CAVENDISH HEALTH CENTRE Patient Participation Report 2012/13

VALIDATE THAT THE PATIENT GROUP IS REPRESENTATIVE

Practice population profile
Show how the practice demonstrates that the PPG is representative by providing information on the practice profile:
Cavendish Health Centre is a central London Practice based in Marylebone in Westminster. The Practice has 6203 registered patients as at 19 March 2013.
The Practice has a high percentage of elderly patients, although most patients are of working age and a low number of school age children.
The Practice has a low deprivation score with most patients being considered affluent.
Patient population: 6203 (2985 Male and 3218 Female)
Age and Sex
Age / Males / Females
00-09 / 294 / 268
10-19 / 112 / 146
20-29 / 397 / 640
30-39 / 815 / 843
40-49 / 536 / 465
50-59 / 372 / 333
60-69 / 274 / 268
70-79 / 118 / 149
80-89 / 58 / 81
90-99 / 7 / 24
100+ / 2 / 1
Ethnicity
The most up to date Ethnicity profiles provided by the PCT are from 2008 and show that our population is made up of 49% ‘White British’ and 26% ‘White Other’. Patients of all other ethnicities make up a very small percentage at <24%.
Ethnicity / % of population
White British / 49%
White Irish / 2%
White Other / 26%
Mixed / 4%
Indian / 5%
Pakistani / 1%
Bangladeshi / 1%
Other Asian / 2%
Black Caribbean / 1%
Black African / 1%
Other Black / -
Chinese / 3%
Other ethnic group / 5%
Working patterns of patients
Predominantly middle aged working population in the upper socioeconomic group (mainly desk based jobs). A significant proportion of patients are on benefits and in supported housing. 15.8% of our population are over 60 and the majority of these patients are retired. / Levels of unemployment
Data taken from search run on clinical system:
48% employed
3% unemployed
3% retired
This question is asked on our registration form and is coded via a template onto EMIS Web, however not all patients respond to this question. / Carers
31 coded carers on clinical system
Care groups, e.g. Nursing Homes, Learning Disability Community, Mental Health Groups
No care homes / Other
PRG profile
Show how the practice demonstrates that the PPG being is representative by providing information on the PPG profile
Age, Sex and Ethnicity
We currently have 10 PPG members.
Age / Males / Females
00-09 / - / -
10-19 / - / -
20-29 / - / -
30-39 / - / -
40-49 / - / 1
50-59 / - / 2
60-69 / - / 1
70-79 / 1 / 2
80-89 / 1 / 2
90-99 / - / -
100+ / - / -
Ethnicity / % of PPG
White British / 80%
White Irish / -
White Other / 10%
Mixed / -
Indian / -
Pakistani / -
Bangladeshi / -
Other Asian / -
Black Caribbean / -
Black African / -
Other Black / -
Chinese / -
Other ethnic group / -
Other / Undisclosed / 10%
Working patterns of patients
4out of the 7 PPG members are either self-employed or employed. The other members are retired. / Levels of unemployment
No PPG members are unemployed. / Carers
No current carers
Care groups, e.g. Nursing Homes, Learning Disability Community, and Mental Health Groups.
Representation in the following groups from PPG members:
  • Information & Advice Volunteer with Age Concern, Westminster
  • User Committee of the Integrated Care Pilot in NW London
  • Central London Healthcare User Panel
  • Sub groups of the CLH User Panel including Mental Health
/ Other
Differences between the practice population and members of the PPG
Please describe variations between the group and what efforts the practice has made to reach any groups not represented.
Our PPG formed in 2011. It originally had 12 members but due to circumstances and commitments some of the members dropped out and in March 2012 we had 7 members. Through advertising and word of mouth we have now increased our PPG to consist of 10 patients and we continue to work on expanding our PPG and making it more representative.
We originally sought patient volunteers throughthe following means and we continue to do so:
  • Posters in the surgery
  • Practice leaflet
  • Practice website
  • Patients were invited by clinicians to join
  • Patient questionnaire invited patients to join
  • PPG
  • Practice staff
The PPG has always recognised that it is not truly representative of our patient population and it always has this on its agenda, discussing ways to encourage other patients to join the group.
We are aware that we need more PPG members of working age as we have 1037 patients in the 20 – 29 age bracket and 1658 patients in the 35 – 44 age bracket, a total of 2695 out of our 6203 patients who don’t have representation. However the PPG and the practice understand that by definition the people who may have the time to give are those who are not working i.e. are retirement age.
In our most recent Patient Survey we have again invited patients to contact the Practice Manager if they wish to be part of our PPG, or even just give their email address if they wish to be consulted on Practice issues but do not want to commit to the PPG meetings.
The PPG continues to promote and encourage patients to join the group.

