PATIENT PARTICIPATION REPORT 2012-13
March 2013
GP Practices have developed and worked with a Patient Reference Group in order to work more closely with patients in:
- Gaining feedback from their patients
- Helping the practice to assess findings from a survey
- Agreeing the practice priority areas for changes
Langley Corner Surgery has a Patient Reference Group (PRG) whose membership is a group of patients who are representative of the practice population.
Patients at Langley Corner Surgery have been asked to complete a patient survey questionnaire and the results of this document will form the basis of this report and will assist the Practice in future planning and development of services.
CONTENTS
1. Langley Corner Surgery profile
2. Membership of the Patient Participation Group
3. The priorities for the survey and how they were agreed.
4. Management of the Patient Survey Questionnaire
5. The Patient Survey results
6. Action Plan
7. You said…………..We will:
8. Appendix - Patient Survey
1. Langley Corner Surgery
The Location
Langley Corner Surgery has been a GP Practice in Crawley since 1954, with the original Crawley practice dating back to 1740. The premises are owned by the practice and over the years have been extended to become the excellent, modern “fit for purpose” building that we have today. More consulting rooms were added in 2008 to help extend the range of services offered to patients
The Doctors
Dr Jill Avery (Partner) (f)MB BS DRCOG MRCGP
Dr Ketan Kansagra (Partner) (m)
BSc MB BS DRCOG MRCGP
Dr Bilal Ali (Partner) (m)
BSc MB BS DRCOG MRCGP
Dr Jude Gunasegaram (Partner) (m)
MBBs MRCP MRCGP DRCOG MSc
Dr John Craik (m)
Dr Radhika Vohra (f)
Dr Helena Fulker (f)
Dr Charlotte Paul (f)
We have a full team of staff including nurse practitioners, nurses, healthcare assistants, phlebotomists, secretarial, reception and administration staff. We also have district nurses, health visitors, midwives and a carers’ advisor regularly on site and participating in practice meetings.
Philosophy of the Practice
The philosophy of the practice is to provide a high standard of patient care in an efficient and well-organised but friendly environment. Patient’s interests are kept to the fore with a strong emphasis on continuity of care. All partners have a strong commitment to the NHS remaining in public ownership.
The Practice aspires to achieving a good work-life balance and flexibility in the workplace and a high level of achievement under the Quality and Outcomes Framework (QOF) targets.
The Patients
Langley Corner Surgery has a current list size of 9800 patients. The practice population is very diverse, mainly urban with some rural patients, covering all age ranges, and includes care of patients at a local boarding school and in several nursing and residential care homes.
Training Practice
The practice has a long history as an exceptional training practice with two of the partners being trainers with one or more registrars (fully qualified doctors who are training to be GPs) in the practice at any time.
The practice also regularly takes part in the training of medical students from St. George’s Hospital and Brighton and Sussex University Hospital.
Practice Opening Hours
Mondays to Fridays / 8.30 a.m. / 6.30 pmExtended Hours Clinics: / Mondays / 6.30 pm – 8.00 pm
Tuesdays and Wednesdays / 7.00 am – 8.30 am
We do not close at lunch-times, although the phone lines are diverted to an emergency number between 1.00 – 2.00 p.m.
Phone calls to the Surgery outside of the core hours of 8.30 – 6.30 p.m. are recommended to NHS Direct or to the Harmoni Out of Hours service.
This will shortly change to NHS 111.
Pre-bookable appointments and telephone appointments with Doctors, Nurses and Healthcare Assistants can be booked online, by telephone or in person at reception.
On the day appointments can be booked by telephone or in person at reception.
The Practice population
Ethnicity
Age Profile
Sex Profile
2. Patient Participation Group
We formed the group last year 2011-12 and then lost a few and added a few members this year 2012-13. How did we recruit members to the Group originally in 2011?
· We advertised on our website www.langleycornersurgery.co.uk
· We advertised in the waiting room
· We displayed a poster in Urdu on the TV screen
· The Doctors asked patients if they would be interested in joining the group
· The Doctors suggested patients of varying ages and ethnic origin who were invited to join
· Some patients contacted the Practice directly to enquire if they could join the group
How did we refresh the membership of the group this year in 2012?
· We advertised on our website www.langleycornersurgery.co.uk
· When patients came to discuss improvement suggestions with a doctor or the Practice Manager we asked if they would like to join the PRG for ongoing involvement
· Some patients contacted the Practice directly to enquire if they could join the group
The Practice Manager contacted all patients who had expressed an interest to explain that we would be requesting a cross-section of our patient population to support us in creating the patient survey and then in prioritizing actions once the results were in.
In 2011-12 eventually 14 patients agreed to join the group and were sent a draft survey questionnaire asking for their comments and suggestions for any additional questions that could be added. Their suggestions were then incorporated into the final questionnaire.
In 2012-13 we had 20 patients agree to support and be involved with the patient survey design, results review, priority setting and action plan.
Regarding matching the demographics of the PRG with the practice population:
In particular, we are pleased to have continued membership across the age ranges. More women than men are members although the differential is not great. We are mindful that we need to encourage more patients from ethnic backgrounds to join the group and we will therefore be more proactive in inviting patients on an ad hoc basis.
We have sent the results of the patient survey to the Practice Reference Group and have in both years received some very constructive feedback. There has also been some very helpful ideas on how to prioritise essential services with “nice to have” ones. All comments have been incorporated into the summary and action plan at the end of this report.
Patient Reference Group profile
Ethnicity
Age
Sex
3. Priorities for the Survey and how these were agreed
1
The Partners, GPs, Nurse Manager, Deputy and Practice Manager met to discuss concerns raised by patients during the previous year and any themes to them. The wider administrative team was also asked for idea and input into particular parts of the proposed survey.
