St. Neot’s Surgery

Patient Participation DES - Local Participation Report 2013

Document Control

A. Confidentiality Notice

This document and the information contained therein is the property of Dr Lawrence & Partners.

This document contains information that is privileged, confidential or otherwise protected from disclosure. It must not be used by, or its contents reproduced or otherwise copied or disclosed without the prior consent in writing from Dr Lawrence & Partners.

B. Document Details

Classification:
Author and Role: / St. Neot’s Patient Group
Organisation: / St. Neot’s Surgery
Document Reference: / PRG1
Current Version Number: / 1.0
Current Document Approved By: / St. Neot’s Patient Group
Date Approved: / 22/3/13

C. Document Revision and Approval History

Version / Date / Version Created By: / Version Approved By: / Comments
1.0 / 22/3/13 / St. Neot’s Patient Group

St. Neot’s Surgery

Local Patient Participation Report

Date Published: 22nd March 2013

A description of the profile of the members of the PPG:

Core Group
1.  White British Male aged 56- Has been at the surgery all his life and works as a community paediatric nurse
2.  White British Male aged 75- Has been a patient at the surgery for 5 years after moving from Bristol. He is now retired however his previous work was based in Personnel and Human Resources
3.  White British Female aged 58- Has been a patient at the surgery all her life. She has extensive experience on many groups and has spent most of her working life in Education and Child Welfare.
4.  White British Male aged 30- Has been a patient at the surgery for 2 years. He currently splits his time between attending college and volunteering at St. Luke’s Hospice
5.  White British Male aged 69- Has been a patient at the practicefor 13 years when he moved to Plymouth. He is retired after spending 38 years working for the railway
6.  White British Female aged 58. Has been a patient at the surgery for 27 years. She is involved with the voluntary sector and commissioning Adult Social Care for Plymouth City Council
7.  White British Male aged 59 - Has been at the surgery for 23 years and has extensive experience working for several we groups.
Virtual Group- 56 members signed up so far, with a higher mix of younger and female participants to compensate and is currently actively recruiting (56 members so far)
See Appendix A: Demographic Data for how the profile of the core group matches the practice population and the patient survey responses (2013). 2012 data was used for practice population.

A description of what steps the Practice has taken to ensure that the PPG is representative of its registered patients and where a category of patients is not represented then what steps have been taken by the Practice in an attempt to engage with those patients:

For example – virtual patient group / committee / survey asking to take part etc.
The Practice initially ran a high profile visual campaign to recruit members with posters in all 3 waiting rooms advertising the group and inviting patients to register interest in becoming a member (see Appendix B- example of flyers)
Along with the posters various sized flyers were produced and distributed to the local shops in the area and attached to prescriptions handed out both at the surgery and at the various chemists that collect from the surgery. The Group is also advertised on the practice website and applications of interest are found at reception. The Practice Manager assigned a GP and Receptionist Representative to the PPG
Once the initial core group had been running for over a year it was felt that to make the group further more representative an online Virtual Group should be setup to run alongside it. An Open Day was set up in January whereby Patient Group Members came into the surgery alongside a poster campaign and actively recruited new members to the Virtual Group concentrated on areas that were under-represented in the core group with good success. 56 members have been recruited so far and they were all given the opportunity to come on the draft Patient Survey 2013 before it was published.
Appendix A shows that the patient survey results is quite representative of the practice, particularly in age range, but the virtual group with be helpful in complementing the core group to make the overall group more representative Once sign up is complete for the virtual group, it will be profiled too.

A description to be entered in around how the Practice and the PPG determined and reached an agreement on the issues which had propriety within the Local Practice survey:

For example: A form was disseminated for a period of two weeks to all patients that attended the Practice to ask them for their views on which areas of priority they felt should be addressed within our annual Practice survey. To reach all patients we also engaged in setting up a virtual patient group and emailed the survey out to those patients too. Following this the outcomes were discussed at a bi monthly meeting with the PRG committee and agreed the list of priorities that would need to be addressed within the local Practice survey.
The PPG is a new group and has been working to a tight deadline and therefore were not able to recruit a virtual group initially, but has got it off the group in the last few months (see above). For 2012, The Practice and the group researched previous surveys carried out and instructed the Partners of the Practice to pass on what suggestions they may have, particularly in light of the impending move to new premises in approximately 18 months time. The members held a two week consultation period and met to submit the first round of questions. During the 2nd meeting it was agreed that the survey would reflect a patient’s journey from booking to attending and service satisfaction. A sub group was tasked to put together a draft questionnaire which was then submitted, amended and agreed by the whole group at a further meeting which was also attended by Practice GP and Receptionist representatives.
For 2013, a similar working group was held, deciding to concentrate on areas brought up in the 2012 survey- namely appointments system perspectives and satisfaction with services and also concentrate on more free text answers to get qualitative opinions. There was also the opportunity for the new Virtual Group to put forward their views.
Due to certain lack of knowledge about surgery services revealed in the 2012 survey (eg. about opening hours an appointments system), the design of the 2013 survey was educational with a comprehensive description of the appointments system and the plans for the future.

