Patient Participation Group - DES 2013/14

Southwood Practice

Patient Participation Group - DES 2013/14

Section 1

In order to involve patients in decisions in the range and quality of services at Southwood Practice we set up a Patient Representative Group in 2009 and have held regular meetings.

Since its conception the group have discussed several issues and made suggestions to improve services at the Practice, using surveys both in house and online to assist with discussions.

One item discussed has been DNA rates and how to reduce them. The Practice introduced the appointment text reminder service and began a campaign to update patient records with current telephone numbers both landline and mobile. Although DNA rates dropped, this is an ongoing concern and we have noted patients opting out of the service.

In our survey Jan 14 we asked ‘how do you receive your appointment reminder?’

88.1% receive a text reminder

4.5% opted out

81.3% of those who opted out said they don’t need reminding and

18.8% said it was too complicated to use.

We then reduced the number of reminders sent for each appointment and changed the wording of the message to make it clearer.

PRG meetings have been arrangedon 28.7.09, 15.9.09, 20.10.09, 2.3.10, 9.3.10, 15.6.10, 22.3.11,5, 10, 11, 7.11.11 and 19.2.13. Surveys carried out have included GPAC in house survey, opening hours survey, communication survey. The minutes of meetings and survey results are posted on the Practice website along with the previous

DES report 2012 and the DES report Part 2.

To ensure convenient access to the Practice we offer a variety of appointment options. Patients are registered on a pooled list and do not have a designated GP.For continuity of care patients are able to book routine appointments with the GP and nurse of their choice including OOH appointments 2 evenings a week. Appointments can be booked either by telephone, face to face or via the internet using Patient Access. Routine telephone appointments are also available to book up to 4 weeks in advance. For more urgent care we offer a telephone assessment appointment on the day, often this resolves the patients’ problem without the need for a face to face appointment. Once a clinician has triaged the patient they have the ability to book an appointment on the day or within 3 days whichever is appropriate.

Southwood Practice have an open list for all new patients living within the designated boundary which is recorded on the Practice booklet,marked on a map available in the surgery and on Practice website which has a convenient postcode checker giving a simple yes or no to whether the address is within the Practice boundary.

The opening hours of the Practice are posted on a brass plate at the front door, on all appointment cards and on the Practice website and in the Practice booklet as well as on NHS Choices website.

Patients are able to self refer to several health and social providers and information is available and advertised within the Practice using leaflets and posters which are all available on the Practice website.

Some of the self referrals available are:

-Surrey and Hants Mental Health

-MIND

- Local Youth Counselling

- Rushmoor Voluntary Services

- Podiatry

- Alzheimer’s Society

- Books on prescription

Section 2

Component 1: Develop a PRG

Southwood Practice set up a PRG in 2009 and there have been several changes of members since. The group originally consisted of mainly retired members of the Practice population however we have been successful in recruiting some younger men and women from varying ethnic groups making the group more representative of the Practice population.

In September 2011 we set up a Virtual Patient Representative Group.

All members of the PRG and VPG are volunteers and both groups continue to grow in numbers.

To ensure we have a representative cross section of the practice population, we continue to invite all new and existing patients to join the PRG and/or the VPG by handing out information leaflets which include a form to register their interest in joining, we also advertise on our website, on posters and by word of mouth.

The practice profile has been established using information gathered from patient registration documents, a new patient questionnaire and updated routinely during appointments. It covers information such as age, gender, ethnicity, carers and employment status.

We ensure that we comply with the Equality Act 2010 by inviting all patients who are registered at the Practice are welcome to join the PRG and VRG regardless of age ethnicity or disability.

The Practice does not have a high number of patients with learning disabilities, drug use or patients in care homes and although all patients are encouraged to join the PRG and VRG patients from these groups are not currently members.

Component 2; Agree areas of priority with the PRG

The subject of the survey was communication and the priority was to establish if we were conveying information and changes effectively to patients. The questions asked covered the subjects of;

- changes in the Practice,

- information available to patients about services offered in the Practice and on referral

- surgery opening times

- patient satisfaction

- themes from compliments and complaints

- the recent CQC Inspection

At a meeting of the PRG on 14th Oct 2013 we discussed the planned survey and questions that we would like to ask. On 28th Nov 2013 the draft survey was circulated to the PRG for feedback prior to it being used. With some minor changes to wording and a couple of questions, the survey was sent via Monkey Survey to our PRG, VRG and distributed in the waiting room on hard copy.

A link to the Monkey Survey was added to Face Book, Twitter and on the Practice Website inviting patients to take the survey.

Component 3; Collate patient views through use of a survey

After discussion with the PRG and staff the Practice decided to use Monkey Survey for the purpose of this DES.

The survey questions were decided by the staff and members of the PRG and having previously used Monkey Survey we felt confident in using it once again and found it to be easy to use both in setting up and taking part and the analysis to be accurate. Prior to writing our questions we looked at the guidance from the NAPP website, previous Monkey Surveys and looked historically in surgery.

Component 4; Provide PRG with the opportunity to discuss survey findings and reach agreement with the PRG on changes to services.

The results of the survey were sent to the PRG and VGP and then discussed at the PRG meeting on 3rd Feb 2014 and it was generally felt that the response rate was lower than expected from patients outside the PRG and VRG compared to the amount of work involved. It showed us those who responded prefer text and email as a method of communication for major changes; however this is probably not suitable for many of our elderly patients as the elderly population may not be IT literate.

We asked: how would you like to be informed of future changes to our services?

Our survey said: 22.4% waiting room posters

12.6% leaflets in waiting room

16.1% leaflets attached to prescriptions

74.0% email

50.4% text

We did:revamped our posters, made leaflets available in the waiting room, gave out leaflets with prescriptions and collect and update email address and mobile telephone numbers in surgery.

