Standard Reporting Template

Bristol, North Somerset, Somerset and South Gloucestershire Area Team

2015/16 Patient Participation Enhanced Service – Reporting Template

Practice Name: Queen Camel Medical Centre

Practice Code: L85 044

Signed on behalf of practice: Date:10.03.16

Signed on behalf of PPG: Date:10.03.16

1.  Prerequisite of Enhanced Service – Develop/Maintain a Patient Participation Group (PPG)

Does the Practice have a PPG and/or PRG? YES
Method of engagement with PPG and/or PRG: Face to face, Email, Other (please specify) Meetings every 2 – 3 months and email communication between.
PRG is an email group for occasional questions/feedback. This group is not yet regularly consulted but is being built up with the aim of providing additional
feedback to support the PPG.
Number of members of PPG and/or PRG: 14 members of PPG 88 members of PRG
Detail the gender mix of practice population and PPG and/or PRG:
% / Male / Female
Practice / 49 / 51
PPG / 33 / 66
/ Detail of age mix of practice population and PPG and/or PRG:
% / <16 / 17-24 / 25-34 / 35-44 / 45-54 / 55-64 / 65-74 / > 75
Practice / 16 / 7 / 7 / 9 / 16 / 15 / 16 / 13
PPG / 7 / 0 / 0 / 20 / 14 / 40 / 20
Detail the ethnic background of your practice population and PPG and/or PRG:
White / Mixed/ multiple ethnic groups
British / Irish / Gypsy or Irish traveller / Other white / White &black Caribbean / White &black African / White &Asian / Other mixed
Practice / 99 / 0 / 0 / 0.5 / 0 / 0 / 0.25 / 0
PRG / 100 / 0 / 000 / 00 / 0 / 0 / 0 / 0
Asian/Asian British / Black/African/Caribbean/Black British / Other
Indian / Pakistani / Bangladeshi / Chinese / Other
Asian / African / Caribbean / Other Black / Arab / Any other
Practice / 0.2 / 0 / 0 / 0.08 / 0.12 / 0.1 / 0.1 / 0.08 / 0 / 0.04
PRG
Describe steps taken to ensure that the PPG and/or PRG is representative of the practice population in terms of gender, age and ethnic background and other members of the practice population:
At every PPG meeting we review membership. We have advertised widely on the waiting room TV, in Parish Newsletters, online and on Surgery noticeboards. This drive has yielded a few volunteers but not in our target group (young adults) so we adopted a policy of PPG members directly approaching younger adults in their areas. This led to one possible recruit but after a formal invitation there was no response. Further approaches to young parents in particular (as representatives of under 16s as well as 25 to 44 year olds) have so far met only polite refusals. This group is, by definition, busy. We discussed moving meetings to more parent friendly times but actually most parents are busy in the day, particularly if they are working, as well as early evenings so this was shelved. We continue the quest to be more representative. In terms of ethnic diversity the practice has less than 1% from ethnic minorities so we are keen to be diverse but have not targeted specifically non-white patients. This is all included in the meeting minutes stored on line.
Are there any specific characteristics of your practice population which means that other groups should be included in the PPG and/or PRG?
e.g. a large student population, significant number of jobseekers, large numbers of nursing homes, or a LGBT community? YES/NO
No there are no specific groups but we do cover a large area with individual communities (59villages and hamlets) and we have attempted to keep a mix of villages so that all parts of the practice are represented and no one village over represented.
If you have answered yes, please outline measures taken to include those specific groups and whether those measures were successful:
We initially invited members from a mix of villages and have been fortunate that as members have left we have usually found more from the same area.

