Seymour Medical Practice. Patient Participation Report

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1 Seymour Medical Practice Patient Participation Report

2 Contents Introduction Action Plan Review Survey Formulation and Conduct Survey Results Action Plan The Future of the Patient Reference Group Appendices A - Patient Profile B - Patient Survey C - Patient Survey Response Analysis D - Opening Hours Page 2 of 13

3 Introduction For the three NHS years to , GP practices have been encouraged to engage in a program of patient consultation within the structure of an optional Patient Participation Enhanced Service. The purpose of this program is to ensure that patients are consulted on decisions about the range and quality of services provided and, over time, commissioned by their practice. Seymour Medical Practice believes that it is good practice to consult our patients and is appreciative of the stimulus provided by this initiative and very grateful to the patients who have given their time to become involved in the our Patient Reference Group (PRG) and to respond to our patient survey. This report is structured to provide the required evidence to NHS England of the practice s engagement in a program of patient consultation as defined by the Patient Participation Enhanced Service and, as required, is also made available in its entirety on the practice s web-site We look forward to achieving our action plan and to continuing to consult patients about future changes. Page 3 of 13

4 Action Plan Review Performance against the Action Plan was reported to the PRG at a meeting convened in the Practice and those actions outstanding were reconsidered and where appropriate and agreed have been carried forward to the Action Plan. PRG Member Recruitment Public invitations to join the PRG resulted in more enquiries from patients from age and ethnicity groups which are already well represented. It has therefore been necessary to refrain from inviting such respondents to join the group to avoid further imbalance in the group composition. To address the ethnicity balance of the group, the Practice clinicians were asked to issue personal verbal invitations to specific patients who are in the under-represented groups. Print contact slips have been issued to clinicians so that potential members in these groups can provide their contact details to the Practice Manager. The Health Link workers were also asked to recommend members to the group. At the end of the year, the membership of the group was polled to confirm which patients wish to continue their membership and the results of this survey are outlined in Appendix A. The group membership is still subject to the historic under-representation of patients of Asian Indian and Black African ethnicity. The year-end survey has also revealed the withdrawal of younger members of the group who have indicated that they have insufficient time to attend the group meetings. The emerging age imbalance of the group will be addressed through the Action Plan. Customer Service The actions in this area are designed to improve patient satisfaction by demand management, capacity planning and raising practice staff skill levels. - Reception Staff Customer Service o Further Investment in Customer Service Training o Improve Reception Staff Presentation - Uniforms & Name Badges Under the Reception & Access Manager, the Reception team s annual staff appraisals, personal development plans, training and quarterly performance reviews are now being comprehensively implemented. Where appropriate, staff have been sent on external courses and the Reception & Access Manager has also run internal workshops in customer care. Monthly silent-monitoring of Reception staff call handling has also commenced. Reception staff are now wearing a new uniform in the Practice purple and name badges will be issued in Reception Staff Resourcing o Audit Telephone Demand Profile using new Telephone System Reporting Software o Re-plan Reception Resourcing within Existing Budget in line with Demand Profile Monthly reports of telephone demand management are now subject to analysis. Individual call handling statistics are now shared with each individual Reception staff member as part of their performance reviews. Page 4 of 13

