Pendle View Medical Centre

Local Patient Participation Report

2012

Stage One – demonstrate that the patient group is representative

Demonstrate how the Patient Reference Group is representative by providing a detailed breakdown of the practice population below:-

Total Practice Population

Age
Under 16 / 16-24 / 25-34 / 35-44 / 45-54 / 55-64 / 65-74 / 75-84 / 85+
1061 / 538 / 793 / 664 / 860 / 882 / 778 / 474 / 178
Gender / No.
Male / 2999
Female / 3229

Specific care groups e.g. nursing homes, learning disabilities, drug users, carers

Specific Care Group / No. of Patients
Carer / 83
Learning Disability / 21
Drug User / 8
Residential/Nursing home / 59

Patient Reference Group

Demonstrate how the Patient Reference Group is representative by providing a detailed breakdown of the Patient Reference Group membership below:-

Age
Under 16 / 16-24 / 25-34 / 35-44 / 45-54 / 55-64 / 65-74 / 75-84 / 85+
0 / 1 / 0 / 2 / 0 / 5 / 3 / 1 / 0
Gender / No.
Male / 6
Female / 6
Ethnicity
White British / Irish / Mix Carribean / Mix African / Mix Asian / Indian / Pakistani / Bangladeshi / Black Carribean / African / Chinese / Other
11 / 0 / 0 / 0 / 0 / 0 / 2 / 0 / 0 / 0 / 0 / 0

Specific care groups e.g. nursing homes, learning disabilities, drug users, carers

Specific Care Group / No. of Patients
Carer / 0
Learning Disability / 0
Drug User / 0
Residential/Nursing homes / 0

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Differences between the practice population and members of the Patient Reference Group
Describe any variations between the practice population and the Patient Reference Group membership. Provide details of the efforts the practice has made to reach any groups that are not represented.
Steps taken to ensure that the PPG is reflective of the whole patient population.
The practice chose to develop a face to face Patient Participation Group that would be representative of the whole practice population.
Patients were invited to join the Patient Participation Group through the practice newsletter, website and posters in the waiting room. In addition GPs opportunistically asked patients to join the group targeting patients that would be representative of the whole population.
Uptake initially was poor. An application form was then developed asking patients whether they would be interested in joining the PPG. This was then handed out to all patients presenting at reception. 27 patients responded and requested to become members of the PPG.
PPG Profile
Members
Current membership -12
Gender
The Patient Group is representative of the population with regards to gender.
Gender / Practice Profile / PPG Profile / Difference
Male / 48% / 50% / -2%
Female / 52% / 50% / +2%
Age
The Patient Group is under represented in the age groups 0-16, 25-34 and 45-54. Patients in the under represented groups expressed interest initially to join the PPG however never attended the meetings.
With the Patient Participation Group up and running, the practice will focus on engaging these under represented groups.
Age / Practice Profile / PPG Profile / Difference
0-16 / 17% / 0% / -17%
17-24 / 8.6% / 8.3% / -0.3%
25-34 / 12.7% / 0% / -12.7%
35-44 / 10.7% / 16.6% / +5.9%
45-54 / 13.8% / 0% / -13.8%
55-64 / 14.2% / 41.6% / +27.4%
65-74 / 12.5% / 25% / +12.5%
75-84 / 7.6% / 8.3% / -0.7%
85+ / 2.9% / 0% / -2.9%
Ethnicity
It is difficult to reflect the profile of the practice accurately as the practice does not have the ethnicity status recorded for all patients. Efforts are being made to record ethnicity for all patients.
Ethnicity / Practice Profile / PPG Profile / Difference
White British / 83.3%
Irish / 0%
Mixed / 0%
Asian/Asian British / 16.6%
Black/Black British / 0%
Chinese / 0%
Other Ethnic Group / 0%

Stage Two – validate the survey and action plan through the local patient participation report

