Profile of the members of the PRG

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1 Profile of the members of the PRG Thornaby and Barwick Medical Group 2014 Local Participation Report (The data and information contained within this report is gathered from and relates to Thornaby & Barwick Medical Group.) The Patient Representative Group was established in April As last year, the current membership of the PRG is reflective of patient groups that have flexibility around working and income and potentially have free time to become involved in issues that reflect their understanding and expectation of healthcare services. In practice patient demographics are representative of a younger, family based community with approximately 25% of all patients being in the under 18 years age group. Currently the Patient Representative Group is: 43.75% Male and 56.25% Female The split between our surgeries is: 12.5% are Thornaby Medical Centre Patients 87.5% are Barwick Medical Centre Patients The Age Sex Profile of the Patient Representative Group is: Age Group Female 2013 Male 2013 Female 2014 Male 2014 <16 0% 0% 0% 0% % 0% 0% 0% % 0% 6.25% 0% % 11.25% 12.5% 12.5% % 11.25% 18.75% 6.25% % 11.25% 18.75% 12.5% % 11.25% 0% 12.5% % 0% 0% 0% >84 0% 0% 0% 0% In comparison the age sex profile of the practice population as of February 2014 is: Age Group Female February 2014 Male February 2014 Under TOTAL The Patient Representative Group consists of registered patients who have: Engaged in the Patient Participation Group surveys and have registered an address. Not engaged in a Patient Participation Group survey but have registered an address.

2 In February 2014 the ethnicity of the Patient Representative Group is: March 2013 February % British 6.25% British 5.5% White 6.25% White 39% White (British) 31.25% White (British) 50% Undeclared 56.25% Undeclared The steps taken by the contractor to ensure that the PRG is representative of its registered patients and where a category of patients is not represented, the steps the contractor took in an attempt to engage that category. The first decision taken to ensure that the PRG is representative of TBMG registered patients was the decision to make the group a virtual one. This allows patients to participate in their own time and at their own convenience. A further decision was taken that hard copies of all communications will and have been made available to enable all patients to participate, regardless of their ability to access a computer. The second step to ensure that the PRG is representative of TBMG registered patients is the establishment of the Patient Representative Group which has been advertised: On repeat prescription slips On the practice website In both of the s Receptions In the Patient Participation newsletters On notice boards throughout Thornaby Medical Centre & Barwick Medical Centre. On notice slips provided by staff, which are also available on notice boards in both medical centres so TBMG patients accessing other healthcare services could be made aware of the Patient Representative Group. This was done to ensure that all registered patients could access information about the Patient Representative Group regardless of whether they were attending one of the s surgeries. It was also agreed between the Manager and Project Co-ordinator that a clear definition of the roles and responsibilities of those participating understand their roles in the scheme and therefore produced an Engagement Strategy, a copy of which is included in the appendix. These actions have been maintained throughout the third year of the Patient Engagement DES. The practice continues to explore the potential use of text messaging technology via the clinical software system to promote the Patient Representative Group. Whilst there has been a good degree of success in patient sign up for online services, sign up for sms messaging has been limited as a patient choice and work continues to progress this plan.

3 Details of the steps taken to determine and reach agreement on the issues which had priority and were included in the local practice survey The appointed Project Co-ordinator responsibilities continue to include taking a lead role in the facilitation of communication with registered patients, the PRG and the PPG. The Project Co-ordinators contact details are displayed on every poster, leaflet and communication relating the Patient Participation DES. During the past twelve months the Project Co-ordinator has continued to request the members of the PRG to put forward issues which were of concern to them. Unfortunately it was found and reported that patient feedback reduced over the second half of We believed this to be due to lowering interest levels from patients participating in the project. It was, and remains, hoped that once introduced, text messaging information promoting the PRG and PPG will reverse this trend. A further decision was taken to change from surveying patients on a bi-monthly basis to just once a year. However, it was also agreed that the topic of the survey will still be kept specific to one or possibly two issues. The result of these decisions has been a significant increase in participation. Six times as many patients took part compared to the January 13 survey and eight and a half times as many participants compared to the October 2012 survey.

