kilburnpark medical Centre
patient participation report
April 2012 – march 2013
Practice population profileKilburn Park Medical Centre is based in Kilburn Ward, in the London Borough of Brent. Our patient list remains open and within the last year, the practice’s list size has grown by approx 6% to 7450* registered patients.
The mix of patient groups varies from time to time though the majority of our patients reside in social housing within an area of high deprivation. Key groups include; longstanding local residents, refugees and asylum seekers, a large numbers of non-English speakers, patients with co-morbidity, patients in residential accommodation and economic migrants.
*March 2013
KPMC Practice Population Age / Sex Breakdown
KPMC Practice Population Age / Sex Breakdown
<5 / 5-15 / 15-25 / 25-35 / 35-45 / 45-55 / 55-65 / 65-75 / 75-85 / 85+ / Total
Male / 232 / 433 / 417 / 745 / 663 / 583 / 301 / 188 / 104 / 36 / 3702
Female / 197 / 386 / 442 / 837 / 680 / 504 / 297 / 221 / 136 / 48 / 3748
Total / 429 / 819 / 859 / 1582 / 1343 / 1087 / 598 / 409 / 240 / 84 / 7450
There is a fairly even split of male/female patients, 50.3% female, and 49.6% male. Whilst 21% of patients belong to the 25-35 age groups, they only make up 5% of our patient reference group.
A)A DESCRIPTION OF THE PROFILE OF THE MEMBERS OF THE PRG
PRG profile
Our Patient Representative Group (PRG) currently consists of 37 patients.
The ethnicity mix of our current membership
Patient Age Sex Distribution
<5 / 6-15 / 16-25 / 26-35 / 36-45 / 46-55 / 56-65 / 66-75 / 76-85 / 8+ / Total
Female / 0 / 0 / 0 / 2 / 6 / 3 / 6 / 1 / 4 / 1 / 23
Male / 0 / 1 / 0 / 0 / 2 / 1 / 1 / 2 / 5 / 2 / 14
Total / 0 / 1 / 0 / 2 / 8 / 4 / 7 / 3 / 9 / 3 / 37
0% / 3% / 0% / 5% / 21% / 11% / 18% / 8% / 24% / 11% / 100%
The age split of the male/female patients on the PRG currently stands at 61% female & 39% male. Whilst 4.3% of our patients belong to the 75 years and over age group, they make up 35% of our PRG.
Virtual Patient Group
The practice has a virtual patient group to enable patients who find it difficult to attend meetings to still engage with the Practice. Minutes of meeting and newsletters are sent to the group.
B)The steps taken to ensurethat the prg is representative of the registered patients and where a category of patients is not represented, the steps taken to enagage that category
Differences between the practice population and members of the PRG
The practice has identified that the following groups are under-represented.
- The under 30s (both male and female)
- Patients from ethnic minority groups
- Parents with young children
The practice has in times past booked interpreters to attend with members of the reference group to interpret and participate in the discussions taking place.
The meetings times are varied, from afternoons (prior to school runs) to late afternoons to accommodate for the working population as well as parents with young children.
The Practice continues to advertise in house to all patients, inviting them to join the participation group. GPs and staff members also personally invite patients to join the group and attend the scheduled meetings.
The Practice continues to have an in-house multi-lingual notice board which advertised the PRG Meetings. The PRG continues to be promoted in the practice newsletter, which is available to all visitors to the practice.
Survey
c) Details of the steps taken to determine and reach agreement on the issues which had priority and were included in the local practice survey
In 2011/12 the survey was put together with thorough consultation, discussing individual questions with the PRG. Although this was a very useful experience, upon reflection the PRG agreed in the October 4th meeting that it would be better to use the Improving Practice Questionnaire CFEP UK surveys, which the Practice had used in times past. This was for two reasons; firstly this is a validated survey and secondly, they liked the idea of being able to compare trends over an interval of time.
The members of the PRG were issued a copy of the survey to examine at the meeting. The PRG agreed that the content of the sample questionnaires were adequate and there was no need to add any further questions, which was an option from the survey providers.
