Patient Participation Directed Enhanced Service 2012/13 Abbey View Medical Centre Report This report summarises the work that the Abbey View Patient Reference Group has undertaken during the last 12 months. The group was initially formed to engage more with our patients. Its immediate task was to discover what are the issues affecting patients visiting the medical centre. The report describes the activities of the group over the last 12 months, actions taken, and results of the second patient survey. Practice Profile Our practice currently has a population of 14, 957 patients, of which 52% are female and 48% are male. Their ages are broken down as follows: 0.16 20% 55-64 13% 17-24 8% 65-74 12% 25-34 9% 75-83 7% 35-44 12% 84+ 5% 45-54 14% We do not have ethnicity recorded for the full population but of the 7156 patients who have had their ethnicity recorded the results are as follows: White British 97% Black African 0% Black other 1% Asian 1% Other 1% Patient Reference Group (PRG) profile The group is a face to face group who meet once a month on a formal basis. It has an elected chair and secretarial support from within the group itself. All meetings are minuted and minutes communicated to all group members, Karen Mills (Practice Business Manager) and Dr Damien Patterson (Practice PRG Lead Partner). The PRG numbers 13 members and has membership from the following groups: Patients who work Patients who are retired
Patients both with and without children at home Carers Patients who are gay/lesbian 3 members are aged 35-44 1 member is aged 45-54 3 members are aged 55-64 5 members are aged 65-74 1 member is aged 75-84 All are white British. 9 are male and 4 are female It has not yet been possible to get representation from the following groups: Patients with learning difficulties Drug users Vulnerable adults Young people under 25 University students The Polish community who represent the most significant ethnic group within our practice population. Steps taken to ensure membership of the group is representative of the practice population. The whole practice population was profiled using our clinical system which takes its information from our new patient questionnaires, and the result is as described above. Following this all new patients have been offered the opportunity to join the group by adding a sheet to the new patient questionnaire which is handed back to our reception staff with their name and contact details if interested. Current patients are routinely invited to join by periodic leafleting within the practice. Where we have found it difficult to attract certain groups of patients our GPs have also approached individuals directly where it was felt that they may be willing to contribute. involved. The groups above however, still remain unrepresented.
Arrangements are in hand to met he head of the largest local school. It has a reputation for involvement in the community and the aim is to involve 6 th formers. Patients have also been offered the chance, via the same methods, of becoming part of the larger reference group who agree to be contacted directly, generally via email, to give an opinion on the various issues which have come up from the monthly group meetings. Patients are also asked about their interest via the patient survey itself using an additional sheet attached to the back of the survey. This has proved a useful tool for recruiting additional reference group members. This group so far numbers approximately 400 and is growing all the time. Steps taken to engage with non-represented groups As stated above our GPs have successfully directly approached patients from 2 nonrepresented groups who have agreed to come along. This is quite a successful method of encouraging patients to be involved and it is not always necessary to commit to the group on a long term basis. The PRG also has 1 current member who is directly involved with youth groups in the town and is liaising with them to try to encourage involvement from this group. This could also possibly include current or ex-drug users, young carers, vulnerable young people and others who are difficult to reach otherwise. Patients who are in nursing/care homes are also an obvious group who are underrepresented though it may be that they will find it easier to become part of the larger reference group given the difficulties that they face in travelling to meetings. We have discussed this group within the practice and are hoping to involve our District Nursing team in canvassing opinions from willing volunteers! To date however, this has not been successful though as the reference group grows we hope to access the views of this group more via email. Determining the issues to be prioritized and included on the survey The first survey carried out was detailed in the last report of March 12. During the 12 month period to the end of March 2013 the following actions have been carried out as a result of the views expressed by the practice patient population in that survey: The 2 sets of heavy wooden doors at the main entrance to the building have been replaced with automatic doors. This has significantly improved the ease of physical access for many of our patients.
