ILKLEY MOOR MEDICAL PRACTICE

PATIENT COUNCIL (PPG)

REPORT

Version: 1

Produced by: Wendy Ribbands, Practice Manager

Date: February 2012

1.Introduction

Ilkley Moor Medical Practice Patient Council (PPG) was originally established in 2003, at which time we set up a constitution (Appendix 1) and established some basic ‘Aims and Objectives’ (Appendix 2). Every effort is made to recruit lay members that offer an accurate representation of the patient list, and our recruitment process includes personal contact, press releases, open days, practice website and notices within the medical centre. The group has also created a close working relationship with IlkleyGrammar Schoolin order to ensure that the younger age group is truly represented and we currently have 2 student members. A link was also setup between our website and the school website to aid with the flow of information. In an effort to spread this representation even wider, we have set up a ‘virtual’ group, currently 16 members, covering a good cross section of the practice population.This ‘virtual group’ is designed for patients who wish to be kept informed, and are happy to contribute but who do not wish or are unable to attend the meetings, and also for those on the waiting list to join the Patient Council.The virtual members contribute via email, telephone and personal contact with council members. We hope this will encourage more & more patients to become involved with a view to strengthening the relationship between patients and the practice. (Appendices3 & 4)

All lay members are elected for a 3 year period, and have the option of seeking re-election for a further 3 year term. These members are re-elected by the council at the Annual General Meeting. If any members leave, new members are approached from our waiting list, taking care to target any minority representation with regard to age, ethnicity etc in an attempt to reflect the practice population. The Council Officers are elected annually, and at present constitute a chair, vice chair and secretary (Appendix 5). The Council operates within a published constitution, along with a set of aims and objectives.

Within the PPG we also set up ‘sub-groups’ to look at specific areas such as

  • Organisation of Annual Health Awareness Day
  • Public relations/Information distribution
  • Recruitment
  • Community Projects
  • Mental health
  • Parkinson’s

The Officers of the PPG are also invited to attend the Practice ‘Away Day’, and have been an integral part of setting up the Practice’s ‘Health Awareness Day’ at which they have a stall of their own where patients can ask questions, or bring any ideas forward.

The PPG meets bi-monthly for 1-2 hours in the Conference room at the practice, where sandwiches and drinks are provided. The Agenda and Minutes of Meetings are distributed to members and are also available on the Practice website. A copy of the minutes is also enlarged to A3 size and pinned to the PPG notice board in reception. Meetings this year were held on 12/1/11, 16/3/11, 11/5/11, 13/7/11, 14/9/11, 16/11/11 & 11/1/12 (Appendix 13 – Minutes of last 5 meetings).

We originally met at lunch time, but have recently been alternating between lunch and tea-time in order to encourage attendance by memberswho cannot attend during the day.

Members are invited to discuss any ideas and suggestions for the improvement of services at the practice, and where practical, these ideas are quickly implemented by the Practice Manager.

The Officers, lead GP and Practice Manager also meet on a regular basis to review target issues, and the Council Officers also attend some practice meetings, where they are able to discuss these issues and ideas with the wider staff.

  1. Description of the profile of the PPG

After lengthy discussion in our early years it was decided that our current membership made up of 16 lay members and 4 staff members would be a manageable number, and we have worked on this basis ever since. This is currently made up of 7 male and 13 female, including the Practice Manager and a GP partner. Our practice population is predominantly White British, and this is reflected in the make up of our group. We also have a high proportion of elderly in the practice and this is also reflected in the group as follows:

70 – 80yrs= 7

60 – 70 yrs= 5

50 – 60 yrs= 2

40 – 50 yrs= 2

2 school representatives

It was felt that even though we have a high elderly patient base, we were definitely light in the younger age group even though we regularly advertise and approach patients direct (Appendix 6. This has partially been addressed since our approach to the local Grammar School (Appendix7) and the appointment of our 2 school representatives, and of course the recent participation of our ‘virtual’ group (see Appendix3 for e.g. of leaflet encouraging membership). We will however continue to look for and target support amongst the younger element of the patient population.

3.How the practice has worked to ensure that the Group is representative of our registered patients

The group regularly advertise throughout the practice for new members in a variety of ways:

  • Mail shot included in all letters sent to patients
  • Leaflet included in all ‘New Patient Packs’ for all new patient registrations
  • Mail shot attached to every prescription awaiting collection
  • Adverts in local press
  • Stall at Health Awareness Day
  • Presence and notices at local community projects, community centre, churches, library etc
  • Promotion of group on practice website
  • Promotion on group’s notice board within the practice
  • Item in patient newsletters
  • Printout/introduction included in all new registration packs
  • Personal approach to local Grammar School
  • Personal approach to specific patients/minority groups
  • Word of mouth

Patients are also welcome and are encouraged to come along to any of our meetings on an ad-hoc basis if there is a particular subject relevant to them they wish to discuss. They are also able to attend any of the relevant sub-group meetings which may be of particular interest.

