Wilton Health Centre J83062

Wilton Health Centre Local Patient Participation Report 2012 – 2013

Introduction

A survey was designed to ask for the views of practice patients and take those views into consideration in shaping services and improving quality at Wilton Health Centre.

The surgery currently has 3,160 registered patients, 60 patients less than when we conducted the survey a year ago. We have a 50:50 spilt of male and female patients.

Just under a quarter of all our patients are aged 65 or over and almost 60% of patients are of working age (between 17 – 64). The under 18’s represent 18% of the practice population. There has been no change in figures compared to 2011-2012 survey

Breakdown of registered patients by age

2012 - 2013:2011 - 2012

18 % are under 1618 % are under 16

7 % are aged 17 – 247 % are aged 17 – 24

10% are aged 25 – 3410% are aged 25 – 34

13% are aged 35 – 4414% are aged 35 – 44

16% are aged 45 – 5415% are aged 45 – 54

13% are aged 55 – 6413% are aged 55 – 64

23% are aged 65 and over23% are aged 65 and over

Of the 3,160 patients registered at Wilton Health centre just 2% are recorded (on the clinical system) as being carers.

The Office of National Statistics website tells us that: our region (Wilton & Wylye Ward) contains:

  • 3% ethnic minorities
  • 16% Households with someone with a long-term illness
  • 36% households with dependent children
  • 25% unemployed or retired

Engagement

In order to obtain a representative sample of patients, 100 questionnaires were given to visiting patients by the Reception team. Clinics for pregnant women and chronic health conditions were targeted, as were patients with disabilities and from a variety of ethnic origins. We also sent out the questionnaire electronically to members of the Patient Reference Group (PRG) to encourage completion and a wide representation from our practice base.

Wilton Health Centre has two groups running simultaneously. The Patient Participation Group (PPG), which has been established for many years, but is largely presented by retired males and does not represent the surgery’s patient demographics. It has been very difficult to encourage patients to join the PPG, (perhaps due to the time commitment for meetings), so another group was formed: The Patient Reference Group (PRG), which is more representative of the practice population and a virtual group, which can be contacted via email or post.

Patient Participation Group (PPG)

Our Patient Participation Group (PPG)now comprises of just4members who are all registered patients. There is currently no presentation from female, younger patients, working aged patients or patients from ethic minorities. This was the reason why we decided to create a larger more representative group to drawn in ‘fresh blood’, whilst reducing the need for face-to-face meetings.

Patient Reference Group (PRG)

Patients joined the PRG in one of two methods, either by submitting a request to join, which was circulated during October – December 2011 and again October – December 2012 as part of an exercise to update patients’ personal records to include next of kin, alternative contact numbers and an option to join the PRG. (These members were added to an electronic register and were the initial group when collating ideas on what was important to them; as patients; in order to identify areas that could be addressed to improve their patient experience at Wilton Health Centre).

The second method of patient recruitment was opportunistic recruiting of patients when presenting to the surgery and they were asked if they would like to participate in the survey and help to surgery to address their needs and improve quality.

Breakdown of PRG members

There are now 98 active PRG members:

Gender:

There is an equal spilt between male and female patients

Age:

  • 0% wereunder 16
  • 1% were aged 17 – 24
  • 6% were aged 25 – 34
  • 4% were aged 35 – 44
  • 4% were aged 45 – 54
  • 13% were aged 55 – 64
  • 35%were aged 65 – 74
  • 28%were aged 75 – 84
  • 9% were aged 85 and over

Ethnicity:

The vast majority describe their ethnicity as “British” or “White British”. However as this information is drawn from the patients’ medical records (no ethnicity was recorded to participate in PRG) 32% of members have a “not known status”. 1 member stated their ethnicity was “Irish”.

Chronic Health Condition:

Over two thirds of the PRG members recorded stated that they had a chronic health condition (68%).

Carers:

4 patients stated that they were a carer for a relative, friend or neighbour.

Under Represented Groups

We feel that we were under-represented in younger patients aged between 17 and 44 (probably younger families, working, or healthy andtherefore not regularly seeing the GPs) as well as patients from ethnic minorities.

