NightingaleValley Practice

Patient Reference Group

Comments and Action Plan as of March 2015

Date / Details and action / Comments / Update as at March 2015 / Actions
Reception area / March 2012
Reviewed March 2015 / As the reception area is the favoured option for information gathering, ensure that notice boards are clear and concise and are regularly updated / All notice boards have been reviewed and have been divided into separate headings so it is easier for patients to find the information they need / We are have instigated a review of the notice boards at Brooklea, and will be combining general notices that are pertinent to all visitors to both Nightingale and Birchwood. This will then release space to better display Nightingale specific messages. / We aim to have this completed by June 2015
Appointments / March 2012 / Extended hours are popular with 90% of respondents agreeing they would like to book an appointment in the future. Review current extended hours provision to ensure consistency in availability and meeting demand. / We have kept the current extended hours as they are, as they do need to be covered by our Receptionists. However, we have opened up additional appointments to meet extra demand. We also offer Nurse appointments which are very popular. We will continue to review our extended hours. / We have recruited an additional GP, Dr Julie Dando and an Advanced Prescribing Nurse, Debbie Blackmore to the team, to support increased demand. We will continue to monitor capacity monthly
March 2013 / 96% of our patients rated our opening hours as good or above / We are extremely pleased with this response as we feel we do offer great flexibility, across both our surgeries
March 2013 / 65.3% of our patients rated availability of routine appointments as good or above / We are aware this is an emotive subject and we are challenged in providing an infinite number of appointments that meets all patients’ requirements. We do ask for some flexibility from our patients as some appointment times are very popular and it is advisable to book well in advance for a routine appointment
March 2013 / 64% of our patients rated availability of urgent appointments as good or above / We have introduced telephone triage for patients wanting to see a GP urgently once all routine appointments have been allocated. The GP will call back and discuss your symptoms over the phone and will call you in to be seen if necessary. We have found that a high percentage of calls have been managed over the phone. Our patient population has not significantly increased over the past year, however, we are not alone in seeing an increase in demand for appointments and services and are doing the best we can to satisfy demand. We will continue to gauge response from our patients and monitor closely / We still continue with our telephone triage service and Nurse Debbie Blackmore has joined the triage team to allow more capacity.
Telephone Access / March 2013 / 76% of our patients rated the ability to speak to a GP on the telephone as good or above. 14.7% did not respond or felt the question was not applicable / We are very happy with this response as we do try to return calls to our patients once the morning or afternoon surgery has finished. However there are going to be times when a GP may not get back to you on the same day dependant on the nature of the query. We will continue to monitor access. / Our GP’s continue to endeavour to get back to patient’s requiring a call back. With the introduction of a named GP for the over 75’s it has made it even easier to allocate calls to GP’s.
March 2012
Reviewed March 2015 / Freeform feedback told us that some patients are still having problems getting through on the phone / In March 2012 we installed a new telephone system which fairly distributed calls to the next available receptionist. Over time, the system has enabled us to forecast how many calls we can expect within any given timeframe. We have now allocated an additional Receptionist to handle calls in the first 1 hr of the day and will monitor whether this is helping with the first flurry of calls in the day.
We have also purchased some additional software to the telephone system which will let a caller know where they are in the queue thereby helping our patients make a decision as to whether their call is urgent enough to hang on or whether it would be better to call later in the day. The new software is scheduled to be installed in April.
We will continue to monitor the situation / This is still an ongoing issue and many of our patients leave it until later in the day which makes our call flow more manageable. AS part of our review of the building we will be seeking agreement to increase the number of lines to the building to enable more call to arrive with us. / July 2015
Waiting area and waiting times / March 2012
Reviewed March 2015 / There are times when our Dr’s and Nurses run behind, usually through no fault of their own. We need to agree a process to ensure patients are informed and are aware of how long they have to wait before they see their Doctor/Nurse. / The action plan for 2012 led to an agreement that, where a GP or Nurse was running behind the Receptionist, wherever possible, would let the patient know.
Satisfaction has increased but there is still room for improvement so we will continue to monitor the situation. / Following the upgrading of our check in system we are now looking for software which will enable the patient to view whether the GP is running late at point of checking in – this is part of the 2015-16 action plan / September 2015
March 2013
Reviewed March 2015 / 72% of our patients felt the waiting time in our surgery was good or above
We have received a lot of feedback on how we could improve your time while in the surgery. / We are currently investigating options in supplying an information TV which could lead to an improved experience whilst waiting in the surgery. We are hoping this is not cost prohibitive but will need to work with the Birchwood practice, who also reside in the health centre on how we can make this work.
We have just completed extensive works to our Riverside surgery and new seating will be arriving any day now to replace the low seating that lot of people struggle to get out of. / We have now received agreement form our landlords to erect an information TV. The funding is currently being agreed and we are hoping this will be installed, in Brooklea, by July 2015 / July 2015
Our Website / March 2012 / Consider revamping website to enable access to information for patients without having to come into the surgery / It is our belief, backed up by responses from our patients, that in these days of advanced technology our website needs a bit of an overhaul. Most patients who responded to our survey tended to use the website for basic information e.g. our opening times. However, we would like to encourage more patients to use the services that are on our website. A benefit to this would be that if more is done on the website we would like to think we would see a reduction in telephone calls making it easier for our patients to contact us when they need to. We would also like to give more information on how to self manage minor conditions and give tips on lifestyle choices etc. which could lead to a reduction in the need to make an appointment. Therefore, we are currently reviewing our options on purchasing a new website. / We have now launched our new website and have publicised this to the PPG/PRG for comment and in our waiting rooms.
