CMK MEDICAL CENTRE Patient Participation DES Introduction & Background CMK Medical Centre is an urban training practice, originally situated in the centre of Milton Keynes who moved to a new, purpose built surgery constructed by private developers approximately 6 ½ years ago. We are now situated in Bradwell Common and whilst we are some 10/15 mins walk away from the centre, we have retained our name as we are considered to be the surgery closest to The Hub & Centre MK. The new surgery houses 10 GP s (8 partners + 2 salaried GP s); 5 nurses; 2 HCA s + phlebotomist; Midwife; a District Nurse team and a team of Health Visitors. We also have a small Boots pharmacy next door. We currently have circa 15,500 registered patients and unfortunately there is rather a transient element to our patient base due to temporary housing with the result that we register on average 215 patients each month and deduct around 165 each month. Our patients are of varying ethnicity as follows: Patient Access The surgery is open from 8.00 am until 6.30 pm and appointments can be made by telephone; booking on-line or coming into the surgery. We ensure that we are able to meet current demand by releasing/embargoing the appointments as follows:
Routine (non-urgent) Appointments: These are bookable up to 6 weeks in advance with all clinicians and we try to accommodate a patient s preference for day/time whenever possible. A number of these appointments are also available to book on-line. (access anytime of day/night). Emergency Appointments: We refer to these as urgent, on the day appointments and embargo a certain amount of appts each day for clinicians. Additionally we have a duty doctor in both morning and afternoon with a full clinic of on the day appointments available. Telephone Appointments : In addition to the morning appointment slots, each GP has a number of telephone slots and if the patient is unable to get into the surgery but wants to speak to their doctor, they are allocated one of these slots. If the patients own doctor is not available they have the ability to speak to an alternative doctor if necessary. These are widely used and appreciated by our patients. Patient Participation Group (PPG) Our Patient Participation Group (PPG) was originally formed in 2009 but disbanded upon the resignation of the chairman. Early in 2011, the surgery embarked on a patient recruitment initiative in an endeavour to attract more patients of a wider demographic and there are currently approximately 15-20 in the group with anywhere in the region of 7-15 patients attending the regular meetings held at the surgery, now known as the Patient Reference Group (PRG). Support has been provided by the current Chair of the group, Saira Walker with assistance from other members including Paul Winter, current elected representative on the Patient Congress commissioning group (i.e. MK Commissioning). Janet Mulley is his deputy. One of our Partners attends each meeting together with Jan King, Practice Business Manager or Yvette Baker Office Manager plus Sarah Knight a receptionist/administrator at the surgery. The group is representative of our surgery demographic and includes patients of varying ethnic backgrounds and diversities with a fairly even split between male/female. We continue in our efforts to attract more to our meetings which includes: Notices on our media screen Invitations attached to our repeat scripts Information on our website Information given to parents during the baby immunisation clinics Invitations given to mothers attending the breast feeding groups A regular update on our surgery Newsletter Unfortunately, the only group not represented at the meetings are any younger patients (i.e. <40). In an effort to include our younger patients, we contacted local schools; higher education colleges; Milton Keynes Library (who are displaying 9 posters over various sites for us) and Carers MK who have a young carers division. We have suggested to the Heads of Sixth Form that their students might like to consider including such involvement as part of their social studies.
Additionally, our Practice Manager Group created a poster which is being advertised in a number of schools in Milton Keynes inviting young patients to join a Virtual PRG in their own surgery. This invitation is also displayed on our own surgery website. Sadly there has not been much interest shown so far but we will continue to try to reach this difficult group. In a further attempt to widen the patients demographic in terms of age; ethnicity & clinical needs a virtual (vprg) group has been formed comprising of approx 30 patients. Patient Survey The survey was devised following much discussion at our PRG group meetings over the previous months which had centred on the high volume of DNA s (did not attend) and which clearly has an impact on the number of appointments available. PRG members felt that by working on one aspect i.e. the number of DNA s it would have a beneficial impact on the other (number of appts available). The difficulty of getting through to the surgery on the telephone sometimes was also subject to debate and whilst the members could understand the difficulties faced in this regard, they felt it should be included in any survey to get the views of larger numbers of patients. Whilst the group were supportive of our GP s making the choice not to offer extended hours i.e. evening/weekend working, they felt that perhaps a bit more flexibility within the core hours of 8.00-6.30 would prove beneficial to all and again wanted to ascertain others views on this. The current patient survey was therefore devised and agreed with the PRG, and posted on our website, advertised in the surgery on the media screen and flyers were handed out at our reception desk. Reference to the survey was also attached to every new patient registration (around 215 per month). We received approx 550 completed surveys and were delighted with the positive response to most areas. The age demography of the patients was as follows: How old are you? 0-15 0% 16-24 4% 24-45 34% 46-64 32% 65+ 21%
At a PRG meeting held on 16 February, the results of the survey were discussed and it was clear that those present felt happy with most aspects of the service offered at CMK Medical Centre and were complimentary about doctors and staff. Areas highlighted on the survey for possible attention were as follows: Q2) When you have phoned the surgery, how do you rate the ability to get through on the phone? POOR 23% FAIR 26% GOOD 33% EXCELLENT 13% PRG members accepted the difficulties of dealing with such high volumes of calls when there are 15500 patients. They felt that on-line booking (see details below) would assist in this area also. Appointments 4) How do you rate the ease of booking an appointment? POOR 13% FAIR 25% GOOD 36% EXCELLENT 23%
Patients attending the PRG meeting felt that the on-line booking system was excellent but probably not widely enough publicised. On-line booking was made available approx 3 years ago and the number of appointments has been gradually increased since then. The PRG thought it would assist patients in the ease of booking GP appointments if these numbers could be increased further and at a subsequent meeting with GP s it was agreed that we should do so. The on-line booking numbers have now been increased by a further 40% (i.e. 210 appts) in acknowledgement of the PRG s suggestion. 5b) If you are not happy with appointment times what changes would you suggest? (Please tick all that apply) EARLY MORNING 30% LUNCH TIMES 21% EVENING 32% Varying the surgery clinic times was discussed at the PRG meeting and the practice manager was pleased to inform them that since completion of the survey, one GP now starts his surgery at 8.00 am on 2 mornings each week with another working through the lunchtime on 1 day. Following the PRG meeting on 16 th February, a meeting with GP s and some admin staff took place and it was agreed to offer additional early morning phlebotomy appointments and these will now start at 8.10 am every day with 2 phlebotomists available on 2 of these days from 8.10 am. Another GP has also offered to start her surgery at 8.00 am every working day i.e. Tue-Fri. PRG Meeting Discussions Since the regular meetings commenced last year, the PRG members have been keen to focus on reducing the numbers of patients not attending appointments without cancelling. They were horrified by the volumes and felt that the surgery should take a very firm line particularly as there would be another 270 min appts available every month if everyone cancelled. The action points in our plan reflect the strength of feeling about these missed appointments and this job is now undertaken on a weekly basis by a member of our admin team. An action plan has been devised to ensure all objectives are met and this will be reviewed at future PRG meetings.