4.Steps taken to determine and reach agreement on the issues which had priority and which should be included in the local practice survey.

All Patient Council representatives are briefed to canvas the views of our patients. We also have appointed members associated with many local agencies e.g. church, Community Centre, Schools etc in order to provide a constant flow of information and exchange of ideas.

Our patients are invited to use both the suggestion box and web site page to submit their suggestions for improving the patient experience.

The practice also use information obtained routinely via complaints, general comments from patients and National GP Survey, which are fed back to the Practice Manager and brought up at the Council meetings. We also took into account the requirements of the practice with regards to CQC standards etc, and any planned changes within the practice.

As our PPG has been running successfully for the last 9 years, and has had regular involvement each year, a lot of the issues raised during these years have already been implemented and dealt with. We find that the major issues of GP availability, continuity and opening hours recur each year despite our attempts to gear the service to as many patients as possible.

As these were the main issues identified yet again, our current questionnaire was reviewed and developed with a view to providing a simpler more user friendly format which patients would be happy to complete. This format was then reviewed and revised by a sub-committee, and the Council felt that it would be good to provide a similar format to last year which would allow us to evaluate whether changes already implemented have had any significant effect on the patient experience in these areas.

5. How the practice sought to obtain the views of its registered patients.

In advance of the questionnaire being issued, it was advertised to the patients that this was about to take place.

This questionnaire was then issued to 400 patients at random, varying the time and day, of which 380 were subsequently returned. The patient age range was:

<20 yrs / 21 – 40 yrs / 41 – 60 yrs / 61 – 75 yrs / 75+
24 / 78 / 114 / 89 / 75

Of these patients, 117 patients suffered from a longstanding condition/illness and 263 had no longstanding condition.

The survey including patient comments was then analysed by the Practice Manager and a PPG staff member. The Council members were kept involved at all stages of the process, from identifying issues and priorities to devising the questionnaire and the final report of the findings fed back to the PPG by the Practice Manager at one of the bi-monthly meetings.

Copy of Comments (Appendix 8)

6.Steps taken by the practice to provide an opportunity for the PPG to discuss the contents of the action plan

The results of the Survey and Action Plan were presented using pie charts and text, at one of the PPG bi-monthly meetings and the findings discussed. At thismeeting, issues wereraised and discussed to decide on the priority of each item on this Plan,and progress discussed at subsequent meetings.

All results are reviewed by the Council, along with practice staff, in order to prepare an action plan for the future (Appendix 9). Examples of a few items implemented as a result of previous surveys include:

  • Amending opening hours to provide more flexible access to services. The practice is now open from 7.30am to 8pm on Monday, Tuesday and Wednesday, 7.30am to 6.30pm on Thursday and 8am to 6.30pm on Friday.
  • A ‘buddy’ system has been created by the GP’s so as to provide more continuity for patients with long term and chronic illnesses.
  • A four week consultation has reviewed the operation of the appointment system, resulting in a number of changes being implemented.
  • The re-design of the practice website to in include more information and to make it more user friendly
  • Lowering of reception desk
  • Information TV in waiting area
  • Touch screen booking in – to reduce waiting times and queues in reception.
  • Health Promotion room – BP machine and BMI machine for patient use.
  • Warfarin Clinic
  • Domiciliary Phlebotomy
  • Newsletter
  • Redesign of car park layout
  • Re positioning of toilet roll holders in public toilets

and many more.

  1. Details of the findings that arose from the local Practice survey.

Patients were asked a total of 14 questions with regard to their experience at the Practice, including GP’s, staff, availability of GPs, telephone availability and opening hours (Appendix 10). There is also a space available for comments.

The vast majority of comments we received were exceedingly complimentary, with just the odd complaint/suggestion. Of these, it was mainly the opening hours (especially at weekend)and how busythe telephones are first thing in the mornings which were the major concerns.

8.Summary of the evidence (including statistical evidence) relating to the findings or basis of proposals arising out of the local practice survey.

See (Appendix11) which show the pie charts, (Appendix 12) showing gender and age rang and (Appendix 8) which givescomments received and presented to the PPG at the bi-monthly meeting.