5 Two members of the permanent Reception staff are now on flexible shift contracts allowing improved rota-ing of staff to match demand profile. - Improve Reception Front Desk Privacy o Install New Queue Barriers o Improve Patient Signage - Respect Reception Front Desk Privacy & Noise Level Awareness The queues for Seymour Medical Practice and Easton Family Practice have now been separated and the new queue barriers will be installed in April Signage regarding Reception front desk privacy will be mounted on the barriers. - Physical Queue Reduction o Implement Clinician Appointment On Time Status Messages o Re-audit Queuing Reasons o Increase Use of Check-In Screen - Regular Maintenance & Patient Training o Increase Telephone Appointment Booking dependent on telephone queue reduction o Increase Online Appointment Booking & Prescription Ordering o Increase Prescription Requests & Collection via Pharmacists The self check-in screen now reports the clinician on-time status to patients this has resulted in fewer patients queuing for appointment start time checks. Mounting the check-in screen on a pivot arm has enable Reception staff to provide informal patient training which has increased usage. Improved cabling of the check-in screen has reduced down-time. The Action Plan will focus on ways in which the physical queue demand can be reduced to a serviceable level by offering equivalent or superior alternative service solutions to our patients including telephone and online appointment booking and repeat prescription request/collection by pharmacists. - Telephone Queue Reduction o Install Back Office Telephone System Electronic Display Board - to report incoming call status o Review Installation of Patient Partner Automated Telephone Appointment Booking System o Patient Education Telephone Triage All Day Same Day Urgent Care o Increase Online Appointment Booking The telephone system electronic display board is scheduled for installation in May-14. In the interim, software has been installed on the Reception & Access Manager workstation to provide live information of call queuing which is then verbally relayed to the Reception team and can be used to allocated staff resources when possible. The Patient Partner telephone booking system was the subject of a pilot study by Easton Family Practice and was found to be significantly under-utilised by patients. The Practice has therefore decided to reserve this investment for other projects to improve customer service. The Reception team and the triaging GPs have continued to explain the All Day Same Day Urgent Care service to patients. The Action Plan will focus on ways in which the telephone demand can be met more effectively and whether this demand can be reduced by offering equivalent or superior alternative service solutions to our patients including online appointment booking. - Increase Online Appointment Booking & Prescription Ordering o Patient Education Online Appointment Booking & Prescription Ordering Page 5 of 13

6 o Patient Web-site Usage Workshop requires investigation o Staff Training Patient Registration for Web-site Usage The new patient registration form has been developed to give increased emphasis to registration for online appointment booking. Reception staff have been given further training so that they can better advise patients asking for online access or experiencing difficulties with online access. Further promotion of online access will be carried forward to the Action Plan and will be mounted following the migration of the appointment booking software to EMIS Web Appointments which will necessitate a change to the method of online access. Appointment Access The actions in this area are designed to increase patient satisfaction by improving appointment availability and appropriate usage. - Implement DNA Management The DNA policy implementation has been carried forward to the Action Plan as it is judged that the resources required to implement will be significantly reduced by the migration of the appointment booking software to EMIS Web Appointments. - Patient Education - Access o Urgent v Routine o Telephone Triage - All Day Same Day Urgent Care The distinction between urgent and routine healthcare needs and the telephone triage service offer has been communicated in every patient communication channel. This is an ongoing process of patient education. GPs are also reinforcing these messages during urgent care consultations particularly those presented to the telephone triage service. - Patient Education - Self Care & Pharmacy Consultations o Use of NHS Direct and o Minor Ailments Scheme The Practice have developed three web-site patient information videos and feature some of the Practice GPs advising patients on access and care of children with fever and respiratory infections. Other patient education initiatives are carried forward to the Action Plan. Repeat Prescription Administration The actions in this area are designed to increase patient satisfaction by improving repeat prescription administration and reducing Reception front desk queuing by promoting the use of pharmacists for repeat prescription requests and collections. - Encourage Pharmacist Prescription Collection - Review Pharmacist Repeat Prescription Request Process - Patient Education Repeat Prescription Process including Use of Pharmacist - Improve Efficiency of Pharmacist Repeat Prescription Administration Following review, the protocols for the pharmacist repeat prescription administration have been revised improving efficiency for both the pharmacist and the Reception team and resulting in pharmacists consuming less Page 6 of 13

7 Environment Reception front desk time thus improving the patients physical queue experience. The Action Plan will carry forward the patient education initiatives relating to the use of nominated pharmacists. The actions in this area are designed to attempt to tackle waiting room noise and improve way-finding in the Health Centre. - Improve Patient Signage - Noise Level Awareness - Implement New Health Centre Signage o Colour coded according to service o Visible from Waiting Room o Clearer Room Numbering New signage, colour-coded according to provider, has been installed throughout the Health Centre. The Action Plan will include some supplementary signage initiatives to deal with noise level awareness and to address some areas where room signage is not sufficiently visible from seating areas and in corridors. Page 7 of 13

