Local Patient Participation Report March 2014

Waterloo Health Centre

5 Lower Marsh, London, SE1 7RJ

Practice Business Manager: Ms Rona Sian

T: 020 7928 4049

Executive Summary

The following report outlines requirements for a Local Patient Participation Report to satisfy the PP-DES 2013 – 2014 requirements as directed by the;

THE NATIONAL HEALTH SERVICE ACT 2006

The Primary Medical Services (Directed Enhanced Services) (England) (Amendment) Directions 2011 Insertion of new direction 12A - “Patient Participation Scheme”.

Practice Business Manager / Rona Sian
Number of doctors / 7
Number of patients / 8820

The practice has a virtual Patient Reference Group. This means that patients are invited and encouraged to give their feedback via surveys on various aspects of the practice in a number of ways. The current number of PRG Members is 15 and recruitment is on-going.

Summary Outcomes & Action Plan – PPDES Year 3 Results

Agreed action plans:

  • Reviewing our repeat prescription service
  • Improved use of IT for communication with our patients and streamlining our administrative processes
  • Improve our waiting area by reviewing confidentiality, displays of patient information and updating the seating.

Waterloo Health Centre Local Patient Participation Report 2014

About The Practice

We are a busy, friendly and caring general practice based in a street market near Waterloo Station. We have a diverse population of nearly 9000 patients.

The team at Waterloo Health Centre comprises 4 partner doctors and 2 salaried doctors.

The team also includes 2 Practice Nurses, 2 Health Care Assistants, our Practice Manager, reception and administrative staff. The team is further complemented by our allied health professional staff which includes practice based Counsellor, Psychologist, Drug & Alcohol Worker, Chiropodist and Dietician.

We offer a wide range of general practice services including those for pregnant women, diabetics, asthmatics, minor surgery and child health clinics. We actively encourage those with long term health conditions to attend the practice for regular reviews.

Services / Description
IUCD (‘Coil’) Fitting / Contraception advice is available from all practitioners. IUCD fitting is available Tuesday and Friday. Patients should book an appointment with a doctor to discuss further
Implant Fitting / The contraceptive implant ‘Implanon’ is fitted by Dr Morris. Patients should arrange an appointment to discuss with her further
Antenatal Care / We provide shared care with the community midwifery team. The antenatal appointments are booked with the GP
Baby Clinic / A walk-in clinic for advice and weight checking. Vaccinations for all children up to age 5 by appointment only. This operates on Thursdays between 1.30 – 3pm
Vaccinations and Travel Clinic / Routine and travel vaccinations for all ages are available. This is a nurse led service. We also run flu vaccination clinics in October. Further information is available at reception.
Chronic Disease Management / Regular appointments with our Nursing team to help manage chronic problems such as asthma and high blood pressure.
Smoking Cessation / We provide a Nurse-led stop smoking service. Patients should make an appointment with the team to discuss.
Minor Surgery / Our doctors undertake minor surgery procedures including joint injections and removal of lumps and bumps. We also perform cryotherapy for some conditions.
Dietician / We have a dietician who provides advice on diet and lifestyle choices.
Chiropody / This clinic runs weekly to deal with common foot and nail conditions. Patients should ask at reception for details
Diabetes Care / We manage patients with diabetes from diagnosis to long term care and follow up.
Psychologist / We have a psychologist based 2 days per week to help manage a range of mental health problems. There is no need to see a GP
Counselling / We have a practice based counsellor who can be accessed by our patients.

