UNIVERSITY MEDICAL CENTRE PATIENT PARTICIPATION GROUP ANNUAL REPORT & ACTION PLAN

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1 UNIVERSITY MEDICAL CENTRE PATIENT PARTICIPATION GROUP ANNUAL REPORT & ACTION PLAN Introduction & Recruitment of the Patient Participation Group Review on how and why the Patient group was established: The University Medical Centre Patient Participation Virtual ( ) Group was established in October Recruitment pathways to actively encourage patients to participate in the new group led to discussions between the Medical Centre and various student bodies within the University. Support in securing further new contacts within various University Departments was achieved and the reasoning behind why the Medical Centre wished to create a patient group and what was hoped to be achieved from doing so was communicated successfully. Advice was sought regarding a best practice approach to be adopted to help inspire interest from the student population and how we could actively encourage participation in what would become the patient representative voice of the University Medical Centre. It was extremely beneficial that the new University contacts included staff within the student union and various student support groups. Taking advice from knowledgeable University staff well placed to disseminate information to students has proved to be a positive step in helping the University Medical Centre recruit from our registered student patient population. The task of recruiting members from our local residential patient population outside of the University was met by simple advertising within the Practice and by on- going face to face discussions both in the Practice and at health promotion events. There has to date continued to be a positive interest resulting in a well- balanced membership which includes older and employed patient representatives complimenting the younger student demographic to successfully retain our Patient Participation Representative Group. 2012/13: Patient Participation Group - Update: The University Medical Centre Patient Group will always need to reflect a changeable membership due to the large number of patients registering with the Practice each year when the new academic student intake enrols in the University. In order to ensure patient group numbers are maintained when students move away it has been essential to continue advertising the opportunity to participate in the Practice s patient group and to allow new members to join at any time. The recent Report produced by the Primary Care Foundation for the University Medical Centre suggested a 27.8% turnover on the Practice patient list each year. This evidences the need to ensure the Patient Participation Group remains open for membership and that there is a need to monitor and maintain representation from all groups of our patient demographic. Alongside recruitment of new members to the Patient Group, most of whom are new University students, the Practice has also managed to retain and increase membership from our local residential patient population and also University staff registered as patients with the Practice.

2 Sustained membership has helped to provide some stability and consistency whereby more established members of the group are well positioned to review the changes and improvements that have been considered or implemented by the Practice over the last few years. Continuity of membership working in harmony with the new student patient representative helps to make us aware of issues, concerns or feedback that may differ depending on the individual patient type that is priorities to be considered for change or improvement could vary depending on whether a patient was a local resident, a University member of staff or a student. The ability to have input from such a wide and diverse patient community is extremely important and helps the Practice to recognise areas for focus when we review and look to improve our primary care service provision. Why a Patient Participation Virtual ( ) Group and how this has evolved? Taking in to account expert knowledge from our University contacts it was deemed that a Patient Participation Virtual ( ) Group would be the most appropriate option to introduce over and above a face to face patient representative group. With a predominantly young patient demographic registered with the Medical Centre it is apparent that patients engage very well with this virtual method of communication. It was considered that a virtual forum would act as ongoing encouragement to our younger patients to participate who may otherwise have been deterred had there only been the option of a physical group. It was also understood from previous attempts to introduce a patient forum at the Medical Centre that the younger population would be much more likely to participate in far greater numbers if a virtual group was established. Whilst the patient group has remained in the form of a virtual representative, moving in to 2012 and 2013 the Practice has also had an element of physical engagement on an ad hoc basis. This has been made available to help and offer support to the on- going needs of our very diverse patient population and the Practice would like to continue to encourage the possibility of a more established physical patient group if patients are happy and willing to partake in this way. Whilst currently most patients have preferred to continue with virtual participation, the option to engage face- to- face remains available to offer a combination of virtual and physical patient group representation. How have we engaged with our Patient Community? The Medical Centre continues to engage with the University community by actively participating in the Annual Freshers Fair on campus and offering a two week new student registration period at the Practice every September. Medical Centre staff also support the University s Refresh Fair during February which is another opportunity to offer advice and information and to make new patients aware of the Practice s Patient Group should they wish to join. Participation in ad- hoc health promotion activities at the Practice and on- site at various locations within the University campus has continued. The student union and student advice representation centre have organised campaigns which were supported by Medical Centre staff and we maintain a keen commitment to continue to participate in such events. The Practice has also worked closely with the University Health & Safety Office to help provide a number of joined up thematic health promotion campaigns aimed predominantly at University Staff. Membership forms for the Patient Participation Group are made available when supporting health promotion events to ensure our wider patient base who may not regularly visit the Practice can access this information.