Method of Communication

This was very much two-fold. Initially patients were given a preference of contact method and we opted to send questionnaires electronically and via the postal system. The surgery also includes self-addressed envelopes to encourage participation at no additional cost to the patient.

Although email would be the most effective way of communicating, patients still prefer the information on paper and we will continue to offer both formats of communication. (One comment received back, was that the electronic copies of the questionnaire were difficult to complete as the form required tick, so perhaps in the future we will consider using a surveying tool, such as Survey Monkey)

Questionnaire

The questions were based upon areas identified in the preliminary questionnaire asking patients to identify the most important areas for development and improvement within the surgery. Over 80% of patients said appointment availability and continuity of care were the most important areas to them. This is a continuation of themes from last year and therefore it was decided to further survey and toinvestigate the impact of the changes already put into place since September 2012.

The questionnaire was circulated for patients to complete between 18th February and 1st March 2013.

Creditability of the Questionnaire

The design of our survey was based on a combination of the General Practice Assessment Questionnaire and discussions at Practice Manager’s meetings and Partners meetings.

We chose not to use an external agency, but interpreted the data in house with a double and sometimes triple check system to ensure the validity and accuracy of the data.

Respondents

Questionnaires were handed out to patients attending surgery between February and March 2013. 91 patients completed the questionnaire, all of which are registered patients.

Gender:

Of the surveyed patients: 33% were male and 58% female

Age:

Of the surveyed patients:

  • 2% were under 16
  • 3% were aged 17 – 24
  • 6% were aged 25 – 34
  • 16% were aged 35 – 44
  • 11% were aged 45 – 54
  • 19% were aged 55 – 64
  • 21%were aged 65 – 74
  • 18%were aged 75 – 84
  • 4% were aged 85 and over

Ethnicity:

The vast majority of patients surveyed descried their ethnicity as “White British” (98%). However the following ethnicities were also represented:

  • 1% “Indian”
  • 1% “Other Asian”

No one chose NOT to state their ethnicity

Employment:

The majority of patients who completed the survey were “retired” (43%). Only 40% of patients completing the survey are “employed” either full or part time (32% recorded as working “full time” and 9% recorded as working “part time”). However three people recorded their current employment status as being on “maternity or paternity leave”. There were 9 patients who are registered “disabled” and unable to work due to his/her disability, 3 “homemakers” and one “student” completed the questionnaires. Interestingly no one declared their status as “unemployed”.

Carers:

  • 9% care for a relative, friend or neighbour unpaid

Under Represented Groups

We feel that we were under-represented in younger patients aged between 17 – 44 (probably young families, working, or healthy and therefore not regularly seeing the GPs). We felt we were overrepresented in patients aged 65 and older and this is highlighted with the number of patients that completed the questionnaire and recorded employment status as “retired”. However this cohort of patients is the group the surgery sees most often and have the time to participate in extra voluntary activities.

We were satisfied with our representation from patients from ethnic minorities and felt this was in relation to the practice demographics and were extremely pleased with the improvement in being able to engage patients with disabilities. Last years’ survey did not include any patients with a disability, whereby this year 9% of completed questionnaires came from disabled patients.

We tried to reach out to these under represented communities by approaching them directly through GP involvement as well as Receptionists identifying during appointment bookings etc. Unfortunately the response was still lower than expected in these underrepresented groups. Posters displayed in the surgery or external community boards did not appear to be effective. More patients participated after being asked directly if they would like to join; whilst waiting for an appointment as they were a captured audience.

Themes emerging from the questionnaire

  • 97% of patients agree that the new Duty GP system works
  • A third of patients still unaware the appointment system had changed
  • Almost half of all patients to have gone through the Duty GP triage system were seen by a GP later that day
  • 75% of patients were called by a GP within 2 hours
  • Half of the patients completing the questionnaire were still not convinced that the new system improved availability to book appointment sup to 6 weeks in advance
  • Just over half of the patients felt that even with same day appointments that it matters which GP they are seen by
  • 80% of patients agreed that the sex of the GP did not matter if a same day appointments was required

Results of Survey

91 patients responded in full to the questionnaire (we discounted incomplete questionnaires).

