Dr Kuchhai & Saheecha the Health Centre

Dr Kuchhai & Saheecha The Health Centre

Patient Reference Group(PRG)

Introduction

This report describes how the PRG was formed and priorities set to provide a practice survey. The results of the survey were then discussed with the patients and an action plan was agreed upon. The Report was posted on website and on going dialogue with PRG to be undertaken to maintain and improve patients care.

Practice Population Profile

Within the Clinical system, Vision, there is a breakdown of the profile and this is shown below.

Main Criteria / Criteria subgroups / Percentage (%) of Patients Matching This Criteria / No. Patients Required For PPG / Where data taken from NEEDS TO BE AMENDED as Dr KAW's figures
Gender / Male / 48.26% / 85 / Vision using clinical audit organisational reports updated on 09/02/11
Female / 51.74% / 91
Ethnicity / British/ Mixed British / 65.13 / 115 / Patient details recorded on Vision's clinical audit system, patient profiling subsection- updated on 10/01/2007
Irish / 0.62 / 1
Another White Background / 6.54 / 12
White and Black Caribbean / 0.01 / 0
White and Black African / 0.03 / 0
White and Asian / 0.01 / 0
Other Mixed Backgrounds / 0.31 / 1
Indian/ British Indian / 1.42 / 3
Pakistani/ British Pakistani / 0.34 / 1
Bangladeshi / 0.27 / 0
Other Asian / 0.93 / 2
Caribbean, W.I., Guyanese / 0.3 / 1
African / 5.54 / 10
Other Black Background / 4.4 / 8
Chinese / 0.25 / 0
Other Ethnic Group / 0.38 / 1
Employment Status / Employed / 96.56 / 170 / Population total and number of people claiming JSA in Heaton, Gooshays, Harold Hill wards using Ward Atlas website
Unemployed / 8.39 / 6
Age / <5 / 14 / 15 / Vision via clinical audit organisational reports updated on 25/07/11
5-15 / 14 / 7
15-25 / 15 / 24
25-35 / 15 / 26
35-45 / 15 / 26
45-55 / 13 / 22
55-65 / 9 / 17
65-75 / 6 / 10
75-85 / 4 / 8
>85 / 3 / 4
Total Patients in PPG / 176

This shows that 176 patients are the target number for PRG of which 48% should be male and 52% should be female. When looking at ethnicity, the largest proportion was White British representing 65% and the next group was African at 6%. , then there are 2 groups representing almost 5% each (Indian, other Asian, Caribbean and other black) From the local Authority Statistics, we were able to drill down to the wards to ascertain that our patient profile was representative of local ward constituencies.

Representation

We obviously tried to get the Patient Reference group to represent the Practice Profile and there were a minimum number of members that we tried to achieve and also try to match this with the sex and ethnicity mix.

Differences between the Practice population and the members of the PRG.

Age / <5 / 14 / 15 / Vision via clinical audit organisational reports updated on 25/07/11 / <5 / 0
5-15 / 14 / 7 / 5-15 / 1
15-25 / 15 / 24 / 15-25 / 5
25-35 / 15 / 26 / 25-35 / 8
35-45 / 15 / 26 / 35-45 / 5
45-55 / 13 / 22 / 45-55 / 9
55-65 / 9 / 17 / 55-65 / 3
65-75 / 6 / 10 / 65-75 / 2
75-85 / 4 / 8 / 75-85 / 0
>85 / 3 / 4 / >85 / 0
Total Patients in PPG / 176 / Total / 33

If and when we achieved our minimum number, we propose to encourage representation from those age groups which were under represented. In March we had recruited 33 PRG members of which the youngest was 21 and the oldest was 77yrs old. Whilst the numbers have been steadily increasing, although now we need to concentrate on trying to recruit under 55year old. Whilst this will take time, it is important to listen and be supportive, and discuss options available. Members needed to know that we are trying to maintain and improve the health of our patients making them aware that there are budget constraints.

Process to recruit

We encouraged them and tried to persuade them as this practice did not previously have a Representative Patient Group. We achieved this in the following ways:

• spoke to patients and encouraged them to give their views and participate

• Emailed patients who we had their email addresses, and encouraging them to complete our survey on line

• advertised on our website. (see doc attached)

The priorities were set by asking patients to prioritise see letter/email sent.