Survey
Describe how the priorities to be included in the local patient survey were identified and agreed with the Patient Reference Group.
Details on how the PPG identified and agreed priorities for the patient survey
PPG meetings
The first meeting was held on 18th October 2011 at 6.30pm (minutes available on the website). All 27 patients were invited and out of the 27 patients, 12 attended and four sent their apologies.
The senior partner gave a presentation covering the following aspects:
  • What is a patient participation group?
  • Why have a patient participation group?
  • An overview of the doctors at the practice and their roles
  • An overview of the practice staff
  • The practice profile
  • Practice statistics
  • What patients think we are doing well?
  • What could we do better?
  • Next steps
It was agreed that the following meeting would focus on the priorities highlighted by the PPG to identify how these could be addressed.
The second meeting was held on 22nd November 2011 (minutes available on the website).
The Practice Manager gave a presentation on the findings of the practice survey results for 2010-2011. These results were presented for the group to consider when developing the survey for 2011-2012.
After considering the survey results the group was asked which of the priorities should be focused on when developing the survey. The following areas were considered:
Access
The following suggestions were made with regards to access:
  • To capture the views of patients on access to appointments in more detail
  • Need to gauge when is the best time for patients to ring for an appointment
  • Option to ring at 12 noon
  • Option to ring in the evenings
  • Alternative ways to book appointments i.e. online
  • Telephone consultations
  • Triage system using a Nurse Practitioner
  • Survey those who access same day appointments
Patients who fail to attend appointments
  • Consider auditing patients who fail to attend, looking at:
  • Age
  • Sex
  • Illnesses
What services patients want
  • Online appointments
  • Ordering prescriptions online

Describe how the questions included in the local patient survey were drawn up.
The group agreed to concentration on gaining the views of patients who access the same day appointment system known as ‘extras’. Patients who are unable to obtain a booked appointment are offered to attend at the end of surgery as an ‘extra’.
The numbers of patients attending as extras can be large and the group were eager to explore the following:
  • whether patients feel they receive a high standard of care
  • whether the quality of the consultation is affected
  • whether they would prefer pre-bookable appointments
  • whether they like the facility of booking same day appointments
  • how they find accessing the appointment system via the telephone
  • which patients are attending as extras
  • why are patients attending as extras
The survey would be handed out to patients who attended for a same day appointment as an ‘extra’.
The PPG put forward the following suggestions as to how the survey could be handled:
  • Volunteers could hand questionnaires out in the waiting room and encourage patients to complete them
  • A section should be included within the survey to ask patients for comments and suggestions
  • GPs could hand out questionnaires at the end of consultation
The Questions
The survey asked questions relating to:
  • Access to appointments
  • Telephone access to book appointments
  • Clinical consultations

Provide details of the methodology used to carry out the survey including the following:-
How the survey was conducted i.e. by paper or electronically, in the surgery or by mail
How the patients to be surveyed were selected (they should be representative of the practice population)
The number of patients surveyed
The number of surveys completed
Details of how the survey was analysed i.e. in house or outsourced.
  • The survey was developed based on the GPAQ questionnaire and circulated to the PPG members for approval and a few minor changes were made.
  • As agreed by the group the survey took place over a one week period
  • During the week commencing Monday 16th January 2012 for 1 week, 49 questionnaires were handed out at reception to patients attending as extras
  • 41 questionnaires were completed and returned
  • Volunteers assisted patients needing help with the questionnaire
  • The Practice Manager collated and analysed the results in-house

Provide details of the survey results.
The Results
Please see Appendix 1
Provide details of how the practice discussed the results of the survey with the Patient Reference Group.
The following steps were taken to discuss the results and findings of the survey with the PPG
A PPG meeting was held on Tuesday 7th February 2012 to discuss the results (minutes available on the website). The Practice Manager presented the results to the group along with a summary of complaints that had been received.
Summary of Results
After considering the results the group looked at its objectives from the previous meeting.
Which patients are attending as extras?
85% of patients who completed the questionnaire also completed the section on their profile and demographics.
  • 60% female, 40% male
  • The mean age is 37
  • 52% of patient are in employment or full time education
  • 48% of patients were on long-term sickness, at home or retired
  • 95% of patients had been seen once or more within the last 12 months
  • 90% of patients had been seen as an extra once or more within the last 12 months
  • 37% of patients had never been offered a pre-bookable appointment
How do patients find accessing the appointment system?
  • 53% of patients were satisfied with ringing in at 8.15am for an appointment
Quality of care
  • 81% of patients were satisfied with how well the doctor listened
  • 79% of patients were satisfied with how well the doctor explained the treatment
  • 75% of patients were satisfied with the amount of time the doctor spent with them
  • 80% of patients were satisfied with the doctors questions, care and concern
  • 61% of patients were able to understand problem/illness more after seeing the doctor
  • 55% of patients were able to cope with problem/illness more after seeing the doctor
Discussion
Patients attending as extras still receive high quality care. Communication and continuity of care was not affected.
Satisfaction rates for accessing appointments needs to be improved. There was concern that some patients are accessing the extras service as they are not aware they can book appointments in advance or that when they get through on the telephone all the appointments have been taken for the day. Not all patients are happy ringing the surgery at 8.15am for an appointment.
Most patients do like accessing appointments as an ‘extra’ if it means they are guaranteed to be seen on the same day and are happy to wait.
Action Plan
Describe how the practice agreed the action plan for implementing the findings or proposals arising from the local practice survey with the Patient Reference Group. Please enclose a copy of the agreed action plan.
The action plan was discussed at the Patient Participation Group Meeting on 7th February 2012.
Please see Appendix 2
Detail any findings or proposals arising from the local practice survey that have not been agreed as part of the action plan and the reasons why.
The group felt that the service provided was excellent and did not feel the need for any changes with the appointment system. After considering the results and patient complaints the practice felt steps were necessary to improve patient satisfaction with regards to the appointment system.
Detail any proposals which impact on contractual arrangements.
No proposals will impact on contractual arrangements
Local Patient Participation Report
Provide the practice website address on which the Local Patient Participation Report has been published. Please enclose a copy of the Local Patient Participation Report.