9.Details of the action plan which the practice, and, if relevant, the PCT, intend to take as a consequence of discussions with the PPG in respect of the results, findings and proposals.

A copy of the action plan (Appendix 9). As we have been up and running as a PPG for so long, our PPG members are involved in a lot more issues than those presented by the survey , and our action plan reflects this and other on going issues and involvement.

It was felt that as we had previously looked at all the possibilities regarding opening hours and the log jam of calls at 8am every morning including an “Investigation and Report into Appointment Booking” (copy of which can be supplied on request), what is needed mainlyis patient education. Discussion was held on how to get across to patients the merits and limitations of the appointment system.

10.Issues and priorities taken on by the practice as a result of this report.

A leaflet on the appointment system was developed which is now included in all new patient information packs, slipped in with all prescriptions and inserted with all out going letters.

The PPG also play a big part in this communication to the patients, especially during our annual events as detailed in the Action Plan under ‘Expected events current and ongoing’. They are also looking to have regular articles published in the Ilkley Gazette and to include information in the Practices quarterly newsletter.

11.Practice Information - opening hours, obtaining access to services, extended hours, times when individual healthcare professionals are accessible to patients

Ilkley Moor Medical Practice is open between 7.30am and 8pm Monday to Wednesday, 7.30am – 6pm on Thursday and 8am – 6pm on Friday. The late sessions are manned by GP partners and at least one practice nurse.

Where the appointments have all been allocated for the day, the admin staff can add extra appointments to each surgery where needed. These are provided on a rotational basis to the GP partners and salaried GPs up until 5pm. After this time all extras go to the GP on-call and on-call cover.

SURGERIES AND APPOINTMENTS

Appointments

01943 6049990800 -1800

(Weekdays)

Opening times

Monday }

Wednesday}0730 -1930

(GPs and Practice Nurses)

Tuesday0730 -1930

(Practice Nurses)

Thursday 0730 -1800

Friday 0800 -1800

GPs are available during these times subject to absence for study days, PCT meetings, annual leave or other circumstances.

Over a third of GP appointments are available to book on the day from 8.00 am. Patients wishing to book in advance may make an appointment up to 2-3 months ahead in the case of GPs, and up to one year ahead for nursing staff and midwives.

We also offer the facility of booking a telephone appointment with any GP or nurse during surgery time should a face-to-face consultation be unnecessary. Practice staff will take details and the GP/nurse will telephone at a pre-arranged time.

All surgery appointments for practice nurses and other clinics may be made in advance.

If appointments clerk sees a potential problem in advance, the number of pre-bookable appointments can be reduced for that day, and extras added if/where necessary. In instances of extreme shortage, we will try to source a locum (from within the practice initially).

We work on a ‘today’s work today’ policy, so that if demand is particularly high on any given day and we run out of appointments, more are added to each GP surgery in rotation, one at a time as required by the admin staff. Appointments clerk and Office Manager monitor the situation ahead and throughout each day, although any member of staff can alert them to potential problem areas they may foresee.

Likewise, with nursing shortages, locum nurses are requested where necessary in advance and extra appointments allocated on the day if urgently needed.

12.Conclusion

The Ilkley Moor Medical Practice Patient Council continues their involvement with the Airedale Hospital NHS Foundation Trust, The Leeds Teaching Hospitals NHS Trust including WharfedaleHospital, IlkleyGrammar Schooland other local Ilkley agencies. The PPG is also heavily involved withLocal Involvement Network (LINK), with our Chairman Barry Taylor visiting all interested localities, promoting the importance and value of a PPG group and sharing our experiences and developments to date . The Council has recently assumed the responsibility for the production of the practice newsletter, which we publish on a quarterly basis. They have also developed close working relationships with other local patient groups, and have been instrumental in establishing a liaison forum for all existing patient groups within the newly formed clinical commissioning group.

The PPG will continue to assist the Practice in the organisation and running of the very successful and ever growing annual health awareness day, as well as the men’s health days, street doctor and liaison with local pharmacies.

In conclusion, there seems little doubt that the new plans for the running of general practice will present significant challenges to all concerned, and that patient participation will become an important element of these developments. The Patient Council is here to ensure that our patient’s collective voice continues to contribute to the continuous improvements to practice services, and to provide practical support to the surgery in implementing change where we are able to do so. The council is always anxious to ensure that it is truly representative of our practice, and our body includes people from a very wide background and experience. Should anybody be interested in becoming involved in the Patient Council, either directly or as a ‘virtual’ member, you are invited to contact the chairman for further information. Contact details can be acquired at reception, or via the Practice website, and we look forward to hearing from you.