We have included on line access forms in our new patient packs and advertised on our website and in the surgery waiting rooms
March 2013 / 32.7% of our patients were aware they could book appointments on our website
22.7% of our patients were aware they could order prescriptions on our website
Car Parking / March 2013
Reviewed March 2015 / Some freeform comments were received about the problems with parking at Brooklea Health Centre / We are as frustrated regarding the lack of car parking as our patients. The current road works and ongoing development of the Wicklea site has only caused more disruption. We are speaking to the BristolCity Council regarding our concerns and we will monitor the situation.
There is plentiful parking at our Riverside Surgery in St Annes / This became a key priority for 2014/15 and we have requested an additional disabled parking space to be allocated. We have now submitted a bid for either procurement or development of the building where we would like to rebuild the building creating more space for cars. This is a key priority for 2015-16 / March 2016
Our Staff / March 2013 / Freeform comments have sung the praises of our staff / We have received some amazing feedback regarding our receptionists and other staff. It is lovely to receive this feedback and this will be shared with the team. They work extremely hard to help our patients even when some things are outside of their control. We aim to deliver the best training on offer to our team and knowing they are valued is a great bonus. Where a patient has felt they have not been treated as they would have liked, we have dealt with the situation quickly and with minimal fuss, and would like to think that these occurrences happen very rarely. We are always looking for feedback and a great way of doing this is responding to our surveys or posting a note into our suggestion box. / We continue to receive great comments and would like to thank both our staff and our patients for the very positive feedback
Appointment availability / March 2014
Reviewed March 2015 / To prevent further DNA’s (Did Not Attends) / Consider trialling an automated system to remind patients of booked appointments / this became cost prohibitive for the surgery as we have seen a notable decrease in funding and our priority has been to better resource our front line medical team. However since migrating to a new clinical system in December (EMIS Web) we have been told there is a likely solution through EMIS in September this year.
Appointment availability / March 2014
Reviewed March 2015 / To prevent further DNA’s (Did Not Attends) / Publicise number of people who attended their appts rather than DNA’s / In retrospect, and discussed at March 2015 meeting, we had not considered what was an acceptable number of DNA’s (as you should expect some) and whether the proportion of DNA’s to attended appointments were of a significant number to persuade patient’s who did not attend their appointments to with cancel or turn up. This will now be reviewed during 2015. / September 2015
Appointment availability / March 2014
Reviewed March 2015 / To prevent further DNA’s (Did Not Attends) / Ask receptionists to obtain verbal agreement from the patient to inform the surgery if they need to change or cancel their appt. / Ongoing / Review September 2015
Appointment availability / March 2014
Reviewed March 2015 / To prevent further DNA’s (Did Not Attends) / Ensure appt cards and pens are available on reception desk to write down their appointments themselves (if appropriate) / Ongoing - In addition we have upgraded the appointment cards which have reminders to call if the patient is unable to attend an appointment. / Review September 2015
Appointment availability / March 2014
Reviewed March 2015 / To prevent further DNA’s (Did Not Attends) / Ensure current system to deal with continuous DNA’s is adhered to. / Updated and complete
Appointment availability / March 2014
Reviewed March 2015 / To prevent further DNA’s (Did Not Attends) / Consider using volunteers to support clerical work within Practice e.g. telephone patients to remind them of their appointments (we need to understand Information Governance Implications) / We felt this had confidentiality implications which we felt was a risk to patient information. We do have a confidentiality agreement but it was felt it would be difficult to reinforce if the volunteer was not employed by us or by the NHS. There was also the challenge of the number of telephone lines coming into the building and not wanting to tie them up first thing to allow incoming calls to take priority. We will review on an ongoing basis / Review September 2015
Confidentiality / March 2014
Reviewed March 2015 / To allow confidentiality for all patients in reception area / To find ways to improve the queuing situation at the Reception
desk at peak times, in order to:
a) Reduce queues
b) Where there are queues, to improve patient confidentiality for
patients dealing with Reception staff. / At our Riverside surgery we have created a sound barrier screen to enable a patient to discuss confidential matters if needed. This is to the side and at a right angle to the front reception desk and allows the Receptionist access to the patient’s records and appointment booking.
At Brooklea we have upgraded our check in screens to enable people to check themselves in for pre arranged appointments. Check in can be completed quickly and reduces queuing time at busy times. The check- in screens are placed to the left of the front door as you enter. The only time a patient would need to check in at the reception desk is when we need to obtain or impart information to that patient.
We have erected a ‘queue control’ barrier to encourage patients to stand back from the reception desk to allow the receptionist to deal with one patient at a time and allow them personal space without being overheard. There is also a screened confidential area to the left of the reception desk for patients to use, this has been there for some time but it was felt we needed to re-publicise its purpose. / Review September 2015
Appointment availability / March 2015 / To prevent further DNA’s (Did Not Attends) / Consider allowing patients to text a practice mobile to confirm cancellation of appointment / July 2015
Appointment Availability / March 2015 / Pharmacy Initiative / Some pharmacies are now able to treat simple ailments e.g. hay fever, head lice, athletes foot etc / Advertise pharmacy services on the website and in the waiting room / May 2015
Premises / March 2015 / Improvement of Premises and car parking / Penny Goodman to discuss next steps once we know whether we have been granted funding from the procurement and development of primary medical care premises fund. / Discuss at next meeting / June 2015
NEXT MEETING / Next Meeting to be booked / Penny Goodman to arrange / April 2015