Silverdale Practice Local Patient Participation Report
March 2012
Introduction – Information on Burgess Hill
Silverdale Practice has two sites based in Burgess Hill which has a population of approximately 30,000 people and is situated about ten miles north of Brighton. It has expanded rapidly since the 1950s to its present size. The town has several industrial estates providing employment and there are also good commuter links between the town and GatwickAirport, Croydon and London.
There are two railway stations servicing the town, Burgess Hill and Wivelsfield. Both are on the London-Brighton line with trains to Eastbourne and Lewes from Wivelsfield.
There are six primary schools within the town, an independent school and two comprehensives, one of which has a sixth form. There are also sixth form colleges in Haywards Heath and Brighton. In addition, there is an adult education centre offering a variety of courses.
The shopping centre offers a good variety of shops ranging from well known chain stores to smaller independent traders. There is a large Tesco store on the ring road to the western side of the town.
There is a pedestrianised shopping mall which is home to many retailers and the library, along with the Martlets Hall which plays host to many well known and local entertainers. Also situated on the ring road is a leisure centre with a swimming pool, gym, sports hall and playing fields. Burgess Hill also has its own cinema.
There are many sports clubs in the town – football, rugby, cricket, hockey etc and a variety of other clubs and activities. There is also a very popular nature reserve and footpaths which connect to DitchlingCountryPark on the northern edge of the new South DownsNational Park.
To find out more about Burgess Hill the following websites might be useful:
Silverdale Practice (PMS Practice)
The practice currently has five partners and one part time salaried GP and operates from two sites – Silverdale Surgery and The Avenue Surgery in London Road. Silverdale Surgery is an approved training practice and at times accommodates ST and FY doctors on four monthly rotations as well as Y5 medical students from BrightonMedicalSchool, giving them the opportunity to gain experience in a primary care environment.
There are three other GP surgeries in the town, with Silverdale being the largest. There are in excess of 11,000 patients registered at the practice. The doctors currently prefer to operate a personal GP list as it is felt that this offers a higher quality of service.
Consultation times are as follows:
Mornings Surgery – 08:40 – 11:00 with emergency surgeries from 11:30am
Afternoon Surgery – 16:00 – 17:30 with emergency surgeries following
The practice also offers extended hours access from 7:30am and 6:30pm
The practice offers the following clinics and services:
Asthma/Respiratory clinic / Child health including vacs and immsHeart Disease/Stroke clinic / Foreign travel advice and immunisations
Diabetes clinic / Maternity medical services
Contraceptive advice and services / Minor surgery
Vaccination and Immunisations / Smoking cessation
Flu and Pneumococcal vaccinations / Well woman – breast and cervical screening
Health checks
Appointments are booked via telephone or in person. Same day appointments are available for emergencies and each GP sees emergencies at the end of their normal clinics. Referrals are made either directly to the provider under Patient Choice or via the Choose and Book Service giving patients the opportunity to book their own appointments.
All GPs make home visits if necessary. Out of hours duties are covered by Harmoni, as commissioned by West Sussex PCT.
Prescriptions are ordered in person, via the website: or by post.
The practice clinical team consists of:
Practice nurses / Midwifery teamPhlebotomist / Health Visiting team
District nurses / Community Psychiatric nurse
Health Care Assistant
The practice is registered under the Data Protection Act. Patients have the right to see computerised data by written request. West Sussex PCT monitors for Access and Quality to ensure that the practice is meeting Department of Health Quality Markers.
Silverdale Practice Patient Population Report
Males – 5487
Females – 5495
Age / Male / Female0-9 / 575 / 509
10-19 / 705 / 673
20-29 / 569 / 561
30-39 / 653 / 638
40-49 / 941 / 911
50-59 / 784 / 730
60-69 / 636 / 665
70-79 / 406 / 482
80-89 / 190 / 254
90-99 / 28 / 67
100+ / 0 / 5
IH – Dr Holwell
RD – Dr Denney
SP – Dr Plant
TT – Dr Taylor
EB – Dr Bird
Key Objectives for Patient Participation Groups
The purpose of Patient Participation Groups is to ensure that patients are involved in decisions about the range and quality of services provided, and over time, commissioned by their practice. It will help to encourage and reward practices for routinely asking for and acting on the views of their patients. This includes patients being involved in decisions that lead to changes, to the services their practice provides or commissions, either directly or in its capacity as gatekeeper to other services. The aim is to promote the proactive engagement of patients through the use of effective Patient Reference Groups (PRGs) and to seek views from practice patients through the use of a local practice survey. The outcomes of the engagement and the views of patients are now published on the practice website.
