Well Street Medical Centre Patient Participation Group: Action Plan in Response to the Patient Survey

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1 Q1: Results Positives: Almost two thirds of the respondents have accessed the practice website in the past year. Most patients access the website once a month. The most likely explanation for this is that the website contains a link to the Patient Access site where repeat medications can be ordered. Needs Improvement: The practice should continue to promote the website as an easily accessible point of up-to-date information for those with the internet. The practice needs to ensure the website compliments its existing communications to patients, rather than replace it. 1

2 Q2: If you used the website, how useful did you find it to? 2

3 Postitives: Most of the existing features the website offers are considered moderately useful to very useful. Repeat ordering and the updating of contact details is conducted through Patient Access which is linked to the website but not directly available on the practice site. This may explain the slightly higher number of not at all useful and not very useful responses. Due to the security settings that need to be applied for the transfer of sensitive information the offering of this services through Patient Access (an extension of the surgery s clinicial system) is necessary. Needs Improvement: The surgery should review the layout of its website to ensure all headings are clear. Discuss the formation of a PPG review team who access the website on a quarterly basis and highlight to the practice administrators any areas that are unclear or require updating or improvement. Who/When: Agenda item for 03/06/14 Q3: How useful do you rate the following existing services? 3

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5 The existing services are, on the whole, considered moderately useful to very useful. Responses of not very to not all useful can be expected for services that require either a mobile phone or access to the internet. On reflection, the inclusion of a not applicable answer would have been appropriate. The highest number of not very to not all useful responses were reserved for the cancelling appointments online feature. This may be because internet access is not always possible, particularly if the cancellation is necessary on the day of the appointment. It may also be explained by the fact that it has not yet possible to rebook the appointment online (this is addressed below). The feature, however, does provide another mechanism of contacting the surgery. Q4: How useful do you rate the following services were they to be offered? The survey was conducted when the surgery was trialling an appointment text reminder service. The surgery will re-instate the feature when it upgrades its clinical system in the summer of

6 The responses show a willingness to embrace technology and the practice s use of all communication methods available. In this small practice sample, the use of text messages in the form of review due/health campaign messages appears to be slightly more popular than the use of s (90%/89% vs. 83% moderately to very useful respectively). More than a quarter of respondants viewed online appointment booking as not very to not at all useful. Practices are currently incentivised to provide online appointment booking. Providing appointments online offers greater convenience to our online patients and reduces telephone traffic for those that do need to get through. The comments section of the survey and subsequent PPG response reveals concerns that making appointments available online will stop patients being able to book slots over the telephone. This is not the case. Slots that are made available online can still be booked by staff in the surgery. The practice understands the importance of ensuring online appointments are carefully introduced to ensure equitable access to appointments for all patients. 6

7 Continue to offer online appointment booking with the practice s Foundation Year 2/Registrar doctors. Review offering a small number of appointments online for doctors that work in excess of seven sessions (4 days) a week. Pursue the option of ordering repeat medications 24/7 via telephone when upgrading the surgery s existing telephone system. This is in the surgery s plans but will now likely be revisited once the upgraded clinical system (offering text appointment reminders) is up and running. Continue to collate patients text and contact details. Review consent requirements for the sending of health related alerts via text and . The practice s understanding that explicit consent via another media (i.e. written consent) was required was considered unnecessary by the PPG. The practice has the necessary software in order to send health related alerts via text message. Q5: Prior to sending out appointment reminders by text message, we sent out a one-off text message enabling patients to opt-out of the service. If we were to send out 'Review Due'/health campaign messages by text, would you be happier providing your consent to receive these by? Two thirds of patients were happy for the practice to use a positive opt-in to text service as their consent for the practice to send health-related alerts. However, as one third of patients would be happier to provide consent in writing,the practice needs to revisit NHS guidance on the use of text messaging. Review consent requirements for the sending of health related alerts via text and e- mail. Q6. The purpose of text reminder service was to reduce the number of DNAs (did not attend). What number of missed appointments in a twelve-month period would you consider warrants a warning letter (in the absence of any mitigating circumstances)? 7

8 Over half of the respondents feel that two unexplained DNAs would warrant a warning letter from the practice. This subject is often raised at PPG meetings with strong opinions voiced regarding wasted clinical time. The practice does acknowledge that at times of high demand, appointments are being booked well in advance. This would further support the continuation of an automated text reminder service. Q7. What number of missed appointments in a twelve-month period would you consider unacceptable (in the absence of any mitigating circumstances)? Just over three quarters of patients felt three missed appointments in a twelve month period was unacceptable. Please see Q8 for planned actions 8

9 Q8. How do you think we should deal with patients who persistently fail to attend booked appointments, without a good reason? Of the options presented, 45% of respondents feel that those who reach an unacceptable level of appointments should be considered for removal from the practice list. However, the majority of respondents (55%) feel a lesser action should be taken. Draft a DNA policy for discussion at the next PPG meeting on 03/06/2014. The practice s new clinical system will automatically flag a patient s missed appointments when each new appointment booking is made; this is an improvement on the current system, which requires accessing a separate screen or manually entering an alert. With this in mind, a verbal warning could be issued following the first two DNAs, a written warning could be issued at the third with the patients registration with the surgery subject to review should they miss more than three appointments. To help patients keep track of their appointments text confirmations could be sent at each appointment booking with text reminders sent the day before the appointment is due to take place. The practice will also investigate if text notifications can be sent automatically when a patient misses their appointment. 9

10 Q9. Please enter any further comments below Who/When: Positive remarks on surgery facilities/staff 6 Thank you! Opinion on DNAs 4 Opinion on Online Booking Positive 1, Negative 5 Suggestions that the service only be available for doctors that work more than 3 days / 5 days a week. We acknowledge that this is a problem patients feel strongly about and we do too. This is why we want to develop a DNA policy in conjunction with the PPG to ensure that the message is clear: repeat DNAs, without good explanation, are unacceptable. Online appointment booking will not be available for all staff and all sessions. Online booking is new to the surgery too and we plan to start small and continually assess that a) the system is not being abused and b) access to appointments is equitable for all patients. Send appointment reminders routinely to those with memory problems 1 Negative comment regarding date of next routine appointment 1 Once the surgery is up and running with its clinical system, text reminders will be sent to all patients. We acknowledge the number of doctors available has currently reduced due to holiday and maternity leave. This does have an impact on appointments. The surgery has recruited a further female GP who will start in June