The Doctors

Dr Jane Beckley MBBS, MRCGP, DCH, DRCOG, DFFP

Dr Deborah Maynard MA, MB BChir, DRCOG, DFFP

Dr Katy Morris MRCGP, DRCOG, DFFP

Dr Mark Smith MBBS, MRCGP, DRCOG

Dr George Verghese BSc, MBBS, MRCGP, DRCOG

Dr Lucie Berthoud MRCGP, DRCOG

Dr Matthew Dennison BM, DTM&H, MRCGP

Dr Prashanthi Reddy MRCGP, DRCOG, BMchb, DFFP

The Practice Staff

Practice Support Team

Rona Sian Practice Business Manager

Sasha Tonks Patient Services Supervisor

Sonia Sinclair Assistant Practice Manager

Eileen Marriner Practice Secretary

Sue McKone Receptionist/Admin Assistant

June Mah Receptionist/Admin Assistant

Julie Barham Receptionist

Sara Farrell Receptionist

Rachael Singleton Apprentice Receptionist

Practice Nurses

Michele Olphonce Practice Nurse Team Leader

Helena O’Donnell Practice Nurse

Our practice nurses specialise in preventative medicine. Appointments can be made for immunisations, suture removal, cervical smears & sexual health screening, contraception & family

Healthcare Assistants

Debbie O'Connor Health Care Assistant

Claire Goldie Health Care

Assistant planning advice, blood pressure checks, blood tests, ear syringing, foreign travel, asthma and COPD checks, vaccinations and advice.

District Nurses

The district nurses are based at the Moffat Clinic and can be contacted on 020 3049 5210.

Our healthcare assistants support the nursing team by providing phlebotomy (blood taking) clinics as well as monitoring blood pressure, smoking cessation, new patient health checks, vascular disease checks and dressings. They also provide administrative support in the chronic disease management of our patients.

Additional healthcare staff

Lynds O’Connor - Counsellor

Anita Leslie Drugs & Alcohol misuse worker

Ghazala Khan Dietician

Tim Amour Podiatrist

Jennifer Enuson Health Trainer

Opening Hours Reception Times / Telephone Lines
Monday / 8.00am – 6.30pm / 8.00am – 6.30pm
Tuesday / 8.00am – 6.30pm / 8.00am – 6.30pm
Wednesday / 8.00am – 8.15pm / 8.00am – 8.00pm
Thursday / 8.00am – 6.30pm / 8.00am – 6.30pm
Friday / 8.00am – 6.30pm / 8.00am – 6.30pm

The practice also offers extended hours appointments on Wednesday between 18:30-20:00. These extended surgery times. The practice is open for telephone calls, prescription enquiries or registration at this time. The SELDOC out-of-hours service will operate for emergencies at these times.

We have introduced a simple system to improve GP access. Telephone the surgery during normal working hours and speak to a member of the Reception Team. Arrange for a time for the GP to call you back who will discuss your problem and arrange an appointment if appropriate.

You are able to book appointments with our Nursing Team as normal.

Home Visits

Home visits are available for patients who are too ill to visit the surgery.

When the Surgery is closed

For urgent health problems outside of our normal surgery hours, patients are advised to call the SELDOC service on: 020 8693 9066 or go to:

Our nearest walk-in centre: Soho Centre for Health and Care.

Step / Description / Surgery Comments / Experiences
Continual Development of Patient Reference Group (PRG) / The PRG is a representative group of patients from the practice. They are responsible for providing feedback to surveys and collaborating with the practice to analyse the results and agree realistic change opportunities. / We had an initial drive to recruit as many people as possible; however, this is an on-going process so that any of our patients, new or current, have the opportunity to contribute.
Determine Priority Areas / Key areas include but are not limited to the following:
  • Access
  • Overall Satisfaction
  • Seeing a Doctor
  • See a Nurse
  • The Reception
  • The Surgery Environment
  • Demographics
  • Specialised Clinics (e.g. Flu, Minor Surgery)
Patients were presented with a sample questionnaire from the National Association of Patient Participation as a basis for discussion.
Patients are also given the opportunity to provide comments regarding other areas they would like to see addressed. / In year 1 of the PP DES, patients gave us three main areas of priority to focus on.
  • Access
  • Seeing the clinician
  • The surgery environment
In year 2 of the PP DES, we looked at the following surveys;
  • Seeing a clinician
  • Surgery Environment
  • Website
In year 3 of the PP DES, we looked at the following surveys;
  • Seeing a Clinician
  • Surgery Environment
  • Prescriptions
  • Patient access

