Laurel House Surgery
Patient Participation Group EOY Report and Action Plan 2013-14
Chairman: Dr S Sareen MBBS. MS. MRCS. MRCGP. Dip. DERM
Vice Chairman: Charis Howell
Secretary: Kim Bowen
The Laurel House Patient Participation Group was started in August 2011. Initially the formation and primary objectives of the group were discussed at Partners meetings in conjunction with the documentation received from the original ‘PCT’.
Dr Sareen was nominated as the chairman for this group along with Charis Howell as vice chairperson and Kim Bowen as secretary. It was decided that we would try to get maximum participation from our patients and that it should be fully representative of our patient population.
The first meeting of the group was held on 27th September 2011 at Laurel House Surgery where the aims and objectives of the group were discussed. The constitution of the group was agreed and signed by the members and any ideas and suggestions for the future direction of the group were reviewed and agreed.
This is the third year of the Laurel House Patient Participation Group and we have strengthened the group with the inclusion of more members this year.
The group is advertised on the practice website: www.laurelhousesurgery.co.uk and pamphlets are readily available for patients at the Practice. Posters are displayed in the reception and waiting areas of the surgery giving details of the group and its function.
It was also decided that the doctors would actively discuss the group with their patients opportunistically during consultations.
The first meeting of the group this year was held on the 13th. March 2013. The new members were welcomed and informed about the rules and expectations of the group.
Summary of the main Issues reviewed during P.P.G. Meetings and taken forward as part of the Practice Action Plan:
Dr. Sareen discussed progress achieved within the Practice over the previous year together with various issues the Practice was facing during the next 12 months.
Discussion took place with regard to an on-line patient booking/appointment system and that the Practice was actively involved in moving this objective forward. The Practice did
however face some issues regarding compatibility of I.T. equipment – provisionally scheduled for replacement this next year, funds permitting.
Book on Day appointments (BOD’s) were discussed. The meeting was informed that if all BOD’s had gone and the patient really needed to see a doctor that particular day then they should be able to see the Duty doctor.
The Duty doctor now gives a leaflet to patients on the day which explains what is classed as urgent appointment and reminder notice is also put on the Duty doctor’s door.
The question of ‘Did Not Attend’ appointments (DNA’s) was raised by one member of the group. Practice DNA numbers are reported monthly on the notice board. It was felt that patients should be made more aware about DNA’s at their next consultation.
The parking situation was felt to be an ongoing problem and continues to be discussed within the Practice. One member asked if we could have a barrier system in-place. This has been investigated but apart the very high installation/maintenance costs, the experience of other local practices have shown this to be very difficult to manage – especially when faults/accidents/damage occur. It was pointed out by one of the members that she had seen many people park there and then go into the dentist or in the opposite direction.
The Practice had in the past, used a part-time warden but following much abuse and intimidation it was deemed a risk to the person. The question of who owned the property was raised - did the land actually belong to the surgery. Mrs. Bowen stated it was not and that it was rented from the council.
A further question was raised asking if we really needed to provide a car park. It was suggested that the money be put back into the practice rather than paying for a car park with very limited spaces. This matter is still being reviewed.
The Practice complaints procedure was discussed in detail and the policy is published on the practice website as well as being available from reception.
Telephone access to the Practice was discussed and it was hoped that the on-line booking system would help in this respect. It was confirmed that the Practice was not part of the 0844 number system.
The Practice will be looking at an alternative telephone system 2014-15 but this is resource dependent. The Practice has also carried out a review of disabled access during the last 12 months.
Although the Practice has been actively publicising the Patient Participation Group, we are still short of active members. This will be one of the initiatives we are proposing to undertake next year. We plan to increase out poster campaign, expand Patient Participation Group (PPG) information currently on our website and ask GP’s, Nurses to raise this with patients.
Dr. Sareen highlighted the issue of patients being able to register with any GP they choose, regardless of where they live from next year. This will almost certainly have
resource implications for the Practice. Currently, no funding has been identified to help support additional cover this extra work may generate.
Over the last three years, we have had two doctors retire and new doctors join Laurel House who are bringing new ideas to the Practice and over the next few months two more GP’s will be joining us on a part-time basis.
The Practice continues to be popular and extremely busy. Our branch surgery in Fazeley was required to take on additional patients from another local practice that had closed.
Following discussions with the PPG, the Practice website was given a make-over by Kim Bowen – all 20 categories were reviewed and updated where necessary.
A new first page alert feature and the ability to download a patient questionnaire was also introduced.
Laurel House Surgery 2013-14 Patient Questionnaire:
This is our third year conducting an in-house ‘Patient Questionnaire’ survey. This year’s questionnaire and topics were discussed at a meeting of the PPG and a draft questionnaire circulated for approval. Following input from the team, the survey had been better designed and more concise.
A requirement for next year’s questionnaire – ‘friends and family – would you recommend?’ was felt appropriate to include in this year’s questionnaire. Patients started completing them from mid-December onwards. Progress was reviewed in regular practice meetings and the PPG updated.
The patient survey has now been analysed and the findings presented to the Patient Participation Group and discussed in detail. Both the patient survey results and the minutes from the patient participation group meetings have been uploaded to the practice website. Representation of the results are in both graphical and tabular/text format.