We accessed the questions on the National Association of Patient Participation Groups website -http://www.napp.org.uk/resources/sample-questions/ and also considered what specific topics we needed to consult the practice population on.
An initial draft was sent out to members of the PRG for their comments and/ or suggestions. There were many very helpful and valuable suggestions. Several questions were added, several rephrased and the layout of the questionnaire reworked to make it easier to complete and therefore more likely to be completed!
4. Management of the Survey
To ensure that we gained responses from a representative sample of our patients we conducted a survey of patients, identifying age, gender, ethnicity, attendance and disability. From this survey we generated a sample that followed the criteria including
· Patients of known varying ethnic origin, basing our sample on a search of our patient database
· Patients with a chronic medical condition, learning or physical disability, including patients in nursing and care homes
· Patients of all age ranges
· Patients who had not visited the surgery for over 1 year
We were then able to monitor as results came in to check that each group of patients was being represented in the survey results.
Distribution of Questionnaires:
· For 2 months we advertised the survey heavily in the waiting room, providing copies and/or reminder slips to complete online as per the preference of each patient who came in.
· Doctors and nurses distributed questionnaires to patients who attended the surgery for appointments
· We sent an SMS message in the New Year to each patient with that service enabled to invite them to complete a survey and have their say.
· We advertised the questionnaire on our website and patients were able to complete this on-line via a link.
The Practice was required to obtain 50 completed questionnaires for each full-time GP which equated to 280 questionnaires. In total we received 293 responses. None of the questionnaires contained patients’ names. We distributed the questionnaires from December – February, allowing patients plenty of time to complete and return them to us.
The tool for collecting the responses was one provided by the company with whom we have our website, My Surgery Website. Patients who completed the survey online had their responses feed straight into the data collection function. Paper copy surveys received at the practice were inputted into the same data collection function by a random staff member.
We believe that the responses obtained reflect favourably that we have achieved this representative sample of patients.
5. The Survey
Demographics of the Survey respondents:
Patients were asked to complete details of the following:
Are you male or female?
How old are you?
Which ethnic background do you most closely identify with?
Which type of disability do you consider yourself to have, if any?
6. Action Plan
Once the Practice survey results were received, the Partners met to discuss the findings and to identify the priorities to create an action plan for. The survey results were also sent out to the Patient Reference Group for their comments and feedback. Specifically, from the results, they were asked to either say what the top 3 things the practice should focus on, or what the priority should be from each section of the survey.
The responses received from the PRG were again constructive, thoughtful and specific. Each input given by the PRG responses was then included in either a major action, a smaller adjustment to an existing service or by a commitment to review the topic more rigorously in the near future for ideas. The top priorities agreed on were:
· Allocation of appointment types (specifically pre-bookable ones)
· Difficulty in getting through quickly on the phone
· Information provision (at the surgery, online, in consultations)
· Telephone system – cost of calling 0844
The following action plan covers each of these as well as the main theme from each section of the survey:
7. You say……………..We will:
Appointments Availability
You said:
J 70% of urgent appointment requests are handled to your satisfaction
L 23% are not, either half the time or less
J 83% value the duty doctor service
In July we will:
- Provide appointments pre-bookable for 2 weeks and onwards, not just 3 weeks
- Provide appointments for tomorrow and for the following week (vs 48 and 72 hour in advance as currently)
- Keep the duty doctor service but also review to see if we can provide it using several doctors each day - thus increasing the chance each patient has of speaking to / seeing the doctor of their choice
Booking Appointments
You said:
J 86% said our receptionists are helpful friendly and courteous all or most of the time
L 44% don’t get to speak to someone quickly enough
In May we will:
- Keep more staff on the phones in the busiest hours and reduce the need for calls as follows, thus enabling us to answer more quickly:
- Add a text message service for “all clear / no further action” test results (no patient details to be sent, just a simple message)
- Provide online booking from 08:00 for half the same day appointments – and keep half available for booking via the phones from 08:30
- Make duty doctor phonecalls bookable online from 08:00
- (In July) restructure our release of pre-bookable appointments to make this easier (see section on availability)
We completely understand that some folks prefer not to mention any detail at all to a receptionist. However it is very useful for us when booking a call with the duty doctor. We also find that although some folks prefer not to comment, most don’t mind. We respect both views entirely.
In May we will:
Keep the method where the receptionist will ask a question about the purpose of the duty doctor call but structure it clearly and ensure that all our team follow the same method. They will:
- Ask whether you are calling for a new problem, follow up appointment or medication/annual/care review
- Ask one level more detail - e.g. if it’s a new problem what is the main symptom/area affected, if you need a review which condition.
Telephone Number and System
You said: 57% of you would prefer a local 01293 number system over an 0844 number system, 34% would prefer an 0844 number system.
By September this year we will: Move to a new contract in 2013 that is solely an 01293 system.
Conscious of the risk of engaged tones we will also work to reduce the need for calls in busy periods (see section on booking appointments)
Physical Access
You said:
J On the subject of convenience:
“Well situated, comfortable and generally pleasant”
L On the subject of morning queueing and car parks:
“Covered area to wait in when coming before opening times”
“Better parking at busy times needed”
In May we will:
- Open doors at 08:15 for morning queue (not for other queries)
- Add signage to advertise option to park over the road in alternative car park
Waiting Room
We are very conscious of the lack of privacy at the front desk but also want to preserve as welcoming and open feel as possible.
You said: 62% of survey responders were in favour of music of some sort in the waiting room, 29% were not.
Given these two things during the summer we will: introduce music to the waiting room, but will be very careful to keep the volume appropriate and the style gentle.