Monteagle Surgery, Yateley
Patient Participation Annual Practice Report 2013 – 2014
March 2014
The Patient Reference Group (PRG) was formed on 19th October 2011 as a new initiative to get more patient participation in decisions about the service we give to our patients. This is a virtual group and members can give their feedback via emails.
The virtual group was formed because the previous Patient Group was not well attended and did not attract a cross section representative of our surgery patients.
Patients are offered a joining form when they attend the surgery and when newly register with us. There is also a joining form on our newly restructured web site.
The application sign up form also had questions asking patients to let us know their sex, age group, their employment status, ethnic group and whether they had any long- term health conditions, physical or learning disabilities and also how often they usually visit the practice each year.
We wanted to have this information to ensure that our patient population/demographics were adequately represented.
The Practice Profile shows:
An even split between male and female patients: 2949(49.5 %) = Males 2993(50.5%) = Females
The age range profile of our total patient population of 5942 patients is:
17-34 = 1324(22.3%) 35- 54 = 1928(32.4 %) 55-74 = 1209 (20.3%)75+ = 224 (3.8%)
Ethnicity: White British = 4418 Black =38 Asian = 17Irish =8 Other/not indicated = 202
Employment Status: Data not avialable
Our PRG members profile of 80 members as at 31st January shows:
The male / female split is: 23(28.75 %) = Males 57(71.25 %) = Females
The age range profile of our 80 members of the PRG is:
17-34 = 21(26.25%) 35- 54 = 36(45%) 55-74 = 21 (26.25%) 75+ = 2 (2.5%)
Ethnicity: White British = 76Black = 1Asian =2Irish =1Other = 0
Employment status: Employed/self employed = 44Retired = 7In Education = 1
Disabled= 2 Housewife/Not employed = 3 Not indicated = 23
We were pleased that our campaign to encourage better representation on our PRG group was successful but we felt in particular the gender was not well reflected / represented so we would aim to ensure better representation from our male patients in particular.
We continue to encourage new membership to the group and application forms are available at Reception and via our website New members will be added to our distribution list.
The 80 members of our virtual Patient Representative group were then contacted by email on the 29th January 2014and sent a pre survey to obtain their views and also agree what priorities they felt we should focus on in our patient survey. They were given a suggestion of 10 topics to focus on and we asked them to rank these in priority order. The virtual groupmembers were given until 10th February to respond.
Some of the suggested topics were taken from any complaints, suggestions and comments made by patients during the previous year. At our PPG meeting it had been agreed that we would not put a limit on the number of questions but ask the number of questions according to the number of topics given the top priority during the pre survey.
a) Getting an appointment with a GPb) Getting an appointment with a nurse
c) Clinical care
d) Premises including access and Infection Control
e) Prescriptions and Test results
f) Communications
g) Reception
h) Touch screen booking in system
i) Opening times
j) Community and Hospital health care
Patients were also given the opportunity to add comments or suggestions in addition to the topics offered.
We also included boxes for patients to add any comments regarding what they felt we did well as a practice and also anything they felt we did less well. This would allow us to also include these areas.
In 2012-2013 we received 12 replies from our Virtual Group in regard to choosing priorities. We wanted to have more so this year so we also offered those attending the practice the opportunity to also choose.
We had 16 replies from our PRG and 48 replies from patients attending the surgery from 29th January 2014 to 12th February 2014.
The 5 topics which were given the highest ranking priority were:
Getting an appointment with a GP - 16 patients ranked this as their number one priority.
Clinical Care - 13 patients ranked this as their number one priority.
Prescriptions and Test Results - 9 patient ranked this as their number one priority.
Getting an appointment with a nurse – 7 patients ranked this as their number one priority.
Reception- 6 patient ranked this as their number one priority.
Of the comments made most were extremely positive.
The more negative comments which we would therefore also try and include in the survery were:
More evening appointments needed.
The reception desk area to be reviewed.
Waiting times getting longer to make an appointment with a GP of choice.
The patient survey was then constructed to include all of the above priority areas. We amalgamated the 2 questions of “Getting an appointment with a GP” and “Getting and appointment with a nurse” into one heading of “Appointments”. The 37 questions were included to cover the topics highest ranked by our PRG.
We would encourage men (who only represented 28.75% in the PRG) and also those in our largest age group of 35 – 54 to complete the survey explaining why we wanted them to do so. We would also try and encourage feedback from those who had disabilities or who were attending chronic disease clinics.
The final survey was sent to those on the virtual group on the 12th February 2014 and they were given until the 3rdMarch 2014 to respond. The PRG had also agreed that we would hand surveys to those attending the practice during this same period.
Therefore we also handed out the survey to patients attending the practice between the 12th February and 28th February 2014. They were given the opportunity to complete them and hand them straight in or they could return them before the 3rd March 2014.
The profile of the 141 returning the survey (if indicated) is:
The male / female split is: 47 (33%) = Males 94 (67%) = Females
The age range profile is:
17-34 = 25 (17.75%) 35- 54 = 58(41%) 55-74 = 47 (33.25%) 75+ = 11 (8%)
Ethnicity: White British =135 Black = 0 Asian = 4Irish =0 Unknown = 2
Employment status: Employed/self employed = 89 Retired = 32 In Education = 9
Not employed = 8 Disabled = 1 Not indicated = 2
We had 141 questionnaires returned to us completed.
Please see the attached summary of the replies we received and also any comments made. We were very pleased that the replies to the survey reflected the age profile and ethnicity profile very well so our survey would be a good representation. We however had been unable to encourage a higher proportion of males to reply as they tended to not attend the surgery as often as women according to our analysis of attendances. We had asked all males attending appointments, collecting prescriptions and contacting the surgery.
ACTION PLAN – was agreed with PRG and agree implementation of changes.
At the Practice on 10th March 2014 the replies to the survey were analysed and discussed and a draft action plan formulated. This Draft Action Plan attachedwas then emailed on the 11th March 2014 sent to all 80 of our PRG members for their approval. We also sent them the full list of replies to all 37 questions plus all the additional comments so they could be reassured we had undertaken a robust and fair analysis of the results.
The PRG members were informed in the email that they could comment and influence the final plan by responding as soon as possible and by the deadline to influence the plan of Friday 21st March 2014. They were informed that the final Action plan wouldthen be published on the website before Monday 31st March 2014. It would also be made available in hard copy from the 31st March 2014.
FINAL REPORT / ACTION PLAN
We have summarised the responses to the 4 areas chosen plus any additional comments received below and include sections indication what we feel should be the Action Plan. This has been approved by our 80 PRG members as what we would like to work on for the next 12 months. We have indicated next to the Action points our target date to achieve these plus any progress.
At the end of this report we will also give a progress update on our Report and Action Plan from 2012- 2013. We will also give a reminder of our core and extended hours and how you can access our services throughout our core hours and the arrangements for extended hours.
APPOINTMENTS
Of the 141 replies:
52 Patients felt the most important type of appointment was book on the day and a similar number at 50 thought booking the same week the most important.
The vast majority at 132 were happy or didn’t mind waiting longer to see a GP of their choice. 140 were aware they could ask to see a GP of their choice.
Only 23 out of 141 patients had used the extended hour’s appointments. 22 were not aware of them.
130 patients were happy to be offered telephone consultations.
134 thought the range of appointments met there needs.
73 were interesting in booking on line and 105 were already set up to receive text message reminders.
An even split of patients indicated an interest in using a touch screen booking in system.
Action Plan
It was very pleasing that the vast majority of patients were happy with the range of appointments offered.
- To increase awareness of being able to book appointments on line, extended hours appointments, text message reminder service and telephone consultations– advertise via website and newsletters. Achieve by August 2014
- To review numbers of appointments available to book on the day and on the same week – maybe able to reduce those available 4-6 weeks ahead to do this. Achieve by May 2014. Progress report is that we have already discussed this at a clinical meeting on 17th March and we will do some audits and searches within the next few weeks in readiness for a change to our clinical software system. This would be a good opportunity to review all appointments types.
- To continue to investigate a touch screen booking in system to be installed. Achieve by August 2014. Progress report is that we already have obtained quotes and we will await funding opportunity to progress once our new clinical software system has taken place. We are due for the process for this to be completed over a 6- 8 week period from 3rd April with a live date of 29th May.
CLINICAL CARE
93 out of 141 patients were aware of the information on our new web site on minor illness advice
91 out of 141 were aware of the nursing team clinics and appointments that were available.
98 out of 141 were happy to attend another local surgery for specific clinic, support group or appointment.
128 out of 141 were aware of being able to request a 20 minute appointment if necessary for more than one clinical issue.
Of the 133 patients who had visited a GP in the last 12 months:
132 felt the GP listened to what they had to say.
121 felt involved in decision about care.
123 felt their quality of care was good or excellent
128 felt they received good continuity of care.
110 felt they would find information sheets issued by the GP useful.
123 patients out of 128 rated the care given by the nursing team as excellent or good.
Of the 69 patients who had used nurse triage appointments in the last 12 months only 1 found it not useful.
