London Region North Central & East Area Team Complete and return to: england.lon-ne-claims@nhs.net no later than 31 March 2016 Practice Name: THE MISSION PRACTICE Practice Code: F84015 Signed on behalf of practice: Isabel Cossar Date: February 25 2016 Signed on behalf of PPG: PPG Date: February 23 2016 1. Prerequisite of Enhanced Service Develop/Maintain a Patient Participation Group (PPG) Does the Practice have a PPG? YES Method(s) of engagement with PPG: Face to face, Email, Other (please specify) Face to face, posters, mail, text, telephone, email, NHS Choices, The MissionPractice website, virtual group email and newsletter. Number of members of PPG: 41 Gender Age Practice PPG Male 49% 45% Female 51% 55% Practice PPG <16 19% 0% 17-24 8% 0% Page 1 of 10
25-34 26% 43% 35-44 16% 12% 45-54 9% 19% 55-64 6% 12% 65-74 4% 5% > 75 4% 0% Ethnic Background Practice PPG White (%) 58% 83% Mixed / Multiple Ethnic Groups (%) 5% 0% Asian / Asian British (%) 30% 17% Black /African / Caribbean/ Black British (%) 5% 0% Other Ethnic Group (%) 2% 0% Describe steps taken to ensure that the PPG is representative of the practice population in terms of gender, age and ethnic background and other members of the practice population: Next PPG Meeting Invite.docx PPG promo flyer.pdf Staff canvass patients in the waiting area inviting them to join the PPG. We pay particular regard to the age, gender and ethnicity of patients in an effort to reflect our patient population. For Bangladeshi patients we have a Bengali advocate to call patients and to explain about the PPG and extend an invitation to join. We publish an application form on our website, display posters on walls and notice board and leaflets are placed in reception. Patients can also register on the digital patient call system and by text messages. We also discuss within the PPG meetings how we may go about inviting patients to join the PPG and how to get feedback and suggestions they may have Page 2 of 10
to improve services. This is useful in reaching patients who would not usually get involved in feedback/suggestions and particularly useful for patients who have a low literacy level. We have a health networker on site, who will promote up and coming events/meeting to patients within the waiting area. PPG members encourage patients to use the appointment system machine and will then discuss PPG membership. Are there any specific characteristics of your practice population which means that other groups should be included in the PPG? e.g. a large student population, significant number of jobseekers, large numbers of nursing homes, or a LGBT community? We do not have representation for our Bengali patients although they form a large part of our practice. We have a larger proportion of elderly patients. We also have tried to target our patients who are carers. If you have answered yes, please outline measures taken to include those specific groups and whether those measures were successful: Within the practice once a week a Bengali Advocate is on site, she follows up with phone /face-face conversations to inform patients of the role of the PPG. Information is relayed of coming PPG meetings in order that this particular group may attend. Our PPG members have attended at the practice and canvassed patients in the waiting area. Clinicians hand out invites in their consulting rooms. We have posters on the notice boards, we advertise on the website (and post all minutes, agendas, and dates of meetings). We ask all patients registering for their emails and have a note about the PPG on the registering form. We have a Bengali speaking member of staff who is on available to join the meeting should we have need of a language assistance at the meeting. ndby In the minutes dated August 2015, it was noted we need to do more for the Asian Community perhaps a newsletter to be written in Bengali. 2015_08_25 minutes PPG.pdf Carers - the practice has tried to engage this particular group. This was done by sending out a letter to ascertain who were carers or not, and once Page 3 of 10
received they were sent an invitation by post to join the PPG meetings. 2. Review of patient feedback Outline the sources of feedback that were reviewed during the year: We receive feedback via the practice website, email, face to face consultations, PPG meetings and suggestion box. How frequently were these reviewed with the PPG? This was done via our Friends and Family test reports, circulated via our website and overview at My Surgery website and then reviewed within the PPG meetings bi annually. 2015_04_30 F&FT 2015-05-01 F&FT 2015-06-01 F&FT 2015-07-01 F&FT 2015-08-01 F&FT 2015-09-01 F&FT 2015-10-01 F&FT 2015-11-01 F&FT 2015-12-01 F&FT 2016-01-01 F&FT 3. Action plan priority areas and implementation Priority area 1 Description of priority area: It was agreed that waiting times were a priority issue for the group. 2015_08_25 minutes PPG.pdf Page 4 of 10