In particular, it was agreed that the priorities agreed in 2011/12 were all represented in these questions, in particular; issues of access, phone lines and waiting times.
d) The manner in which KPMC sought the views of its patients
The survey was conducted in-house, during opening hours. All patients visiting the practice were asked to complete the survey. A dedicated member of the reception staff was available to assist the patients, if needed.
The PRG decided that the most effective way to get a broad response was to conduct the surveys facilitated in this way.
It was agreed that the survey should run over an extended period of time to maximise the response. Consequently, the survey ran from 19thNov – 21st Dec 2012 & 7th Jan-l 28th Jan 2013. This is a very busy time of year with a lot of patient traffic through the building, but also gave time for the results to be assimilated.
What were the survey results?
e) details of the steps taken to provide an opportunity for the PRG to discuss the contents of the action plan
Action plan
All members of the PRG were invited by letter sent on 15th February 2013, to attend the meeting on 7th March 2013 and were sent a copy of the survey results for their perusal. In addition, we had an in-house publicity campaign to advertise the meeting.
This meeting was specifically advertised as an opportunity to provide in-depth feedback on the survey, give an update on previously agreed plans and to jointly agree an action plan based on the survey results.
Part of the meeting was dedicated to “Open space” allowing the PRG to also raise any other pressing issues.
See Appendix 1
f) details of the action plan setting out how the finding or proposals arising out of the local practice survey can be implemented and, if appropirate, reasons why any such findings or proposals should not be implemented
The following action plan was agreed by the PRG
PRG Action Plan
Priority for Action / Proposed Changes / Who needs to be involved / What is an achievable time frame?
Electronic communications –SMS text messaging / SMS messaging to be implemented. Initially offering appointment reminders / IT Administrator & Practice & IT System provider & PM
Reception & Admin Staff / Summer 2013
Electronic communications –On-line booking / The practice would continue to look in the feasibility of on-line booking. / IT Administrator & Practice & IT System provider & PM / Revisit this by December 2013
PRG meeting attendance/members engagement / Rotating the time/days of the meetings to see if more members attend / PRG Members & KPMC Management / Summer 2013
PRG meeting attendance/members engagement / Run a PRG recruitment campaign for new joiners to the Practice & verify existing membership / Admin Support Manager / Summer 2013
Check in system – Publicity campaign / Educating patient on- how to use it correctly / KPMC (Admin Support Manager) / April 2013
Check in system – staff competency / Ensure it is in working order daily / KPMC reception & Admin Team / April 2013
Future surveys
*IPQ=Improving Practice Questionnaire / Continue to use CFEP’s IPQ* to enable accurate monitoring of year on year trends. / Practice Manager & CFEP / March 2013/14
As part of the discussion about access, the PRG debated Saturday opening hours.
Some members felt strongly that the GP’s should not work on a weekend. However, it was acknowledged as a way of offering access to people who work, over and above our evening extended hours. The problem identified, in addition to the concern for the GP’s and practice staff was one of resources.
It was agreed that this could be for future consideration, but it was not an immediate priority. Therefore this was noted in the minutes and reported to the partners, but not tabled as an action point for 2013/14.
G) a summary of the evidence including any statistical evidence relating to the findings or basis of proposals arising out of the local practice survey
PATIENT PARTICIPATION REPORT 2012/13
Local patient participation reportAll members of the PPG were issued a copy of the report which was produced in February 2013. An in-house publicity campaign was conducted, informing patients that the Local Patient Participation Report was published and copies are available in hard copy and on-line.
A copy of the report is available on the practice website and hard copies are available upon request:
Summary
It seems like the practice is running below the national average benchmark at every level
In every marker of the rate we have marginally improved.