8 Survey Formulation and Conduct For , the PRG agreed, at a group meeting convened in the Practice, that the survey should focus on the following priority areas: - Customer Service patient-staff interaction and response times - Appointment Access availability of appointments - Repeat Prescription Service use of nominated pharmacist Optional use of a nominated pharmacist was identified by the PRG as a way to reduce the physical Reception front desk queue and to allocate increased Reception team resources to providing an improved telephone service - Self Care use of appropriate alternative sources of care Appropriate self care was identified by the PRG as a way to improve appointment access These areas were identified taking into account: - the priority areas identified by the PRG members in the group meeting the identification of these issues was not contentious - comments and complaints received from patients during Within the priority areas identified, the survey was designed to: - evaluate patient satisfaction with existing services - measure improvements and action plan impact against previous year and targets - determine patient awareness of and willingness to use existing services Mindful of the relative success of response achievement in the & surveys relative to earlier Practice surveys, the PRG decided to continue to use a short survey format limited to a maximum of 15 questions. The questions were suggested in draft by the PRG, drawn up by the Practice and agreed by the PRG. The survey is included as Appendix B. The respondents to the survey were: - patients visiting the Practice who completed a print survey - patients who had accessed the telephone triage service who were surveyed by telephone - patients who completed the online survey To encourage response, the Practice again employed staff to approach patients in the waiting room. The Health Link workers were asked to approach and assist patients who did not have English as a first language. As before, the survey was also advertised on the Reception patient call boards and on every consulting room door and entry into a draw for a 20 shopping voucher was also offered. Usage of the online survey is relatively low. As a new initiative, a text message was sent to a pilot group of patients who had recently accessed services to ask them to complete the survey. This generated a 5% return and is a methodology which will be used more extensively in future when a bulk text message service is implemented. Page 8 of 13

9 Survey Results The survey results were fully analysed (Appendix C) and, where appropriate, compared with the results and the targets set as part of the action plan. The results were presented to the PRG at a group meeting convened in the Practice. The key survey results were: Customer Service - 85% found Reception staff very helpful or fairly helpful this shows an increase in satisfaction over 81% in and meets our target of 85% - 25% of patients find it very easy or fairly easy to get through on the phone this is a reduction on 29% in and falls short of our target of 35% - 50% consider that when queuing at the Reception front desk they are seen very quickly or fairly quickly this compares with 52% in and falls short of our target of 65% - 89% use automated check-in this compares with 81% in and is very close to our target of 90% Appointment Access - 78% with an urgent healthcare need were able to speak to a doctor within two days this compares with 67% in but still falls short of our target of 80% Since the telephone triage system offers a same day telephone consultation to any patient with an urgent healthcare need, this response may indicate a lack of understanding of this service or difficulty in making telephone contact with the Practice in the first instance - 64% could arrange routine appointments with a doctor or nurse within two weeks this compares with 81% in and falls short of our target of 80% Repeat Prescription Service - 60% of patients who receive repeat prescriptions ask their nominated pharmacist to request their prescriptions - 50% of patients who receive repeat prescriptions ask their nominated pharmacist to collect their prescriptions Self Care - 5% had watched the Practice s self-care videos (Unaware 50%) - 50% have consulted a pharmacist (Unaware 14%) - 29% have used the NHS Direct web-site (Unaware 19%) - 46% have telephoned NHS Direct/111 (Unaware 9%) - 79% would like the Practice to provide more self care information 50% would prefer print information 27% would prefer web-site articles/videos Page 9 of 13

10 Action Plan Having analysed the survey results and mindful of the economic resources of the Practice, the following Action Plan was agreed with the PRG at a group meeting convened in the Practice. This plan combines new initiatives with actions carried forward from the Action Plan. Again, the survey, and discussions with the PRG, highlighted areas where patient s awareness or understanding of services was limited. PRG Member Recruitment The actions in this area are designed to recruit new members to the PRG improving the ethnicity and age balance and to ensure member retention. - Membership Recruitment o Web-site Develop section focused on Patient Participation o Clinician Verbal Invitations To Asian Indian and Black African patients To patients in the age range o Text Message Invitations To patients in the age range Membership Retention o Practice Manager Survey - withdrawing members in age range o New Communication & Meeting Structure subject to approval of existing PRG Existing active members favour maintaining the current meeting times and prefer to have face-to-face meetings. Patient Communication & Education The actions in this area are designed to improve communication with patients. These communication streams will be used to channel the patient education initiatives identified in the Action Plan. - Web Site o Develop mobile site o Develop additional sections o Update regularly - Newsletters o Minimum of two newsletters per year o Print available at Reception o Digital available on web-site - Telephone System Messages include call waiting messages and update regularly investigate - Reception Patient Call Board Messages update regularly - Reception Notice Board update regularly - Prescription Messages only applies to patient-collected prescriptions update regularly Page 10 of 13

