Tadcaster Medical Centre Patient Participation Group Report. March 2013

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1 Tadcaster Medical Centre Patient Participation Group Report March 2013 Tadcaster Medical Centre is a GP surgery located in the town of Tadcaster. The building is open from 8.30 am to 6.00 pm Monday to Friday. Appointments can be booked in person, over the telephone, using an automated telephone booking line or via the internet. The practice also offers Saturday morning surgery with a GP from 8.00am to 12.15pm. These are routine appointments, emergency cover is provided by the Out Of Hours GP Service and NHS 111. The Patient Participation Group for Tadcaster Medical Centre had its first meeting in May 2011 and it has met quarterly since then. The group is comprised of patients and practice staff. The practice has been represented by one or two GPs and the Practice Manager, this has varied from meeting to meeting and three GPs in total have worked with the group. The patients range in age from their mid 40s to their early 80s and we have a mix of male and female members, numbers attending meetings continue to vary over the year but have stabilised at around eight. One meeting had to be postponed when the river Wharfe broke its banks and the building was evacuated, this was reorganised once the weather was more stable. When the group was set up the practice decided that the best way to ensure that the population was representative selection would be by invitation. Each GP put forward names and a personal letter was sent from the two lead GPs to the initial meeting on May 20 th Of the initial fourteen attendees eight continue to attend on a regular basis. To try to widen the group the practice has also offered patients the ability to be in a virtual PPG that is only contacted by . We currently have only one member who uses this method despite adding an appeal to all repeat prescriptions and on the practice website. Three new members have expressed an interest since the start of 2013 but were unable to attend in February and we look forward to meeting them at our next meeting.

2 We started the year with a number of actions generated by the 2011/12 survey. Reception A new desk was bought and moved so that there are no receptionists with their back to the desk where patients wait. Some of the reception chairs were moved to face the desk to provide a waiting area that gives the patient dealing with the receptionist more privacy. There was also a plan to reintroduce the glass screen between the reception team and the waiting area to improve the soundproofing. This was initially postponed because of some emergency repair work that was required to the external glazing and is now not going to be possible because of improvements to the desk to make it more accessible to disabled patients. This was explained to the PPG at their meetings through the year. Appointments The PPG had requested that appointments be available to book up to 28 days ahead and this was implemented, initially as a trial to monitor attendance rates and then permanently. Complaints Posters publicising the practice complaints process were put up following a request from the PPG. Details were also put on the prescription counterfoil. In addition the practice has also developed an Easy Read version of their complaints leaflet for patients who may find the original challenging to use. At the June meeting these actions were discussed but the PPG were also asked for their opinion on the repeat prescription system at the practice. They had already supported the removal of the ability to request prescriptions over the telephone and this was implemented in April The latest guidance suggested that prescriptions should only be given to the representative of the patient if they had written consent on their record. This was felt to be too harsh by those present as many were aware of elderly or vulnerable patients whose lives would be made more complicated by this. It was also felt that it would also increase queues at reception as the reception team would have to check each patient record and the person collecting would have to show identification. It was agreed that we should ask the wider patient population for their opinion on the matter to ensure that the PPG had considered all viewpoints.

3 The survey was completed over the summer of 2012, it was offered to patients collecting and requesting their prescriptions and reviewed by the PPG at their autumn meeting. The results are shown below. 3% felt that prescriptions should only be given to the patient themself 4% felt that written permission from the patient should be required to give a prescription to anyone else 83% felt that the current system of checking that the person collecting knows the patients name and address before giving a prescription should remain in use 11% felt that we should give a prescription to anyone who knows the name of a patient. ACTION: It was agreed that the practice policy should remain unchanged. However written consent will be required before adding a patient to a pharmacy collection scheme. For the main survey the PPG were asked to come up with the areas to be covered and the questions to be asked. For this resources from NAPP (National Association for Patient Participation) were used to trigger ideas. The group felt that the areas that needed to be covered were: Telephone access The booking of appointments Privacy in reception Opening Hours of the surgery Overall perception of the practice These areas were selected because of strong feedback in the previous year or because of issues that they had heard raised in the wider community. It was decided that the survey needed to be kept reasonably short to ensure as many people as possible completed it. Most of the questions involved tick box answers but there was space left at the end for any other opinions that the patient completing it wanted to share. This was felt to have been a particularly useful area on the survey used in 2011/12. The survey was collated by the practice and checked by the PPG members to ensure that it represented what they were expecting based on the questions they had selected. It was then completed by patients between December 2012 and February 2013, all responses were anonymous and were collated by the practice. The results and a document containing all the comments left by patients were circulated to the PPG members (including the virtual PPG) in advance of their February meeting so that they could review them.