More informally, we

• sought their views on our website and made reference to it in conversations with patients.

•Invited patients to attend discussion meetings

•Arranged medical education meetings e.g. bowel cancer (made them aware that by providing a small sample- a test could be carried out and in many cases lives had been saved)

•Intend to supply a practice Newsletter

The results of the priorities are attached

The Outcome being that the patients endorsed our priority selection with a slight variance as follows

Clinical Care 1

Getting an appointment 2

Customer service 3

Patient Information 4

Telephone Access 5

Time keeping 6

Waiting Room Facilities 6

Opening Times 8

Parking 8

Describe how the questions were drawn up

From the priorities received, the Practice Manager and his Assistant sat down with example surveys e.g. MORI that had been previously been set and decided upon a selection that represented the priorities. This questionnaire was then forwarded to a few patients for their comments. Generally, there was a census of opinion. The questions needed to be pertinent, relevant and inclusive as we did not want the task to be time consuming, but relevant. From the priorities questions were selected and adapted to the patients and practice views

How was the survey conducted?

Paper forms of the Practice Survey were sent out by letter and those who we had an email address were encouraged to input on line or return the paper forms to surgery for input

Validate the survey and action plan through the local patient participation report

What were the results?

Question 1. Have you visited the practice in the last six months?

Yes94%

No5%

Question 2. How quickly were you seen?

Same Day29%

Next day5%

Three days29%

Five days11%

More than five days5%

Not Applicable17%

It is positive to see that the majority of patients are able to be seen within 3 days, with almost 30% being seen on the day they requested an appointment.

Question 3. In the past six months how easy have you found contacting the surgery by telephone?

Very Satisfied52%

Fairly Satisfied29%

Satisfied11%

Fairly Dissatisfied5%

Very Dissatisfied0%

Not applicable0%

If you do have difficulty getting through on the telephone, at which time of the day do you experience the greatest problem?

Mornings64%

Afternoons5%

Evening5%

Patients feel that they are able to contact the surgery by telephone however some patients commented that there was often a delay in the opening of the appointments line, the number is very often busy and the opening hours of the appointment line are unsuitable for patients who are working during those times. This needs to be reviewed. Opened the appointments line for longer periods of time. Another suggestion was an online appointment booking service.

Question 4. In the past six months how easy have you found speaking to a Doctor on the telephone?

Very Satisfied11%

Fairly Satisfied5%

Satisfied5%

Fairly Dissatisfied0%

Very Dissatisfied0%

Not applicable76%

The majority of patients do not use this service; however those that do use it are satisfied with it.

If you have had difficulty speaking to a Doctor, at which time of the day do you experience the greatest problem?

Mornings5%

Afternoons0%

Evening0%

Question 5. In the past six months how easy have you found speaking to a Practice Nurse on the telephone?

Very Satisfied23%

Fairly Satisfied0%

Satisfied5%

Fairly Dissatisfied0%

Very Dissatisfied0%

Not applicable70%

Those that use this service are satisfied with it

If you have had difficulty speaking to a Practice Nurse, at which time of the day do you experience the greatest problem?

Mornings5%

Afternoons0%

Evening0%

Question 6. In the past six months how easy have you found obtaining test results on the telephone?

Very Satisfied0%

Fairly Satisfied29%

Satisfied11%

Fairly Dissatisfied0%

Very Dissatisfied0%

Not applicable58%

Those that use this service are happy with it

If you have had difficulty obtaining test results on the phone, at which time of the day do you experience the greatest problem?

Mornings11%

Afternoons0%

Evening0%

With regard to telephone conversations, with the doctor or nurse, this service is not utilised as effectively as it could be. This needs to be reviewed and we need to identify whether the staff are still happy to do, if so we need to make patients more aware of this service.

Question 7. When you last requested to see a Doctor were you seen.

The same day17%

Within 24 hours11%

Within 48 hours23%

Other29%

NO Appointments available for my Doctor5%

Appointment times available were not convenient5%

Other5%

The majority of patients are seen within 48 hours which is positive.

Question 8. How helpful do you find the receptionists at the surgery?

Very Helpful76%

Fairly Helpful11%

Helpful5%

Not very helpful0%

An encouraging reflection on our reception staff

Question 9. The last time you saw the Doctor how long after your appointment time did you have to wait to be seen?

