This report describes the consultation process we followed to work with patients in the year April 2012 – March 2013. The aim of the process to was to:
- consult patients to identify areas where we could improve our service,
- agree an appropriate action plan with patients
- implement the action plan.
This process was carried out in six stages, as described below.
Our thanks go to all of our patients who helped us by responding, and in particular to the Patient Participation Group, who assisted us with the process.
Step 1. Developing a Patient Reference Group
The practice is very fortunate to have an active Patient Participation Group (PPG) who meet on a monthly basis. The PPG has the overall aim of helping to improve the health of our patients in the community by promoting self-help. Recent meetings have covered First Aid for Babies and Toddlers and Falls Prevention. There is more about this group on our website, at
However, this is a fairly small group, and we wanted to engage with a much larger number of our patients. We therefore gave this larger group a different name – thePatient Reference Group (PRG)– to distinguish it from the PPG.
We already had the core of our PRG in the form of patients who helped us last year by giving us feedback and allowing us to hold their names for future consultation. We undertook a further recruitment exercise during the period July 2012 to September 2012to increase the numbers, and to seek fresh views.
To ensure we provided an opportunity to join the PRG to a wide range of patients covering different ethnic backgrounds, age ranges and care needs, the following campaign approaches were used. The purpose of this was to ensure that we reached, or at least tried to reach, a reasonable cross-section of the patient population.
- Patients were given a direct invitation to join the PRG from GPs and nurses when attending consultations.
- Asking patients to join the PRG by handing out patient survey forms on reception to all patients who attended the surgery. Patients could either complete the survey in paper form, or online.
- Using volunteer members of our Patient Participation Group to canvass waiting rooms during routine clinics and during our Saturday morning flu clinics.
- Staff members approaching patients in the waiting room, targeting particular clinics, eg baby immunisations.
- Advertising posters in surgery to encourage all patients to join the group.
- Inviting new patients at the point of registration to join the PRG.
- emailing patients who had given their permission for this.
- Advertising prominently for new members on our website. By this means we hoped to make contact with at least some of our patients who don’t often attend the surgery, either because they work and/or are generally well or because they don’t have transport (young or retired).
As a result of this work a total of 197 (140 female/57 male) patients were recruited for Phase II (including those from phase I). This patient group was comprised of a broad range of ages as follows:
As might be expected, younger patients were relatively lightly-represented, since they tend to visit the surgery less frequently. However, there were sufficient numbers to give this group a voice. Conversely, older patients made up a slightly larger share of the group. Overall we felt this was a very satisfactory profile.
Please note that we have included younger children with their parents in calculating the patient population in Table 1 above, since they are obviously unable to participate in their own right. 22 of our responders had young children, so we feel that this group was also well covered.
The gender split was rather less even:
Again, this reflects the relative levels of surgery usage by the two groups. However, 57 patients was felt to be a sufficient number to ensure that male patients’ views were represented.
On ethnic origin, we had data for 3,071 patients, just over a quarter of our practice population. Patients declaring themselves to be British, mixed, British, or White British constituted the overwhelming majority at 87%. The only significant sub-groups were:
- Other White, at around 5%.
- A small Indian or British Indian contingent at around 2%.
We felt that there was relatively little value in addressing such an unbalanced split.
Instead, we decided to focus on ensuring that we had reasonable representation from patients with the most common chronic conditions. As regular users of our services, they are particularly well-placed to focus on patient care, which turned out to be the main area that patients selected for focus this year (see below). We therefore asked all respondents to the main survey if they had any chronic illnesses, with results as follows:
Overall, patients with chronic conditions were more than adequately represented, although there was some variability by individual condition, as might be expected with such low numbers.
Step 2.Agree areas of priority with the PRG
Patients who had completed the recruitment form and agreed to join our PRG were asked to help us choose key areas of focus by the use of a questionnaire which was distributed to 197 patients for two weeks between 8th and 22nd October 2012 via email, letter and paper copies at Reception. We asked patients to select two key areas to explore from a supplied list of 6 choices, selected on the basis of their popularity with patients last year.
47 patients responded to this preliminary questionnaire, with the following results:
The two most popular areas of focus were quality of care (could our service be improved during consultations and side effects correctly explained) and how well trained our staff are (do our staff appear well trained and competent). These therefore provided the areas of questions that the patient survey would focus on. The answers will also provide sound evidence for ourselves and for the Care Quality Commission (who will be regulating primary care from April 2013) on the extent to which we are delivering the outcomes which the CQC expect in these key areas.
Step 3.Collate patient views through use of a survey
A draft patient survey was created, focussing on these two areas. This draft was discussed with the smaller Patient Participation Group at their committee meetingon Tuesday 23rd October 2012. They came up with some helpful suggestions for improvements which were then incorporated before we issued the main consultation survey itself. In particular they asked for the number of questions to be reduced.
This survey was collated and distributed to all PCG members between November 2012 and early January 2013 via email and post. Copies of the survey were also available on our website with hard copies available on Reception at both Botley and St Lukes Surgeries.
A total of 151 replies was received, 62 online and 89 paper copies, with 45 replies from male patients and 106 from female patients. (The practice has just under 12,000 patients in all). This was a pleasing 50% increase on last year’s numbers.