The results will also be displayed on the practice notice boards in the waiting room areas of the surgery. Additional copies can be downloaded from the website or are available at reception. The survey results have also provided very useful feedback for doctors, practice nurses and support staff.
Several issues, both good and bad, were highlighted - namely:
a) Telephone access:
The length of time patients sometimes have to wait to access the surgery by telephone, particularly in the morning, with 19.9% of patients finding it difficult to get through and a further 38.5% not finding it easy - see earlier comments – An action plan is under consideration but it is heavily dependent on funding streams and additional workload.
b) Booking a GP of patient choice:
The importance of being able to book a GP of patient choice was significant – very important.45.7% and fairly important 41.0% (86.7%) but only 59.5% (13.9% easy, 45.6% fairly easy) actually found it easy to do so. However, 70.7% of patients were able to book an appointment at the time of their choosing – (15.4% very easy, 55.3% fairly easy)
c) Access to practice nurse appointments:
Most patients found it easy to book an appointment with a Practice Nurse (34.5% easy and 58.7% fairly easy).
d) Telephone consultations:
Patients would definitely like the facility to book telephone consultations (63.2%) this represents a significant departure from our normal practice – see early comments and actions points.
e) How doctors and nurses listened to what patients had to day:
Patients reported a high level of satisfaction (excellent/good) in relation to how well the Doctors and nurses listened to what patients had to say; GP’s, 68.5% excellent, 30.4% good, and Nursing 54.3% excellent, 45.3% good.
f) Method of booking appointments:
A large proportion of our surveyed patients (68.0%) still prefer to make an appointment by telephone, although it was also noted that there was an increasing group of patients (16.2%), that would like an on-line booking facility to be made available – See previous comments and action points. 8.1% of those surveyed preferred to book in-person. We accept that an element of this may be due to difficulties experienced with early morning telephone access.
g) The range of health services offered by Laurel House:
‘The Practice adequately covers the whole range of health services I require’. 89.0% (23.0% strongly agree 66.0% agree) of patients agreed that the Practice adequately covers the range of services they required from a surgery. The Practice does take the provision of services that we offer to our patients very seriously and it was gratifying to see that no patients in the survey disagreed with this.
h) The provision of adequate health information for our patients:
‘The surgery provides me with adequate health information’ 83.6% (22.9% strongly agree 60.7% agree) of patients felt the way the Practice provided information on health issues was adequate and only 2.4% of those surveyed thought we fell short in this respect.
i) Access to information about our practice:
It is interesting to note that an increasing proportion of patients now access practice information via our website, but that the vast majority gather information about the Practice via the telephone or from practice notice boards and wall posters.
As mentioned previously, we are currently in the process of organising the provision of online appointment access for a selected number of pre-bookable appointments with both doctors and nurse’s and another new facility allowing on-line repeat prescription requests. Discussions are ongoing to improve telephone access, particularly in the mornings.
Outcome Summaries and Action Plans for 2014-15:
On-Line Booking Access:
It is accepted that on-line booking of appointments is one of the ways the practice can move forward and may also free up the phone system, especially between 8.00 and 9.30 in the mornings. The Practice has already commenced a trial with patients of one partner (PDK). It is still early days but the system looks promising.
Action Plan: To expand this initiative 2014-15 to all GP’s/practice patients who would like the facility of on-line booking of appointments.
On-Line Prescriptions Access:
As with the booking of on-line appointments it is also accepted that there is an increased demand for the facility to order repeat medication on-line. The Practice has also commenced a trial with patients of one partner (PDK) in this respect.
Action Plan: To expand this initiative 2014-15 to all practice patients who would like the facility of on-line ordering of repeat medication.
Book On Day vs Pre-Booked Appointments:
Members of the group felt it would be beneficial to the patients to offer more book on the day appointments so a pilot scheme took place by Dr Young. This has now been extended to all Partners and is working very well. The current ratio is approx 60:40. Feedback from patients has been positive.
Action Plan: This will be extended to other members of the Clinical Team – Associate GP’s and possibly Nurses.
D.N.A. (Did Not Attend) Appointments:
This had been mentioned at several PPG meetings and does represent a significant amount of wasted time for the Practice and uses valuable appointments that could otherwise have been allocated to other patients:
Action Plan: Additional notices of monthly DNA rates/numbers to be published and circulated on practice notice boards and on the practice website. DNA appointments are already recorded on patients clinical records but GP’s are to remind patients of the impact on resources this issue creates. Promoting patients to ring in and cancel appointments giving as much advance notice as possible. On-line access will enable patients to cancel which hopefully will have a positive impact on DNA outcome.
Telephone Consultations:
Dr Sareen had previously asked the group their thoughts on offering patients telephone consultations at the end of surgery. He pointed out though that this would reduce the amount of bookable appointments. The group thought this would be a good idea and once again Dr Young initially piloted the idea with patients being offered a ‘ring-back’ appointment at a time towards the end of both morning and afternoon surgeries. Good feedback from patients – also reflected in the patient questionnaire responses (65.1% in favour).
Action Plan: Initiative to be extended to other members of the Clinical Team – Associate GP’s and Nurses.
Late Arrivals: