Patient participation directed enhanced services report. Orchard Surgery, Dereham March

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1 Patient participation directed enhanced services report Orchard Surgery, Dereham March

2 Orchard Surgery Opening Hours Mon, Tues, Thurs & Fri 8am till 6:30pm Wed 8 till Midday. Duty Doctor available until 6:30pm Main contact number Fax number Out of Hours (emergencies) Website

3 Orchard Surgery Extended Hours Access Scheme In addition to our normal appointment times, we can offer additional appointments with a GP at the following times: Mondays between 6:30pm & 7:45pm Wednesdays between 7:30am & 8:00am

4 Objective Ensure that patients are involved in decisions about the range and quality of services provided by the practice. This includes patients being involved in decisions that lead to changes to the services their practice provides or commissions, either directly or in its capacity as a gatekeeper to other services.

5 Actions Develop a Patient Reference Group (PRG) Agree with the PRG areas of priority Collate views of patients through surveys Discuss survey findings with PRG Agree action plan with PRG Publicise action plan and results Implement changes Review

6 Develop a Patient Reference Group (PRG) Identify population of practice The following charts show the results of a report demonstrating the diversity of the Practice patients: Patient diversity 6% 1%5% 1% 87% British European Mixed other Other White Other Patient age ranges -16 6% 3% 17% % % 13% % 12% % Social factors, age and sex were also included.

7 Develop a Patient Reference Group (PRG) Engage a representative cross section of patients All practice staff took responsibility to ask registered patients visiting the practice if they would like to take part in a Patient participation group. In addition to this posters were placed in the reception area asking for volunteers. The group was also publicised on the homepage of our website. This provided a number of responses, however to reach a wider and more diverse section of patients we identified patients in minority and specific social groups through reports and while in consultation with the doctors. Those identified on site were invited to take part. For those identified through reports addresses were gathered from on-line sign-up requests and the on-line prescription facility, invitations were then sent by . Patients who opted in were asked to complete a short survey which captured their age, ethnicity, address where appropriate and how often they used the practice facilities. With the Patient Participation group formed, we were able to move forward to looking at areas of priority.

8 Make-up of PRG Sex Age 57% 1% 42% Male Female Not completed 16% 17% 6% 1% 2% 10% 8% 20% 20% Ethnic Background 4% 1% 1%1% 3% 90% British European Mixed other Other w hite Other Unknow n

9 Agree with the PRG areas of priority Establish areas of improvement The Annual Patient survey was completed in October 2011 which gained patients opinions on Clinical care, getting an appointment, reception and opening times. The results identified Patients priorities and issues throughout the practice and allowed a comparison to be made to the National GP survey issues. Present findings to PRG In January 2012 a meeting was held with members of the PRG to discuss the results of the survey, explain the Care Quality Commission, review complaints received by the practice and identify area s of priority. A copy of the minutes were added to the Practice website for all to view. Agree areas of priority Various actions were taken and it was agreed that the main area of priority was to reduce the number of DNA s (missed appointment) to enable better access to doctors when needed. It was suggested that the best way to do this was to issue appointment reminders via text or .

10 Collate views of patients through surveys Determine questions to be used The questions were chosen in the PRG meeting based on feedback from the patient survey and findings regarding lost doctors hours due to DNA s. All agreed that the questions needed to determine if patients would like appointment confirmation by text or once the appointment was booked and if a reminder was sent how far in advance they would like this to be. In addition it was felt important to include if our patients felt it would be appropriate to send a message following a DNA. Method of contact An on-line survey was produced, details of which were ed to the virtual patient group. Posters were displayed in reception an and all patients attending the surgery were invited to take part. Collate results The results were collated via a web tool and manual data input. The results of the survey can be seen on the following pages.

11 Survey Results for Text The questions captured personal details of patients to ensure that a fair representation of the practices population were consulted. These results are available in a graph format on request. If w e w ere to send you a reminder before your appointment, how soon should this reminder be sent? 15% Reminder text 24 Hours 1% 30% 54% Reminder text 48 Hours Reminder text 1 Week Reminder text Not at all Would you find it helpful to receive a text message confirming your appointment detals, at the time you book your appointment? 27% Should we send texts to patients that miss their appointments without warning us beforehand, warning that they might be taken off of our patient list if they miss another appointment? 29% 73% Text Yes Text No 71% Warning text Yes Warning text No

12 Survey Results for The questions captured personal details of patients to ensure that a fair representation of the practices population were consulted. These results are available in a graph format on request. If w e w ere to send you a reminder before your appointment, how soon should this reminder be sent? Reminder 24 Hours 28% 12% 27% 33% Reminder 48 Hours Reminder 1 Week Reminder NO Would you find it helpful to receive an message confirming your appointment details, at the time you book your appointment? Should we send s to patients that miss their appointments without warning us beforehand, warning that they might be taken off of our patient list if they miss another appointment? 48% 52% Yes No 31% 69% Warning Yes Warning Not at all

