Local Patient Participation Report Year 3,2013-14

Part 1.

Age/Gender/Ethnicity of Crondall New Surgery PPG.

  • The Crondall New Surgery PPG in the past year hasconsisted of 14attending patient members of committee meetings on-site.
  • 2 of our long-serving PPG members have retired from the committee in this past year, although they remain as virtual members who correspond via email. 4 new members have joined.

Ethnicity:Broken down by ethnic background, the PPG are92.9% white British, and 7.1% of Other/White/Asian background.The 2011 Census figures for Hart (Appendix 4) show that the make up of the Hart District Council area is 90.7% White British and 9.3% other ethnic backgrounds, and therefore we are fairly representative of this. Our ambition is to have a cross-section of society so we will work on this for the future.

Gender: Our active attending membership is 78.6% Female and 21.4% male which is not as representative of the general population but has increased from an 81:19 split last year. The Hart area does have slightly more females to males, with a 51:49 split, and this matches the registered patient population at the surgery.

Age: Korner Banding table showing % of PPG against % registered population of the surgery.

Korner Banding / % of PPG / % of Registered Population
0-24 years / 0 / 31.3
25-34 years / 0 / 9.1
35-44 years / 21.3 / 15.6
45-54 years / 14.2 / 16
55-64 years / 7.1 / 10.2
65-74 years / 28.5 / 10
Over 75 / 28.5 / 7.7

Looking at the Korner Banding table, we remain unrepresented by the 0-24 years category. We now have 3 members in the 35-44 category, 2 in the 45-54 category, 1 in the 55-64 category, 4 in the 65-74 category and 4 in the over 75 category. We are aware that we are under-represented in the younger end of the spectrum but have actively tried to recruit additional members and this is ongoing – see Appendix 3- Minutes of Meetings 2013-14.

We have managed to increase the number of males and also the proportion in age group 35-44. This has in fact taken a considerable effort on our parts and as a group we are very pleased with this direction as it represents families with young children living in the village.

We noted previously that the surgery does have a higher proportion of older people and a lower proportion of younger people registered with us and living in Crondall than the general population of Hart District, as our boundary does not encompass any towns and we are a rural-based practice.

Our Virtual PPG on Facebook this year, and it now includes32 people who have opted in. On our website, we have hugely increased our circulation to 99 regular patients who have opted in to receive automatic email and newsletter updates. When surveyed, patients said that they were very happy to provide their details in order to receive updates but did not wish to attend any meetings in person. Therefore, we are extremely grateful to our loyal, long-serving PPG members who attend meetings held at the surgery or elsewhere, and who participate fully in the group as well as arranging activities, supporting health events in Crondall on our behalf and fundraising.

Our virtual group of patients, who responded to this year’s survey, are considerably more representative of the whole population in the district of Hart. This is demonstrated in the recent survey results seen below in Appendix 2.

Part 2.

Agreeing areas of priority with the PPG

The priority areas come from the outcomes from the 2012/2013 PRG survey, focus areas raised within the PPG group and direct patients’ suggestions. All the members of the PRG who attend meetings were advised of the need to decide on areas of priority and suggestions were put to them to discuss. The outcome of these discussions were also used in this years PPG survey which aimed focused on two parts – firstly, following the work done to improve confidentiality in the surgery premises, is this work borne out by patient experience?, and secondly, identifying patients who care, as part of a forthcoming piece of work on supporting carers in our community.

Previously we have repeated the questions from the previous year’s survey so that we had a direct comparison of results, and this also acted as a gauge to confirm whether the areas recognised by us as a priority also affected the general patient population. However, this year we have taken a different approach. As we consider the patient information given in the surveys to be valued and important, it is also important to us not to collect information from patients that we were not actively using as part of our project work and therefore we have not repeated last year’s questions particularly on subjects such as religion and sexuality as we were not then using this information for any specific purpose. This was agreed in our meetings with the PPG in October and November 2013. The minutes of these discussions can be found in Appendix 3 - Minutes of meetings.

Those priorities were as follows, in order of importance decided by the PRG and the practice and from survey results in Year 2 and 3.

  • Confidentiality of environment in reception/waiting area and consultation rooms
  • Giving patients a strong voice
  • Identifying patients who are carers
  • Appointment booking process/Booking-in process

