Local Patient Participation Report and Actions Taken March 2012
Local Patient Participation Report and Actions taken March 2012
Profile
Face to face group profile as at 1.3.12
15 patients
11 female patients
4 male patients
15 White British/English ethnic group
35-44 = 1
45-54 = 2
55-64 = 3
65-74 = 2
75-84 = 6
Regular visits to the Practice = 4
Occasional = 11
Rarely = 0
Virtual PPG group profile 29.2.12
47 patients
30 female patients
17 male patients
45 White British/English ethnic group
1 Asian ethnic group
1 refused to disclose ethnic group querying its relevance
25-34 = 6
35-44 = 9
45-54 = 11
55-64 = 12
65-74 = 6
75-84 = 3
Regular visits to the Practice = 19
Occasional = 25
Rarely = 3
Recrutiment
We are a split site Practice with diverse patients demographics and wanted to ensure equity between the two sites. As we felt that this would be a challenge in itself we decided to form two groups, one face to face and one virtual. The rationale behind this was that the virtual group might attract participation from young patients and those that work who might not want to spend time attending face to face meetings. Having spent several years collecting email addresses with consent, an email was sent out to over 200 patients who regularly use our email prescription services asking if they were interested in joining the group on the basis of “ just a few questions occasionally” We had a very good response to this email with 30% responding positively. 15 patients asked to join the face to face group.
We created posters for the waiting rooms advertising the face to face group. Doctors told patients about the group, we posted on our twitter page @BramhallParkMCandfacebook ( reception staff mentioned the group to patients and there was a note on prescriptions.
The practice feels that the current membership reflects the types of patients who have a certain level of free time and are able to be flexible about their meeting attendance.
Priorities
When we felt that we has a good number of patients interested we emailed 65 virtual group members in August 2011 and asked for their opinion on what their priorities were as patients. We had a good response. These were identified as follows:
Getting an appointment
Clinical care/ Continuity of care
Opening times / Working patient appointments
Reception issues / Confidentiality
Parking
Agreement on priorities
In October 2011 the Practice Manager held a meeting with the face to face group to discuss the virtual group opinions priorities. The minutes of the meeting are on the website The face to face group amended the questionnaire drafted by the Practice. The group decided on reflection that as parking issues were not under Practice control then they did not want the question asked. It was agreed that a sign should be placed on the patient group notice board explaining that the Practice cannot try and deal with the parking situation due to planning issues and none ownership of the Shaw Heath site. The group also felt that it should be made clear that it was not essential to answer all the questions
The Survey
The patient survey was carried out for a two month period in November and December 2011. Over 600 patients chose to complete the survey.
Evidence
The survey results are published on the Practice website.
The Results
The survey results were collated by the Practice Manager and 5 members of the patient group who had volunteered to help. A document was produced of key themes arising from the survey. This is on the website but summarised as follows
Appointment requested in next 2 days but patient not able to make an appointment
72% of respondents at Shaw Heath had tried and 46% said no appointments available
75% of respondents atBramhallPark had tried and 49% said no appointments available
Obtaining an appt with a Doctor
41% SH said very easy
43% BP said very easy
Obtaining an appt with a nurse
49% SH said very easy
48.4% BP said very easy
Clinical Care/ continuity of care
59% SH said prefer to see particular Doctor
67% BP said prefer to see particular Doctor
37% SH said always or most of the time manage to see that Doctor
38% BP said always or most of the time manage to see that Doctor
Opening times / Working patient appointments
SH – 25 answered Q6 about preferred times
24% want “evenings” and 12% “before 9am”
BP – 43answered Q6 about preferred times
33% want “after 6pm”
14% “ early am”
12% Saturday am
Confidentiality/Reception issues
75% SH said don’t mind if overheard in reception area
76% BP said don’t mind if overheard in reception area
32.8% SH said very easy to get through on phone
40% BP said very easy to get through on phone
Discussion with the Practice Team
The results were presented to the Practice team at an Away Day on 8th February 2012. Several service changes were provisionally agreed as a result of the survey. Particular emphasis was put on access to appointments and opening hours. It was felt that continuity of care priorities identified would benefit from these proposals. There was some surprise at the positivity expressed about confidentiality in the reception area, the Partners and Management team had been under the impression that this was a major concern for patients but the survey disproved that idea. We had made changes anyway prior to the survey being published
Discussion with the Patient Group
The results were sent to the members of the face to face group prior to a meeting of the face to face group on 22nd February 2012, several amendments were made to the results prior to the meeting which excluded “haven’t tried” and “don’t knows” from the results as they were seen to be skewing the results.The minutes are on the website. An anonymised summary of complaints received by the Practice was also made available to group members along with details of how many consultations are carried out each year and patient numbers.
