Alexandra & Crestview Surgeries

Patient Participation Report 2013/14

5.

1. Maintaining the Patient Reference Group (PRG)

The PRG age, gender and ethnicity profile has not changed significantly since it started in 2011. Membership is not representative of the practice in terms of the age profile, and being aware of this the practice has had a continuous process of trying to raise the profile of the group and recruit members.

Age groups / 0-17 / 18-29 / 30-49 / 50-64 / 65-74 / 75-84 / 85-110
Patient Population
Males / 11.31% / 8.62% / 14.12% / 8.69% / 5.16% / 2.31% / 0.83%
Females / 10.85% / 7.97% / 12.18% / 8.41% / 4.74% / 3.26% / 1.54%
PRG Members
Males / 0.00% / 3.70% / 3.70% / 18.51% / 25.92% / 3.70% / 0.00%
Females / 0.00% / 0.00% / 11.11% / 18.51% / 14.81% / 0.00% / 0.00%

For much of the year a general A5 patient leaflet was available in waiting rooms about the PRG and an A4 poster on the notice boards, then from September when our PRG newsletters started we removed the old materials as the newsletters are colourful and promote the PRG. The newsletters were placed in waiting rooms and reception desks and available electronically on the website.

In addition, housebound patients were given patient surveys which contained information about the PRG and how to join at the time practice nurses visited them to administer their flu vaccinations. These were provided with stamped addressed envelopes to send back to the practice manager.

The PRG was mentioned in its own section of the Patient Survey to draw patients’ attention to its existence, what it does and how to join, and a message with the next PRG meeting details and how to join is on the practice website under the Latest News section as well as a permanent section regarding the PRG itself.

The PRG is invited to communicate with the practice and other members by email but meets bi-monthly, usually one meeting will be held at a lunch time and the next in the evening to make these meetings available/accessible to workers and students (may find evenings better) and older patients (who may find during the day better).

2. Method and Process for Agreeing Priorities for a Local PracticeSurvey

In 2012-13 the Great Yarmouth and Waveney Patient Participation Group which one of the practice PRG members regularly attended, planned to create a uniform patient survey that could be used amongst practices who wished to participate so that results from those practices could be compared. However at the PRG meeting of 10/04/13 Roger reported that theGreat Yarmouth and Waveney Patient Participation Group was not in a position to do this for 2013-14 so the PRG would again create one for the practice itself. In May the practice manager did a first draft of a patient survey using questions from the Royal College of GPs and asked PRG members to comment on this in advance of the June meeting.

The first draft survey was discussed at the PRG meeting on 12/06/14 and suggestions were made to include a section on carers and a section on the PRG itself. The notes of the meeting are attached with the patient survey discussion at item 6:

The second draft was emailed to the PRG group for further comments/additions on 13/06/13:

In July Health East CCG member practices had a meeting around various Quality and Outcome Framework targets specifically around trying to reduce patient inappropriate A&E attendance whereby the majority of practices agreed to including some questions about A&E attendance in their patient surveys towards encouraging patients to think about alternatives. This was discussed as part of the August PRG meeting (item 5 in the attached minutes) and the PRG agreed to the inclusion of the questions in the practice Patient survey.

3. Details and Results of the Local Practice Survey

The survey was laid out on 6 sides of A4 (3 double-side pages) with the first page mainly taken up with the introduction and purpose of the survey. The questions were divided into seven sections or themes:

  1. Your experience in the surgery today (or at your last appointment)comprised of six questions which covered the behaviour and competence of receptionists and clinicians who the patient had seen.
  2. The practice and medical research – two questions designed to alert patients to the fact that the practice is research active and to gauge patients’ interest in this area
  3. On-line services – one question asking patients if they used the online repeat prescription ordering system and/or booked GP appointments on line followed by open-ended questions for feedback.
  4. Practice Patient Reference Group– one close ended question asking patients if they were aware of the PRG but also a paragraph providing information about the PRG and how to join.
  5. Attendance at a hospital’s Accident & Emergency department– four questions asking about patient’s recent A&E attendance, reason/s for attending and whether they were aware of alternatives.
  6. Some questions about you – a section on gender, age, ethnicity and occupation of the respondent and whether or not they had caring responsibilities and if so did they know how to access services a carer may require, with a space for any comments.
  7. Friends and Family Test – contained a question asking whether the patient would recommend the practice to their family and friends with a space to comment if they answered ‘no’ and a further space prompting any comments or feedback to the practice on any aspect.