Survey
Describe how the priorities were set? -
Following her attendance at an area PPG meeting last year, the secretary proposed that carers (people who care for others, but not as an employment) were underrepresented in society and do not have a voice. Therefore the PPG chairman and secretary proposed that we ask patients if they wished to identify themselves as a carer, and some other questions around how this affects their own lives.
With this information, they would like to work on creating support mechanisms etc in the forthcoming year, so this was duly included.
The section on confidentiality was repeated because the surgery team have made significant changes for this purpose over the last yeardue to some of the outcomes of last year’s survey, so it was to ascertain if the changes have been successful and whether patients had appreciated and taken note of this.
How were the views of registered patients sought?
Survey questionnaires sent to each patient who is either of these three groups– current PPG member (14), Virtual PPG member (32), signed up to receive newsletters (99), and multiple copies were placed in a prime location in the waiting room and patients were asked to complete these while waiting for their appointment.
How were the questions were drawn up?
The survey questions for 2013-2014 were based on the original set of questions supplied by NAPP (National Association of Patient Participation) and from priority areas decided by the PPG and additional questions on Confidentiality which were produced in discussions in the PPG meetings.
How was the survey conducted?
For Year 3, it was conducted via email, via a link on our websiteand on paper. 61 responses were received between 21/02/2014 and 21/03/2104.
What were the survey results?
See Appendix 2 for a complete breakdown of the results.
Action plan
How did you agree the action plan with the PRG?
In each and every PPG meeting, and through review of the survey results from 2011-2013.
What are the main findings/ proposals that can be implemented?
The PPG and Practice discussed the survey results and patients’ comments and reached agreement for changes as set out in the action plan (see below).
What are the findings/ recommendations that will not be implemented?
Please include reasons?
The PPG did not agree that the surgery required electronic systems for booking in on arrival in 2012 however due to increasing list size and higher patient attendance numbers this was resubmitted to the PPG and also to the surgery staff in a quarterly staff meeting. They all feel that at the current time it would adversely affect the relationships between staff and patients and therefore this was again shelved to be reviewed at the end of 2014.
The actions that the practice intends to take / has taken in respect of the findings:
ACTION PLAN
Issue or Concern / Remedial Action (in priority) / Completed
From 12/13 report - Patients (and their children) can gain access to the LHS side of the building through the car park and this could compromise privacy in consultation rooms.
(From PPG and Patient concerns) / Local contractor to provide permanent fixed fencing across front LHS of building to prevent access from front of surgery. / This was completed in Summer 2013. Patients no longer complain that children are accessing private areas on practice land and there are no further concerns regarding confidentiality on this matter.
From 12/13 report-Confidentiality in Room1 which has an extra door for direct access from the waiting room but this causes noise transmission and patients are concerned regarding the confidentiality of their consultation.
(Identified by staff, patients and PPG concerns also) / Door is to be removed and door space gap to be filled with soundproofing board and sealed with an acoustic prevention sealant. Access to Room1 is to be via the main corridor and not through waiting room. / Yes – main works completed in January 2013. Door removed and space sealed. Acoustic testing completed May 2013. There is no sound leakage into the waiting room anymore and therefore no confidentiality issues with utilisation of Room 1 by clinicians.
Patients speaking to the receptionist can be overheard by people waiting to see a clinician, in the waiting room. (Identified from practice survey 12/13) / Entire waiting room layout redesigned and reconfigured to ensure that patients talking to reception are not watched and therefore are not as aware of being overheard by patients waiting for their appointment / Redesign completed Nov. 2013. There is no one way to prevent people who are speaking to reception from being overheard by persons behind, but this is a significant change to the surgery waiting area and also improves patient flow. See Appendix 1 Reconfiguration diagram
Patients who are carers are not supported enough to ensure they stay happy and healthy. (From PPG Area meetings (5 year plan for SHIP) and PPG members concerns. / Patient survey configured to help to identify numbers of carers who are patients. / Ongoing.
Once process of identification is completed, the aim is to work with the RCGP project ‘Supporting Carers in General Practice’ with the addition of a practice-based clinical lead ‘Carers champion’.
Gauging patients feelings, obtaining ideas and inspiration regarding our surgery as a whole (PPG request) / PPG requested a ‘Comments’ or ‘Suggestions’ box for the waiting room. / In progress. There has been one in the past which was removed as it was not well used and not felt helpful by the surgery staff. Will be put to the staff at their next team briefing in April 2014.
Are there any contractual considerations to the agreed actions?
Not currently.
Local patient participation report
The survey summary results and the Practice action plan are now available on the practice website and a paper copy has been circulated to the following groups – surgery staff, PPG group, GPs and clinicians, a copy is also available in the waiting room for patients and visitors. Any person who has signed up to our newsletter updates via the website will be advised that the new document is available.
Opening times
Confirmation of the opening times of the practice premises and the methods of obtaining access during core hours (Mon to Fri 8am to 6.30pm).
This includes arrangements under the extended hours scheme.
Opening times: Mon to Fri 08:00 to 19:00. Closed Saturday and Sunday.
Extended Hours – Every Tuesday 18.30 to 20:00 for pre-booked appointments.
Telephone access – 8:00 to 18:30 Monday to Friday. OOH message outside these hours advising how to obtain healthcare services in an emergency.
Internet – ‘Emis access’ self booking GP appt’s- 24 hour access.
Patient.co.uk iPhone and android app for appt booking – 24 hour access

Appendix 1 – Reconfiguration of waiting room in 2013(not to scale)

Previous configuration – all chairs in rows pointing forward.

This symbol represents the patient chairs and the arrow shows the

direction they face in.

New configuration – no patient chairs directly face the reception desk.