13 Agree action plan with PRG Meet with PRG to discuss survey findings A face to face meeting was held on 15 th March 2012 to gain the PRG s views on the survey findings and agree on an action plan for the next steps. Minutes of the meeting were captured and published. Action plan The agreed action plan can be found here. Other considerations Following an in-depth investigation it has become apparent that contrary to information received we are unable to set reminders for at this time. This has been put on hold pending system updates planned over the coming year. There were no contractual considerations as a result of the proposed changes. Publicise action plan and results Completed. Please see the Orchard Surgery Website

14 Implement Changes agreed by PRG Launch SMS text appointment reminders Following training of all staff the text message reminder service was launched in May The service was advertised on the website, via posters in the surgery and on screen prompts for staff to ask if people wished to sign up to the service. The on-line PRG group were also asked to take part via . As sign-up was low within the first month it was agreed that invitations to join the service would be included on repeat prescriptions and in new patient packs. Full details of the steps taken can be seen on the action plan

15 Review Steps taken Review with PRG Updates with regards to steps taken and sign up numbers were discussed in both the June and September meetings details of which can be found in the minutes. Sign-up had been slow with only 467 patients taking up the option for the reminder service. DNA s had continued to increase with a total of 816 appointments not kept during the previous three months to the September meeting. It was suggested and agreed by the PRG that it would be more beneficial to the patients and the practice if everyone who had provided a mobile number was signed up to the service and an option to optout was given. This took place during September increasing numbers to It was also decided that the time of the reminders being sent would be changed from 18:00 to 10:00 the day before to give patients time to call and cancel if need be.

16 Review Steps taken Review with Patients In September the PRG agreed a set of survey questions for patients to answer re service provided by the practice, the SMS reminders and the use of the website, notice boards and newsletter. The survey took place in November, the results can be found on the following Pages.

17 Questions asked How would you like news to be communicated: Newsletter, Posters, Notice boards, Leaflets, Website, Other Have you ever made use of any of the following: Newsletter, Posters, Notice boards, Leaflets, Website, Other Have you ever used our website to: Book an appointment, Place a request for a repeat prescription, Fill in travel forms, Raise a query, Gain information, Not aware of above Have you received a text appointment reminder: Yes, No Did you find this text reminder helpful: Yes, No Was the length of time the reminder was sent in advance appropriate: Too Long, Too Short, Just right

18 Results How would you like news to be communicated 4% Newsletter 23% 12% 30% 12% Posters Notice Boards Leaflets Website 19% Other The majority of patients would like News to be communicated by Newsletter and the website, 30% of patients asked are using these at the moment Have you used the following 6% 19% 11% 17% 19% 10% 18% Newsletter Posters Notice Boards Leaflets Website SMS reminder None

19 Results Have you used the Website to: Book Appointment 40% 23% request Repeat prescription Travel Raise a Query 11% 3% 23% Gain Information Not aware 40% of people asked were not aware of the services offered on the website

20 Text Reminder Results Have you received a text reminder Was the reminder helpful 3% 65% 35% Yes No Yes No 97% Was the time of the reminder appropriate 6% 6% 88% too long too short just right Out of those taking part in the survey 35% had received an appointment reminder via text. Of those that did the majority found the reminder helpful, with 88% saying that the timescale was just right. Patient comments: very useful, very good, very helpful

21 GPAQ Analysis percentage of patients marking Good and above Doctors Nurses Satisfaction with doctor giving you enough 94% 96% time Satisfaction with how well doctor listens 95% 96% Satisfaction with doctor s explanations 93% 95% Satisfaction with doctor involving you in 92% 91% decisions about your care Satisfaction with doctor treating you 94% 97% with care and concern Satisfaction with doctor creating confidence 99% 94% and trust How helpful do you find the receptionists at your GP practice? Helpful and above 97%

22 Review Of Results The PRG met on 6 th December to discuss the results the findings are as below: 97% of those patients who had received a text reminder found the service helpful, with 88% saying that the timescale was just right. Since introducing this service DNA s have reduced by 20%. Patient comments: very useful, very good, very helpful Positive results have increased across the survey compared to previous Years. Some of the positive comments made by patients include: I have complete faith in the doctors and nurses at the surgery I always get the best of treatment - all very courteous and polite - 100% I have noticed a huge improvement in the surgery this year, especially with the reception staff. So much better!. Also feel more confident in the present group of GP's The overall appearance of the surgery is important. Orchard is first class, it's clean, bright and the reception staff are very polite, courteous and cheerful. The chairs are clean, magazines in good order and the soft music makes it a relaxing place to be. I was head of PR and whilst the medical team are of upmost importance, it is true that the total ambience of the surgery helps patients feel calm and confident. A professional reception gives one the feeling that the rest of the visit will also be calm, professional and reassuring.

23 Review Of Results Actions for Patients raised issues with the following areas: Opening hours late night opening Waiting times Doctors running late Appointment System Waiting too long for non-emergency appointments Reception Getting through on the telephone These Issues have been included in the action plan and will form the basis of our next project with the PRG on how to improve the service offered by the practice.

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