4 The manner in which the contractor sought to obtain the views of its registered patients At the inception of the scheme an information leaflet and poster regarding the establishment of the Patient Participation Group were created, distributed and displayed in each Reception (a copy of the information leaflet and the poster is available upon request). In addition a webpage was added to the practice website specifically for Patient Representative and Participation Groups, with the same information as contained within the leaflet. The poster clearly outlines that these groups' activities are directed by the views and opinions of registered patients. The poster also directs patients to the information leaflet and practice website for further information. The information leaflet and webpage outlines the requirement of registered patients, the method and frequency of patient participation group surveys, the method and frequency of patient participation group survey results being published and encourages patients to both register their interest in participating with the PPG and PRG and put forward the issues and priorities they wish to be raised. This year it was proposed to have just one patient participation survey to try and increase participation, which as reported in last years report had been dwindling over the course of 2012 and early The practice sought to increase participation via the use of text messaging services. Patients who had registered a mobile number were to be contacted and informed when the survey was taking place and how to take part. The practice will continue to work towards this goal.n As last year every opportunity (on newsletters, leaflets, surveys, etc) patients have been encouraged to put forward the issues and priorities they wish to be raised. Thanks have also be continually made to all those who have participated in the latest survey and feedback on survey results. Details of the steps taken by the contractor to provide an opportunity for the PRG to discuss the contents of the action plan. Communication with the Patient Representative Group (PRG) members is still made via their registered address. Patients who wish to be a part of the PRG still have the facility to be provided with hard copies of all correspondence but there are currently no members of the group taking this option. Each member of the PRG receives the same communications, with proposals that have come out of the activities of the Patient Participation Group (PPG). Any responses are then shared anonymously with the other PRG members.

5 Details of the action plan setting out how the finding or proposals arising out of the local practice survey can be implemented and, if appropriate, reasons why any such findings or proposals should not be implemented. Following the decision to revise our surveying timetable the revised 2013 action plan is below. Last year we stated one of the continual themes of frustration highlighted by the Patient Representative Group, and the Patient Representative Group, is waiting times for appointments. We highlighted one of the biggest contributing factors and sources of frustration to TBMG, as any other, is DNA rates. In an attempt to combat waiting times, the Manager and Project Co-ordinator followed up some research highlighted by one of the s' Partners. The research was carried out by Steve Martin (Commitments, norms and custard creams a social influence approach to reducing did not attends (DNAs) Journal of the Royal Society of Medicine 2012: 105: ) which focuses on reducing DNA rates through cost-free, positive behavioural modifications. TBMG spent two months implementing the suggested methods of positive behavioural modifications and consulted staff to try to identify further suggestions along the same principal. In addition to this, the Manager has been in communication with the PCT, NHS Hartlepool and Stockton-on-Tees CCG, as well as fellow Managers within the area as to the potential benefits of these simple measures and discussed training being established across the CCG. The Patient Representative Group were consulted on these actions and asked to provide feedback on what changes they notice around the and when communicating with the Reception staff. In a period of three months prior to the scheme introduction 1554 patients DNA d appointments, whereas, following the introdiuction of the positive measures this figure stood at 1432 unattended appointments during a three month period. Analysis of a full year effect found that prior to the newly introduced positive messages, there were some 6485 missed appointments with this figure falling to 6342 the following year. It is also worth notiting that the patient list size also grew by some 733 patients during the same period. TBMG therefore believes that these measures have had a positive effect on patient non attendances for pre-booked appointments As a result of the 2013 Patient participation Survey and the overwhelmingly positive response from our patients, TBMG will therefore be adopting the same approach to the open access flu clinics during TBMG will also have readily available the leaflet how to cope with flu like illness over the winter and when you might need extra help from a pharmacist or a doctor? from early autumn onwards. As supported by our patient participation survey; patients, for who it is feasible and practical, will be encouraged to register for the online appointment booking and repeat prescription service to alleviate the demands on Reception. It is also hoped that online booking of appointments will also further improve attendance rates as patients will be able to check and review bookings at their convenience.