What actions were taken to address the priority? The staff members encouraged patients to sign on the Online Booking System and booking slots were made more available for staff members to book patients into. Telephone callers needs and requirements were assessed so that they are signposted to the right member of staff / service. Team members announce when there are delays to patients appointment times and try to explain the reasons for the delay. Staff also advise patients on any delays when they are signing in for their appointments. The GPs restructured their appointment templates to accommodate their individual ways of working in order assist their running to time. Result of actions and impact on patients and carers (including how publicised): As a result of these changes 9 out of 10 GPs ran to time. Priority area 2 Description of priority area: It was agreed that answering the telephones was a priority for the group. What actions were taken to address the priority? Feedback on Phone-Use: At the November meeting GN circulated a chart showing the phone activity for the month. Overall there were 5452 incoming calls. Of that total 807 (14.8%) were abandoned calls, which is when the caller is in the queue but hangs up before their call is answered by a receptionist. This does mean Page 5 of 10
that 85.2% of calls are answered. Of the 807 abandoned calls 25% of callers waited less than 2mins before hanging up and 75% were waiting more than 5 minutes before hanging up. The group decided that we would continue to monitor performance but needed to have more information on the wait times for callers. There are two things to measure: one is how long are patients waiting in the queue before speaking to a receptionist and two, the wait time before callers abandoned their calls. The practice altered the measurement intervals so we would have more information on those that waited more than five minutes. In December the reception supervisors paid particular attention to abandoned calls by monitoring the numbers via the display board. That month we had 4519 incoming calls, of which 514 were abandoned (11%). Of the abandoned 57% of callers hung up after waiting less than two minutes. With 41% waiting over 3mins before abandoning. The Chair of the PPG asked how long patients were in the queue. We still have to extract the information on wait times for callers who do not abandon. The practice will continue to provide these stats monthly. The aim is to reduce the abandoned calls and the wait times. But the message is that Mission Practice DOES ANSWER the telephone but many patients abandon calls if not answered within 2 mins. The practice needs to work on reducing wait times for those not abandoning their calls. A PPG member asked when the peak-times are for Reception getting phone-calls: answer Mon am but all mornings are busy as the morning staff can handle as many as 400 calls. IC talked of chance to drop in a message while patients are waiting on the phone: an engineer is needed to do this. IM spoke of call looking as if it s abandoned if patient takes up another option e.g. booking online. Another issue is if some frustrated caller keeps calling. Our aim is to REDUCE THE NUMBER OF FRUSTRATED CALLERS! IC spoke of high expectations from some patients who may miss their doctor s appointment one day and then request a same-day appointment the following day. IM encouraged use of doctor telephone consultations. JG suggested that info displayed in surgery should say that it s endorsed by PPG, not just the Practice defending itself. Page 6 of 10
Result of actions and impact on patients and carers (including how publicised): Staff were aware of the queuing system as monitored daily. Senior Members of the Team printed out statistics on a daily basis. The patient-queue at Reception is also reduced when PPG volunteers help patients understand how to sign in using the machine. Priority area 3 Description of priority area: It was agreed that getting an appointment was an issue for the group. What actions were taken to address the priority? The introduction of telephone consultation over and above the option for same day appointments. The option of an ipad to be used by the GPs when a home visit is made. The use of ipads to allow and support remote access to clinical records while on home visits. The practice decided to try and work on reducing the number of DNAs. The DNA letter was redrafted and all clinicians send DNA s, where appropriate, to patients who frequently DNA. We display the number of DNAs on noticeboards in the practice and on the website. New registered patients encouraged/advised to use the Patient Online Access. Result of actions and impact on patients and carers (including how publicised): The same day treatment system allows patients suffering acute episodes to be triaged and either seen that day or seen that week by their names GP. This is very popular with patients who often are happy with a telephone conversation with their GP. It also supports continuity of care as anything that Page 7 of 10