The current surgery population has 3130 male and 3176 female patients registered and of the patients who responded 55.5% were female and 44.5% were male and with some representation from each age group with the exception of the over 86 years.

16 – 25 years2.7%

26 – 35 years16%

36 – 45 years26.6%

46 – 55 years21.1%

56 – 65 years16%

66 – 75 years10.5%

76 – 85 years7%

Ethnicity is routinely recorded at registration, at patient surveys and each consultation. The patient who took part in this survey showed a cross section of the practice population were represented with

79.4% White British

0.4% Irish

0.8% Caribbean

0.4%African

0.8%Asian

2.0%Indian

0.4%Nepali

Any future changes we would need to look at reaching a wider net of patients who may not use technology as well as those who do.

The PRG members feel we could make more use of publicising Practice services by using the waiting areas of the Practice using posters and notices and television screens.

CQC

At the meeting on 3rd Feb 2014 the Practice Manager reported that we had been one of the first in the area to have a CQC inspection. The inspector was with us all day and took the opportunity to sit with and speak to members of staff and patients who were in the waiting room.

The outcome was that we have passed our CQC inspection and there are no major changes planned for the Practice.

The results of the CQC Inspection are displayed in the waiting room and on the Practice website.

A selection of compliments and complaints received recently from patients appear to follow a similar theme, either patients really like the appointment system are they don’t like it at all. It was generally felt in the meeting that is difficult to satisfy all patients but that the surgery offers a variety of appointments including pre-bookable and on the day and within 2 days following telephone assessment. The possibility of patients not understanding how triage works prompted the Practice change from ‘Triage to ‘Assessment appointment’

No significant changes were thought needed to take place.

Component 5; Agree action plan with the PRG and seek PRG agreement to implement changes.

As discussed at the PRG meeting 3rd Feb 2014 the agreed action plan is to therefore;

1/ Promote in house services and self referral services more widely in the waiting areas

we will: - use eye catching displays in the waiting areas to promote all services that we offer at the Practice and all the self referral schemes available

2/ use all communication methods available to reach as many patients as possible.

We will: - use Text, email, posters, leaflets, website, face book, twitter

messages on right side of prescriptions, messages on the self check screen and verbal communication in order to reach as many patients as possible.

3/ Promote online services more widely

we will: - attaché information to all prescriptions leaving the building and include information in new patient information packs inviting patient to register for their PIN

4/ there are no major changes planned for the Practice

The minutes of the meeting are posted on the Practice website.

Component 6: Publicise actions taken – subsequent achievement

1. The PRG is made up of staff and current registered patients who are all volunteers. The group is currently made up of 16 patients and 3 members of staff including the Practice Manager. There are 4 men and 15 women and cover a range of age groups between 20 – 80 years and of various ethnicities.
2. Every patient joining the Practice is invited to be involved in the PRG and VRG by giving them a leaflet about the groups and a form to register their interest in joining the group. The leaflets are available to all patients registered both in the practice and on the Practice website and are handed to patients booking appointments and collecting prescriptions.
3. Discussion with the PRG and staff determined what was to be included in the patient survey and agreement from PRG members were sought prior to using the survey, and followed up at the PRG meeting to discuss the outcome.
4. The survey was conducted online by Monkey Survey. Patients were asked to take part by following a link attached to an email or text. Hard copies were available in the waiting room for patients to complete.
5. The members of the PRG were invited by email to a meeting to discuss the findings of the survey and the contents of the action plan. Notices in the waiting room advertised the meeting and invited new members to attend.
6. The details of the action plan agreed at the PRG meeting on 3rd Feb 14 is to

1/ Promote in house and self referral services more widely in the waiting areas

we will: - use eye catching displays in the waiting areas to promote

all services that we offer at the Practice and all the self referral schemes available

2/ use all communication methods available to reach as many patients as possible.

We will: - use Text, email, posters, leaflets, website, face book, twitter

messages on right side of prescriptions, messages on the self check screen and verbal communication in order to reach as many patients as possible.

3/ Promote online services more widely

we will: - attaché information to all prescriptions leaving the building and include information in new patient information packs inviting patient to register for their PIN

4/ there are no major changes planned for the Practice

There were no proposals that were rejected and therefore not be implemented.

1. The survey showed that of the patients surveyed only 56.2% knew that the Practice Nurse offers minor illness appointments and only 11.2% are aware the Practice offers Minor Surgery appointments, just 2 examples that the PRG felt should be publicised more and it was agreed that more information should be made available to patients in the waiting room, on the website and in the Practice booklet.
2. As discussed at the PRG meeting on 3rd Feb 2014 the Practice will follow the action plan agreed.
3. The Practice is open from 8:30am to 6:30pm Monday to Friday. Patients who require medical assistance between 8:00 and 8:30 am and telephone the surgery line will be directed via a message to the most appropriate contact which may be to telephone 01252 524344 For urgent assistance outside of these hours 111 offer a 24 hour telephone line and for medical emergencies A&E or 999 as appropriate.
4. Southwood Practice offers routine pre-booked appointments with all clinical staff up to 4 weeks in advance, including extended hours surgeries on 2 evenings a week for both GP and Nurse Appointments between 6:30 and 8:00pm for pre booked appointments.

If patients are unwell on the day a telephone assessment appointment is offered with a call back from a clinician who may either offer advice over the telephone, an appointment that day or within 3 working days whichever is most clinically appropriate.

The action plan is displayed in the waiting room and on the practice website.

If you wish to become a member of either the PRG or VPG please contact

Lorraine Stratton at the surgery on 01252 371715