The Leys Health Centre Oxford

Patient Participation Report 2012/13

Produced for the Patient Participation DES 2012-2013

This report summarises development and outcomes of The Leys Health Centre Reference Group (PRG) in 2012/13.

It contains:

A Practice Profile

A summary of our practice profile including patient demographics

It also contains the following sections which reflect the DES components as outlined in the Patient ParticipationDES self declaration form 2012/13

1. Establishing a Patient Reference Group (PRG)

A summary of the recruitment process used to ensure that the PRG is of sufficient size to be as

representative as possible of the Practice population.

2. Method and Process for Agreeing Priorities for a Local PracticeSurvey

The method the Practice adopted to seek the views of the PRG in determining the priority areas for

the Practice, to include in a local practice survey.

3. Details and Results of the Local Practice Survey

A description of the local practice survey and how it was carried out, as well as details of the survey

results.

4. Discussing Survey Results with the Patient Reference Group (PRG)

Details of how the Practice consulted with the Patient Reference Group (PRG)

5. Agreeing an Action Plan with the Patient Reference Group (PRG)

Details of the draft action plan setting out the proposals arising out of the local practice survey

results, how that was agreed and how the proposals can be implemented

6. Publishing the Local Patient Participation Report

Details of where this Report has been published and also details of the Practices opening hours and how patients can access services

Practice Profile

The Leys Health Centre is a large, busy, multidisciplinary training practice five miles from Oxford city centre. It has a patient list of 10,650 serviced by 7 GP Partners plus two further GPs and a registrar. There are also 3 practice nurses and two Phlebotomists/Healthcare assistants.

Ethnically the Practice population is made up principally of those who would describe themselves as ‘white British’ (over 50%) and ‘white/mixed British’ (18%). The remainder (and who have stated their ethnicity) come from a wide variety of ethnic groups – see graph below.

The vast majority of patients (88%) have English as their first language. The remainder (and who have stated their main language) speak a wide variety of languages. The following graph shows these. However, day-to-day experience also tells us that most of these patients have English as a second language.

In terms of gender, the practice population is evenly balanced. However as the next graph shows the practice has a significantly larger proportion of children and younger adults than older adults.

1.Establishing a Patient Reference Group

Develop a Structure that gains the views of patients and enables the Practice to obtain feedback from the Practice population e.g. a Patient Reference Group (PRG)

DES Component 1

As part of component 1 of the DES Practices are required to establish a Patient Reference Group comprising only of Registered Patients and use best endeavours to ensure their PRG is representative.

Recruiting to the Patient Reference Group (PRG)

1.1Process

The Leys Health Centre continued its PRG recruitment this year in order to further improve representation:

1)Surgery decorated with posters in key locations such as the reception desk, pin boards, front door, back of toilet doors, walls etc.

2)Display stand in reception with balloons, posters, and survey topic/sign up forms, etc.

3)Survey topic/sign up forms were uploaded onto The Leys Health Centre website.

4)Survey topic/sign up forms were published in the November 2012 edition of the Leys News. (This free newspaper reaches 5,000 plus households in the Leys area.) This was identical in content to the leaflets used in the surgery.

5)Patients were asked on an ad-hoc basis by doctors if they wished to join the group

6)Doctors also nominated patients from ‘special care groups’ e.g. blind, hard of hearing etc., who may be interested in becoming members of the PRG. This list of patients was contacted by letter and telephone and four of them agreed to join the PRG.

A decision was taken at the beginning of the process in 2011 to create a ‘virtual’ PRG and to try and recruit as many patients as possible to become members. This was in an effort to try and make the PRG as broad and representative as possible. A strong, positive feature of a relatively large PRG, such as this, is that it represents a very large range of individual characteristics and needs for the patients themselves, but also within their extended families

This approach continued in 2012/13 and, in order to reach those who were unable to come into the surgery, such as frail or care home residents, and the ‘usually well’, who would only attend surgery rarely, we placed an article in the November 2012 issue of the Leys News. This article advertised that we were still actively recruiting for new PRG members and included a form enabling people to vote for topics to be included in our Patient Survey. This free paper reaches nearly 100% of the households in our Practice catchment area.

New members of the PRG are welcome at any time. This has also been reflected on the practice website since the launch of the PPG. 16 new PRG members have joined between April 2012 and March 25th2013, while we have lost 25 due to natural ‘patient churn’.

The Leys Health Centre’s PRG communication strategy has continued to offer the opportunity to participate to the broadest possible range of individuals and groups.

The Leys Health Centre is also trying to engage a small sub-group of the larger virtual PRG to become more directly involved. 7 members of our PRG have agreed to meet with members of the Leys Health Centre for a broad discussion on the future shape of the PRG. A date for this has yet to be set.

1.2 Patient groups represented in the Practice PRG.

Patient Reference Group

  • All the data collected from the ‘sign up’ sheets was entered into an excel work book in 2012 and cross referenced with EMIS to allow further information to be included, such as demographics etc. This allowed the Practice to analyse the comments made and establish how representative the PRG was. The database has been updated as new members have joined and members have left.

