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1 Standard Reporting Template Bristol, North Somerset, Somerset and South Gloucestershire Area Team 2014/15 Patient Participation Enhanced Service Reporting Template Practice Name: Westbury On Trym Primary Care Centre Practice Code: L81017 Signed on behalf of practice: Harriet Longman Date: Signed on behalf of PPG: Sarah Hazell Date: Prerequisite of Enhanced Service Develop/Maintain a Patient Participation Group (PPG) Does the Practice have a PPG and/or PRG? YES / NO Method of engagement with PPG and/or PRG: Face to face, , Other (please specify) Number of members of PPG and/or PRG: 64 Detail the gender mix of practice population and PPG and/or PRG: % Male Female Practice PPG Detail of age mix of practice population and PPG and/or PRG: % < > 75 Practice 23% 5% 11% 17% 13% 11% 10% 10% PPG 0 0 6% 8% 15% 22% 27% 22% (4) (5) (10) (14) (17) (14)

2 Detail the ethnic background of your practice population and PPG and/or PRG: Practice PRG White British Irish Gypsy or Irish traveller Other white Mixed/ multiple ethnic groups White &black White &black Caribbean African White &Asian Other mixed Practice PRG Asian/Asian British Black/African/Caribbean/Black British Other Other Other Indian Pakistani Bangladeshi Chinese African Caribbean Arab Asian Black Any other As a matter of principle we do not collect ethnicity data about our patients or about the members of the PPG, believing that equality is about how we behave, not the information we collect. However with some reluctance, and for the purposes of this report only, we note that the BME ethnicity groups comprise about 6% of the population of the Westbury on Trym and Henleaze districts, and we would estimate (which is itself a form of prejudice of which we d not approve) that this represents a similar proportion of the PPG. Describe steps taken to ensure that the PPG and/or PRG is representative of the practice population in terms of gender, age and ethnic background and other members of the practice population: A large proportion of the practice population is under 16 years of age. It is unlikely that this group would form part of a PPG and so it is not surprising that the PRG is more representative of older patients, although it is more closely representative of the patients who use the surgery, who tend to be older. We have seen an increase in PRG numbers this year, increasing from 34 members to 64 members. We have also seen an increase in involvement of under 45 s which has increased from 12% of our group to 14% of our group, the 45 plus age profile of the PRG has also become a closer representation of our Practice population.

3 During the year we have made several targeted approaches to increase our representation on the group. During the year we have released 4 quarterly newsletters. Each newsletters includes an advert inviting patients to join our PRG and welcoming those from representative groups. The newsletters have also been a key way to publicise our progress on our action plans and to communicate with patients on key messages. (Here is an extract of the invite text): Would you like to be on our patient participation group to provide your views on how the surgery is run and could be improved? We would particularly welcome involvement from under 25 s, carers, patients with disabilities and patients from ethnic minority backgrounds. Please us on or let any of the clinical staff or reception staff know that you would like to be involved. If you have an address please let us have it. We will also post you our newsletters These newsletters have been: - Available in the waiting room Posted within our routine patient letters (3,000 4,000 letters during the year) ed to all the patients we hold addresses for (which is currently just over 900 patients, representing 10% of our overall practice population Added it to our website (copies are available to view via the website to be read alongside this report as required) One of our newsletters has also been published in the BS9 magazine, with a readership across the majority of our practice area of Bristol, BS9 In addition to the use of the newsletter we have also: - Written to patients on our Carers register about the group Asked clinicians through appointments to invite patients to give feedback and opportunity to join the group

4 Had posters in reception and in the patient toilets, and on our JAYEX board (patient TV calling system / information screens) Used our facebook page to promote and invite involvement Had two lunchtime social events for our volunteer drivers Written to parents of under 4 s as part of the pre school flu vaccine invite letter Are there any specific characteristics of your practice population which means that other groups should be included in the PPG and/or PRG? e.g. a large student population, significant number of jobseekers, large numbers of nursing homes, or a LGBT community? YES/NO We have a higher than average number of elderly patients, with 20% of our population being over 65. This is already reflected in our PRG. If you have answered yes, please outline measures taken to include those specific groups and whether those measures were successful: As above we feel that the increase in the e-group numbers (from 34 to 64) has shown that the work to promote the group and increase involvement has been successful 2. Review of patient feedback Outline the sources of feedback that were reviewed during the year: Our Friends and Family test data from December 2014, January 2015 and February 2015 CFEP Improving Practice detailed patient survey 201 patient responses