VALIDATE THE SURVEY AND ACTION PLAN THROUGH THE PATIENT PARTICIPATION REPORT

Survey
Please describe how the priorities for the survey were agreed with your PPG
The priorities were agreed in discussion at the PPG meeting on 5 February 2013
Having established the priorities, please describe how the questions were developed, e.g. Survey Monkey, NAPP website, etc.
The questions were developed by the PPG and Practice in discussion at the PPG meeting on 5 February 2013
Please describe how you carried out the survey?
  • The survey was carried out online on our Practice website
  • The survey was available at reception
  • The survey was also available in all 3 waiting rooms
  • Posters were put up in the Practice advertising the survey and asking patients for feedback
  • 180 surveys were sent out to patients to try encourage feedback from well patients in addition to unwell patients who were targeted in the Practice
  • All staff were involved in encouraging patients to complete the survey

Please specify the dates the survey was carried out.
13 February – 6 March 2013
What were the survey results?
Please refer to full survey results and patient comments which are on our website
Note: Personal comments were removed.
In summary:
  • 109 patients completed a survey
  • 57% female, 24% male and 19% didn’t say
  • In terms of ethnicity, 39% of patients who responded were ‘White British’ and 32% of patients were ‘White Other’
  • 85% of patients who responded were either ‘Satisfied’ or ‘Very Satisfied’ with the Practice’s Access and Information, particularly when thinking about the achievements over the last year
  • 87% of patients who took part in the survey said they were either ‘Satisfied’ or ‘Very Satisfied’ with the Suitability and Access to the Practice’s Premises
These results show that we have a high proportion of patients who for the most part of satisfied with the service Cavendish Health Centre provides.
The group did recognise that the number of patients who completed the survey was likely not to be representative of the entire practice population but that with surveys it is incredibly difficult to get truly representative data.
In the survey there were two further questions and these were open questions:
  • Please identify any areas where the practice could do better, or where, in your experience the service falls short of your ideal
  • Do you have any further comments you would like to make?
There was a lot of feedback from patients in regards to the above two areas. The group agreed that for the most part the comments were positive and a wonderful reflection on the service that the Practice provides with many remarks about how friendly the staff are.
There was however a number of common issues raised by patients and these were discussed by the group and formed the action plan.
Action plan
Please describe how you agreed the action plan with the PPG?
The results of the survey were discussed in the PPG meeting held on the 12 March 2013 and items for the action plan agreed based on patient feedback and where it was possible to implement change. Feedback for the action plan was also discussed by Practice staff.
Please include a full copy of the agreed action plan. The main actions were:
Cavendish Health Centre Patient Survey 2012/13: Results and Action Plan
  • Each question was in bold font followed by the explanation
  • The actions from 2011/12 survey were listed and then patients were asked for feedback
  • A question about satisfaction with the premises was included
  • Patients were invited to participate through the PPG or through the email circulation list
  • The survey was made available online and in the Practice
  • Paper copies were sent out to patients selected at random to ensure we targeted a mixture of patients who are attending the surgery and those who haven’t
Looking at the overall levels of satisfaction to the questions asked, the Practice has achieved well.
  • 109 patients completed a survey
  • 57% female, 24% male and 19% didn’t say
  • In terms of ethnicity, 39% of patients who responded were ‘White British’ and 32% of patients were ‘White Other’
  • 85% of patients who responded were either ‘Satisfied’ or ‘Very Satisfied’ with the Practice’s Access and Information, particularly when thinking about the achievements over the last year
  • 87% of patients who took part in the survey said they were either ‘Satisfied’ or ‘Very Satisfied’ with the Suitability and Access to the Practice’s Premises
These results show that we have a high proportion of patients who for the most part of satisfied with the service Cavendish Health Centre provides.
The group did recognise that the number of patients who completed the survey was likely not to be representative of the entire practice population but that with surveys it is incredibly difficult to get truly representative data.
In the survey there were two further questions and these were open questions:
  • Please identify any areas where the practice could do better, or where, in your experience the service falls short of your ideal
  • Do you have any further comments you would like to make?
There was a lot of feedback from patients in regards to the above two areas. The group agreed that for the most part the comments were positive and a wonderful reflection on the service that the Practice provides with many remarks about how friendly the staff are.
There was however a number of common issues raised by patients and these were discussed by the group and formed the action plan:
Telephone system
Patients reported that it was difficult to get through on the phone at times.
A new telephone system was introduced last year in September 2012 following the results of the Patient Survey 2011/12. The new system did have teething problems when it was first introduced as well as technical difficulties. Initially both patients and staff were very unhappy with the system. Since November this has noticeably improved and there is no longer the same negative feedback. This is reflected in the comments received by staff at the Practice. AG commented that she feels there are a higher volume of calls received than there were last year and that there are more ‘active’ patients within the patient population. More patients call in now rather than walking in.