3 In addition to attending promotions and campaigns, the Practice has also engaged with the School of Management having met with a group of MBA students focused on a Project to understand how patients can access Primary Care services. This engagement was beneficial by way of receiving feedback from yet another element of the University community and our wider patient group. The Practice believes in the importance in this type of ad- hoc engagement and communication which helps to achieve input from our diverse patient demographic. The different ways in which we continue to engage with our patients ensures that the views and opinions from all representative groups that make up our patient community can be obtained and not only those who regularly attend the Practice. The continuation of our Patient Participation Group will help the Practice to achieve important feedback to help us focus on what should be considered as priority areas for future developments as we look towards continued improvement. University Medical Centre Practice List Size, Profile & Population Type: The University Medical Centre has 11,141 patients currently registered as of March 23 rd The Practice registered patient list changes almost daily with larger fluctuations in patient numbers recorded from late June each year when students leave and de- register from the Practice. Patient numbers fluctuate dramatically once again each September when approximately 3,000 new students from the University s annual academic intake register with the Practice. Most recent analysis identified a 27.8% turnover of patients on the Practice s registered list each year. The Practice continues to deliver all core primary care services to local residents and to the University community which includes students and staff. Student patients make up the largest proportion of the Practice s patient list. Practice Profile: Gender 5980 patients (54 %) are Male 5161 patients (46%) are Female Practice Profile: Age 0.6% aged under 16 76% aged between % aged between % aged between % aged between % aged between % aged between % aged between % aged over 84 Practice Profile: Ethnicity 67% represent the White British ethnicity profile group 3% represent the White and Black Mixed ethnicity profile group 0.5% represent the White and Black African ethnicity profile group 9% represent the Asian / Mixed British ethnicity profile group 0.5% represent the Black British or African ethnicity profile group

4 14% represent the Chinese ethnicity profile group 6% of patients represent the other ethnic origin profile group Patient Participation Representative Group Profile 2013: The Patient Participation Group currently consists of 31 members as follows: Patient Participation Group: Gender 17 patients (55%) are Male 14 patients (45%) are Female Transgender Patients: The University Medical Centre has been providing advice and support to the student community who have recently set up a Transgender Support Group. The Practice is actively helping to make patients and students aware that this group has been established by promoting the availability of this group to patients and visitors to the Practice. Although the Practice has identified that we currently do not have any transgender patients in our patient group we will continue in ad- hoc engagement with the Transgender Support Group and are hopeful that participation may be taken up later in the year. Patient Participation Group: Age 0% aged under 16 36% aged between % aged between % aged between % aged between % aged between % aged between % aged between patients are aged over 84 Patient Participation Group: Ethnicity 67 % represent the White British ethnicity profile group 3% represent the White and Black Mixed ethnicity profile group 3% represent the White and Black African ethnicity profile group 16% represent the Asian / Mixed British ethnicity profile group 3% represent the Black British or African ethnicity profile group 6% represent the Chinese ethnicity profile group 2% of patients represent the other ethnic origin profile group Patient Participation Group: General The University Medical Centre has actively encouraged membership from the wide section of our patient demographic. The Patient group currently consists of the following members: Employed local residents Employed University Staff Retired local residents

