CMK MEDICAL CENTRE

Patient Participation DES

Introduction & Background

CMK Medical Centre is an urban training practice, originally situated in the centre of Milton Keynes who moved to a new,purpose built surgery constructed by private developers approximately 6 ½ years ago. We are now situated in Bradwell Common and whilst we are some 10/15 mins walk away from the centre, we have retained our name as we are considered to be the surgery closest to The Hub & Centre MK. The new surgery houses 10 GP’s (9 partners + 1salaried GP); 5 nurses; 2 HCA’s + phlebotomist;Midwife; a District Nurse team and a team of Health Visitors. We also have a small Boots pharmacy next door. We currently have 16,000+ registered patients and unfortunately there is rather a transient element to our patient base due to temporary housing with the result that we register on average 215 patients each month and deduct around 165 each month.

Our patients are of varying ethnicity as follows:

Patient Access

The surgery is open from 8.00 am until 6.30 pm and appointments can be made by telephone; booking on-line or coming into the surgery. We endeavour to meet current demand by releasing/embargoing the appointments as follows:

Routine (non-urgent) Appointments: These are bookable up to 6 weeks in advance with all clinicians and we try to accommodate a patient’s preference for day/time whenever possible. A number of these appointments are also available to book on-line. (access anytime of day/night).

Emergency Appointments: We refer to these as ‘urgent, on the day’ appointments and embargo a certain amount of appts each day for clinicians. Additionally we have a duty doctor in both morning and afternoon with a full clinic of ‘on the day’ appointments available.

Telephone ‘Appointments’: In addition to the morning appointment slots, each GP has a number of telephone slots and if the patient is unable to get into the surgery but wants to speak to their doctor, they are allocated one of these slots. If the patients own doctor is not available they have the ability to speak to an alternative doctor if necessary.Additionally, we frequently add further calls/messages to meet patient demand. These are widely used and appreciated by our patients.

Profile of the Patient Participation Group (PPG)

Early in 2011, the surgery embarked on a patient recruitment initiative in an endeavour to attract more patients of a wider demographic and there are currently approximately 15-20 in the group with anywhere in the region of 7-15 patients attending the regular meetings held at the surgery, now known as the Patient Reference Group (PRG).

Support has been provided by the 1stChair of the group, Saira Walker, with assistance from other members including Paul Winter, current elected representative on the Patient Congress commissioning group (i.e. MK Commissioning). Paul updates the PRG members at all meetings with issues/progress made and emails any minutes. Janet Mulley previously his deputy has recently taken over from Saira as Chair.

One of our Partners attends each meeting together with Jan King, Practice Business Manager and/or Yvette Baker Office Manager plus Sarah Knight a receptionist/administrator at the surgery.

The group is representative of our surgery demographic and includes patients of varying ethnic backgrounds and diversities with a fairly even split between male/female.We are pleased that recent recruitment to this group has included a member from LINK and a hospital governor. We continue in our efforts to attract more to our meetings which includes:

  • Notices on our media screen
  • Invitations attached to our repeat scripts
  • Information on our website
  • Information given to parents during the baby immunisation clinics
  • Invitations given to mothers attending the breast feeding groups
  • A regular update on our surgery Newsletter

Regrettably, we have had little success in recruiting younger patients (i.e. <40) to our group but continue in our efforts to do so. Previously,we have contacted local schools; higher education colleges; Milton Keynes Library (who are displaying 9 posters over various sites for us) and Carers MK who have a young carers division. We have suggested to the Heads of Sixth Form that their students might like to consider including such involvement as part of their social studies.

Additionally, our Practice Manager Groupcreated a poster which is being advertised in a number of schools in Milton Keynes inviting young patients to join a ‘Virtual’ PRG in their own surgery. In afurther attempt to widen the patients demographic in terms of age; ethnicity & clinical needs a ‘virtual’ (vPRG) group has been formed comprising of approx 30 patients.

Outcome of last years Action Plan (2011-12)

Both the results of this year’s survey + last year’s action plan were discussed at a PRG meeting held on 29 January.