The responses were collated and analysed with results as shown below. (These were responses to the question:
How good was your clinician at:
The results showed a pleasingly high level of overall satisfaction, and this was commented on by the patients at the subsequent meeting.
The three main areas of focus that did relatively less well than the others (though still good overall) were:
- Making patients aware of significant potential side effects of any medicines prescribed.
- Training patients in the use of equipment eg inhalers.
- Involving patients in decisions about their care.
Further comments and suggestions made by members of our PRG included:
- Making clear the status of the person the patient is seeing
- Continuity of care
- More time with patients
- Easier methods of contacting doctors e.g. email.
Step 4.Provide the PRG with the opportunity to discuss the findings and reach agreement with the PRG on changes to services
To further discuss these results and help us move forward, all members were invited to a Cheese and Wine Evening on 15th January 2013. A pleasing 16 patients attended for an evening of very lively discussion, which continued well beyond the expected time. We are grateful to all those who attended for taking such an active part in helping us to improve our services.
At this meeting we presented the findings from the questionnaire, as above, and discussed the best way forward in each case. The presentation and discussion are detailed in the minutes, along with the action plan. These were emailed to all attendees of the meeting. These minutes are available separately on the website, or from Reception. The minutes were also emailed to those that could not attend, where we had an email address available, along with a summary report on the survey results. Further comments or suggestions from these patients were encouraged, although none were received.
A considerable number of further positive suggestions were made by those present and will be separately followed up, but the main actions are summarised in the table below.
Step 5.Agree action plan with PPG and seek PRG agreement to make changes
The members of the PRG in attendance at the meeting discussed and agreed a number of action points. Full detail is given in the minutes (available separately). The summary list of actions is given below. All of these actions are now complete.
No: / Task: / Person Responsible: / Status:1 / Create printable handouts for patients on side-effects associated with some common medications, and when to seek advice. / SM/GPs/RD / The partners have identified the medications where this is most likely to be an issue, and have worked with the patient participation lead to create suitable notes. Action complete.
2 / Create a handout on inhaler technique with references to online videos, and mentioning that library machines can be used for internet access. / RD / RD has created a one-page inhaler technique handout for patients. This has been reviewed by GPs and by a nurse with special expertise in this area. The leaflet includes signposting to an online video, as action 4 below. Action complete.
3 / If possible, include information on possible faults with the existing 24-hour blood pressure machine instructions, also the advice not to wear at night. / RD / RD met with HCA 31.1.13 to identify common faults. HCAs already have a handout for patients. The reception team have been provided with an updated letter and verbal instructions for patients booking these at the front desk. Action complete.
4 / Include pointers to online aids in printable handouts for common conditions, especially where there are useful decision aids on treatment types. / SM/GPs / The partners felt more comfortable with the official site, patient.co.uk, so this has now been incorporated into the appropriate leaflets. Action complete.
5 / Set up a single source of paper handouts in both buildings, and establish stock control procedures / SM / List established. Stock control will be managed by the Reception Team Manager. Action complete.
6 / Brief Reception and Triage teams to make clear who an appointment is with (Doctor, Nurse Practitioner etc) and whether they are male or female. / RD / Reception and nursing teams briefed at their January meetings. Action complete.
7 / Doctors to wear name badges / RD / Badges created for all regular GPs, issued in February, and GPs reminded to wear them. Action complete.
8 / Where possible, adjust the balance of appointments slightly to favour locums for same-day appointments, and partners for routine ones, especially when scheduling additional sessions. (This to assist with continuity of care). / SM/HB / The scheduler has now adjusted appointment allocations accordingly. Action complete.
For future consultation(ie to be considered as candidate survey topics next year):
No: / Action: / Target Date:1 / Publicise the survey more widely – shops, libraries, and big screens. The PPG have agreed to help with advertising and distribution of the survey. / Dec 13
2 / Include another question on the wait for routine appointments / Dec 13
3 / Consider possible solutions to the question of triage confidentiality for patients at work, and consult on options if appropriate. / Sep 13
Step 6.Publicise the actions taken, and subsequent achievement
This report identifies the actions agreed, together with progress on achievement, as shown in Step 5 above.
The report is available in hard copy from the reception team in either of our surgeries, and via:
- The practice website, at
- Our entry in the NHS Choices website, at
A big thank you!
We would like to thank all our patients who helped in the development of this report and those who responded to our survey. If you would like to join our patient group in the future, please contact any member of staff.
Contact us
Receptionists are available either by telephone (01489 783 422) or in person during the normal surgery opening times listed below:
St Lukes Surgery
Mon – Friday8.00 – 6.30pm
Sat*see extended hours
Botley Surgery
Mon, Tues & Thursday8.30-12.30pm/3.00-6.00pm
Wed & Friday8.30-12.30pm
*The surgery offers early morning/late evening and some Saturday morning additional sessions for pre-booked routine appointments only, available to those patients who find it difficult to attending during normal surgery hours. These are staffed on a rota basis by our regular clinicians. Please ask at Reception if you would like to book one of these appointments, and do please say if you would like to see a particular clinician.
Thank you for reading our report.
Rachel DiaperPractice Lead on Patient Participation
Steve McIntyrePractice Business Manager