Appendix 2PPG & Survey Results Report -Survey Results

Listening and Caring Patient Survey – 21/02/2014 – 21/03/2014

Number of Responses: 61

Dear Patient,

Thank you for taking part in this survey. We want to ensure that our practice is listening to you and all our patients, understands their needs, improves the experience at our surgery, and establishes whether you spend your time caring for others and how this affects you.

Your responses will shape the future of your healthcare, and help us to better meet your requirements.

To receive the results of this survey and to help again in possible future surveys, please enter your email address in the box below. (Your answers are always completely confidential.)

Please answer all of the questions and click 'Send' when completed.

Q1. Are you:

MALE27%

FEMALE68%

Not specified1%

No response4%

Q2. Please select the age group that best represents you:

Under 180%

18-241%

25-341%

35-4421%

45-5411%

55-6411%

65-7421%

75-8421%

85 and over6%

No response7%

Q3. Which of these best describes what you are doing at present?If more than one applies to you, please select the main one only.

Full-time paid work (30 or more hours per week)21%

Part-time paid work (under 30 hours per week)16%

Full-time education (school, college, university)0%

Unemployed0%

Permanently sick or disabled1%

Fully retired from work37%

Looking after the home16%

Doing something else4%

No response5%

Q4. If you are employed, roughly how long is your journey to work (door to door)?

Up to 30 minutes11%

30 - 60 minutes16%

More than 1 hour6%

I live on-site3%

No response64%

Q5. If you need to see a doctor at your GP Surgery during your typical working hours, can you take time away from your work to do this?

Yes32%

No18%

No response50%

Q6. In general, would you say your health is:

Excellent8%

Very good27%

Good24%

Fair29%

Poor8%

No response4%

Q7. Do you have any of the following conditions? Please include problems due to old age and tick all those that apply to you

I do not have a long-standing condition32%

Deafness or severe hearing impairment11%

Blindness or severe visual impairment0%

A condition that substantially limits basic physical activities - walking, climbing stairs, lifting or carrying26%

A learning difficulty3%

A long-standing psychological or emotional condition8%

Other, including any long-standing illness19%

Q8. Do you look after children, a partner or dependent adults in your family on a daily basis?

Yes32%

No59%

No response9%

Q9. Do you have carer responsibilities for anyone in your household with a long-standing health problem or disability?

Yes6%

No78%

No response16%

If you answered yes to Q9, please answer the following questions about caring responsibilities.

Q10a. Are you registered as an official carer, or in receipt of carers allowances?

Yes3%

No21%

No response76%

Q10b. Have you informed us at the GP surgery that you are a carer for someone else?

Yes4%

No13%

No response83%

Q10c. Do you provide personal care for someone who lives with you, such as your partner, unofficially, for example: you do not receive carers allowances and are not known to social services?

Yes8%

No31%

No response61%

Q10d. Do your caring responsibilities mean that you have little or no time to look after your own health, do your hobbies or interests, or have 'me-time'?

Yes, significantly1%

Yes but I get some respite occasionally3%

No I receive some assistance0%

No I don't want/need any time out13%

No response83%

Q10e. If you could meet with other people in a similar position locally, to talk about the issues around caring full-time, offload and unwind for a small period of time on a regular basis and make new friends, is this something you would be interested in?

Yes definitely1%

Yes but I can't leave my dependent person alone to do this0%

No thank you13%

No response86%

Q12. How long have you been a patient of Crondall New Surgery?

less than a year16%

1 - 3 years19%

4 - 7 years1%

more than 7 years59%

Can't remember0%

No response5%

Q13. In general, how satisfied are you with the care you get at the surgery?

Very satisfied78%

Fairly satisfied8%

Neither satisfied nor dissatisfied3%

Slightly dissatisfied4%

Very dissatisfied0%

No response7%

Q14. Would you recommend the surgery to someone who has just moved to your local area?

Yes, definitely88%

I might do8%

Probably not1%

Definitely not0%

Don't know0%

No response3%

How can we improve?

Would you be interested in joining a Patients Group, where you would be able to shape the services and future of your surgery? Select all the ways you would be happy to do this.

In person (at a meeting)8%

Via email22%

On our facebook page0%

ACCESS

Q15. When did you last see a Doctor at the GP Surgery?

In the past three months65%

Between 3 and 6 months ago21%

More than 6 months ago6%

I have never been seen at my current GP surgery3%

No response5%

Q16. If you haven't seen a Doctor in the past 6 months, why is that?Please tick all that apply

I haven't needed to see a doctor9%

I couldn't be seen at a convenient time0%

I didn't have transport0%

I don't like or trust the doctors1%

Another reason1%

Q17: Did you know that you can already book appointments online, or via a free app called Patient.co.uk, to see a doctor?

Yes47%

No45%

No response8%

Q18. How do you normally book your appointments to see a doctor or nurse at the surgery?Please tick all that apply

In person16%

By phone80%

Online21%

Using the Patient.co.uk app4%

Via another person4%

Q19. Which of the following would you prefer to use to book an appointment at the Surgery?Please tick all that apply