Themes to be considered by the Practice
The patient group members felt that there were four main areas that needed to be considered by the Practice
These were communication with patients, continuity of care, getting an appointment within 48 hours and appointments for working patients outside “normal” hours. It was felt that the key is communication, the Practice already provides a range of appointment times for example but perhaps this has not been communicated effectively to patients.
This is an extract from the minutes of the meeting
A)It was felt that perhaps patients were not aware of all the different appointment times, types of appointment, individual expertise and availability for all the Doctors in the Practice. It was felt more advertising was needed in order for the patients to realise they could utilise appointments at both sites
B)Continuity of care was identified as an issue to be considered. It was felt that this linked in closely with A) above.
C)Getting an appointment within 48 hours was a clear issue raised in the survey results but the group felt that the questions asked to address this in the survey were ambiguous and needed to be re phrased for the next survey. Clearly the Practice provides open surgeries each day so why patients could not get an appointment was discussed.
D)Appointments outside “normal” surgery times – for the vast majority of respondents this was not a great issue but the group agreed that approx 50% of patients worked this is a useful service on Saturdays and mornings.
Action Plan
Communication with Patients
Promote website further
Produce a Patient Newsletter regularly – two group members agreed to help
Promote the Patient Group noticeboard, We will display the action plan on our group noticeboards at each site. This will take the form of a “WOW” board and “you asked….we did”
Provide information to Patients about which doctors are where and when and also what they specialist interests they may have. This information will be added to the website, practice leaflet and notice boards.
Update the Practice Leaflet – section on telephone advice needs amending
Continue twitter updates and facebook page updates
Continuity of Care
Communicate to patients that continuity of care is to some extent reliant on patients booking their follow up appointments well in advance.
Communicate to patients that Open “emergency” surgeries are not necessarily going to be with a preferred Doctor due to the nature of the appointment
This links in with the communication plans above
Getting an appointment within 48 hours
The Practice has agreed to purchase at a cost of £3000 the Front Desk appointments system to aid appointment reporting, future capacity and access planning. Our current free appointments system does not have this capacity and is unable to facilitate our desire to offer flexible appointments capacity. The software will allow the practice managers to monitor access of all appointments, identify areas of need and conversely where over-capacity may exist in order to modify working patterns in the future. Over time it will also allow us to predict future problems that may arise as a result of bank holidays and annual leave in a far more controlled and objective manner. It is envisaged that access across both sites can then be fine tuned throughout the year and avoid situations of pressure on particular parts of system, clinicians or nurses. The practice is keen to ensure that access and service quality remain at the forefront of its continual development cycle. This year has seen its largest growth in registered population and as a result we have invested in more doctor time by recruiting another salaried doctor. Capacity is being closely monitored to ensure this investment improves overall access. A second benefit from this is increased continuity of care for practice patients and less reliance on locum doctors.
The Practice has recently employed another Doctor to help with 48 hour and same day demand. The impact of this increased capacity is still being monitored but initial review suggests this is improving capacity.
Regular non attender figures to be posted in the reception area at both sites as a reminder to patients how many appointments are lost each month
Appointments outside “normal” hours
The Practice agreed to open alternate Saturdays mornings at BramhallPark and Shaw Heath. Prior to the survey the Practice only opened on Saturdays at Shaw Heath. This service is primarily for working patients and is for pre booked appointments only. . The Saturday morning surgeries form part of the practices commitment to the extended hours direct enhanced service which we have participated since its inception. Originally the surgeries took place at Shaw Heath but were open to all patients of the practice as a whole, this decision was taken as it was deemed that the Bramhall population had on the whole better access to private transport than the deprived Shaw heath population.
Two Doctors, Dr Devine and Dr Stirling are to offer appointments after 6.30pm once per week on alternate weeks. , instead of the previous arrangement where each doctor undertook a early morning surgery as a part of the extended hours scheme.
Opening Hours as at March 31st 2012
Bramhall 0161 426 9700
Monday to Thursday – 7.30 am – 6.30 pm
Friday – 7.10 am to 6.30pm
Shaw Heath 0161 426 9350
Monday to Friday – 8.00 am – 6.30 pm
Saturday 8.30am – 10.3am
Extended Hours
Dr Devine – Friday 7.30 – 8.00 am
Dr Rooney – Thursday 7.30 – 8.00 am
Dr Patel – Monday 7.30 – 8.00 am
Dr Bayes – Wednesday 7.30 – 8.00 am
Dr Webster / Dr Stirling – Tuesday 7.30 – 8.00 am
All the above Doctors plus Dr Yazici and Dr Davidson have a rota to offer appointments between 8.30 and 10.40 on Saturday