Silverdale Practice Patient Participation Group
Members of the PPG
There are 24members of the Silverdale PPG, most of whom visit the Practice regularly or occasionally. All registered patients were invited to join the group. Application forms were published on the website and were displayed in the waiting rooms and on the front desks of both sites. Reception staff also opportunistically promoted membership face to face. There are twelve men and ten women representatives. We intend to grow the group and will continue to encourage patients to join.
AgeRange:
2 members – 24 – 34
1 member – 35 – 41
5 members – 45 – 54
7 members – 55 – 64
7 members – 65 – 74
2 members – 75 – 84
What steps were taken to ensure the PPG was representative of its registered patients?
The Practice has endeavoured to attract specific registered patients, particularly under-represented groups. For those unable to commit to attending meetings the option of virtual group membership was made available. It became apparent that patients, such as young people in full time education, carers, full time workers and those with young children were reluctant to commit to membership. The majority of patients approached believed that the group was an excellent idea but were not keen to join at the present time. Flexibility and free time, along with a strong interest in the development of primary care services in the local community have proved to be the main attributes of our now established group. The Practice will continue to seek new members through continued advertising on the Practice website and in the waiting rooms. Ethnic categories are particularly under-represented and despite direct targeting in this area we are somewhat disappointed that the representation remains low.
How did the Practice and the PPG determine what questions should be in the Practice Survey?
The Practice Manager emailed the PPG prior to publication of the survey on the website and asked for suggestions and ideas. The Practice already had a well established questionnaire and views of the PPG were added to this questionnaire resulting in a comprehensive survey which ensured that all issues regarding patient experience would be covered. Past complaints and significant events were also taken into account and helped create some of the priority areas.
How did the Practice obtain the views of its registered patients?
Prior to the survey, posters were displayed at both sites of the Practice asking patients to either go online and complete the survey, or fill in the paper copies made available or distributed by reception staff at the front desk and in the waiting rooms. The reception staff were instrumental in targeting specific groups of patients to ensure a good representation. Completed hand written questionnaires were entered onto the website by the Practice Manager to ensure correct analysis by the ‘MySurgery’ survey tool.
How did the Practice seek to discuss the outcomes of the local survey?
The Practice Manager emailed the PPG members and invited them to attend a meeting on the evening of 19th March to discuss the results of the survey. The invite was sent three weeks prior to the meeting date to ensure members were able to make arrangements to attend. The meeting was attended by twelve PPG members (with a good age range of 20’s,50’s, 60’s and 70’s) two GPs, the Practice Manager and Lead Secretary. The senior partner gave patients an overview of commissioning to date and what it will mean for our locality. Copies of the survey results were handed out to all PPG members. The results were discussed in detail and an action plan was agreed.
MINUTES OF FORMAL MEETING OF THE
SILVERDALE PATIENT PARTICIPATION GROUP
Monday 19 March 2012 – 6:30pm
Avenue Surgery Burgess Hill
Present: / Patient Group: / (CB) / (PH)(HC) / (JH)
(MD) / (CH)
(TD) / (HI)
(MH) / (VR)
Practice Reps: / Dr Ian Holwell (IH) -Senior Partner
Dr Robert Denney (RD) - Partner
Jan Bell (JLB) - Practice Manager
Julie Burgess (JMB) – Secretarial Lead
IH welcomed those present and thanked them for volunteering to be members of the newly formed Patient Participation Group (PPG).
He gave the group a brief overview of the historical background surrounding the concept of a PPG. He hoped the new group would be proactive in generating suggestions and ideas to enable Silverdale to plan for the future in a way which would strengthen the partnership between patients and practice.
JLB suggested that the PPG could evolve in whatever way the members wished – it could operate as a virtual group who only met up occasionally or if they wanted to be more proactive, social events could be organised, should there be a volunteer to act as social secretary. They might like to think about the idea of a Facebook or Twitter account.
IH then gave a background of the changing climate which affected the way in which healthcare was delivered nationally. It appeared that all political parties agreed that “something needed to be done about the NHS” but there were inevitably many differing approaches as to how this should be achieved. There remained a lot of opposition to the planned Health and Social Care Bill which would see the demise of the present Primary Care Trust structure to be replaced by local Clinical Commissioning Groups (CCGs) led by healthcare clinicians. It would be naïve to assume that driving down costs was not also a prime consideration underpinning the need for change.