11 - Staff Promotion brief staff on issues to promote with individual patients where appropriate and possible Customer Service The actions in this area are designed to improve patient satisfaction by demand management, capacity planning and raising Practice staff skill levels. - Reception Staff Customer Service o Improve Reception Staff Presentation - Name Badges o Improve Reception Staff Approach Greet with a Smile - Reception Staff Resourcing o Audit Telephone Demand Profile o Re-plan Reception Resourcing within Existing Budget in line with Demand Profile - Improve Reception Front Desk Privacy - Install New Queue Barriers including Reception front desk privacy signage - Physical Queue Reduction o Re-audit Reception Front Desk Presentation Reasons o Increase Telephone Appointment Booking dependent on telephone queue reduction o Increase Online Appointment Booking & Prescription Ordering dependent on migration to EMIS Web Appointments o Increase Prescription Requests & Collection via Pharmacists - Telephone Queue Reduction o Audit Telephone Call Reasons o Install Back Office Telephone System Electronic Display Board o Patient Education Telephone Triage All Day Same Day Urgent Care o Increase Online Appointment Booking dependent on migration to EMIS Web Appointments - Increase Online Appointment Booking & Prescription Ordering o Implement EMIS Web Appointments new online access method o Patient Education Online Appointment Booking & Prescription Ordering o Staff Training Patient Registration for Online Access Appointment Access The actions in this area are designed to increase patient satisfaction by improving appointment availability and appropriate usage. - GP & Nurse Recruitment & Retention The Practice has shared with the PRG the issues relating to the national supply of GPs and the additional issues relating to the perception of inner city work. - Implement DNA Management dependent on migration to EMIS Web Appointments - Patient Education - Access o Urgent v Routine o Telephone Triage - All Day Same Day Urgent Care Page 11 of 13

12 It is anticipated that self care initiatives will also have an impact on access and action relating to increasing appropriate self care are listed below. Repeat Prescription Service The actions in this area are designed to increase patient satisfaction by offering the option of a more convenient service and reducing Reception front desk queuing by promoting the use of pharmacists for repeat prescription requests and collections. - Patient Education Repeat Prescription Process including Use of Nominated Pharmacist for Request and Collection - Audit Patient Experience of Repeat Prescription Process using a Nominated Pharmacist for Request and Collection - Join Pilot of Electronic Prescribing Service electronic transfer of prescription request and fulfilment between Practice and pharmacists Self Care The actions in this area are designed to improve appropriate self care and use of other health care resources to improve access to GP & nurse appointments while maintaining patient safety. - Patient Education o Self Care Concept o Pharmacists o NHS 111 & NHS Direct - Practice Web-Site Self Care Section Develop & Promote - Self Care Videos Develop Further & Promote - Self Care Articles Develop Web-Site & Print Environment The actions in this area are designed to attempt to tackle waiting room noise and improve way-finding in the Health Centre. - Improve Patient Signage - Noise Level Awareness - Health Centre Signage o External Opening Times & Contact Sign o Additional Waiting Room & Corridor Directional Signs This Patient Participation Report will be published on our web-site and print copies will be made available to patients on request. The report will be advertised in our next print newsletter and on our Reception patient call boards. Progress against plan will be made, and reported to the PRG, during In the view of the Practice, the action plan does not raise any contractual issues. Page 12 of 13

13 The Future of the PRG The Practice intends to continue working with the PRG. The patient membership of the Patient Reference Group (PRG) will be subject to renewed recruitment activity in with particular focus on the recruiting members to restore the age and ethnicity balance of the group. Sarah Forde, Practice Business Manager, and Dr Ruth Muir, GP Partner, will continue to be involved in the management of the Practice s Patient Participation program. As in , opportunities will also be taken to introduce other members of the Practice team at PRG meetings. Going forward it is envisaged that the PRG will be consulted on issues that will inform the Clinical Commissioning Group s commissioning decisions. Page 13 of 13