A description of how the Practice sought to obtain the views of its registered patients

For example: The Practice utilised the NAAP resources to support the Practice in compiling a good quality survey of questions, which were also linked to the priorities highlighted. For those patients that do not attend the Practice regular we also utilised the monkey-survey system and emailed out the survey to all our virtual PRG members.
The Practice researched previous surveys and consulted the patient group for their perspective of what patients would like to comment on. The Practice mentioned also future plans (eg. expansion of online access, moving into new build and potential new appointments system). Details were also posted on the website as was the survey through the facilities of mysurgerywebsite.co.uk. A response number of approximately 200 completed surveys was estimated for the 1 week period. Members of the patient group were personally available at the surgery to assist in gathering views and completing surveys during this time. Surveys were also studied and processed daily to ensure that a diverse population completed surveys so that groups less represented could be targeted to ensure that as wide a group of views were gathered as possible. Other members associated with the agency such as the Community Matron were recruited to reach members that would normally not visit the surgery but would see a GP in their home setting.

A description of how the Practice sought to discuss the outcomes of the local survey and the Practice’s action plan together

For example: Following the analysis of the local patient survey – the action plan was discussed in detail with the committee and the emailed to the virtual patient group – explain what the outcome of this meeting was etc.
Each survey completed in paper form (see Appendix C- Patient Survey) was entered via the Practice website which links to a script that collates responses and comments to produce statistical information in the form of a report including easy to interpret pie charts (see Appendix D- Survey Results). The PPG met together with the Practice Representatives to consider the findings of the survey. A plan was discussed considering what actions could be put into place almost immediately and those that would need further planning and discussion. As the survey had been designed in sections relating to patient journey each section was discussed agreeing various actions.
2012 Summary
Much of the survey findings were very positive especially in terms of clinical services and consultations and although only 3% reported that they were not satisfied with the overall care at the surgery whilst 51% were very satisfied 40% reported to be only fairly satisfied and it was agreed that action was required to improve this statistic. The report is displayed in each waiting room and on the Practice website along with key statistics and findings in poster and newsletter format (see www.stneotssurgery.co.uk).
2013 comparisons
Overall satisfaction appears to be more positive once split into satisfied vs dissatisfied
78% were satisfied with GP/NP services
88% were satisfied with Nurse/HCA Services
83% were satisfied with Reception Services

A description of the findings or proposals that arose from the local Practice survey and what can be implemented and if appropriate reasons why any such findings or proposals should not be implemented

For example: Change of opening hours – explain if these are feasible, why implemented or not implemented, Explain had discussions and agreement with the PRG or if not the PRG the PCT etc.
The main focus of the new survey was re consultation system plans for future to keep pace with increasing demand. It appears that 57% of patients feel the change to mixed access 2 years ago has made no difference, but 48% feels there is room for improvement by using ‘Advanced Access’ (St. Levans based) system with only 10% feeling that would make it worse. This has informed the partners to be able to consider the system once we move into the new build and have more telephone lines.
Booking in screens are more widely used than first thought (75%) though only 10% people use online access. A push to incorporate a decent booking in screen and continue to promote online booking (some confusion in free text comments re instructions) would be helpful.
Free text comments have been useful too (Appendix D- Patient Comments). Majority of comments were positive. The points we can draw out for them is
-benefits from uniformed staff in new build to increase professionalism
-better access for new build with lift access
-better clarity with online services.
-increase work to reduce pressure on appointments and waiting times through consideration of telephone triage.

A summary of any evidence including statistical evidence relating to the findings or basis of proposals arising out to the local Practice survey:

For example: Opening hours of the Practice 98% of patients agreed that the opening hours on a Saturday were excellent. These can be positive or negative etc.
Appendix A shows demographic comparisons of the data collected during practice population search, patient group data and patient survey results. There is room for improvement (particularly with encouraging response from males and avoiding over-representation of 55-65 year old patients in patient groups) but none appear significantly out of expected variations. We excluded the under 18 year old group in the age spread as it is impossible to guarantee full capacity for all of them to be able to complete the survey and take part in the patient group though do have a patient group member with significant paediatric experience to compensate for that.
Overall the demographics are consistent enough for the above proposals to be valid, but we agree that further work should be made to advertise the group further to make it even more representative. This can be the further open days that have been useful for getting the virtual group off the ground that goes some way towards addressing underreprentation of females and younger groups. Appendix D lists all the findings in detail. The proposals related to the percentages are listed both above and below.

A Description of the action which the Practice, the PCT intend to take as a consequence of discussions with the PPG in respect of the results, findings and proposals arising out of the local Practice survey. If this is the second year of the scheme detail here any changes and issues since the 31st march 2012 local patient participation report was completed.

2012 plan
1.  Production of new literature detailing opening hours and the re-assessment of Patient Information Boards with a member of the PPG taking a lead role in ensuring that the information remains up to date and relevant (Currently still in progress, will be easier to fully incorporate in new build).
2.  A clear statement regarding the electronic booking system should be displayed (Achieved, booking in screen usage has improved and reflected in 2013 survey result). in all of the waiting rooms and Receptionists need to be clearer both on the telephone and in person. The PPG will also look into whether a queuing system can be re-incorporated into the telephone system (Achieved through telephone engineer).
3.  It was agreed to continue to promote and develop both online prescriptions and appointments (Still room for improvement as only 10% online usage)
4.  PPG to report back to the Partners to help inform and guide with regard to the layout within the new premises. This may include a further consultation period with plans displayed within the waiting room inviting further comments and suggestions (Achieved and was successful in increasing practice support for Patient Group and funding recent Open Day. A repeat meeting will be held this year).
2013 plan
1.  Discuss use of uniform with new build with staff to increase professionalism
2.  Concentrate on good access in construction of new build particularly regarding lift
3.  Improve clarity of online appointment booking
4.  On account of positive patient feedback, evaluate seriously use of system based on increasing use of telephone triage (St. Levans style advanced accesss) to reduce waiting times and increase appointment availability.

A description of the opening hours of the Practice premises and the method of obtaining access to services through the core hours: