Oxgate Gardens Surgery

Oxgate Gardens Surgery

HARNESS WEMBLEY PRACTICE

“Patient Participation Group” Meeting

FRIDAY 21 March 2014

1.30 – 3.00

Attendees: 3 Patient,

 3 Staff, Practice Manager, Practice Nurse, Receptionist Lead

INTRODUCTION

Carolyn the new Practice Manager welcomed everyone who was able to attend the meeting.

Harness Wembley Practice initiated the PPG group in 2013. This was because in the past Harness Wembley Practice patients attended the Harness PPG group which was chaired by one of our patients.

Harness Wembley Practice believed that the patients were not getting heard enough looking at the complaints being posted on the NHS choices website and it was decided to create a Harness Wembley Practice PPG. This was agreed by the chair of the Harness PPG group.

The PRG representatives agreed that the future has to be emails where possible and agreed that the surgery should start getting patients to update their contact details and add their email address to their medical notes. Carolyn informed the meeting that it would become part of the registration pack.

It was also agreed that the surgery would continue to communicate with patients through other ways:

 Surgery website

 Notice board in the front of the Practice

 Life channel shown on the TV in the waiting room

 Practice leaflets

 Notices around the surgery

 Mjog – texting patients on their mobiles.

Review of Patient Feedback and Concerns

The first meeting was held with only a couple of patients to discuss the concerns raised on the NHS Choices Website, and throughout the Harness locality which was reflected in the Harness PRG meetings.

The patients concerns raised was:

  • Access
  • Appointments
  • See a GP

Harness Wembley Practice is one of the 16 Harness Practices. The patients from Harness Wembley attend the Harness PPG meetings, which is Chaired by a patient from Harness Wembley Practice. The feedback during the meetings has been the constant complaint from patients with regards to accessing appointments.

The Harness Network group decided to find a solution for all 16 practices and sought and got an agreement from all the Harness Practices to approach a company called Alpha to carry out an in-depth Access survey of patients, through the individual Practice.

Harness Wembley also looked at the National GP patient survey issues, the verbal complaints, the complaints posted on NHS choices website and listened to the their patients who attended the Harness PPG group. The main questions were the following:

  • Telephone contact
  • Opening Hours
  • Seeing a Doctor of your choice
  • Length of time waiting in the Practice
  • Appointments
  • Patient experience
  • Seeing a Nurse

The Meeting agreed that the questions asked were in depth and delighted that for the first time questions were being asked.

Survey Out come

The survey was given to Harness Wembley Practice who attended appointments and when doctors attended home visits.

The number of patients surveyed was 121.

The results of the survey was benchmarked against the other 15 Harness Practices. The results were also discussed in a Practice Meeting.

The results were shared with the new Harness Wembley Practice PPG in March 2014 once it was set up.

The results and report of the patient survey has been posted on the Harness Wembley Practice website.

Harness Wembley Practice – Access Survey

The Harness Wembley Practice survey of patients regarding access and appointments and opening times was collated and sent to Alpha to analysis and benchmark.

The Survey showed:

  1. Patients were pleased with the opening hours and availability.

PQ Q9 – 93% of patients questioned are satisfied with their surgery opening hours.

  1. Reception staff were helpful

PS Q4 – 79% found the receptionists helpful at your GP surveys

  1. GP consultations

PQ QA11 – 85% feel the GP is very good/ good at giving them time during their consultation.

  1. Making appointments

PQ Q1 – 75% of patients book their appointments by phone

PS Q3 – 75% felt it was easy to get through to someone at your GP surgery on the phone.

Harness Wembley Practice, looked at the comparison with other Harness Practices and found that they are rated in the middle with positive results.

Initial thoughts from the analysis of the survey data is that Harness Wembley Practice is one of the Harness Practices that patients double booked if their choice of doctor was not available, about 27% when the average for Harness Care is 16%.

This shows that patients get appointments and are seen, however their choice of doctor is not always available. This shows that Harness Wembley patients are looking for continuity of care and will therefore rebook.

The doctors who work at Harness Wembley are salaried GPs and work part time. Before the doctors changed on a regular basis and only a couple of GPs stayed the same, hence the rebooking.

Harness Wembley has listened to the patients and the survey and has now put in place 6 GPs on a permanent contract who are working on a rota with set times and days.

Please see the appointment model shown in the last section. This shows that 6 GPs have been employed on a permanent contract to provide the same day a week clinical sessions.

The Practice understands that it will take time for the patients to gain confidence with the GPs but they will be guaranteed the same GP on that same day every week. Harness Wembley see this as a positive step in improving Access and care of our patients.

Harness Wembley Practice – Demand and Capacity survey

Harness Wembley Practice also carried out surveys of their reception staff, GPs and a survey on demand and capacity of appointments.

Harness Practices also held educational meetings with Practice staff to discuss concerns and find solutions. This was agreed at the Harness PPG meeting.

The Harness Wembley Practice carried out a demand and capacity survey on the appointment system.

Harness Wembley looked at the demand survey and held a clinical meeting. The doctors were also informed that they did not have enough time to process and action the pathology results, letters, and administration. A solution was agreed and capacity was put in place.

The demand for appointments survey showed that the Harness Wembley needed in total for the week – Monday through to Friday – 406 appointments, these were routine, on the day, home visits and telephone triage.

The chart below clearly shows the amount of appointments needed and that in December 2013 the amount of appointments available was 72.

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The demand survey showed that on average on a Monday 127 appointments are needed and on average on a Tuesday 111 appointments were needed.

Action Plan by the Harness Wembley PRG Group

At the new Harness Wembley Practice PRG group only 3 attended however it was the initial one and patients and staff felt positive that more will attend.

Over all the meeting discussed in detail the survey and the demand survey. It was felt that it was an excellent and in-depth survey and thanked the Practice for tackling a very difficult area.

The Practice Manager explained to the meeting that a clinical meeting was held to discuss the appointments and patient demand and what the solution was for capacity. The doctors also discussed their concerns that they needed more administration time to be able to action pathology results and hospital letters, home visits. The solution was discussed in detail and capacity was agreed and put into place.

For example Harness Wembley made available for Mondays 130 appointments to ensure that capacity met the demand. This was achieved by adding an extra GP.

This also ensured that all GPs had same day appointments, routine, home visits, telephone triage, administration, pathology results.

The Harness Locality also have a Hub has available for all Harness Practices. This provides Practices to be able to book for their patients extra 36 appointments a day, Monday to Friday and then on Saturday they have 72 appointments. These appointments are shared out between all the 16 Harness Practices. The Hubs are located at 2 points, 1 in Wembley and 1 in Harlesden to cater for all of Harness patients.

Harness Wembley Practice has 7 appointments available and uses the Hub located at Chaplin Road.

The demand survey showed on a Monday the Practice needed 127 appointments and in response the doctor’s capacity was changed to ensure that demand was met. The new GP rota increased capacity to 130 appointments for Monday as well as using the 7 appointments available through the Hub which means a total of 137.

There are no significant changes which impact on contractual arrangements that also need to be agreed with NHS England.

Conclusion/Summary

It was agreed with the PRG that the new capacity for appointments looked good and that until it has been in operation for a couple of months it would be difficult to see if it has improved the demand.

It was agreed that another survey with the same questions would be run in June and the results of the survey and questionnaire of the GPs would be discussed at the next PPG meeting in July/August 2014 – date to be arranged.

The Practice Manager explained to the meeting that a clinical meeting was held to discuss the appointments and patient demand and what the solution was for capacity. The doctors also discussed their concerns that they needed more administration time to be able to action pathology results and hospital letters, home visits. The solution was discussed in detail and capacity was agreed and put into place.

Next meeting – July 2014