14 Seymour Medical Practice Patient Participation Report Appendix A Seymour Medical Practice Patient Participation Report Appendix A Patient Reference Group Patient Profile Age Practice PRG % No. % Under 16 20% 0 0% % 0 0% % 0 0% % 1 8% % 2 17% % 5 42% % 1 8% % 1 8% Over 84 1% 2 17% Gender Practice PRG % No. % Female 46% 7 58% Male 54% 5 42% Ethnicity Practice PRG % No. % White - British 39% 4 33% White - Irish 1% 0 0% White - Other 2% 0 0% Mixed - White & Black Caribbean 3% 1 8% Mixed - White & Black African 1% 0 0% Mixed - White & Asian 0% 0 0% Mixed - Other 0% 0 0% Asian or Asian British - Indian 6% 0 0% Asian or Asian British - Pakistani 16% 2 17% Asian or Asian British - Bangladeshi 3% 0 0% Asian or Asian British - Other 2% 0 0% Black or Black British - Caribbean 17% 4 33% Black or Black British - African 7% 0 0% Black or Black British - Other 1% 1 8% Chinese 1% 0 0% Other 0% 0 0% Page 1 of 1

15 Seymour Medical Practice Patient Participation Report Appendix B Seymour Medical Practice Patient Participation Report Appendix B Patient Survey Introduction In consultation with our Patient Reference Group (PRG), the Seymour Medical Practice has prepared this short patient survey to consult on certain areas of our operations. The questions in the survey relate to the areas of operation that the PRG, other patient comments and the Primary Care Trust have highlighted as priority areas for review and action. Our aim is to improve the service that we offer within the budgetary constraints to which we are subject. The Practice will use the results of this survey to inform the development of an Action Plan which will be published and available for all patients. This is an on-going process of patient participation. Please tick one response to each question. The Survey Patient Profile It would be helpful if we could know how often you use our services 1. How often do you telephone or visit the Practice? Weekly Monthly More than once a year Once a year Less than once a year Never Customer Service We would like to understand how patients perceive our reception service both at the front desk and on the telephone. 2. How helpful do you find our reception staff? Very helpful Fairly helpful Not very helpful Not at all helpful Don t know 3. When you telephone the Practice, how easy is it to get through? Very easy Fairly easy Not very easy Not at all easy Don t know Page 1 of 3

16 Seymour Medical Practice Patient Participation Report Appendix B 4. When you need to talk to someone at our reception desk, how quickly are you seen? Very quickly Fairly quickly Not very quickly Not at all quickly Don t know 5. Do you use our automatic appointment check-in service? Yes No If no, why not? Appointment Access We would like to understand how patients feel about the availability of appointments with the Practice. 6. If you need to consult a doctor urgently, are you able to speak to a doctor, within two days? Yes No If no, why not? Don t know 7. If you need to arrange a routine, non-urgent appointment with a doctor or a nurse, are you able to book an appointment within the next two weeks? Yes No If no, why not? Don t know Repeat Prescription Service We would like to understand our patients use of nominated pharmacists if they are receiving repeat prescription service from the Practice. 8. If you use our repeat prescription service, do you ask a nominated pharmacist to request your prescriptions? I do not receive repeat prescriptions Yes No If no, why not? 9. If you use our repeat prescription service, do you ask a nominated pharmacist to collect your prescription for you? I do not receive repeat prescriptions Yes No If no, why not? Page 2 of 3