4 A summary has been prepared and a number of copies laminated for patients to see in the surgery. The file is also available to download from our website. If patients want a copy this can be requested from the reception team. The PPG met to discuss the survey on February 12 th Those who attended the review meeting commented that overall the comments regarding the practice were positive but that themes emerged within the results regarding the administrative areas such as appointments, reception and access to the building. In many cases these were the same findings as the previous year. RECEPTION Issue The survey highlighted a concern over privacy in the reception area and that the reception team prioritise the telephones over patients who are waiting at reception. Action Last year some of the chairs had been moved to face the reception desk to give space between waiting patients and the person dealing with the receptionist. 84% of patients still felt that they could be heard and although most were not concerned about this 25% did feel it was something they were unhappy about. The suggestion from the group was to move these chairs over to the far side of reception to widen the area people use to sit in. COMPLETE FEB 2013 Again a line or clear demarcation area was discussed behind which patients should wait. Survey responses had suggested that the receptionists should police this but there was concern that this could lead to aggression from the patient population. It was agreed that this should be further investigated by the practice team to see if there was a safe way of having a bank or airport style rope system or a line on the carpet. COMPLETE MARCH 2013 The issue of waiting patients feeling ignored was also discussed. Whilst the PPG understood the need to prioritise the telephones they also felt that the reception team could be more proactive in acknowledging patients via brief eye contact to let them know they had been seen. The practice team agreed that this should be normal practice. The reception team have now been briefed to remember to look up and let waiting patients know they are aware that they are there. COMPLETE MARCH 2013 APPOINTMENTS Issue The survey raised concerns about booking to see a familiar GP and how far ahead appointments are available. This has been another year of change with the departure of Drs Hayes and Metcalfe but the group were reassured that Dr Burgin will be staying on after

5 his training completes in August. Locum staff will continue to be a feature until then but from the summer should become rare. The group discussed the extended booking period that they had requested and felt that it still represented a good service for patients. The practice team outlined the different times and ways that appointments are released and the different patient groups that they are designed to help (for example the automated system is useful for patients who work, particularly those on shifts). The group could not think of any way to change this and on balance felt that it should be left as it is. The survey showed that patients were not clear on the practice opening hours, particularly the extended hours. These should be promoted, the suggestion being via the new practice newsletter. Action Include opening hours on the newsletter, highlight Saturday surgery. ACCESS Issue Within the comments section of the survey there were a number of complaints about the two sets of doors and incline that need to be navigated to get into the surgery. This had been raised at an earlier PPG meeting and a sign added to alert patients to the bell that calls a member of the reception team to help them but this was felt to be an inadequate response. Action Wall mounted rail for patients to use as they come up to the surgery door to be installed. QUOTES ARE IN AND A BUILDER HAS BEEN INSTRUCTED. Automatic mechanism to be fitted to the outer door. (THIS IS CURRENTLY WITH AN EXPERT BUILDER, AWAITING QUOTE AND TIMING) Inner door to be held open as there is no line of sight between the two and automating both could pose a risk to patients. The door will be held by a door stop linked to the fire alarm. COMPLETE FEB 2013 The PPG had said in their autumn meeting that they felt that longer term patients may be less aware of how the practice works and what services we offer as they do not have an up to date practice leaflet. Staffing changes over the year had been publicised on the website but for those without internet access there had been some confusion over who worked at the practice and who had left.

6 It was suggested that a newsletter (patients had seen this at other practices) would be a useful way of sharing information, particularly if it was available at the local chemists as well as at the practice. A draft of this was presented to the PPG in February and approved, it was agreed that these will be produced on a quarterly basis and include basic service information as well as any current health campaigns and a profile on one member of staff. For the first issue this will be Dr Burgin. This newsletter will appear in late March/early April and will be called Medical Centre Update.