Before time0%

On time0%

Under 5 minutes0%

Between 5 to 10 minutes17%

Between 10 to 15 minutes17%

More than 15 minutes.64%

The response to this question has highlighted a major concern within our surgery. The majority of patients are being seen more than 15 minutes after their appointment which is not good enough. In order to reduce patient waiting times it is important for each session to start on time and all allocated times are adhered to, when possible.

Question 10. How satisfied are you with the opening hours for the surgery?

Very Satisfied58%

Fairly Satisfied11%

Satisfied29%

Fairly Dissatisfied0%

Very Dissatisfied0%

Not applicable0%

Overall patients are satisfied with the surgery opening hours

Question 11. On your last visit with the Doctor were you given enough time to discuss your medical need?

Yes100%

No0%

Vey positive response

Question 12. Please answer the following questions based on your last visit to the Doctor.

Question A. Did the Doctor ask about your symptons?

Yes100%

No0%

Question B. Did the Doctor listen to what you had to say?

Yes94%

No5%

Question C. Did the Doctor involve you in the decision about your care?

Yes70%

No29%

Question D. Did the Doctor explain tests and treatments, and check your understanding of them?

Yes58%

No41%

Question E. Do you think the Doctor was taking your problems seriously?

Yes88%

No11%

Question F. Did you have confidence and trust in the Doctor you saw?

Yes94%

No0%

From this response patients are happy with the care given by the doctors

Question 13. The last time you saw a Practice Nurse at the surgery, how good did you find the practice nurse at the following?

Question A. Were you given enough time to discuss your medical need?

Yes88%

No5%

Question B. Did the Prctice Nurse listen to what you had to say?

Yes88%

No5%

Question C. Did the Practice Nurse explain tests, treatments and check your understanding of them?

Yes76%

No11%

Question D. Do you think the Practice Nurse was taking your problems seriously?

Yes82%

No5%

Question E. Did you have confidence and trust in the Practice Nurse you saw?

Yes82%

No5%

A good reflection of the care that the nurses give – very positive response

Question 14. In general, how satisfied are you with the care you get at the surgery?

Very Satisfied52%

Fairly Satisfied41%

Satisfied5%

Fairly Dissatisfied0%

Very Dissatisfied0%

Not applicable0%

Patients are happy with care that they receive at the surgery

Question 15. How would you describe the overall cleaniness of the surgery premises?

Very Satisfied58%

Fairly Satisfied29%

Satisfied11%

Fairly Dissatisfied0%

Very Dissatisfied0%

Not applicable0%

Patients feel that the environment is kept at a clean and satisfactory level

Question 16. If you use your own transport to travel to the surgery how easy is it to park?

Very Satisfied35%

Fairly Satisfied17%

Satisfied17%

Fairly Dissatisfied11%

Very Dissatisfied5%

Not applicable11%

We do provide a car parking facility at the health centre and parking is available on the surrounding streets at both locations.

Question 17. Please answer the following questions about yourself.

Gender

Male35%

Female64%

Other0%

Age

Under 18 years0%

18 -24 years5%

25 -34 Years0%

35 - 44 years35%

45 - 54 years5%

55 - 64 years41%

65 - 74 years11%

75 - 84 years0%

85 years and over0%

White

English88%

Welsh0%

Scottish0%

Northern Irish0%

British5%

Mixed/multiple ethnic Group;

White and Black Caribbean0%

White and Black Affrican0%

White and Asian0%

Any other mixed background0%

Asian or Asian British

Indian0%

Pakistani0%

Bangladeshi0%

Chinese0%

Any other Asian Background.0%

Black/African/Caribbean/BlackBritish

Carribean0%

African5%

Any other Black/African/Caribbean background0%

Which of these best describes what you are doing at present? If more than one of these applies to you please tick the main one only.

Full Time Employment (30 Hours or more per week)35%

Part-time Work (under 30 Hrs per week)17%

Full Time Education (school,college,university)5%

Unemployed11%

Permantly sick or disabled5%

Fully Retired from work5%

Full time Carer11%

Looking after the home0%

Other5%

The patient survey highlighted that patients have an issue with contacting the surgery by telephone. For us to improve this we need to make sure that the appointments line is opened on time. Some suggestions were longer opening hours for the appointments line, additional evening openings of the appointments line as well as an online appointment booking service. It was also noticed that the majority of people do not use the phone-in service to contact their doctor or nurse or enquire about test results. We need to carry out further investigations in order to determine why this service is not being used. From there we can work on improving its efficiency and making patients more aware of the phone-in service.