Opening Times
Provide the opening hours of the practice and the method of obtaining access to services throughout core hours.
Monday / 8.15am-12.30pm / 1.30pm-6.15pm
Tuesday / 8.15am-12.30pm / 1.00pm-6.15pm
Wednesday / 8.15am-12.30pm / 1.00pm-6.15pm
Thursday / 8.15am-12.30pm / 1.00pm-6.15pm
Friday / 8.15am-12.30pm / 1.00pm-6.15pm
Patients requiring urgent attention between 8.00am -8.15am and 6.15-6.30pm can contact the practice emergency doctor.
Patients can book appointments over the telephone or at the surgery
If the practice has entered into arrangements to provide extended hours access please provide the times at which individual healthcare professionals are accessible to registered patients.
The practice offers extended hours on Wednesday Evenings. Two GPs provide a session each from 6.30pm -8pm.

Acknowledgements

The practice would like to thank all members of the Patient Participation Group for their continued support. We would also like to thank DR for providing volunteers to assist with the questionnaire.

Appendix 1

SURVEY RESULTS

2012

Question 1

In the last 12 months how many times have you been seen by a doctor?

None / 2 / 5%
Once or twice / 9 / 22.5%
Three or four times / 6 / 15%
Five or six times / 7 / 17.5%
Seven or more times / 16 / 40%

Question 2

In the last 12 months how many times have you been seen as an extra?

None / 5 / 12.2%
Once or twice / 16 / 39%
Three or four times / 4 / 9.8%
Five or six times / 7 / 17%
Seven or more times / 9 / 22%%

Question 3 (Thinking about the times you were seen as an extra)

Question 3 a

Was the appointment appropriate for the condition you came in for?

Always / 23 / 59%
Almost always / 9 / 23%
A lot of the time / 4 / 10.3%
Some of the time / 2 / 5.1%
Almost never / 1 / 2.6%
Never / 0 / 0%

Question 3b

How do you rate this?

Very poor / 1 / 2.6%
Poor / 1 / 2.6%
Fair / 6 / 15.3%
Good / 6 / 15.3%
Very good / 14 / 36%
Excellent / 11 / 28%

Question 3c

Were you offered a pre-bookable appointment?

Always / 4 / 10.5%
Almost always / 2 / 5.3%
A lot of the time / 2 / 5.3%
Some of the time / 16 / 42%
Almost never / 6 / 15.8%
Never / 8 / 21%

Question 3d

How do you rate this?

Very poor / 1 / 2.7%
Poor / 4 / 10.8%
Fair / 10 / 27%
Good / 11 / 29.7%
Very good / 8 / 21.6%
Excellent / 3 / 8.1%

Question 4

How do you rate ringing at 8.15am for an appointment?

Very poor / 5 / 13.2%
Poor / 5 / 13.2%
Fair / 10 / 26.3%
Good / 6 / 15.8%
Very good / 3 / 7.9%
Excellent / 9 / 23.7%

Question 5a

How thoroughly did the doctor as about your symptoms?

Very poor / 0 / 0%
Poor / 1 / 2.4%
Fair / 5 / 12.2%
Good / 9 / 22%
Very good / 11 / 26.8%
Excellent / 15 / 36.6%
Does not apply / 0 / 0%

Question 5b

How well did the doctor listen to what you had to say?