Action Plan
It was very pleasing that the vast majority of patients were happy with the clinical care received from GP’s and nurses.
- To increase awareness of the type of information on our web site including minor illness, type of clinics offered by the nurses and that patients are able to request a double appointment of 20 minutes for more than one issue –advertise via website and newsletters. Achieve by August 2014. Progress is that we have already added minor illness information and information for care in pregnancy. We have already added information on the types of clinics our nurses offer.
- To continue to encourage GP’s and nurses to issue information sheets to assist patients. Progress report is that we have already discussed this at our clinical meeting on the 17th March 2014.
- Investigate a touch screen booking in system to be installed. Achieve by May 2014. Progress report is that we have already obtained quotes.
- To work with local practices to offer services and support groups to patients especially useful as the other practices may have suitable rooms available. Achieve by June 2014. Progress report is that we have already set up some clinics for patients with COPD at another Yateley practice to offer some support including Breath easy sessions.
TEST RESULTS /REPEAT PRESCRIPTIONS
130 out of 141 patients who replied were aware they need to call after 2 pm for results.
115 felt they were given sufficient information.
120 were aware how long each of their tests would take to get a result.
84 were aware of being able to order repeat prescriptions on line.
108 were aware they could arrange repeat prescriptions via a pharmacist.
127 were aware they need to request repeat medication in plenty of time incase the GP needs to speak to them and discuss a review of their medication.
Action Plan
It was very pleasing that the vast majority of patients were happy with the information given and were informed how long they needed to wait for a result and that they needed to call after 2 pm for a result.
- To increase awareness of being able to request repeat prescriptions on line and that they can arrange these via a pharmacy - advertise via website and newsletters. Achieve by May 14. Progress report is that this has now been actioned.
RECEPTION
140 out of 141 felt the receptionists were polite and helpful.
135 out of 141 felt they were knowledgeable and sensitive to patients needs.
98 out of the 101 who replied felt the reception team answered their telephone calls quickly.
136 out of 141 felt the waiting area was comfortable and welcoming.
117 out of 141 felt the posters and leaflets available were useful.
63 out of 117 were aware they can ask to discuss something sensitive or confidential in private with a receptionist.
Action Plan
It was very pleasing that the vast majority of patients were happy with the reception team being polite and helpful and also that they were knowledgeable and sensitive to their needs and that they also answered the phone quickly. Also that patients felt the waiting room was comfortable and welcoming.
- To increase awareness of being able to ask for a confidential discussion with the receptionist for sensitive issues– via Posters and leaflets to be created in the surgery and also on the website and newsletters. Achieve by June 2014. Progress report is that the team have been made aware of this and will offer this as soon as they feel a sensitive issue is raised.
COMMENTS
We also encouraged patients to comment on each of the areas if they felt they would like to do so and we had not covered it sufficiently in our questions. Some of the themes are as follows:-
Appointments
Being able to make an appointment on a day off with a particular GP.
- We are sorry but unfortunately if patients are wishing to see a particular GP on a particular day this can not always be accommodated as most GP’s are either part time or do not work every day in the surgery.
Being able to book an appointment in a few weeks time at the request of the GP.
- We will suggest in future that the GP books this with the patient at the time to save the patient having to contact reception as the GP will be aware of how long it can wait.
Reception
Use the windows for different things. Remove glass. Sound proof glass. More privacy.
- Unfortunately the comments for this were of opposite in nature - in that some wanted more privacy and some wanted less. We are continuing to look at how this area can be improved. The use of the 2 windows can only be undertaken when we have staff on duty to sit in both places. We will look into this suggestion further now that the staffing levels have increased.
Flowers in reception area, air fresheners, TV, Easy chairs, soft music.
- Fresh flowers would unfortunately possibly create issues for asthmatics, artificial flowers are frowned upon by Infection control as are air fresheners.
- We will investigate further the suggestion of a TV and soft music.
- We feel the chairs are already suitably soft and we would not have sufficient space for easy chairs.
Any other comments
Being asked for the reason for making an appointment.
- We do need to make sure patients are seen by the most appropriate clinician and at the most suitable timeframe. Patients can sometimes not realise that they need to be seen urgently whilst others may request to be seen immediately but can wait. The receptionists on many occasions need to encourage patients to dial 999 for an ambulance
GP running behind by sometimes 40 minutes.
- Our GP’s aim to run to time but on occasions they do need to deal with emergency home visits or allow extra time for patients with complex medical needs. We apologise for those who sometimes may need to wait but do hope most of our patients will understand.
Would like the Practice Managers email address