6 A summary of the evidence including any statistical evidence relating to the findings or basis of proposals arising out of the local practice survey In previous years, surveys had covered a limited number of set topics. Due to the decision to change to just one survey in the year the amount of questions was increased from five, as has been the practice for the first two years. Eight questions were put to Thornaby and Barwick Medical Group Patients. The findings were: 97% of respondents were able to access flu vaccinations at a time when they were able to attend. The remaining 3% said they required evening or weekend clinics. However, our flu clinics ran open access, no appointment needed for the first 4 to 6 weeks at our Thornaby surgery and on Saturday morning at our Barwick surgery by appointment. Patients from either surgery were able to attend these clinics. Of the 4700 patients on our flu list, our Nurse staff provided flu vaccinations to 1977 patients in the first 3 weeks of our flu clinics. NHS rules say we can only give flu jabs to patients with specified chronic illnesses. Patients were asked if you do not fall into these categories, is there any other help we can provide to you to stay healthy over the winter? No patients stated that any further help was required. However, 76.5% responded that a self-help leaflet on how to cope with flu like illness over the winter and when you might need extra help from a pharmacist or a doctor? would be helpful. We also asked patients if there were any other subjects they would like us to cover in future patient surveys. In response to this, one patient said more doctors appointments and a second said Reception. Patients may remember that our April 12 survey was about Reception services and the results were provided along with some patient information in our June 2012 Newsletter. 3% of respondents identified themselves as a carer to enable the practice to contact them regarding help and support we can offer. 85% of respondents did not answer this question. 26.5% of respondents said they would like to register for an online repeat prescription ordering for all patients over the age of sixteen. 38% said they would not like to register, 35.5% did not respond to this question. To provide comparison to the Patient Representative Group (PRG), facts about the patient demographics of the 2013 survey are: 62.5% of respondents were male. 37.5% were female. 100% of respondents were over the age of % of respondents are classified as regular or occasional attendees to the practice. This highlights that the Patient Participation Group is also reflective of patient groups that have flexibility around working and income and potentially have free time to become involved in issues that reflect their understanding and expectation of healthcare services.

7 Details of the action which the contractor, i. and, if relevant, the CCG NHS England, intend to take as a consequence of discussions with the PRG in respect of the results, findings and proposals arising out of the local practice Towards the end of the second year of this project TBMG was implementing suggested methods of positive behavioural modifications and had consulted staff to try to identify further suggestions along the same principal. In addition to this, the Manager has been in communication with the PCT, NHS Hartlepool and Stockton-on-Tees CCG, as well as fellow Managers within the area as to the potential benefits of these simple measures and discussed training being established across the CCG. The Patient Representative Group had been consulted on these actions and asked to provide feedback on what changes they notice around the and when communicating with the Reception staff. The outcome of these actions was that patients noticed the change in information displayed in the practice and commented positively on the results as opposed to negatively suggesting that patients who DNA d should be charged for the missed appointment. Due to the overwhelming positive response from our Patient Participation Group, as well as our Patient Participation Group, TBMG believes that the approach taken to flu vaccination services in 2013 was a resounding success, especially with regards to the open access clinics. TBMG will therefore be adopting the same method in TBMG will also have readily available the leaflet how to cope with flu like illness over the winter and when you might need extra help from a pharmacist or a doctor? from early autumn survey. onwards. ii. where it has participated in the Scheme for the year, or any part thereof, ending 31 March 2013, has taken on issues and priorities as set out in the Local Patient Participation Report. 76.5% of respondents stated a self-help leaflet on how to cope with flu like illness over the winter and when you might need extra help from a pharmacist or a doctor? would be useful. The practice therefore produced leaflets that were available in both surgery Receptions. The information was also included on our Advise for Common Illnesses page on our website, with additional information provided, as a joint project with our neighbouring practice, to pre-school and primary schools in our local area. With 1456 patients registered for on line services at 1 st March 2014, TBMG is hopeful that we can not only continue to improve access to patient healthcare services, as patients have requested, but to enhance communications further with patients. TBMG has extended the information available to individuals who identified themselves as carers, along with our other registered carers. Information regarding additional support and help that can be provided by not only the practice but other additional organisations has been incorporated into a new leaflet and placed on the practice web site.