Very poor / 0 / 0%
Poor / 1 / 2.4%
Fair / 2 / 4.9%
Good / 5 / 12.2%
Very good / 19 / 46.3%
Excellent / 14 / 34.1%
Does not apply / 0 / 0%

Question 5c

How well the doctor explained your symptoms and treatment

Very poor / 0 / 0%
Poor / 0 / 0%
Fair / 3 / 7.3%
Good / 12 / 29.3%
Very good / 11 / 26.8%
Excellent / 15 / 36.6%
Does not apply / 0 / 0%

Question 5d

The amount of time the doctor spent with you today?

Very poor / 0 / 0%
Poor / 0 / 0%
Fair / 8 / 19.5%
Good / 8 / 19.5%
Very good / 12 / 29.3%
Excellent / 13 / 31.8%
Does not apply / 0 / 0%

Question 5e

The doctor’s patience with your questions?

Very poor / 0 / 0%
Poor / 1 / 2.4%
Fair / 3 / 7.3%
Good / 10 / 24.4%
Very good / 9 / 22%
Excellent / 18 / 44%
Does not apply / 0 / 0%

Question 5f

The doctor’s care and concern

Very poor / 0 / 0%
Poor / 0 / 0%
Fair / 3 / 7.3%
Good / 11 / 27%
Very good / 10 / 24.3%
Excellent / 17 / 42%
Does not apply / 0 / 0%

Question 6 (After seeing the doctor today do you feel..)

Able to understand your illness?

Much more than before the visit / 17 / 47%
A little more than before the visit / 4 / 11.1%
The same or less than before the visit / 10 / 28%
Does not apply / 5 / 13.9%

Question 6b

Able to cope with your problem and illness?

Much more than before the visit / 12 / 32.4%
A little more than before the visit / 12 / 32.4%
The same or less than before the visit / 9 / 24.3%
Does not apply / 4 / 10.8%

PATIENT SATISFACTION

Question / Mean Satisfaction Rate
Q3b-Appointment appropriate for condition / 73%
Q3d-Offered a Pre-bookable appointment / 56%
Q4- Patients satisfied with ringing at 8.15am for an appointment / 53%
Q5a-Thoroughly asked about symptoms / 77%
Q5b-How well the doctor listened / 81%
Q5c-How well the doctor explained the treatment / 79%
Q5d-The amount of time the doctor spent with you / 75%
Q5e-The doctor’s patients with your questions / 80%
Q5f-The doctors care and concern / 80%
Q6a-Able to understand your problem/illness / 61%
Q6b-Able to cope with you problem/illness / 55%

Patient comments

Comments relating to booking appointments

Too early for some who have been on a night shift”

“Most of the time telephone line is busy at 8.15 and after a lot of time when they answer about 8.30 the phone they say that all appointment are booked so you can only come in extra!!”

“Would love to see online appointments to see all available appointments-this would reduce phone calls and toing and froing with the reception staff, this would also see them up to attend to other duties within the practice”

“Good idea, although if phone lines are busy it can be hard to get through and thus, miss the chance to book same day appointment”

“USELESS”

Its always been possible to get a same day appointment if booking in as in extra, however, I cant remember the last time that I could look for a specific doctor same day as”

“It would be better if you could ring at any time of the day for a same day appointment”

“I would like to be booked a appointment for next day”

“Often difficult to get through – Then when you do – no appointment left for that day”

General Comments

It was very good to be able to see a doctor one hour after telephoning as it put my mind at ease for the weekend”

“Dr Finnigan is a very good doctor also Webborn and Dr Ions”

“Always great always go home feeling i’ve bin treated well”

“Dr Webborn showed us a map of the problem and described what was wrong-he also explained a lot of other things which were important, I was very happy my appointment was with Dr Webborn”

“Not a problem with the doctors just the system of getting an appointment to see one”

“They are very helpful good doctor”

“Inconsistency with how different doctors examined my problem when attending an appointment. Also, when an illness/problem I’ve had recurs or does not clear up well following first treatment, have had the feeling that doctors (some not all) rush in getting you in and out as soon as. Apart from this reception staff very helpful and friendly, also have never had to wait to long to be seen by the doctor, even as an extra, very satisfied with this.”

“Fortunately I am rarely ill! To get an appointment at short notice is difficult predicting when you are going to be ill to book in advance-so to get in is good. The few times I have been, I have got in later same day as an extra so not a problem. Doctors I have seen over the years all been lovely”