2.  Review of patient feedback

Outline the sources of feedback that were reviewed during the year:
National Ipsos MORI Poll results presented at most meetings and discussed by PPG. QCMC outperformed national and local averages in every domain. It was agreed that the resource is excellent in its user friendly navigation and ability to focus on individual ages and genders. It was also agreed there are shortcomings in that QC is highlighted as ‘could improve’ for 100% of respondents had confidence in the last nurse they saw. This is clearly nonsense but is based on the domain that we are closest to local averages in. The PPG agreed that the very good results reflected accurately the practice experience that they recognise and congratulated the practice on the results.
Practice Complaints are reviewed at every meeting.
Friends and Family test. This was previously incorporated into our annual practice survey. We have been an early adopter of F&F and prepare the data annually. Of note is that the F&F result in practice is extremely similar to the Ipsos MORI F&F question, with results of 99% and 98.4% respectively. According to NHS choices we have the highest F&F figure in Somerset for at least 2 years running and in the latest set we remain in the top ten without any fall in our own figures. The PPG were delighted and not surprised by these excellent results.
The PPG reviews at every meeting whether they wish to ask for additional feedback from other sources. The PPG received this information and were pleased that it was all positive.
CQC. The PPG were actively involved on the day of the inspection with at least 2 members spending considerable time with the inspectors answering questions. Our first report was published in October 2015 and the PPG reviewed the draft report at their November meeting. The across the board good results with a few outstanding areas was felt to be a good solid result. It was also felt that we could have targeted the inspectors better if we had understood what they wanted. We spent too long covering basics when actually they wanted to be impressed by unusual stories and examples. In future a file of exemplary practice will be held. Overall , there was a feeling that the CQC really gave great weight to innovation but were a little bored by the core business of timely and responsive access and high clinical standards.
How frequently were these reviewed with the PPG and/or PRG?
Ipsos MORI is reviewed annually
Practice Complaints At every meeting when they occur.
Friends and Family Test. Reviewed annually by the PPG.
Questions to Patient Reference Group as and when suggested. Reviewed at every meeting.
CQC was discussed after the inspection.

3.  Action plan priority areas and implementation

Priority Area 1
Description of priority area:
The Crisis in recruitment locally together with the likely retirement of two partners in the medium term presents a huge challenge to the future stability of the practice
What actions were taken to address the priority?
The two older partners have reduced their hours to allow a new partner to be recruited (we have secured a recent former registrar). In addition a long established associate GP from a local practice has joined as a part-time partner. Establishing this new partnership should allow a greater degree of security going forward for patients.
Result of actions and impact on patients and carers (including how publicised):
We have publicised the changes widely on our website, on the waiting room TV and in local parish newsletters. Feedback informally from patients has been largely positive though naturally some remain anxious about losing their long established GPs in the medium term.
Priority Area 2
Description of priority area:
Instability of local General Practice. A number of local practices are undergoing huge upheaval with changes in personnel and in basic structure and this has led to a large number of patients seeking to join our list putting pressure on our existing service provision.
What actions were taken to address the priority?
We have clearly defined our practice boundaries to ensure we don’t expand inappropriately to areas remote from the premises. We are applying a consistent open door policy to requests from patients within the boundary and there is a protocol where doubt exists for requests to be directed to the relevant partner for consideration. We have also added additional surgery slots during the reconfiguration of partners to accommodate this growing list size, and have increased Duty doctor sessions to cover all 5 weekday mornings. We are also exploring greater cooperation through the Rural Practices Network, to ensure that we can support remaining small practices, and receive their support when needed and share resources and information to make us more resilient.
Result of actions and impact on patients and carers (including how publicised):
As of the time of the report we are not finding a great change in the waiting times for patients to receive appointments and we are coping with the demand. This is discussed at PPG meetings.
Priority Area 3
Description of priority area:
The problems with capacity and emergency admissions within our main secondary care provider (Yeovil District Hospital).
What actions were taken to address the priority?
We have embraced the Vanguard project. We have recruited 2 Health Coaches to liaise with vulnerable patients and their carers and help ensure their needs are appropriately met and thence reduce the likelihood of unscheduled admissions. We have taken a view that a small skilled team may be better suited in this regard than a large number of poorly skilled coaches and have been lucky enough to recruit two local nurses with a wealth of experience within the NHS and the practice. We are committed to biweekly “huddle” meetings so that the whole Primary Care Team is involved in the process.
Result of actions and impact on patients and carers (including how publicised):
As yet, we are unable to point to clear successes in terms of reduction of admission and the process is only 3 months into operation in the practice. Anecdotally, the coaches have been very well received by the target group and there is a feeling that there are spinoff benefits to the whole team in terms of effective communication an teambuilding.

Progress on previous years

If you have participated in this scheme for more than one year, outline progress made on issues raised in the previous year(s):


4.  PPG Sign Off

Report signed off by PPG and/or PRG: YES
Date of sign off:
How has the practice engaged with the PPG and/or PRG:
Regular meetings (minutes on line) and email circulars.
How has the practice made efforts to engage with seldom heard groups in the practice population?
We have tried very hard to recruit young parents to the PPG, so far without success.
Has the practice received patient and carer feedback from a variety of sources?
Yes, as listed above, F&F, National Ipsos MORI survey, complaints, PRG questions.
Was the PPG involved in the agreement of priority areas and the resulting action plan?
Yes. The PPG also reviewed the initial report and suggested some of the action plan.
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? No