5 Mature University students Undergraduate University students Postgraduate University students Student Union group volunteers Aims & Objectives of the Patient Participation Group / Patient Surveys: The intention of the Patient Participation Group is to ask for patients views on a range of subjects relating to the Medical Centre. This will help us understand what is important to our patients and we can share what we are able to deliver. Patient involvement, input and feedback helps contribute to the on- going developments in the primary care services we are able to offer and helps provide a focus on the structure of any changes to be considered for implementation in the future. The aim is for our patients to have a voice where the group can potentially have some positive and constructive influence and involvement in future planning to improve the services available. The Participation group facility acts as a communication vehicle for patient feedback which is a benefit for all of our registered patient population which is not designed to concentrate on individual care. Patients feel that they are more involved with their Medical Centre and when we launch new surveys we are able to obtain views on all aspects of the service that we deliver. Our patients still feel it is important to gain a general overview in the surveys we run for all aspects of the Practice from the role of the receptionists and medical secretaries who greet, inform and assist our patients, to the role of the clinicians offering a wide range of primary care medical services. General access is an area that continues to be an important issue for our patients and therefore the Practice commissioned an Improving Practice Questionnaire (IPQ) Survey in The questionnaire incorporated themes that patients felt should be considered as priority areas for further review. This was conducted alongside an Access Survey which addressed comments that waiting times, opening hours and the ability to make appointments in differing ways should be explored further. The survey results were communicated to the Patient group in March 2013 for feedback on what our patients felt should be considered as priority areas for improvement from the survey findings. The final stage of this process was to produce an Action Plan incorporating the responses received which would help the Practice focus on the priority areas. 2012/2013 Survey Statistics & Engagement The University Medical Centre currently has 11,141 patients registered as of 23 rd March To ensure an appropriate representative sample of our patients were able to complete the IPQ survey this was conducted over a period of 2 weeks in January and 2 weeks in February All patients visiting the Practice were asked to complete a survey. The Patient Access Survey was conducted for a period of just over ten weeks running from the second week of January through to the end of the second week of March The Patient Access survey was made available in the Practice and also at various health promotion events for University staff and students during February and March 2013 on the University campus. This helped to ensure that as many patients as possible were given the opportunity to offer us their feedback.

6 PATIENT SURVEY RESULTS Improving Practice Questionnaire 2013: 251 patients responded to the Improving Practice Questionnaire Survey 92% of all patient ratings achieved about the University Medical Centre were recorded as being good, very good or excellent. This is a 5% improvement in the overall ratings achieved in the previous year when the Practice rated 87% in this area on the IPQ Age of Patients responding to IPQ Survey 75% aged under 25 years old 19% aged between 26 and 49 years old 3% were aged over 60 years old 3% preferred not to say Gender of Patients responding to IPQ Survey 50% were female 44% were male 6 % preferred not to say The results were benchmarked against all other GP Practices participating in the IPQ Survey throughout 2012/13 with our patients scoring the University Medical Centre in the top 25% of all results achieved for the following areas: Opening hours satisfaction; Telephone access; Appointment satisfaction; See Practitioner of choice; Waiting time; Satisfaction with visit; Ability to listen; Explanations; Reassurance; Confidence in ability; Time for visit; Consideration; Concern for patient; Recommendation; Respect for privacy / Confidentiality; Second opinion / Complimentary medicine; Overall score The University Medical Centre was scored in the middle 50% of all Practice benchmarked data for the following areas as rated by our patients: See Practitioner within 48 hours; Speak to Practitioner on phone; Comfort of waiting room; Warmth of greeting; Express concerns / fears; Respect shown; Self- care; Reception staff; Information of services; Complaints / compliments; Illness prevention; Reminder systems The University Medical Centre did not have any ratings which scored in the lowest 25% of all Practice benchmarked data for the results achieved from the IPQ Benchmarked data shows that when compared with only those Practices with a similar list size to the University Medical Centre the achievement of the Practice improves even further with ratings for the following areas also moving in to the top 25% of results achieved: Speak to Practitioner on phone; Warmth of greeting; Respect shown; Reception staff; Information of services; Complaints / compliments; Illness prevention; Reminder systems