New software has been purchased for the telephone system allowing it operate an automated queuing and direction system so making the answering of the telephone more efficient, particularly first thing on a morning. Software is being introduced to the clinical system to allow on line booking of appointments. In October 2012 the main agenda item for the PPG was the survey for the 2012/13 year. Discussion took place amongst the group members to pull together pieces of discussions held throughout the year, and they finally decided that they wanted to concentrate on finding out just how much the general practice population knew about the extent of the skills on offer within the medical centre. They therefore designed the 2012/13 survey around this in anticipation of it highlighting the need for information to be provided to patients about the expertise available. This was agreed with the GP Partnership and the survey instigated. How the survey was carried out The questions were drawn up following discussion between the PRG, the Partnership and the Business Manager. There were 2 headline issues which both had supplementary questions attached. Patients were asked to answer the questions on the survey, and also to add any other comments about the practice that they felt were important to them. Interestingly very few additional issues came up here, and those that did were generally mentioned only by a single patient. The survey was carried out in 2 ways. Firstly internally, by handing out written surveys at reception over an 8 week period, and asking patients visiting the practice to give us their views. Contrary to the majority of surveys which have taken place in previous years this year s survey was given to all patients visiting the practice rather than only GP patients, which then included patients visiting the nurses, midwives, health visitors, Registrar (of births and deaths), Complementary Clinic patients (if also practice patients), chiropodist, community mental health team, drug and alcohol services, and nurse practitioners. This then generated a much wider response group than previously and as a practice and PRG we are all very happy that we have accessed as wide a group of opinions as possible. Secondly the survey was emailed to all patients who had given permission for this to occur. This group numbered approximately 400 at the time of surveying of which 8% responded. Survey rationale and criteria for assessing credibility of the results The PRG and the practice chose to carry out the survey in 2 ways in order to increase the number of respondents. In coming years we would all like to use a company such as Survey Monkey to do this but in order to ensure a number of
respondents which is statistically significant we need to first increase the wider patient reference group numbers considerably due to the inevitable low response rate of an email survey. The PRG and practice are also keen not to restrict the responding group only to those who are IT literate and/or have access to email, and therefore will also always offer the survey in written form within the practice itself. In previous years we have worked with recognized survey companies such as In Time Data who have carried out our survey for us and for any practice population they have required 25 responses per 1000 registered patients to ensure that the survey is statistically significant. For our current registered population of 14957 this is equal to 374 responses. We therefore aimed for this number when carrying out the survey for ourselves this year and actually achieved considerably more with 424 returned either directly or by email. We are therefore satisfied that this is a valid outcome. Steps taken to provide the PRG with an opportunity to discuss the survey findings The survey was carried out between November 2012 and January 2013 and the results collected and collated in time for the PRG meeting February 2013. The main agenda of this meeting was given over to presenting and discussing the results and as always minutes were taken and distributed to all PRG committee members, along with the Business Manager and GP PRG lead (Dr Damian Patterson). Action plan resulting from the recent practice survey (The whole survey result can be viewed at the end of this report as Appendix A.) The survey highlighted the confusion evident amongst the patient group about the clinics, services and expertise available within the practice. Some of the more commonly used services, such as the Diabetes clinic and the cervical screening service, were very well acknowledged but other than this there was very little knowledge about the level of healthcare that is accessible closer to home. Patients were essentially in favour of healthcare screening, and had some suggestions as to what they felt would be desirable in this field, however there was clear confusion even from those attending clinics as to exactly what they were. Many patients were of the belief, for instance, that they had been attending a Well Man clinic when this hasn t run for some 10 years now. It was therefore decided that a concerted effort should be made to inform patients about exactly what is offered and how it should be accessed. On this point the practice was particularly keen that any information developed should be very clear about the mode of access as many of the clinics and areas of GP special interest should be accessed by inter practice referral only. The GPs were very clear that they did not want patients trying to self diagnose into the surgery of the ophthalmic
specialist, for example, if this was not appropriate, as this would simply waste practice time. Information leaflets are to be produced describing the clinics and access modes available to patients, and also describing in general the areas of special interest of the GPs. This information is also to be added to the waiting area TV screens once new software has been purchased to allow this to happen in an effective and efficient manner. Basic information is also to be added to the New Patient information handed out at the point of registration with the practice. Survey result summary 400 surveys sent out by email 32 surveys received back by email = 8% of those sent out 530 surveys passed out within the practice 392 surveys received back within the practice = 74% of those handed out Actions which the practice intend to carry out as a consequence of this process To produce an information leaflet describing the clinics and services available to patients and how they are accessed. To purchase software for the waiting room TV screen system capable of adapting this information easily and efficiently. To add the information in a basic format to the new patient information pack. Changes with contractual implications None of the intended actions have contractual implications. Practice opening hours The practice is open from 0830 to 1830 Monday to Friday. Patients can book same day and booking ahead appointments by telephoning the practice from 0830 onwards and requesting an appointment. Patients can also request a telephone appointment for today or a day in the future if they prefer. If all appointments have been filled then a GP will telephone the patient to discuss their issue and proceed according to need ie they may offer a same day appointment, may offer an acute prescription which can be collected by the patient without having to see the GP further, may offer an appointment for some time in the future, may offer an appointment with a more suitable healthcare professional etc
Nurse appointments can be booked in the same way or through the Practice Nurse Secretary. Extended Hours The practice is also open from 1830 to 1930 Tuesday to Thursday inclusive, along with one Saturday morning per month. Patients can book into these appointments if they are unable to attend the surgery in normal working hours for any reason. These surgeries are staffed by a mixture of GPs and Doctor s Assistants to allow access to a full range of clinicians, both male and female.