It was believed that clinicians rather than professional managers were the best placed to understand what services were needed for the local community and practices were encouraged to form themselves into locality groups who would then be given the purchasing power to commission services as appropriate. Practices had no choice as to whether they joined a CCG – if they did not do this voluntarily, they would be placed in a group. A minimum size of a 500,000 patient-base was needed to form a CCG and the Mid-Sussex group, of which Silverdale was already a part, has joined with Horsham to form the North West Sussex Commissioning Association.
The first year of the project would see the CCG having a shadow budget set and the central core of the PCT will provide steering and guidance to the emerging CCGs. Should they not be seen to be performing, the PCT will have the power to call a halt to the process until an alternative group can be established.
IH felt the best way to have an impact on local decision making was to have a voice to protect local services as far as possible. GPs would be encouraged to volunteer to join a central governing board and although IH would be an ideal candidate for this, he was not keen as it would take up at least three days each week and thereby prevent him from delivering a full service to his list of patients.
He went on to refer to difficult times currently. Many services such as major surgery had now been relocated from PrincessRoyalHospital to The Royal Sussex County Hospital, he warned that a locally based hospital would not be sustainable if too many services were removed. There is an argument that centres of excellence can provide the best care for a large local population, however this is and will remain a balancing act between the desire of patients to be treated locally and to have the best care possible. It was pointed out that parking at RSCH is very difficult, particularly when it is often stipulated that patients may not travel by public transport after a procedure. IH said that the site was highly unsuitable and if it was being built now, it would much better be situated somewhere like the Brighton football stadium in Falmer. However millions of pounds have been spent on developing the existing site so the problem with parking will remain and probably get worse as the local population increases.
JLB mentioned that it is important to note that there has been a shift away from all services being delivered from hospital locations, with several community-based services now being available. She talked briefly about the community urology service and the planned gynaecology service. The urology service has several primary care bases and locally patients only have to travel as far as The Sydney West Primary Care Centre in Leylands Road which has superb facilities including operating theatres for certain surgical procedures. IH then spoke of the core services which are provided by the practice now such as diabetic monitoring and control, which formerly would have been almost exclusively hospital-based and this too was felt to be a positive step.
IH spoke of the depletion of the district nursing service. During fund-holding in the 1990s Silverdale had a team of nurses based at the practice and practice funds were used to help develop the service. However, as the PCT evolved, it had been felt that consumers should not also be providers and the team was subsequently moved and over time, staffing levels were reduced, such that now there are less community nurses to cover the whole area than Silverdale had for its own patient-base previously.
He also mentioned the out-of-hours service, Harmoni, which now costs locally £8m pounds a year to run, against the previous GP led out-of-hours service which was provided for £1.5m annually. The number of cars available to transport GPs to domiciliary visits has been reduced to three for the whole of West Sussex. This led HC to suggest that if emergency medical care were needed in the night, it would be sensible to ring 999. Both IH and RD explained there was a concerted effort currently to make people aware of alternatives to ringing for an ambulance or attending A&E as this may well not be the best pathway to obtain appropriate medical care.
IH then went on to pose the question of how GP services in the future would fit into the changing face of the NHS. He also posed the question of how PPG groups would fit in when CCGs were fully in place.
JLB took these questions forward by suggesting this was where the PPG could come into its own. Become enfranchised by letting us know what works well and what needs changing. CB made the point that the group seemed, with the exception of TD, to be made up of a more senior demographic group. JMB suggested that while the practice would continue to advertise for a larger more representative sample, it could possibly targetthose groups not represented. In addition, the current PPG could encourage family, friends, associates and neighbours who are registered at the practice to get involved.
JH mentioned that he was involved with the Sussex Heart Network Group, which had been successful in getting changes made to improve the service so he supported the idea that individuals working together can make a difference.
JLB then posed the question of whether people actually wanted to get involved. The phrase “if it isn’t broken, don’t fix it” was used several times; suggesting that many people were happy with the service the practice was providing so could not seen any reason to change anything. IH suggested that often people only commented if they had something they were unhappy about.
JLB distributed the survey results and the group were keen toknow how many surveys had been completed and when it would be published. JLB reported that the practice had not had the response it had hoped. Few had been completed on line but overall, those that had completed the survey were very complimentary. The survey would be published by 31 March. Several of the group questioned how much publicity had been given to the project. JMB advised it was advertised on line and at both sites. IH made the point that it was unfunded so resources were limited in this respect. MH told the group that the community nursing team distributed questionnaires to patients they were visiting and encouraged participation.