8 The opening hours of the practice premises and the method of obtaining access to services throughout the core hours The opening hours of the practice premises have changed since last years report was submitted. The opening hours are now: Thornaby Medical Centre is open: Weekdays: 8.00am pm (except Tuesday when it is closed from pm for staff training) Barwick Medical Centre is open: Weekdays: and Reception staff are available during these times to respond to patients either in the practice or on the telephone. They can make appointments, note queries and respond to a range of patient requests. Reception staff will always try to respond as quickly as possible to patient queries and requests but response times may be dependant on the availability of the doctor on call. If patients need to speak to a doctor or nurse during surgery opening times, the receptionist will take the patients details and pass any requests to the doctor on call. The on call doctor may need to telephone the patient back if they need further clarification. Patients can also request repeat prescriptions during or outside of the core operating hours by: Leaving their computerised slip at reception or in the repeat prescription box. Posting their computerised slip with a stamped addressed envelope. Fax to their usual surgery. The practice website using their username and password. When the surgery is closed, patients are advised to telephone the NHS 111 service. Where the contractor has entered into arrangements under an extended hours access scheme, the times at which individual healthcare professionals are accessible to registered patients. Since 1st April 2013 Thornaby and Barwick Medical Group no longer provide extended hours access. In 2012 funding to support our evening and weekend surgeries was cut by the Department of Health and whilst we carried on with the extra surgeries for a year, sadly we were unable to continue to do so. The doctors and staff are now looking at how we can support and develop patient services and we will do all that we can to continue to meet the needs of the patients registered at both of our surgeries.

9 Apr-14 May-14 Jun-14 Jul-14 Aug-14 Sep-14 Oct-14 Nov-14 Dec-14 Jan-15 Feb-15 Mar Action Plan Action Activity Lead Further encouragement to patients to join and participate in PRG and or PPG PPG Survey PPG Newsletter Contact PRG Members regarding survey results Review PRG Feedback Proposals Provide more information regarding services, campaigns or changes in the NHS Make how to cope with flu like illness over the winter and when you might need extra help from a pharmacist or a doctor? readily available. Continue dialogue with PRG, PCT & NHS Hartlepool and Stockton-on-Tees CCG with regards to attempts to reduce DNA rates Continue to encourage patients to register for the online repeat prescription service where feasible practical. Manager GP s Manager GP s Manager Manager GP s Manager GP s Manager GP s Reception Staff = Action Taking Place

10 Apr-13 May-13 Jun-13 Jul-13 Aug-13 Sep-13 Oct-13 Nov-13 Dec-13 Jan-14 Feb-14 Mar Action Plan - Revised Action Activity Lead Further encouragement to patients to join and participate in PRG and or PPG PPG Survey PPG Newsletter Contact PRG Members regarding survey results Review PRG Feedback Proposals Provide more information regarding services, campaigns or changes in the NHS Target month for introducing text messaging service Review success of positive behaviour modification techniques Continue dialogue with PRG, PCT & NHS Hartlepool and Stockton-on-Tees CCG with regards to attempts to reduce DNA rates Manager GP s Manager GP s Manager Manager GP s Reception Staff Manager GP s Manager GP s = Action Taking Place

11 Thornaby and Barwick Medical Group Engagement Policy for the Patient Participation Group and Patient Representative Group

12 1. About Thornaby & Barwick Medical Group The Patient Participation Group (PPG) The Patient Representative Group (PRG) The Key Objectives... 1 What are the Projects Key Objectives?... 1 What are The s Key Priorities? Engagement methods, structures and systems... 2 Timescales, Access and Communication... 2 Technology Achieving our Key Objectives Roles and Responsibilities... 3

13 1. About Thornaby & Barwick Medical Group Thornaby & Barwick Medical Group (TBMG) is a large, well established group practice which serves the people of Thornaby, Ingleby Barwick and Maltby. The main surgery in Thornaby town centre, has occupied its present location since 1971, the original building was demolished in 2003 with the current Medical Centre being rebuilt on the same site. Our second surgery at Ingleby Barwick is also a purpose built Medical Centre, which opened in Both sites have access to facilities for disabled people. The Patient Participation Group (PPG) and Patient Representative Group (PRG) are being established to engage patients of the TBMG regarding their views and opinions The Patient Participation Group (PPG) The PPG is the medium by which any patient registered with Thornaby and Barwick Medical Group can participate in the development of their GP. TBMG registered patients can do this by actively participating in the surveys, which allows the freedom to add any comments they wish about any aspect of TBMG services and staff The Patient Representative Group (PRG) The PRG will be a collective of TBMG registered patients, the Project Co-ordinator and the Manager. The PRG will be a forum where TBMG registered patients will be invited to review and provide feedback on the TBMG development plan, as a representative of all TBMG registered patients. Members of the PRG may also be contacted from time to time to discuss the outcomes of the surveys undertaken and will be asked to provide direction for which topic(s) the forthcoming survey(s) may cover. All PRG members will be encouraged to be active members of the Patient Participation Group. 2. The Key Objectives What are the Projects Key Objectives? The key objectives of the project identified by the Manager and Patient Participation Project Co-ordinator are: A Development Plan that considers patient views and opinions. Improved communication between TBMG staff and TBMG registered patients. TBMG patients being more knowledgeable about the services that are provided and how to access them. What are The s Key Priorities? The has agreed that two key priorities are central to achieving effective engagement. These underpin the Strategy and give clarity and direction to both our staff and service users: 1) Focus resources on creative engagement of the seldom heard - Focusing fixed resources on engaging the population that are seldom heard will help us to develop and shape the services required to improve the health inequalities across Thornaby & Ingleby Barwick. The strategy aims to improve communication with the local community and service

