Patient Participation Review March 2012

PPI News January 2012

On the 12th January at 18:30, patients met with staff at Forest Hill Road Group Practice. The primary intention of the meeting was to involve patients in the shaping of practice services. Clinicians were asked to invite patients that represented different patient groups and were provided with sign up forms in their clinical rooms.The event was publicised in the practice on posters and on forms which were attached to prescriptions and left at the front desk.We also advertised the meeting in the newsletter of a local primary school and at our local pharmacies. The invite was open to all patients. All those who could not attend the meeting but registered interest received relevant documents and reports via email or the post and have been added to a list of interested patients for future events and planning.

Although over 35 patients showed an interest in attending the meeting 14 patients met on this occasion. The group consisted of patients who have been with the practice for less than a year and others who had been with the practice as long as 20 years providing a good mix of feedback. The group consisted of both male and female members, patients with chronic diseases and representatives from one of our local care homes.

The meeting successfully identified key areas that patients were concerned with as summarised below:

  • Problems with hospital communication – Delays to letters being transferred
  • Queues at the reception – Making it difficult to arrive in time for appointments
  • Surgeries running late – Being misinformed/not informed by receptionists
  • Physical appearance of the surgery – Notice-boards/unwelcoming front desk. Sign for a stair lift?
  • Concerns about receptionists – Behaviour and attitudes
  • Lack of communication – Patients requiring more information about practice news
  • 0844 number – The costs of contacting the practice
  • Access to appointments – Balancing same day care with routine availability

It was suggested by staff that the group focus on one key area and develop a survey for the wider patient population. It was expressed that this would not be to the detriment of other concerns and suggestions but would provide focus and a set of tangible goals.

The majority of the patient group in attendance decided that the practice should work on understanding patient’s access needs given the changes that were taking place politically. As a result a survey ‘Understanding and Improving Access’ was developed to better understand patient’s preferences regarding the access of clinical care at the practice. Surveys were available online through Monkey Survey and in paper format at the practice which were left at the front desk, sometimes on chairs in the waiting areas and attached to many prescriptions. The survey consisted of 4 very simple multiple choice questions and ran from 19th January – 19th March 2012 with the intention to discuss all results at a Patient Participation meeting on 22nd March 2012, 18:30. This meeting was advertised at the bottom of the survey. The results can be found under the March 2012 section of this report.

PPI News February 2012

Whilst data was being collected for our ‘Understanding and Improving Access’ the practice set about responding to some of the other concerns that patients raised at January’s meeting. The following actions were planned:

  • Concerns about receptionists: We beganinvestigating the possibility of recording calls and are still awaiting some quotes. This should provide additional training opportunities for receptionists and help identify where some of the problems may lie. Name badges will be worn by all administrative staff and a new feedback form requesting named feedback (both positive and constructive) on individual receptionists will be provided. All feedback will be discussed with individual receptionists. In addition, we will be running small focus groups during which patients can meet with receptionists. We think that this will provide an opportunity to lessen the ‘them’ and ‘us’ divide that has been described by patients and receptionists in the past.
  • Queues at the reception:We arecurrently working through quotes to get a new touch screen to reduce queues at reception check in but we are keen to ensure we test drive or confirm that they work accurately.
  • Sign for chair lift: Now displayed.
  • Lack of communication:Bi-monthly newsletter currently being worked on with first edition expected April 2012. This will be available on our practice website, in the practice for collection and available via email request at: .

PPI News March 2012

At a PPI Meeting 22nd March 2012,18:30 the group discussed the results from the ‘Understanding and Improving Access’ survey. 19 patients attended this event with 9 patients who had not attended the previous meeting illustrating that we were reaching new areas of our practice population.The results outlined below were discussed:

  1. Which of the following methods would you prefer if you needed to access medical advice and/or treatment urgently?

2. Which of the following methods would you like to use when booking your appointment to see and doctor or a nurse?

  1. When you last booked an appointment to see a GP did you want:

4. When you last booked an appointment to see a GP did you want:

Findings suggest that the current booking system suits patients as they prefer to book via the telephone. It was expected by staff that more patients would like to utilise an internet booking system but this was not evident in the results. With this in mind the practice can consider focussing on making improvements to the phone system. Although we are unable to break our contract with our telephone supplier and therefore move away from an 0844 number we can at least focus on making the phone lines clearer so that patients can get through more speedily therefore reducing patient costs. Patients attending the PPI meeting were not surprised to find that the number of patients wanting to use the internet for bookings was low although they did question whether the survey had been completed by enough of the younger population who may be more IT literate and IT friendly. As a result we agreed to actively acquire feedback by targeting this population in the future when debating subjects regarding IT.