7 When compared against only those Practices with a similar list size to the University Medical Centre only the following areas remain in the middle 50% of Practice ratings achieved: See Practitioner within 48 hours; Comfort of waiting room; Express concerns / fears; Self- care The University Medical Centre still did not have any ratings in the lowest 25% of Practice benchmarked data when compared against only those Practices with a similar list size. When comparing the University Medical Centre s results from the IPQ Survey conducted in 2013 against the 2012 achievement it shows that the Practice has scored higher ratings in 27 of the 28 areas that patients were questioned about in the survey. The only area that has not improved related to the comfort of the waiting room which the Practice has started to address directly. Themes & comments about how the Practice could improve Feedback and comments received from patients identifying areas for improvement have included some of the following statements in the survey responses: Appointment Booking / Access Walk in service would be good (emergency only) Make appointments online More phone lines open Shorten the waiting time Later opening hours Longer Saturday opening hours Waiting Room More chairs in waiting room More magazines in the waiting room A TV with news Clinician Feedback Longer for consultations Less rushed appointments It s fine and thanks for your help and advice More of the same as it was all excellent Very happy with doctor He is excellent The doctor is good. He couldn t improve What I especially like is that I have seen the same doctor for at least 5 years this creates a relationship and knowledge that is very important. Doctor explained problem immediately, clearly and offered the best way to improve it quickly.

8 Positive comments received from patients in the survey results have included some of the following statements: Has improved the waiting time dramatically! Excellent staff The Practice is good Obviously busy place but good overall Easier to contact on the phone Very friendly and helpful staff Very impressed 100% perfect Never had a better GP/doctors surgery in my life Practice is really great, can't fault it Excellent as it is Happy with service PATIENT SURVEY RESULTS Patient Access Survey patients responded to the University Medical Centre Access Survey from January to March % of Patients who completed the survey felt their experience of booking appointments at the University Medical Centre was either very good or fairly good. Just over 4% felt this was neither good nor poor and less than 1% of patients surveyed felt this was either fairly poor or Very poor. 48% of patients surveyed did not find it difficult to get through to the Practice by telephone, 25% felt that it was difficult to do so and 27% were not sure 77% of all patients surveyed don t feel that there is a time or day when it was difficult to get through to the Practice. Those who felt it was identified that Monday mornings between the hours of 08:00 to 10:00 were the most difficult. 84% of patients surveyed advised that when they contacted the Practice to get an appointment they have been able to speak to / see someone when they wanted to do so. 75% of patients surveyed have been seen by the clinician within ten minutes of their scheduled appointment time either always or most of the time. 95% of patients surveyed found appointment times to be either Very or Fairly convenient Patients who advised they had not attended an appointment without cancelling first had done so because: 41% had forgotten about their appointment 33% couldn t attend or get to the surgery 11% no longer needed the appointment 7% went to the Walk In Centre or to Accident & Emergency at the Hospital instead 8% tried to cancel but were unable to do so One of the common themes in the 2013 Access survey was for the Practice to offer an online booking system which would allow patients to book and cancel appointments on the internet.