The survey was published on 4th September 2013 and given out by clinicians after consultations, available in waiting rooms, handed out at Saturday morning flu clinics, available to fill in from the website and was given to housebound patients by practice nurses carrying out flu vaccinations (SAEs were provided for returns). The survey closed on 1st November 2013 and attracted 360 responses.

4. Discussing Survey Results with the Patient Reference Group (PRG)

The PRG met on 22/01/14 to discuss the results of the survey.

The following observations were made:

  • It was disappointing that despite the fact comments were made requesting help with online services that no-one had signed up to the free sessions at Crestview mentioned in the recent Patient Newsletter (Winter). Michelle suggested that the PRG mention this again in the next Newsletter (Spring 2014).
  • The A&E questions were telling by the quantum of ‘no response’ in the follow-up question about alternatives. Most patients live within close proximity to the hospital, certainly closer than to the Grey Friars walk-in-centre at Great Yarmouth and the minor injuries unit at Beccles. A comment that lamented the poor provision of medical services in the evenings and at weekends was discussed and a group member agreed with this (111 and Out of Hours service) hence A&E being popular.
  • Overall the PRG thought the results were very good. It was accepted that the appointments system could never please everyone all the time.

5. Agreeing an Action Plan with the Patient Reference Group (PRG)

The PRG proposed four action points to the Partners/practice at their meeting on 22/01/14:

  1. Moving the screen in the Crestview waiting room to the notice board wall and ranging all the chairs to face that way
  2. Putting a mirror up in each of the patient toilets
  3. Reviewing information and signposting for carers sent to carers when they register as patients (albeit the list is closed)
  4. Trying an online booking and prescription ordering publicity campaign again such as putting flyers on waiting room chairs to encourage people to read about these facilities and encourage uptake.

These action points were discussed at a Partnership meeting on 25/01/14, actions 2-4 were agreed but it was felt that for number 1 some consideration would have to be made as to how the waiting room seating might be affected to accommodate a change in screen location as seating would not be in the space economical back-to-back lay out. Dr Domek, who used to be an architect, offered to look into this. Dr Domek and the practice manager altered the seating in the Crestview waiting room on 25/02/14 in the evening to test out how it would change. Chairs were laid out in ‘theatre’ style with 0.5metres in between to allow for adequate leg room and wider aisles for pushchairs and wheelchairs. It was found that 7 seats would need to be removed to allow for the new layout if the screen was moved to the wall where the notice boards are positioned currently. This was raised at a Partners meeting on 04/03/14 and it was decided that at very busy times 7 chairs would be missed so the screen will have to stay where it is.

Number 2 - Safety mirrors were installed in the patient toilets at each site week commencing 24/02/14.

Number 3 - The practice administrator who sends out information to new patients who are carers will again develop a notice board display focusing on useful information for carers and will see whether any new directories for carers have been produced locally and if so make these available in the waiting rooms (by end May 2014).

Number 4 – The practice will start another publicity campaign for the online services from week commencing 10/03/14 which will include use of coloured flyers put on each waiting room chair at both sites in the morning and afternoon to try and draw patients’ attention to these services. The PRG’s Spring Newsletter will again try to encourage patients to sign up for a free ‘how to use a computer/get online’ session.

6. Publishing the Local Patient Participation Report on the practice website by the 31.03.14

The report has been published on the Alexandra & Crestview Surgeries website:

Practice opening hours: 8.00am and 6.30pm Monday-Friday. The surgery reception is open for you to visit in person to make an appointment or pick up a prescription between 8.00am and 6.30pm Monday-Friday (both Alexandra Road and Crestview). Alexandra Road Surgery tel. 01502 526062; Crestview Medical Centre tel. 01502 526666. Patients can book GP appointments online, to register to use this service patients ask Reception for a personal registration code.

7. Practice Declaration

The Local Patient Participation Report is a true and accurate representation of the work undertaken to fulfil the requirements of the Patient Participation DES 2013/14

Confirmed by practice manager Michelle Kears BSc (Hons) MBA