bridge Medical Practice` | `6` |
| `New Bank Health` | `6` |
| `Charlestown MD` | `5` |
| `Droylsden Medical Practice` | `5` |
| `Gordon Street Medical Centre` | `5` |
| `Lindley House Health Centre` | `5` |

Examples:

> "I had lost 50% of my blood to an internal bleed"  
> Genuine Bloodshed, `Guide Bridge Medical Practice`, `2 years ago`

> "got wrong medication prescribed 3 times in a row"  
> Ewelina Hartung, `Gordon Street Medical Centre`, `4 months ago`

> "Please don't go to this GP if you care about yourself."  
> Sana Mahdavi, `New Bank Health`, `4 years ago`, after saying wrong medication made her skin problem worse

> "this practise nearly cost me my life ... then ended up on life support"  
> JACOB TAYLOR, `Hattersley Group Practice`, `7 years ago`

> "Never answer phone are rude and have gave wrong medication to my children numerous times"  
> Jack Cunningham, `Charlestown MD`, `6 years ago`

This is not the biggest GTD theme by volume, but it is too frequent to treat as a handful of outliers.

## 7. Public Practice Responses In The GTD Slice Are Weak

The GTD response layer is much thinner and much more standardised than the wider corpus.

Across GTD reviews:

- `164` of `830` reviews have a practice response
- that is only `19.8%` of GTD reviews
- only `42` positive GTD reviews have responses
- `116` negative GTD reviews have responses

But the more important part is what those responses actually say.

In the GTD slice I found:

- `115` responses with boilerplate signposting
- `109` bad negative responses
- `1` response with a clear sign of specific action
- `0` clearly useful negative responses in the stricter sense used in the wider response report

In plain terms: GTD public responses are mostly apology-plus-redirection.

Typical wording:

> "please either contact the practice directly and ask to speak to the practice manager or contact our patient services team via gtd.feedback@nhs.net"

This wording appears again and again, especially in `Gordon Street Medical Centre` responses.

Examples:

> "Your comments have been passed on to the practice manager."  
> GTD response to Ewelina Hartung, `Gordon Street Medical Centre`, `4 months ago`

> "If you would like to discuss your feedback further, please either contact the practice directly and ask to speak to the practice manager or contact our patient services team"  
> GTD response to Meg Wood, `Gordon Street Medical Centre`, `4 months ago`

The GTD response pattern matters because it does not publicly tell patients or PPG members what changed. It mainly pushes the patient back into another route.

By practice, GTD response coverage is uneven:

| Practice | Response rate | Negative response rate |
| --- | ---: | ---: |
| `The Smithy Surgery` | `61.9%` | `75.0%` |
| `Ashton Gp Service` | `42.0%` | `36.8%` |
| `Droylsden Medical Practice` | `41.9%` | `47.4%` |
| `Gordon Street Medical Centre` | `25.6%` | `29.0%` |
| `Guide Bridge Medical Practice` | `21.9%` | `22.5%` |
| `New Bank Health` | `3.6%` | `1.8%` |
| `Charlestown MD` | `0.0%` | `0.0%` |
| `Millbrook Medical Practice` | `0.0%` | `0.0%` |

So the GTD response problem is not only what is said. In some places it is also silence.

## 8. What Has Changed Over Time In GTD Reviews

The GTD slice shows the same broad shift as the whole corpus, but in a more concentrated form.

Among GTD `1` and `2` star reviews:

- `91` sit in the older `2016-2019` window
- `443` sit in the recent `2022-2026` window

The main shift is not that older complaints disappear. It is that digital and remote barriers are layered on top of the older problems.