It is positive to see that the majority of patients are able to be seen within 3 days after requesting an appointment, with almost 30% being seen on the day they requested an appointment.

A concern that has become apparent following the patient survey was the lengthy waiting times. We need to ensure that all sessions (am/pm) are started on time as this has a knock-on effect on subsequent appointments. We also need to ensure that patients are seen for their allocated amount of time, where possible, if this is something that needs to revised further enquiries need to be carried out. Although comments were positive stating they appreciate the reasons behind the delays and accepted them.

From the survey patient are happy with the care that they receive from the doctors and nurses in our surgery.

Action Plan

DR KUCHHAI & SAHEECHA THE HEALTH CENTRE ACTION PALN 2011/2012

Description of Situation / How this improvement will be achieved? / When? / Outcome
Difficulty in contracting appointment line in the mornings. / Discuss with doctors possibly extending the times of appointment line. / Mar - 12 / We will discuss the possibility of removing the times imposed to patients on appointment line.
Some Patients were having difficulties booking appointments due to only two Doctors available. / This will be discussed with doctors and an improvement on this is expected. / Mar - 12 / We have a Locum Dr for three sessions per week.
64% of patients surveyed had to wait between 15-30 mins before being seen for their appointment. / This will be discussed with doctors and an improvement on this is expected. / Apr - 12 / We will endeavour to see patients on time and ensure all sessions start on time. Although comments were positive stating they appreciate the reasons behind the delays and accepted them.
Disabled patients sought special weighing scales. / To enquire with PCT whether one could be bought. / May - 12
Patients have complained about the cleanliness at Heaton Avenue Surgery. / This will be discussed with doctors and an improvement on this is expected. / Aug - 12 / Getting Quotes for Cleaning Company.
27% of Patients have complained about parking at both surgeries. / This will be discussed with doctors and an improvement on this expected. / Aug - 12 / Will review with PCT to increase parking.

In order to develop the action plan, the practice emailed the results of the survey to the PRG and invited them to a meeting. We showed on our display board that patients were invited to a meeting arranged and advertised the meeting on the practice website The Practice Manager met with representatives of the PRG on Wednesday 13th March and with the further feedback from patients that could not attend were able to prepare an Action Plan. This was prepared in draft form by the Practice Manager and circulated to GPs and staff for their comments.

Areas of disagreement

There were no contentious issues

Describe the areas that you could not achieve what the PRG wanted

Where there were requests for patients to be booked 20 minute appointments to assist waiting times, it was agreed that it would impact on the number of appointments that could be booked.

• We advised we are now providing a locum doctor providing an extra three sessions each week

• We agreed to investigate using telephone consultations

• To consider designated times to speak with doctor/nurse

Are there any contractual considerations to the agreed actions?

None

Insert any areas where there were changes to services that required agreement with PCT e.g. opening times

None

Local Patient Participation Report

The report is to be discussed at next practice meeting with both Doctors and all staff to agree who will be responsible for delivery of Action Points on the Action Plan.

The report is to be attached to our website and will be the main topic in our PRP Newsletter

Opening times have not changed

The Health Centre Telephone number 01708 343991 from 8.30am until 6.30pm apart from Wednesday afternoon when surgery is closed and telephone calls are transferred to Out of Hours

Access to the surgery detailed on website or available at reception as below

Monday / 08:30 - 20:00
Tuesday / 08:30 - 18:30
Wednesday / 08:00 - 13:00
Thursday / 08:30 - 18:30
Friday / 08:30 - 18:30
Weekend / Closed

The surgery Reception is open every weekday morning from 8.30am until 12.30pm. Reception opens at 1pm every weekday afternoon until 6.30pm (except Wednesday, when the surgery is closed. There is a late evening surgery on Monday from 6.30pm until 8pm

We open on a Saturday morning once every three weeks provided there is sufficient demand and there is a doctor available.

Outside these hours by calling our practice emergency line you are transferred to the Out of Hours Service direct.