The patient group comprises 244 members

PRG PROFILE

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Report_to_PCT_The_Leys_Health_Centre_PPG_28 Mar20132.doc

Gender

  • Male 73
  • Female171

Age

  • Under 16 2
  • 16-24 21
  • 25-34 61
  • 35-44 50
  • 45-54 42
  • 55-64 18
  • 65-74 30
  • 75-84 19
  • 85-89 1

Employment Status

  • Employed83
  • Unemployed NK
  • Retired 3
  • Student 1
  • Not stated 157

Specific Groups

  • Drug users 0
  • Care home residents/

Sheltered housing 0

  • Representative for above1
  • Learning disability 1
  • Other disability 1
  • Carers6

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Report_to_PCT_The_Leys_Health_Centre_PPG_28 Mar20132.doc

Ethnicity

  • African 3
  • Albanian 0
  • Bangladeshi 1
  • Black British0
  • Mixed British 37
  • Caribbean2
  • Indian7
  • Irish1
  • Polish4
  • Spanish1
  • Other Asian5
  • Other black2
  • White British 127
  • Ethnicity not stated 50
  • Other white 4

Languages

  • Arabic 1
  • Bengali 1
  • Czech 1
  • English 211
  • Hindi 1
  • African 0
  • Polish 3
  • Portuguese 1
  • Punjabi 1
  • Sinhala 1
  • Spanish 1
  • Tagalog 3
  • Turkish 0
  • Yoruba 1
  • Not specified 18

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Report_to_PCT_The_Leys_Health_Centre_PPG_28 Mar20132.doc

2. Method and Process for Agreeing Priorities for the Local Practice Survey

Agree areas of priority with the Patient Reference Group (PRG)

Component 2

As part of component 2 of the DES Practices are required to agree which issues are a priority and include these in a local Practice Survey.

The PRG and the Practice will shape the areas covered by the local practice survey. The areas covered in the local practice survey will, therefore, need to be agreed jointly based on key inputs including the identification of:

  • Patients priorities and issues
  • Practice priorities and issues including themes from complaints
  • Planned Practice changes
  • National GP and/or Local Patient issues

The process used to seek the views of the Patient Reference Group in identifying the priority areas for the survey questions.

  • The surgery was decorated with new posters and survey topic forms were made available in the waiting areas.
  • Forms to establish priority areas for the Patient Survey were also published in the November 2012 issue of the Leys News.
  • Survey topic forms were uploaded onto the practice website.
  • All PRG members were contacted via email or post, asking for their feedback on the proposed questions for the patient survey and updating them on progress made since last year.
  • By 19/11/12 only 25 responses had been received and so over 200 ‘telephone call attempts’ were made to the PRG membership with over 75 PRG members completing the survey over the phone.

The priority areas and how these match those set out by the PRG

The priority areas for the local practice survey were taken directly from the top three responses received during the consultation phase with the PRG.

Priority areas were as follows:

1Grounds and Parking26%

2No improvements necessary23%

3Access to GPs/GP services/Practice Nurses22%

3. Details and Results of the Local Practice Survey

Collate patient views through the use of a survey

Component 3

As part of component 3of the DES Practices are required to collate patients’ views through a local practice survey and inform the Patient Reference Group (PRG) of the findings.

The Practice must undertake a local Practice survey at least once per year.The number of questions asked in the local practice survey will be a matter for the Practice and the PRG to agree. Questions should be based on the priorities identified by the PRG and the Practice.

3.1 Survey questions

  • Details of how the practice determined the questions to be used in the survey are detailed in the practice response 2 above.
  • The practice based the survey on the top three topics
  • Detailed survey questions were designed by a GP Partner at the practice who has extensive experience of research and survey design.
  • The survey went through several iterations, being reviewed by both GPs and non-clinical staff members, and then tested on a small number of “guinea pigs” who had not previously seen the survey. While the survey is no longer available to view, the questions can be seen alongside the results on the practice website

Survey method

3186 patients were invited to participate in the survey, a three-fold increase on last year:

  • 2166 patients were texted and prompted to visit The Leys Health Centre website to complete the Patient Survey or pick one up at the surgery
  • 624 were emailed a copy of the Patient Survey
  • 396 Patient Surveys were posted to patients

(Patient searches were set up to ensure that patients were not duplicated across media)

  • Printed copies of the Patient Survey were left in reception
  • The practice website included a link to the survey
  • Posters were produced and sited around the building encouraging patients to complete the Patient Survey
  • An article was placed in the January 2013 edition of the Leys News encouraging patients to take part in the Patient Survey.