History of Appointments

The majority of patients surveyed (43%) had had an appointment at thepractice within the last month, whilst almost a third had not had an appointment for 3 or more months.

Advance booking of appointments

Just over half of the patients were still unaware that they could book appointments up to 6 weeks in advance (49%). Although this is an improvement on last year’s results, whereby 59% said they were unaware of booking appointments 6 weeksin advance.

Two thirds of patients knew that the appointment system hadchanged and almost the same number of patients had had direct experience of this improvement.

Duty GP System

A staggering 97% of patients believe the new Duty GP appointment system works, with 18% of patients saying they thought the system worked because they did not have to come into the surgery and a further 32% agreeing that patients who need to be seen by a GP are seen by a GP (rather than the old system of first come first served and those patients may not necessarily need seeing by a GP on that day). 14% of patients reported that there were more routine appointments and 36% said that when they used the service, they were called back quickly and given an appointment.

A very small number of patients said they did not think the new system worked and the main reason was because they preferred the old system (first come, first served).

The majority of patients who had experienced the new Duty GP system had called between 0800 – 0900 (83%) and 75% of patients said they were called back by a GP within 2 hours. A staggering 92% felt that the time taken to call them back was acceptable.

Of the patients that went through the Duty GP system, almost half of them were seen later that day by a GP. Just under a quarter of patients said they were given advice over the telephone and there was no need to come into the surgery. 12% were issued with a prescription and a further 5% were provided with a sick note or referral.

Surprisingly it was a 50:50 split of opinion as to whether or not this help to improve patient’s ability to book in advance with the GP of their choice.

Just over half of patients felt it did not matter which GP you saw for a same day appointment and 80% were not bothered by the sex of the GP for on the day appointments. Of the remaining 20% of patients that expressed a desire to be seen by a particular gender of GP, the overall choice of sex was female, with one patient stating that they would always prefer to see a male GP.

Action Plan

Once the responses from the survey were analysed, members from the PPG and PRG met up to discuss the results and drew up an action plan. This was then circulated to the larger PRG for discussion and review before implementation.

Aim / Objective / Action Required / Deadline
To increase patient awareness for the advance booking of appointments (6 weeks in advance) /
  • Update Practice Leaflet.
  • Update Practice Newsletters
  • Display / inform patients via the TV screen
  • GPs to use template for follow up appointments (give to patients)
  • Complex patients to have care plans
  • Update website
/
  • 30/04/13
  • 30/04/13
  • 30/05/13
  • 30/03/13
  • 30/04/13
  • 30/03/13

To increase patient awareness regarding the Duty GP system (improve patient experience) /
  • Circulate information to patient attending surgery (practice leaflets, TV screen)
  • Update websites (for new patients or non-frequent attenders)
  • Review new patient packs to include information regarding duty GP system
/
  • 30/04/13
  • 30/05/13
  • 30/05/13

To consider online booking of appointments (improve patient experience) /
  • Discuss with partners
  • Discuss with TPP
/
  • 30/09/13

To encourage patients to receive SMS text messaging service (to improve DNA rates) /
  • Reception to promote awareness (face to face, leaflets, TV screen,
/
  • 30/05/13

Additional Information

Our list is open to new patients to register. Patients can register in person, or by downloading and completing an electronic form, which is available on our website

Our opening hours are Monday to Friday 0800 – 1830. We no longer close for lunch and the doors remain open between 1300 – 1400 (in response to patient suggestions previously made)

In addition, we hold an extended hours surgery once a week, either a weekday evening between 1830 – 2000 or on a Saturday morning between 0900 – 1030. All extended hours appointments are with a GP Partner and can be made in advance or on the day (except Saturday mornings whereby all appointments are made in advance – as there is no telephone triage available on the day).

Patients may book appointments with doctors or nurses by ringing the surgery or in person at the reception desk. We offer face-to-face as well as telephone appointments and all appointments are a minimum of 10 minutes in duration. If you require a same day appointment, we operate a Duty GP system, whereby all calls received between 0800 and 0900 are triaged by a GP with 1 – 2 hours. Requests for appointments after received after 0900 will also be triage by the Duty GP but may take a little longer to triage (due to pre booked appointments).

Updated: 18/03/2013