Design & Build Surveys / Practice used My Surgery Website survey builder to put together the patient survey using questions from the NAPP / The practice collaborated with the PRG to agree the questions in each survey.
We then worked with them both again in 2012/13 to agree the next set of surveys and agree the questions for 2013/4.
Input channels available are:
• Surgery Kiosk
• Web Portals
• Laptop
• Paper
• Face to Face
Each survey can be used on (published to) one or more of the input channels listed above. /
  • Web Site: open to all practice patients
  • Paper

Advertise Feedback Channels / Inform patients of the available input channels and current surveys, in order to create a greater number of participation responses. Types of promoting include but is not limited to:
  • Encouragement slip given by the doctor
  • Posters
  • Leaflets
  • News Letters
  • Encouragement from all Practice Staff & PRG
  • Surgery Website
  • Notice Board
/ Additionally SMS text messages were sent to patients advising them when the survey was available and means of accessing it. In recognition that some housebound and elderly patients may not have access to these channels, paper copies of each survey together with a SAE were sent to targeted patient groups.
Capture Patient Experience / Patients complete surveys using the available input channels as listed above. / In order to support the Reception Team in encouraging patients to complete the questionnaires, a member of the administration team was made available during some evening surgeries to encourage patients to complete the survey and answer any queries or questions. This gave some patients the opportunity to discuss and understand why their views were being sought and how the results could shape future services.
Additionally, at the end of the consultation clinicians provided their patients with a flyer giving information regarding how to complete the survey.
Produce & Distribute Reports / Results in the form of reports are produced for each individual survey and distributed via the Practice Website, Practice Meetings, Surgery Notice Board, PRG consultations. / The results of each individual survey were posted on the practice website. Patients were informed of this via posters, leaflets and SMS text message. Paper copies of the reports were made available to individuals upon request.
Collaborate with PRG to Analyse Results / The Practice Manager will discuss & analyse the survey results with the Practice Doctors and then discuss with the PRG for further analysis. / The Practice Manager and partners analysed the survey results. A patient group meeting was then arranged specifically to provide an opportunity to discuss the survey outcomes.
In February 2014 we held a patient group meeting to review the last action plan and agree priorities for the next patient survey.
Agree Action Plan / Detailed action plans are created at the end of year two (2012/13) and the end of year three (2013/14) of the PPDES / An agreed action plan between the PRG & Surgery was created after the year one results (2011/12) according to the outcome of the analysis from the results.
A further action plan has been created following the year two results (2012/13).
Details of the year two action plan are provided in the section Discussions & Action Plans below. A further action plan has been created following the year three results (2013/14).
Implement Change / Practice must obtain the agreement of its local CCG to its proposals for any significant change, e.g. change of opening hours.
Approved changes can then be implemented. / Details provided in the section Discussions & Action Plans below.

Input Channel Evaluation Criteria

Input Channels should be thoroughly evaluated for their suitability for use by patient belonging to a practice. The following table describes the advantages and disadvantages of each input channel currently supported for practices. Input Channel / Advantages / Disadvantages
Paper Surveys / Suitable for a large percentage of patients across most services
Known and trusted media for many patients / Production, deployment and collection of surveys required
Data input required
Public Web Surveys / Instant feedback
Fast deployment of survey
Easily changeable / Limited to patients with internet access
Limited to patients with the ability to use technology
Email Surveys / Instant feedback
Fast deployment of survey
Easily changeable
Excellent for tracking feedback for specific treatments (e.g. specialised clinics) / Limited to patients with internet access
Limited to patients with the ability to use technology
Limited to patients with email accounts
Limited to patients who have provided Trust with email addresses
Phone Surveys / Instant feedback
Fast deployment of survey
Easily changeable
Excellent for tracking feedback for specific treatments / Limited to patients with telephone access
Limited to patients with the ability to use a telephone
Additional cost to practice
Touch Screen Kiosks / Immediately and conveniently accessible before and after appointments
Instant feedback
Fast deployment of survey
Easily changeable / Limited to patients with the ability and willingness to use a touchscreen kiosk
Requires suitable physical location
Touch Screen Tablets / Laptops / Instant feedback
Fast deployment of survey
Easily changeable
Immediately and conveniently accessible before and after appointments
Portable / Limited to patients with the ability and willingness to use a touchscreen tablet
Requires overnight charging
Standard Desktop / Instant feedback
Fast deployment of survey
Easily changeable
Immediately and conveniently accessible following treatment / Limited to patients with the ability and willingness to use a desktop PC
Requires suitable physical location
Requires protection from being damaged, lost or stolen
Face to Face interviews / Instant feedback (proving tablet used to input response)
Fast deployment of survey
Easily changeable
Immediately and conveniently accessible following treatment
Patients able to converse with a person, puts at ease
Rapport building / Canvasser must be independent
Additional resource required
Patients may be reluctant to give honest answers to canvassers