Survey rationale

  • The Leys Health Centre wanted to try and increase its reach with regard to the Patient Survey and so chose to fully utilise the text numbers and email addresses, flagged with consent, held on our system.
  • It was verified that the mobile numbers accurately reflected the demographics of our patient population between the ages of 16 and 55. Therefore, selecting all these patients would not significantly skew the results within this age range.
  • As older patients were not well represented within the text numbers used, patients between 55 and 85 were selected for postal surveys
  • Advertising in the local paper was designed to capture patients who were registered at the practice but who do not attend on a regular basis

Collation of the survey results

  • All hard copy answers received were then collated and manually entered into the website survey software. (The practice still holds all completed paper surveys.)
  • The website survey software collated the results. The results were circulated to the partners for their feedback and to all the members of the PRG for their feedback. There was no negative feedback
  • 176 responses were received before the deadline - a 53% increase on 2011/12.

Publication of patient survey

  • A copy of the survey results are published on the practice website and displayed in the Practice waiting room (March 2013)

4. Discussing Survey results with the Patient Reference Group (PRG)

Provide the Patient Reference Group (PRG) with the opportunity to discuss survey findings and reach agreement with the PRG of changes to services.

Component 4

As part of component 4 of the DES Practices are required to provide the Patient Reference Group (PRG) with the opportunity to comment and discuss findings of the local practice survey andreach agreement with the PRG of changes in provision and manner of delivery of services. Where the PRG does not agree significant changes, agree these with the PRG.

Consultation with the PRG on the findings of the survey and any proposed changes highlighted from it.

  • The practice emailed or posted a copy of the Patient Survey results to the PRG membership, together with our proposed Action Plan and asked them to comment, or simply email or post back the form marking it with the words,” Go Ahead”, if they were happy. Boxes were left in reception to receive the responses.
  • Some positive responses were received. No amendments were requested nor negative feedback received within the time period (or since).

5. Agreeing an Action Plan with the Patient Reference Group (PRG)

Agree and Action Plan with the Patient Reference Group (PRG) and seek PRG/PCT agreement to implementing changes.

Component 5

As part of component 5 of the DES the practice is required to agree with the PRG an Action Plan setting out the priorities and proposals arising out of the local patient survey. They are also required to seek agreement from the PRG to implement any changes and where necessary inform the PCT.

5.1 Action Plan that relates to the survey results and copy of the agreed Action Plan for 2012/13.

66% of patients, who responded to the Patient Survey, agreed with the PPG that ‘Grounds and Parking’ as well as ‘Access to GPs’ were their key topics for 2013. 23% had other concerns.

Parking/Grounds

  • Nearly half of those who responded to the question, agreed that parking provision at the health centre is not acceptable and virtually all respondents felt that the situation had got worse over recent years. 7 out of 10 thought that the opening of the dental surgery had inevitably added pressure to the existing parking problems.
  • 43% of respondents felt that disabled patients were disadvantaged
  • 40% agreedthat having more than one wheelchair that carers could use to transport patients from their cars, would make them less concerned about the availability of disabled parking bays.

ACTION: Explore a suitable location in reception for 2 wheelchairs to help carers transport disabled patients from their cars to reception and back.

  • A majority of those who respondedwere preparedto use a bus [12 was most often cited] if it stopped outside the health centre and close to their home and could turn round.They were prepared for this service to run half-hourly. Falcon Road/Knights Road area was identified as an area poorly served by buses at present. In contrast 60% were not interested in a ‘dial a ride’ service.

ACTION: Liaise with the local council and bus operator(s) to establish whether existing routes could be adapted to accommodate patient views.

  • Almost 6 out of 10 respondents expressed their desire to see the grass area in front of the surgery converted into additional parking.

ACTION: The practice does not own this piece of land but will liaise with the landlord of the site in order to establish whether this would be practical/possible.However, funding will be a major issue, even if this is possible.

  • There were opposing views with regard to creating designated parking in surrounding roads.

ACTION: No action at present

  • There was a mixed response with regard to the provision of facilities to lock up bikes and motorized buggies with CCTV coverage. 46% agreed that they would like such facilities but 42% neither agreed nor disagreed. This could be because 6 out of 10 respondents stated that they do not have access to a bicycle.

ACTION: Practice to contact landlord to see what might be possible. Some respondents made interesting suggestions about parking which will also be explored.

Access to GPs/GP services/Practice Nurses

  • Feedback was extremely encouraging throughout this section. 66% of respondents felt that not much needed to change regarding access to GPs and 72% felt that the steps the practice was making would improve access to GPs and nurses for appropriate problems. Only 1% disagreed with this.
  • 82%,of those who responded, would be willing to see a Minor Illness Nurse for things such as cough, cold, earache, etc. Only 7% disagreed/strongly disagreed.

ACTION: We have a new nurse starting in April 2013 who has specialist skills in minor illness and these will be available to patients in the next couple of months.

  • 69% of respondents felt that providing feedback about whether attendance at Open Surgery was appropriate for a particular condition would help keep Open Surgery available to patients with urgent problems. Only 8% disagreed.
  • 67% of respondents would be happy to receive such feedback

ACTION: We are going to change Open Surgery with the objective of improving access for patients who have medically urgent problems. We will take patients feedback about Open Surgery into account. This is a major project requiring many communication strands and staff retraining. We will have to plan carefully and progress will be announced in the next few months.