17 Seymour Medical Practice Patient Participation Report Appendix B Self Care We would like to understand how our patients source self care information. 10. Have you watched the new self-care videos on our web-site? I did not know about this service Yes No If no, why not? 11. Do you consult your pharmacist about your healthcare needs? I did not know about this service Yes No If no, why not? 12. Do you consult the NHS Direct web-site about your healthcare needs? I did not know about this service Yes No If no, why not? 13. Have you ever telephoned NHS 111 or its predecessor NHS Direct? I did not know about this service Yes No If no, why not? 14. Do you think the Practice should be providing more self-care information? Yes No If no, why not? 15. If the Practice was to provide more self-care information, what format would you prefer? Print Web-site Articles Web-site Videos Other If other, what format would you prefer? Thank you for taking part in our survey Please post your completed survey into the Patient Survey Response Box All survey respondents are also invited to complete the attached draw voucher Please separate the voucher from your survey response and post both into our Patient Survey Response Box Page 3 of 3

18 Seymour Medical Practice Patient Paticipation Report Appendix C Number of Responses 259 2% Of Patient List Patient Profile 1. How often do you visit the Practice? Weekly 15% Monthly 45% More than once a year 33% Once a year 2% Less than once a year 3% No Response 1% Seymour Medical Practice Patient Participation Report Appendix C Patient Survey Response Analysis Customer Service 2. How helpful do you find our reception staff? Target Very helpful 37% Fairly helpful 48% 85% 81% 85% Not very helpful 11% Not at all helpful 3% 2% Don't know 1% No Response 3. When you telephone the Practice, how easy is it to get through? Target Very easy 9% Farily easy 14% 23% 29% 35% Not very easy 37% Not at all easy 39% 15% Don't know 2% No Response 4. When you need to talk to someone at our front desk, how quickly are you seen? Target Very quickly 7% Fairly quickly 43% 50% 52% 65% Not very quickly 37% Not at all quickly 11% 9% Don't know 3% No Response 5. Do you use our automatic appointment check-in service? Target Yes 89% 81% 90% No 11% If no, why not? Page 1 of 3

19 Seymour Medical Practice Patient Paticipation Report Appendix C Appointment Access 6. If you need to consult a doctor urgently, are you able to speak to a doctor within two days? Target Yes 78% 67% 80% No 13% If no, why not? Don't know 9% 7. If you need to arrange a routine, non-urgent appointment with a doctor or a nurse, are you able to book an appointment within the next two weeks? Target Yes 64% 81% 80% No 26% If no, why not? Don't know 10% Repeat Prescription Service 8. If you use our repeat prescription service, do you ask a nominated pharmacist to request your prescriptions? Target I don't receive repeat prescriptions 32% Yes 41% 60% 70% No 27% 40% If no, why not? 9. If you use our repeat prescription service, do you ask a nominated pharmacist to collect your prescriptions? Target I don't receive repeat prescriptions 30% Yes 35% 50% 70% No 35% 50% If no, why not? Self Care 10. Have you watched the new self-care videos on our web-site? I did not know about this service 49% Yes 5% No 46% If no, why not? 11. Do you consult your pharmacist about your healthcare needs? I did not know about this service 14% Yes 50% No 35% If no, why not? 12. Do you consult the NHS Direct web-site about your healthcare needs? I did not know about this service 19% Yes 29% No 52% If no, why not? Page 2 of 3

20 Seymour Medical Practice Patient Paticipation Report Appendix C 13. Have you ever telephoned NHS 111 or its predecessor NHS Direct? I did not know about this service 9% Yes 46% No 44% If no, why not? 14. Do you think that the Practice should be providing more self-care information? Yes 79% No 21% If no, why not? 15. If the Practice was to provide more self-care information, what format would you prefer? Print 56% Web-site articles 16% Web-site videos 10% Other 18% If other, which format? Page 3 of 3

21 Seymour Medical Practice Patient Participation Report Appendix D Seymour Medical Practice Patient Participation Report Appendix D Opening Times & Appointments The practice is open for telephone calls Monday to Friday The health centre is open Tuesday to Friday and and on Monday. Pre-bookable appointments are available from to Routine appointments can be booked in advance by telephoning , by visiting the practice or on our web-site for patients registered for online access. Patients who contact the practice with an urgent care need will be offered a call-back from a doctor under our telephone triage system. The doctor will normally call within two hours to discuss the patient s condition and to determine the most appropriate way to meet their healthcare needs. The practice also offers pre-bookable routine appointments on Wednesdays and on alternate Saturday mornings. At these times, the health centre is only open for those patients with booked appointments. Page 1 of 1

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