does not need to be seen on the day will be allocated to the patients named GP. Routine appointment times have been reduced from over two weeks to ten days. A questionnaire was sent to all Carers registered with the practice and responses have been coded in the clinical record. We were disappointed that this contact did not elicit more members for the PPG. However it is understandable that this group of patients may not be free to attend meetings. Information was also included on prescriptions about online booking of appointments. Progress on previous years Is this the first year your practice has participated in this scheme? NO If you have participated in this scheme for more than one year, outline progress made on issues raised in the previous year(s) Points were to expand PPG to include a wider ethnic group, improve telephone queue system, update website with events, meeting reminders and reduce patient DNA. There has been very good progress on these issues as evidenced by the 2014-15 Action Plan and minutes Action Plan 2014-2015 FINAL.pdf 20150202 PPG Minutes.pdf 20150324 PPG Minutes.pdf See below for 2015-16 action plan. Page 8 of 10
PPG Sign Off Report signed off by PPG: Yes at the Feb 23 2016 meeting Date of sign off: Feb 23 2016 The minutes of each meeting are sent to all participants of the PPG i.e. both staff and patients. This report will be signed off on the 23 rd of February 2016 at our next PPG meeting and circulated in advance. How has the practice engaged with the PPG: The practice has continued to ask patients to share their email address with the Patient Group at the time of registration. The practice promotes the group by advertising in the waiting room and patient leaflets. The practice maintains its own notice board and regularly updates. The practice Supervisors are working with the Practice Manager to produce newsletters on a bi-monthly basis. The practice continues to encourage the PPG to increase their membership. The practice promotes and encourages patients to engage with the Patient Group, two new members have joined the Patient Group as a direct result of this. The practices alongside the PPG are in discussions around having a Fun Day in May 2016 to encourage patient to participate within the PPG group. The practice and the Patient Group are aware that the demographic of the Patient Group is 40+ and has tried hard to encourage younger members. However this is still to be achieved despite our best efforts. The Patient Group has a suggestion box in the waiting area and the comments are discussed at the Patient Group meetings. The Patient Group has its own website page with all minutes and appendix publicised on it. Page 9 of 10
How has the practice made efforts to engage with seldom heard groups in the practice population? The PPG has focussed with the help of senior members of staff GPs and the views of the patients re: the system by which appointments can be booked. PPG has requested that a GP attend meeting on a rota basis. Has the practice received patient and carer feedback from a variety of sources? The practice welcomes and reviews patients from a variety of sources including direct feedback, suggestions, compliments and complaints as well as via patient s surveys and the newly introduced Friends and Families Test. The practice has a suggestion box in the reception area. Was the PPG involved in the agreement of priority areas and the resulting action plan? PPG Action plan_2015-16.pdf Mission Practice Charter_2015_07_01 final.pdf Yes the PPG are consulted and agree priorities. The planned agenda for each meeting and the minutes of each meeting are posted to patients. The next agenda and subsequent meeting continue where the previous one left off. The PPG, will also look at what is deemed pressing to be tackled should there be a situation where we have to prioritise. How has the service offered to patients and carers improved as a result of the implementation of the action plan? Do you have any other comments about the PPG or practice in relation to this area of work? This is an on-going process. Agreed plans from previous years have been achieved and some we are still working on. The introduction of the telephone system, the planned arrival of the new Patient Self Arrival System, the change of GP s system template, this has all come about with the collaboration of both Practice and PPG. Complete and return to: england.lon-ne-claims@nhs.net no later than 31 March 2016 Page 10 of 10