We were surprised how many patients preferred a routine telephone appointment suggesting that we may need to increase levels of telephone appointment availability. However some patients at the meeting pointed out that they were unaware a routine telephone appointment system existed. This made it evident to practice staff that we must improve communications and clearly highlight to our practice population all of the available booking options.

32% of patients expressed a wish to be seen on the same day when they contacted the practice. As our current appointment system is entirely pre-bookable the majority of same-day patients are dealt with our Duty Doctor, which can cause delay in communicating with each patient if large numbers require same-day attention. To address this demand, further supported with our internal demand audit, we discussed the need for a percentage of same day appointments to be held back and released on each day of the week. The patients at the last meeting March 22nd supported this idea and we are due to trial this approach in April 2012.

Because 65% of patients express a wish to pre-book their appointment and be seen by a doctor of their choice, albeit with a longer wait for this, we will need to monitor routine availability of appointments so as not to upset this balance too much. We agreed to review this are in summer 2012.

Patients suggested that when carrying out our future surveys we consider the illiterate population by using interview techniques i.e. oral surveys. They also questioned the absence of any young mothers at the group and suggested that we target this group in the future. We agreed that this was a valid comment and that it would be easy to target young parents at the Baby Clinic on Wednesday mornings. Patients also questioned how information was collected from patients. It was explained that the survey was open to all patients and was left in the practice for 2 months. We also explained they were attached to prescriptions. Staff informed the patient group that they were not sent out in the post due to budget constraints. However, patients were informed that in addition to the survey the practice have recently carried out a Demand Audit which took place over a four week period and recorded the appointment requirements of around 2000 patients who contacted the practice during this time. The results suggested the following:

Across the week 35% of all appointment requests were for the same day; not surprisingly the day with the highest % request was Monday

  • Monday – 40%
  • Tuesday – 37%
  • Wednesday – 36%
  • Thursday – 30%
  • Friday – 30%

In addition, there is a reasonable percentage of patients requesting the soonest/first available appointment. Anecdotally the feedback from staff is that these requests were not urgent however there was a view that the patients would prefer an appointment within the next few days if not that day.

  • Monday – 17%
  • Tuesday – 28%
  • Wednesday – 24%
  • Thursday – 25%
  • Friday – 33%

This Demand Audit suggests that the practice do need to improve same day availability particularly at the beginning and end of the week which is not surprising given that patients either have complaints that build up over a weekend or as a result of anticipating the closure over the weekend. This is particularly important given the need to ensure A&E attendances are kept to a minimum.

So what next…

April 2012

At the meeting on 22nd March 2012 the group raised concerns that the practice did not advertise a clinician timetable or display our opening hours clearly. As a result we have now published the below timetables which will be available in the practice and will be updated accordingly.

Practice Opening Hours Reviewed: March 2012 / Mon - Weds / Thurs - Fri
Doors / 07:30 - 19:30 / 07:30-18:30
Phone Lines / 08:00-18:30 / 08:00-18:30
Practice Phone Number: 0844 477 3996
Practice Fax Number: 0844 477 3997

At the same meeting we took forward concerns about the Practice’s physical environment which will begin with a survey questioning the wider patient population. Survey questions were discussed at the meeting and suggestions made to ensure that an option for personal comments be put on the survey this time. Lessons learnt from the previous survey will be addressed including the inclusion of patients who may be illiterate or, for those who do not speak English as a first language. The younger population especially young parents will carefully be targeted with the hope that they are represented at the next meeting. All results will be discussed at the next meeting which is yet to be diarised. Watch this space for the survey which will be available in the practice.

Smaller focus groups which can discuss particular health interests will also be optional and patients with any ideas should submit these via the PPI email address or by notifying the practice by telephone or post. The practice will endeavour to help set these up and supply clinician input where possible.

During April we will be piloting the ‘Meet the Receptionist’ focus groups and if this proves successful will book more in the future.

May 2012

A member from NHS Southwark’s Dulwich Project will be attending the practice on Thursday 3rd May 2012, 18:30. This will provide patients with an opportunity to discuss and shape health services in the local community.

The next PPI meeting where the results of the latest survey will be discussed will be held at the end of May (date to be confirmed).