Patient Reference Group

PRG Membership

Member Profiles

Our ‘virtual’ Patient Participation Group is currently made up of 15 Members of varying age, sex and ethnic origin, with 2 ‘Chair’ or ‘Lead’ members.

PRG Recruitment & Representation

Recruitment to the Patient Reference Group is mainly via our Patient Forum. The Forum had been advertised via posters in our reception area, on our website and in our Newsletter. In addition, 20 invitation letters were sent to patients who had previously attended the forum. This was followed up with emails by the Assistant Practice Manager.

Details including link to website were published in Newsletter

Note: Feedback is not solely reliant on the PRG, surveys are also completed by other Patients from the Practice via the surgery kiosk and web portals etc.

PRG Agreement of Priorities

The Group was asked for ideas on developing a meaningful questionnaire that we could ask patients to complete to enable us to evaluate our services, take appropriate action after analysis of the questionnaires and, ultimately report back to our Patient Reference Group following the outcome and agree actions:

To prompt ideas from those present, they were presented with a sample questionnaire from the National Association of Patient Participation as a basis for the discussion. Some very valid points were suggested by patients for the practice to bear in mind when designing the questionnaire:

  • The surveys should be relatively short in length and should take no more than 10 minutes to complete
  • We established different ways for patients to access the questionnaire as follows: on-line via or website, email, paper copies posted to housebound patients and a dedicated PC in the waiting room.

For those who required help to complete the questionnaire (e.g. learning difficulties /special needs) practice staff were made available to assist.

Results, Outcomes & Findings

Survey results by Input Channel
Input channels
Survey / Website / Total
Seeing a Clinician / 60 / 60
Surgery Environment / 60 / 60
Website Survey / 60 / 60
Total / 180 / 180

Summary of Demographics Survey

The following report provides a summary of the demographics for patients that have completed surveys during the data collection period for year 3 of the PP DES. This includes both PRG Members and other practice patients.

Please note that the reports found on the website display the latest feedback captured and therefore may contain more results than are summarised in this report.

Results are:

  • 61% of the patients were female
  • 30% of the patients were male
  • 9% gave no response

The percentile breakdown of age category of the patients were

  • 0% Under 16
  • 38% 16 to 44
  • 38% 45 to 64
  • 15% 65 to 74
  • 5% 75 or over
  • 4% No response

Ethnic Group percentages were

  • 66% White
  • 13% Black or Black British
  • 3% Asian or Asian British
  • 3% Mixed
  • 1% Chinese
  • 3% Other ethnic group
  • 11% No response

Representation of Registered Patients

Waterloo Health Centre can confirm that the feedback has been provided by a representative group of its registered patients.

Survey Results

Detailed reports for each survey can be found on our website

All results were discussed with the PRG and relevant practice staff; the key outcomes for each survey are highlighted below.

Seeing a Clinician

How often do you see or speak to the GP you prefer?

  • 30 % Always or almost always
  • 10% A lot of the time
  • 10% Some of the time
  • 0% Never or almost never
  • 1% Not tried at this GP practice
  • 49% No response

If you need to see a GP urgently, can you normally get seen on the same day?

  • 65% Yes
  • 11% No
  • 18% don’t know / never needed to
  • 6% No response

How good was the Nurse you last saw at?

  • 43% Very good
  • 18% Good
  • 5% Satisfactory
  • 0% Poor
  • 0% Very poor
  • 0%Does not apply
  • 34% No response

Do you know about the Electronic Prescription Services (EPS)?