5 Patient feedback included in our CQC inspection (from February 2014) Our complaints log Review of our NHS Choices page Comments from our Facebook page CFEP Improving Practice detailed patient survey 201 patient responses The Practice has in the past participated in the CFEP Improving Practice Survey and we at the Practice felt there would be a number of advantages to continuing to use this for our main data collection: The survey has been professionally designed, validated and administered It covers most aspects of patient experience of the Surgery The questions are balanced and avoid the problem of suggestibility The results are comprehensive and easy to interpret There is a large database of other practices against which our results can be benchmarked We can reliably compare this year s results against previous years The survey has statistical validity The Conduct of the Survey The survey was carried out in January/February Patients who attended the surgery were asked to complete the anonymous questionnaire 201 were completed. We decided to continue to link the survey to clinicians for their professional development as this was felt to be beneficial and was appreciated by them. The clinician specific reports were kept confidential to the member of the team but the total feedback collected provides the results of the report. Four GP s and one Nurse participated. The Results of the Survey The survey results, this report and the action plan have been published on the Practice website. (www.westburysurgery.co.uk) PPG Discussion of the Survey Results and Development of the Action Plan

6 The survey results were sent out to the PPG members and they were invited to comment and to suggest actions that could be taken to effect improvements. Three core areas for review and development were identified and these were ongoing areas which have been included in previous survey action plan reports. This continues to be a cycle of consultation, planning and review and some areas of the plan will require monitoring from both the group and the practice. How frequently were these reviewed with the PPG and/or PRG? The friends and family test data has been reviewed monthly and has been published monthly on our website There was a review of the Annual detailed survey compiled by CFEP and this was conducted in March Action plan priority areas and implementation Priority Area 1 Description of priority area: Getting through on the phone / telephone access What actions were taken to address the priority? During the past year we increased our staffing by 5 hours a week for peak times In the past 18 months we increased our telephone lines from 8 to 12

7 In the past year we reduced our greeting message length to make time to connect to operator shorter In the past year we purchased patient partner (automated system) booking software so that we could add and amend our own clinical team profile whenever we chose to change the access Recently, and for the coming year, our reception team have started a programme of planned visits to neighbouring surgeries to find out how the telephone systems operate We have started to work as part of one care consortium collaborative approaches, considering whether calls could be handled offsite / shared telephony. This has been running for one year and is ongoing. Our reception team has set up a working party to look at on the day footfall to the surgery and what time of day they handle the most detailed / complex enquiries to see if we need further staffing increases We plan to review our telephone system infrastructure in 2015/16 to see if we can improve the system further. We continue to ask patients who call early in the day for matters not related to appointments to call back later in the day. We continue to ask patients to phone after 2pm for information on results. Our reception team is looking at how they handle prescription enquiries and whether putting in place restrictions (such as certain times only for prescription enquiries) may ease pressure on getting through on the phone. Result of actions and impact on patients and carers (including how publicised): We do not see any notable increase in satisfaction of telephone access through the annual CFEP survey despite the above measures. We continue to receive feedback from reception team about the length / complexity of patient enquiries during the day Further feedback and suggestions from PRG: Improve the range of appointments available for online booking Add a message to the check in screen advising not to call before 9am unless for an appointment / urgent

8 Find some practices with really good results on telephone access and find out what systems they are using

9 Priority Area 2 Description of priority area: Privacy of the front desk What actions were taken to address the priority? Use of music played quietly by front desk Use of private side office for patient enquiries and a sign saying if you would like to have a private conversation please ask Establishment of a front of house reception working party to look at the flow and functioning of the space and ways that this can be improved without materially altering the fabric of the building Result of actions and impact on patients and carers (including how publicised): Patient feedback unfortunately does not show an improvement in privacy Further suggestions from the PRG : I am not sure if people object to having their name called out presumably there are some potentially embarrassing announcements that could be made. Mrs 46 to room X please Use of numbers instead A second reception point could improve the queueing problem, which at times is often quite long. You could have 1 for booking appointments and checking in for endoscopy, chiropody etc and another one for longer queries. The office could be used for confidential enquires such as booking smears etc that some patients may not want the waiting room to hear. Could you build the second reception point into more like a booth?