The areas selected for discussion were those where there were the greatest differences from the benchmark means scores from all participating practices of similar size (figure in brackets):
Question 4. Can you see a practitioner within 48hours? We scored 43%, (62%) however, the fact that we have a usual GP access to offer patients continuity of care and with the option of booking 4 – 6weeks in advance this may have put a different stance on question 4, as we do offer patients same day access for same day care. However, from a patient’s perspective they may have viewed this question in line with the usual GP access. We are striving to improve our routine access. This allows core doctors to manage their chronic disease patients in routine appointments. We should have scored high, as patients can see a practitioner on the same day for urgent problems.We are currently looking at improving our system to seeing more of our routine appointment patients on the same day.
Question 3. Appointment satisfaction; Scored 52% (67%), which was low, however didn’t believe entirely it was due to patients not getting appointments, but more about having to book in advance. So hopefully the new system should improve future scores.
The group all agreed this could be why KPMC scored low in those areas.
Question 8, Waiting times; Scored 43% (55%) GP’s usually allocate 10 minute consultations, however the GP’s at KPMC are finding that patients come with a multitude of problems in one consultation. GP’s do try to limit the patient to 2 – 3 problems, but even so this does cause clinicians to run late. However, out of courtesy GP’s do tend to inform patients that they are running late. In addition, GPs try to book double appointments for patients with co-morbidities, complex psychosocial presentations, as well as the many who require an interpreter, where this can be anticipated, though this in turn, inevitably has a detrimental effect on access.
Question 2, Telephone access; Scored 44% (61%), which is below the national average of 67%. Since the survey, plans are in place for Reception to be re-arranged so most lunch times are staggered and the telephone lines are now open for 3pm instead of 4pm. We are hoping this will improve our telephone access to patients.
It was apparent that the patients were not all aware of the facility to booktelephone consultations with usual GP but this was discussed and there was general satisfaction with this system.
Question 23; Respect for privacy/confidentially
Scored 65% (74%). Confidentially is the cornerstone for good medical practice. However, we discovered that the design of the reception area is very impractical with a queue of patients, being able to hear each other.
KPMC is a grade 2 listed building and we are limited in what we do in terms of improvements. Reception understand how awkward this can be for patients and are sensitive how they deal with patients at the desk. The practice have erected a notice in reception asking patients to wait behind a certain point in order for patients at the desk to maintain confidentiality, this also seem to work well.
The group were informed that there had beena recent positive meeting regarding the new health centre which should be ready by 2016.
(h) details of actions
(1) intended to be taken as a consequence of discussions with the prg in respect of the results, finding and proposals arising out of the local practice survey
Our agreed action as a result of the survey and subsequent meeting are:
1)introduce SMS texting system (improving access)
2)feasibility of on-line booking (improving access)
3)continue to engage patient population to promote recruitment to the PRG (improving patient involvement)
4)Personal help with automated check in system (improving waiting times)
5)Future survey use of CFEP for continuity of analysis
6)New appointments system designed to increase same day access to usual doctor (improved access) whilst maintaining routine book ahead usual doctor access.
Though this did not arise from our local survey, nonetheless, the common theme about access in our CCG locality has led to the development of same day access HUB for use by all fourteen practices.
(h) Details of actions
(2) as a result of the local patient participation report for the year ending 31/03/2012.
Summary of the progress made with the PRG 2011/12 Action Plan
You said ……. / We did …. / The result is ….
The waiting areas required updating / Purchased replacement seating in the main waiting area.
Painted/decorated the ground floor area
Replaced the ground floor carpets with vinyl flooring. / In July 2012 the main waiting area received a much needed makeover which included replacement flooring and redecoration.
There was a lack of information available on what’s happening at the practice / Implemented regular briefing newsletters (every 2-3 months) / Since April/May 2012 the practice continues to issues regular Newsletters.
The Practice should promote the services on offer. Whilst the services are promoted in the Practice leaflet (which is given to new patients); existing patients were unaware of what services were now available. / Include an update on what services are available at the Practice in the regular newsletters. / This is now ongoing since the implementation of the Practice Newsletters April/May 12
Patients would benefit from having access to drinking water, if needed. / Obtained a water fountain – located in the ground floor reception area. / This was installed in the reception area in July 2012
There was a lack of information available on the members of the Primary health care team / Erected a “Who’s who” photographic display of staff working at the Medical Centre
Ensure that all staff were supplied name badges / In December 2012 the practice erected a “Who’s Who board in the main waiting area.