Over the past year the PPG and the Practice have actively advertised the online booking and repeat prescription service which is available through the Practice’s website through posters, word of mouth and through the website. By utilising these service it would direct traffic away from the reception desk as well as allowing patients more flexibility in booking and cancelling their appointments, without having to queue on the telephone or queue at the front desk.
ACTION: Continue to promote online booking and repeat prescription service available on the website.
Premises
Patients commented on the difficulty accessing the premises with a pushchair or for wheelchair users. This is a common complaint which has been made over the years. The building is an old one and consists of four floors. Access to the main door is up a set of stairs. There is no internal lift, only an external lift from the street level which gives access down to the basement floor.
Through recent minor improvement grant applications to the Primary Care Trust the Practice secured funding towards a Stairlift and automated patient check-ins. Patients should hopefully notice a difference.
Stairlift – this was installed from the ground floor to the first floor. Unfortunately the Practice was unable to install 2 further Stairlifts (one from the basement to the ground floor, and one from the first floor to the second floor) due to fire doors being located in the necessary areas. Having sought advice, these fire doors could not be blocked or adapted. The hope is that patients who have mobility issues would notice a difference as they could see doctors on the first floor instead of being restricted to the ground floor or basement level rooms. They would therefore have more appointments available to them as well as choice of doctor.
Patient check-ins – one has been installed at reception and the other one is in the basement level waiting room. This would allow wheelchair users and patients with children in pushchairs to access the practice via the external lift to the basement floor and then check themselves in using the automated check-in system.
Other successful minor improvement grant applications include:
  • 3 waiting rooms redecorated
  • New chairs for clinical and waiting rooms
  • Hand dryers in 2 out of the 3 toilets
  • Replacement windows for the front of the building (double glazed)
The Practice has invested a significant amount of funding within the last few months to improve the patients’ experience and the PPG agreed that it was difficult to improve the premises beyond current recent changes at this present time.
ACTION: Advertise premises improvements to patients.
Problems with Referrals
Patients commented on delays with referrals. TD explained that in November / December 2012 one of the secretaries had left and the Practice had experienced difficulty in recruiting a replacement. The Practice endeavour to cover this with temporary secretaries but it did result in a delay with referral letters. The Practice worked hard to resolve this and a new secretary is in place and all letters are up to date.
At this point, admin processes were also reviewed and improved.
The PPG agreed that there was no further action at this time but that the feedback from patients in regards to referrals should be reviewed during the next patient survey. It would be expected to see an improvement in comments in regards to this.
ACTION: Review in next patient survey.
Blood Test Request System
Following negative comments about the blood test system in operation at Cavendish Health Centre, the group agreed that this system should be reviewed to see if the system could be improved including educating patients about the system.
ACTION: Two PPG members to visit the Practice to review the system.
SMS reminders
There were a couple of comments about SMS reminders and one patient suggested it would be a useful system to implement. Since the upgrade of our clinical system from EMIS LV to EMIS Web the text reminder system has been in place.
ACTION: Remind Receptionists to check that the box is ticked for SMS reminders when they book patients appointments.
Summary of Actions:
  1. Review Blood Test Request System
  2. Review patient feedback about Referrals in the next survey
  3. Promote online booking and repeat prescription service on the website
  4. Advertise premises improvements to patients

Please describe the areas that you could not achieve what the PPG wanted.
None
Are there any contractual considerations to the agreed actions?
No

Please provide a summary of the progress made with your 2011/12 action plan

You said ……. / We did …. / The result is ….
That it was difficult to get through on the telephone / We invested in and implemented a new telephone system / Despite initial technical glitches, the system is now working and feedback is much improved
That it was difficult to get an appointment / We produced a patient leaflet which explains our appointment system and how best to get one.
We also explain the difference between our triage system for emergency appointments and routine appointments on our telephone welcome message / Patient leaflet available on the website and in the Practice in waiting rooms
More patients are aware of our appointments system
That you needed up to date Practice information / We updated our Practice Leaflet
We updated our Practice Website and have since also introduced a new website which is much more user friendly
We updated our team photoboard / Informative and current information is available to our patients about our team and services

LOCAL PATIENT PARTICIPATION REPORT 2012/13