9 UNIVERSITY MEDICAL CENTRE ACTION PLAN : Once the responses from the Practice surveys had all been analysed and the results understood these were circulated to the Patient Participation Group for their feedback and comment. An Action Plan was drawn up and communicated for review to agree priorities with the group. Priorities Desired Outcomes Notes Status To further explore the possibility of an online appointment booking system for patients. Online Appointment Booking System for Patients The University Medical Centre moved to a new clinical system in August 2012 and with an enhanced internet connection due to be installed soon, moving to this type of functionality will be a more viable prospect Consider the current clinical supplier as an option for the online booking software and research how this will work and integrate with clinical system. Consider feedback from patients and the patient group what is the priority for the functionality of the booking system? Should patients be able to book and also cancel appointments on- line? Discuss options available to the Practice with current Clinical system supplier. Review other online booking applications that are accredited and will work with clinical system functionality to consider for appropriate product implementation. Consider timeframe for installation and will a pilot project be viable? What information do patients need to have in order to be able to make bookings? Consider the most appropriate model for implementation that will work with the large annual patient turnover Action to have made initial enquiries by end of July 2013 for review and discussion internally in the Practice and establish whether a system can be installed prior to the new student academic intake in September Patient Waiting Room This is the one area in the IPQ Survey results where the Practice did not improve from the previous years survey results Continue to improve general patient information available in the waiting room Reception staff to continue with a weekly Physical appearance of the waiting room to be addressed and improved where decoration is required Continue with themed notice boards for display of patient information The patient waiting Room toilet has been cleaned, treated and painted in March 2013 to help address this area in the survey (comfort of waiting room) identified as needing improvement. Demonstrates the Practice is taking immediate action to address the issue.

10 Patient Waiting Room review of the posters on display and where possible offer appropriate themes for patient demographic (sexual health campaigns, mental health awareness and support groups available, vaccination programmes, travel clinics etc...) Consider further options that may be available to the Practice for reading material for patients Quotes are being prepared for redecoration of the patient waiting room expected to be performed in the late summer of 2013 before the students return for the 2013/24 academic year Appointment waiting times and Length of clinical Appointments Perform an audit review of the appointment availability for all clinicians in the Practice The on- going review of appointment times will help to make the clinical sessions more efficient and also help by extending appointment capacity which will help toward reducing patient waiting times where possible A review of appointment times is due to take place after the end of this academic year (from June 2013) to ensure that the right length of appointments are being given to patients as determined by what they are attending for where this is known in advance To begin an audit review of appointment times as from June Telephone Access to the Medical Centre The Access Survey conducted identified that patients are sometimes finding it difficult to get through to the Practice by phone however the majority stated that they did not feel this was the case An audit of the number of telephone calls taken on the reception desk over a period of six weeks in January and February 2013 identified that Monday mornings were by far the busiest time for calls coming through Continue to explore The Practice has discussed the possibility with the University as to whether a separate telephone system can be implemented as currently the phone system is part of the University main switchboard. Practice to progress discussions further and investigate the options

11 Telephone Access to the Medical Centre the possibility of the implementation of an enhanced telephone service. for an enhanced telephone service that would offer more functionality in the system for callers. Also looking to increase the number of telephone lines currently available in conjunction with any new telephone system installed. To review the progress of consideration for enhanced telephone system August 2013 The University Medical Centre s Patient List is open to new patients who reside in Bath and the surrounding areas within our Practice boundary The University Medical Centre Opening Hours are as follows: Monday Tuesday Wednesday Thursday Friday 08:00 18:00 08:00 18:00 08:00 18:00 08:00 18:00 08:00 18:00 Patients may book appointments to see a doctor, nurse practitioner, practice nurse or health care assistant by ringing the Medical Centre or attending at the Practice in person and booking directly with the reception desk. Extended Opening Hours: Appointments are available on a pre- booked basis to see a doctor or a Nurse Practitioner on Saturday mornings at the Practice when a 5½ hours appointment session is offered which runs from 08:00 through to 13:30. The Practice has increased the number of hours made available for extended hours appointments in the last 12 months to reflect the increased patient registered list size since The University Medical Centre offers Urgent Care appointments during the core primary care hours from Monday through to Friday. There is always an on- call duty doctor available to see emergency patients and there are no limitations on the number of emergency patients that can be seen. The duty doctors on- call shift patterns run from 08:00 to 13:00 in the morning and from 13:00 to 18:00 in the afternoon during the weekdays. When there is great demand for GP appointments and patients require to be seen the same day they may be offered a telephone appointment with the duty doctor or the nurse practitioner who will arrange to see the patient if deemed necessary.

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