Since May 2012 all staff now have/wear name badges.
Patients were frustrated with waiting times / We listened and agreed to verbally advise patients when waiting times exceed 20 minutes / Reception and clinical staff now inform patients when the clinician is running more than 20 minutes late
The external signage was out of date – as some of the advertised services were no longer being provided / Ordered new external signage reflecting the practice website address, telephone/fax numbers. / This will be completed by the end of March 2013
Patients were experiencing difficulty getting through on the telephones / Agreed to revisit the telephone line opening times. / Since November 2012 we have extended the telephone lines operating hours. Lines are now re-opened from 3pm most afternoons.
On-line booking of telephone appointments may free up some telephone calls / On-line booking is possible with the current clinical system. Practice to carry this forward as an action for 2013-14 / Carry forward from April 2013
(i) the opening hours of the practice premises and the method of obtaining access to services throughout the core hours
KilburnPark Medical Centre - Opening times
Practice Core Opening Hours – for face to face and telephone appointments
Monday’s Tuesday, Wednesday’s: 08.30am – 1.00pm & 2.00pm –6.30pm
Thursday’s: 08.30am – 1pm & 2pm – 5.00pm
Friday’s: 08.30am – 1pm & 2pm – 6.30pm
Telephone Opening Hours – for telephone access
Monday’s Tuesday, Wednesday’s :08.30am – 1pm & 3.00pm – 6.30pm
Thursday’s: 08.30am – 1pm
Friday’s: 08.30am – 1pm & 3.00pm – 6.30pm
Monday GP’s – Witt, Tate, Joffe, Chitra, Ho, Cramer Nurse - Ashling
Tuesday GP’s - Tate, Joffe, Salpadoru, Witt, Chitra, Ho, Cramer, Nurse - Ashling
Wednesday GP’s –Joffe, Salpadoru, Witt, Chitra, Ho, Cramer, Nurse – Ashling
Thursday GP’s – Salpadoru, Chitra, Ho, Cramer
Friday GP’s - Tate, Joffe, Salpadoru, Ho, Cramer - Nurse – Ashling
(j) The times at which individual healthcare professionals are accessible during extended hours
Practice Extended Opening Hours
Monday’s Tuesday, Wednesday’s: 6.30pm– 7.30pm
During our extended hour’s opening times, patient can access our practice nurse and GP’s, who run concurrent appointments.
Monday GP’s – Witt/Tate
Tuesday GP – Chitra, Nurse - Ashling
Wednesday GP’s – Salpadoru/Joffe, Nurse - Ashling
Information on Access : Out of hours care – when we are closed
When we are closed we have an answer machine message which gives our patients information on how to obtain medical care.
Patients can contact a GP 24 hours a day if they need to. We are part of the London Central & West Care Collaborative Limited GP Co-operative scheme, which collectively look after our patients out of hours.
Patients can contact the out of hours GP’s by on 111 based at St CharlesHospital in Exmoor Street, London. They can give advice over the phone, invite you to St Charles hospital or arrange a home visit.
APPENDIX 1
Minutes of the Patient Reference Group
Thursday 7th March 2013
Attendee/apologies lists held on file
Welcome & introductions
Minutes – Agreed
Matters Arising
What we’ve achieved - Feedback on the Agreed Action Plans from 4th October 2012
The photographic display of “Who’s who” has been put in place and can be located in the Ground floor waiting room.
The up-dated external signage is currently on order; this new sign will include our contact numbers and the practice website the sign should be up towards the end of March.
There is more visible information available in each waiting room, informing patients how to raise a complaint, comment or suggestions.
The practice has provided visible information on the how patients can access the on-call GP when the practice is closed – again, this has is now available in every waiting area.