10 The lack of privacy is embarrassing for not only the patient discussing their private medical matters but also for all the other patients sitting in reception. The use of the private office could work - patients not signing in on the computer would be able to go into the office one at a time and discuss their private requirements.

11 Priority Area 3 Description of priority area: Ability to see clinician of choice What actions were taken to address the priority? We published information in our newsletters about GP s working weeks and why a lot of GP s are now part time. We audited our appointments three times during the year. We have audited and published our did not attend appointment rate. We produced a leaflet called our appointment system explained Result of actions and impact on patients and carers (including how publicised): Through our three appointment audits, we now have a robust system for book on day appointment request handling. We also have dropped the number of appointments held back for on the day booking progressively over the past 12 months. For example in April 2015 this was 60 for a Monday, it was reduced to 55 in September 2014 and as of January 2015 is now 50. Each day of the week has also been dropped to a similar percentage. Without increased funding we cannot offer more appointments per patient but this has enabled us to have more appointments available to book in advance therefore to see clinician of choice. We published a piece about a typical GP day outlining the activities GP s do on a daily basis in our June 2014 newsletter. our appointment system explained leaflet has been available through our reception front desk, on our website in the how to make an appointment section and was published in our June 2014 newsletter

12 We published articles in our Feb / March 2015 newsletter explaining why a lot of our GP s are part time We also published some FAQ s to try to help patients understand the volume of enquiries that we deal with and some of our systems and constraints. Further suggestions from the PRG With all the GPs working part tine I think a buddy system would work well for the majority of the patients. The patients would need to be told who their GPs are.. I am aware that you do need to be registered under a GP but are free to see anyone in the practice. By encouraging patients to see clinician of choice, continuity of care will be better, and patients should be happier and less likely to moan that they have had to wait weeks to see their clinician. Let patients know what the constraints are on accessing GP of choice. eg: Can only recruit part timers usually Explain the Medical conditions / situations where there are clear benefits for patient and practitioner to see the same practitioner and where the practice tries to achieve this. Also might be worth saying that with a computerised system the transfer of information is much more effective so less of a problem seeing someone new. Finally I might add that there are situations where seeing another practitioner could lead to a different diagnosis / better treatment suggestion it does happen GP s are not clones It also means I think being honest that most patients are under the practice not a specific GP even if for admin reasons you appear to have one. Having said all the above it might be worth doing a separate survey to ask those who insist on seeing same GP whether it is justified medically or psychologically

13 Progress on previous years If you have participated in this scheme for more than one year, outline progress made on issues raised in the previous year(s): The three main areas outlined above are areas which were planned following our 2013/14 work and continue to be ongoing. The action planning and review cycle has therefore been continuous during the year and progress is included in the three key areas above.

14 4. PPG Sign Off Report signed off by PPG and/or PRG: YES/NO Date of sign off: How has the practice engaged with the PPG and/or PRG: Newsletters, facebook, face to face meeting held in April 2014 How has the practice made efforts to engage with seldom heard groups in the practice population? Direct use of invite letters, use of newsletters Has the practice received patient and carer feedback from a variety of sources? A variety of sources have been used as detailed in box 2 Was the PPG involved in the agreement of priority areas and the resulting action plan? The PPG advised on the key areas and provided comments and suggestions. How has the service offered to patients and carers improved as a result of the implementation of the action plan? We acknowledge that the three key areas are ones where little progress / impact has been seen on patient satisfaction however these are broad development areas which will require significant financial investment to entirely resolve. The patient experience and understanding of what is realistic for a GP practice to develop with fixed funding is important also. The Practice continues to try to reinforce key messages Do you have any other comments about the PPG or practice in relation to this area of work?

15

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