14 users so that they are engaged in the commissioning process with the North Tees GP Commissioning Consortia via engagement at GPCC Board level. This is especially important in gaining the views of those groups that are seldom heard, where services may be inappropriate and therefore not accessed. This strategy will include feedback from patients who engage with the PPG and PRG. 2) Have patient involvement in the development, purchase of appropriate services, and monitor of their effectiveness Lay involvement is crucial to the development of services. Therefore the will ensure that patients views will be included to form part of the strategic procurement cycle. 3. Engagement methods, structures and systems Two main considerations have been assessed in deciding the most appropriate methods to obtain a representative opinion and view of TBMG patients: Timescales, Access and Communication (of both patients and TBMG employees) Technology Timescales, Access and Communication The PPG will be asked to complete a five question survey bi-monthly starting in July Each survey will have a specific theme. In each month where no survey takes place, the data from the most recent survey will be collated, verified and reported to the TBMG management. These timescales will enable TBMG management to review and update its Development Plan at feasible intervals, as well as address any urgent issues arising. The PRG will be consulted on a more regular basis and will have the opportunity to review and provide feedback on the TBMG Action Plan, as a representative group of all TBMG registered patients. The Action Plan, resulting from the Development Plan, will be reviewed and implemented by the Patient Representative Group. To enable accessibility for registered patients, especially the seldom heard, the Patient Participation Group (PPG) and Patient Representative Group (PRG) are both virtual groups. This is to enable all patients to participate, rather than limiting access only to patients that visit either surgery within the period(s) of the patient engagement. Nevertheless, hard-copies of all communications and surveys will be available from either surgery to enable participation for those who do not wish to access the survey electronically. Virtual Groups, with hard-copy available, enables patients to participate as part of the PPG and or PRG in their own time, by their preferred method, in their chosen environment. Communication will be an inherent part of the project success. All communications are likely to be written, unless exceptional circumstances arise or added value of a physical group or verbal communication is perceived to provide a significant benefit. Technology The project will make best use of the technology available. It is likely that the electronic copies of the surveys will be placed online hosted by a specialist website. Making best use of technology provides all TBMG registered patients with the opportunity to express their views and opinions.

15 4. Achieving our Key Objectives To achieve the Key Objectives and facilitate the s Key Priorities, the practice have engaged the services of a Project Co-ordinator. Through the project co-ordinator the practice aims to achieve, a clear and precise vision, accessibility, current information updates, timely input, and easy access for patients views 5. Roles and Responsibilities Partners To commit to the principles of patient participation and to consider practice development in the context of patient views and opinions Manager To work with all parties involved with Patient Participation including, Patients, Patient Participation Project Co-ordinator, practice staff and to represent patient views and opinions at North Tees GP Commissioning Consortia Board meetings. Project Co-ordinator The Project Co-ordinator is responsible for liaising with the Manager, Patient Representative Group and Patient Participation Group regarding the creation and awareness of the bi-monthly surveys. The Project Co-ordinator is also responsible for collating the data from each survey and reporting the results appropriately. Patient Representative Group The Patient Representative Group are responsible for reviewing the TBMG Development Plan. They are responsible for engaging in the principles of participation groups and voicing their views in a fair and inclusive way that represents all the patients registered with both TBMG and the wider communities of Thornaby and Ingleby Barwick Patient Participation Group The role of each individual Patient Participation Group member is to provide their views and opinions through the bi-monthly surveys. Each PPG member is responsible for ensuring they complete and submit, either electronically or in hard-copy, each survey within the allotted timeframe. Staff All staff members have a role and personal responsibility for patient engagement. This includes the provision of information and the promotion of patient engagement ooo-----

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