In the GTD low-star slice:

- digital-language complaints rise from `1` older review to `42` recent reviews
- face-to-face complaint language rises from `0` to `9`
- phone complaint language rises from `9` to `30`
- walk-in-centre language is present in both periods, from `10` older to `31` recent

Older GTD reviews sound more like this:

> "Never got an appointment!!!! Always regarded to Walk-in centre or A&E"  
> Veroca Hlavaca, `Simpson Medical Practice`, `8 years ago`

> "It’s very difficult to get an appointment. I’ve ... been to the walk in centre more times, than I’ve seen a doctor at this surgery."  
> Jo w, `Droylsden Medical Practice`, `8 years ago`

Recent GTD reviews sound more like this:

> "go online book online that's the procedure you have to follow"  
> mediawise TM, `New Bank Health`, `4 years ago`

> "The online app always says no appointments"  
> Simon Thomas, `Hattersley Group Practice`, `8 months ago`

> "actually getting an appointment face to face is near impossible"  
> Nikki Rostron, `Simpson Medical Practice`, `3 years ago`

So the GTD story over time is not improvement. It is the older access bottlenecks staying in place while the newer digital and triage layers sit on top of them.

## 9. Not All GTD Practices Look The Same

The complaint-heavy picture is strong, but there are clear exceptions and lighter patches.

Best-rated GTD practices in this corpus are:

| Practice | Reviews | Average rating |
| --- | ---: | ---: |
| `City Health Centre` | `10` | `4.90` |
| `The Smithy Surgery` | `21` | `4.05` |
| `Mossley Medical Practice` | `13` | `3.69` |

Examples from the more positive side:

> "Most of my queries are addressed on the same day"  
> Rosanna Respecta, `City Health Centre`, `2 months ago`

> "I was able to get everything sorted on the day."  
> Shehab Samaha, `City Health Centre`, `2 months ago`

> "I moved to this surgery last year, I wish I had done it years ago"  
> Kathleen Ford, `The Smithy Surgery`, `4 years ago`

> "Speedy appointments, great communication and generally very personable."  
> Jessica Mcglynn, `Mossley Medical Practice`, `2 years ago`

There are also partial positives inside otherwise harsh practices:

> "Thea is an amazing doctor"  
> Belinda Bayley, `Ashton Gp Service`, `3 years ago`

> "Doctors are great!"  
> Angela, `Gordon Street Medical Centre`, `Edited 11 months ago`, before describing the rest of the system as failing

This matters for PPG discussion because patients are often distinguishing between individual staff effort and the wider system around them.

## 10. Practice-Level Weight Of Complaint

By low-star volume, the heaviest GTD complaint load in this corpus falls on:

| Practice | Low-star reviews | High-star reviews | Total |
| --- | ---: | ---: | ---: |
| `New Bank Health` | `109` | `24` | `138` |
| `Guide Bridge Medical Practice` | `80` | `15` | `96` |
| `Charlestown MD` | `74` | `22` | `97` |
| `Gordon Street Medical Centre` | `69` | `9` | `78` |
| `Simpson Medical Practice` | `67` | `13` | `81` |
| `Droylsden Medical Practice` | `57` | `16` | `74` |
| `Ashton Gp Service` | `57` | `11` | `69` |

That does not prove these are the worst practices in every real-world sense. But it does show where the strongest public dissatisfaction sits in the GTD review layer.

## Bottom Line

The GTD-managed slice of the review corpus is dominated by one repeated patient experience:

patients struggle to get through the front door, feel blocked or worn down by the route in, and often say the system pushes them elsewhere rather than resolving the problem.

The strongest GTD themes are:

- appointments that feel impossible to get
- phone systems that lead nowhere
- reception behaviour described as obstructive or disrespectful
- weak follow-up on prescriptions, results, and referrals
- online routes that often feel like another barrier rather than an easier way in
- a smaller but serious layer of reviews describing harm, deterioration, or urgent escalation
- very weak public response quality from practices, with heavy use of boilerplate and almost no public evidence of change

The GTD slice is not wholly negative. Some practices, and some individual staff inside harder-pressed practices, are clearly valued by patients. But the balance of the reviews is not close. The complaint load is heavy, repeated, and unusually concentrated around access, follow-through, trust, and being pushed out of the practice route rather than helped through it.

For PPG discussion, the practical question is probably not "is there a problem?" The reviews already answer that.

The practical questions are:

- where is the front door breaking most often
- where are patients being redirected instead of treated
- where are prescriptions, results, and referrals drifting
- where is digital access helping, and where is it just replacing one blocked queue with another
- what public evidence of learning or change can practices actually show back to patients