Areas highlighted on last year’s survey for action were as follows:

Plan: To make more appts availablefor patients:

  • By releasing a further 40% of appointments to be available to book on-line
  • Advertise availability of on-line booking on the media screen in the waiting room
  • Put flyers in waiting room & include on bi-annual Newsletter
  • Sign all new patients with internet access up to this service
  • Continue to make more appointments available by using text message reminders/cancellations & SMS Messaging

Outcome: despite making additional appts available there has been no marked improvement in the booking of appts. This could be linked to increased patient numbers thereby increasing demand

Plan: Decrease number of patients not attending booked appointments

  • Sign all new patients (approx 215 per month) up for text reminders
  • Regularly audit the number of patients who do not attend
  • Write to regular non-attendees
  • Remove any non-attendees following 3 letters i.e.6 non-attendances in 12 month period
  • Publish our protocol and display it on the media screen in the waiting room
  • Include monthly stats on Patient Call board
  • Inform patients in the Newsletter of different ways of cancelling appts i.e. text; on-line; phone
  • Advertise number of patients removed each month on our website (PRG suggestion)

Outcome:despite huge efforts on our part resulting in a number of patients being removed from our list, there has been little impact on our DNA figures

Plan: Provide more flexibility of available appointments

  • Schedule more blood test appts at 8.00 am to assist commuters and ‘fasting’ bloods
  • Seek agreement for some GP’s to commence clinics at 8.00 am
  • Engage GP’s in a discussion around moving clinics to lunchtime or evenings

Outcome:There has been a good outcome to changing clinic times and being more flexible with various clinics. See 5b below

Plan: Give patients the opportunity of using antibacterial handwash particularly when using the patient check-in screen (requested on patient survey under comments section)

  • Purchase a wall mounted hand wash to be placed near the patient check-in screen

Outcome: Hardly used!

Patient Survey 2012-13

We repeated last years survey as the Chair of the group felt that it would be a useful tool in which we could make a direct comparison to the previous year’s results. The survey itself was devised following much discussion at our PRG group meetings last year and which had centred on the high volume of DNA’s (did not attend) and which clearly has an impact on the number of appointments available. PRG members felt that by working on one aspect i.e. the number of DNA’s it would have a beneficial impact on the other (number of appts available). The difficulty of getting through to the surgery on the telephone sometimes was also subject to debate and whilst the members could understand the difficulties faced in this regard, they felt it should be included in any survey to get the views of larger numbers of patients. Thecurrent patient survey was therefore devised and agreed with the PRG, and posted on our website, advertised in the surgery on the media screen and flyers were handed out at our reception desk.

We received approx 640 completed surveys and were delighted with the positive response to most areas. The age demography of the patients was as follows:

How old are you?

0-151%

16-246%

24-4534%

46-6435%

65+16%

Q2) When you have phoned the surgery, how do you rate the ability to get through on the phone?

POOR18% LAST YEAR 23%

FAIR27% 26%improvement seen

GOOD37% 33%

EXCELLENT13% 13%

PRG members accepted the difficulties of dealing with such high volumes of calls when there are 16000+ patients. They felt that on-line booking (see details below) would assist in this area also.

However, during the meeting on held on 29 January 2013 it was disappointing to note that 2 or 3 patients had experience difficulties in getting through on the telephone during the middle of the day and a promise was made to look at another monitoring tool and this appears on our action plan going forward.

Appointments

4) How do you rate the ease of booking an appointment?

POOR11%LAST YEAR 13%

FAIR26% 25%

GOOD35% 36%Little Change

EXCELLENT23% 23%

Patients attending the PRG meeting felt that the on-line booking system was excellent but probably not widely enough publicised. On-line booking was made available approx 3 years ago and the number of appointments has been gradually increased since then. The PRG thought it would assist patients in the ease of booking GP appointments if these numbers could be increased further and at a subsequent meeting with GP’s it was agreed that we should do so. The on-line booking numbers have now been increased by a further 40% (i.e. 210 appts) in acknowledgement of the PRG’s suggestion.

5b) If you are not happy with appointment times what changes would you suggest? (Please tick all that apply)

EARLY MORNING19%LAST YEAR 30%

LUNCH TIMES13% 21%Varies widely from last year

EVENING26% 32%

Actions agreed for next 12 months

See Plan attached

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