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THE BEGGARWOOD SURGERY

 

 

Patient Participation Report 2013 – 2014

 

This year we have selected the General Practice Assessment Questionnaire to use with our patients as we felt that the questions were more appropriate to our need and would give us more concise feedback for us to discuss and amend our working practice to work towards our patients’ suggestions, where possible.

 

We sent out a practice questionnaire to our virtual group for any additions that they would like added to our questions, prior to us handing out the questionnaires to our patients who attend the surgery in February/March 2014.

We had 2 emails bounce back where we clearly had the incorrect addresses. These patients were contacted for their correct address and the questionnaire was resent.  We were then confident that the group had all received the questionnaire.

 

We received only 2 replies. One asked for the heading of the questionnaire to include the name of the practice to make the form more personal and less remote for patients. The second comment was as follows by quote” Patients appreciate a clean, tidy and well cared for surgery, and Beggarwood is always kept so clean and comfortable that I feel this aspect of the practice deserves some mention, as the environment does, in my opinion, exert and influence on patients’ perception of the practice”

 

The second patient to comment asked if we could add a question “ was it made clear to you where you needed to wait for your appointment within the building?”  The patient felt that too many patients wait in the downstairs waiting room rather than upstairs if they are seeing a nurse and patient felt that this was wasting everyone’s time.    We did look into this and felt that this was not appropriate to add as we asked the nursing staff how many patients do not wait in the correct waiting room, and they commented that they had not noticed any patient not being where they would expect them to be.  If patients check in on the touch screen they are directed to the upstairs waiting room by text on the screen, if it is a nurse appointment and we did check with reception staff who always direct these patients upstairs this is also on our induction sheet for new staff.

We did send these comments back to the patient on the virtual group and she was happy with our explanation.

 

We have constantly asked all new patients if they wish to join the virtual group and have had some acceptances our total group is now 36 patients. Our web site does encourage patients to join and staff are encouraged to highlight to all new patients the benefits of the group and we now have an electronic display screen to encourage patients to join.  We are delighted to welcome 3 new patients to our group.

 

As previously stated, we  would very much like to form an actual patient participation group, as well as an email virtual group, to help us listen to our patients and involve them in our decision making.  As yet this had not transpired – we feel probably because we do have a young practice population who probably have work commitments during the day and cannot afford the time in the evenings to come to meetings.  We have all agreed to make this a priority this coming year and already GPs have approached some patients who are considering forming a group so we are hopeful it will happen.

 

We have reviewed the make-up of the Group to ensure that it fairly represents our practice population. This Appendix shows the spread of our patients and we have, where possible, tried to get an even mix of these patients to join our virtual email group.  There has been little change in our patient profile, so we are confident that the group remains representative.

 

We have run 6 monthly random searches to ensure we can attract new members and we have contacted a random selection of people from the following groups: Alcohol Abuse, Substance Misuse, Carers, Learning Disabilities, Patients with Chronic Diseases, Patients with Epilepsy, Random selection of Full GMS registered patients between the ages of 17-85 years, patients from differing Ethnic background and faith and gender

 

Profile for 2013/2014

Practice population profile

PRG profile

Difference

Age

% Under 16

27.79

% Under 16

0

-27.79

% 17 - 24

7.25

% 17 - 24

6

-1.25

% 25 - 34

15.78

% 25 - 34

20

4.22

% 35 - 44

22.71

% 35 - 44

33

10.29

% 45 - 54

13.89

% 45 - 54

22

8.11

% 55 - 64

6.49

% 55 - 64

11.5

5.01

% 65 - 74

4.09

% 65 - 74

6.5

2.41

% 75 - 85

1.66

% 75 - 85

1

-0.66

% Over 85

0.34

% Over 85

0

-0.34

 

Ethnicity

White

 

White

 

 

% British Group

87.2

% British Group

88.82

1.62

% Irish

0.6

% Irish

0.59

-0.01

% White (Other)

2.7

% White (Other)

4.7

2

Mixed

 

Mixed

 

 

% White & Black Caribbean

0.4

% White & Black Caribbean

0

-0.4

% White & Black African

0.5

% White & Black African

0

-0.5

% White & Asian

0.4

% White & Asian

0

-0.4

% Mixed (Other)

0.2

% Mixed (Other)

0.59

0.39

Asian or Asian British

 

Asian or Asian British

 

 

% Indian

1.8

% Indian

1.76

-0.04

 

% Pakistani

 

0.8

 

% Pakistani

 

 

% Nepalese

0

% Nepalese

0

0

% Bangladeshi

0.2

% Bangladeshi

0

-0.2

% Asian (Other)

0.8

% Asian (Other)

0.59

-0.21

Black or Black British

 

Black or Black British

 

 

% Caribbean

0.4

% Caribbean

0.59

0.19

% African

1.2

% African

1.76

0.56

Chinese or other ethnic group

 

Chinese or other ethnic group

 

 

% Chinese

0.8

% Chinese

0.59

-0.21

% Any Other

2

% Any Other

0

-2

 

Gender

% Male

49.59

% Male

49.54

-0.05

% Female

50.41

% Female

50.46

0.05

 

Practice Specific Care groups

e.g. learning disabilities, substance misuse, nursing homes, travelling community, Faith groups, specialist units etc.

 

 

Patients contacted included people from the following groups: Alcohol Abuse, Substance Misuse, Carers, Learning Disabilities, Patients with Chronic Diseases, Patients with Epilepsy, Random selection of Full GMS registered patients between the ages of 17-85 years, patients from differing Ethnic background and Faiths and Gender

 

 

 

       

 

 

The last survey was carried out in 2012/2013 the findings and action plan following the comments in this report are shown below.  We felt that we could use these to see if we had improved in our ratings.   We took on board the major complaints that we had received and as they were mainly on waiting times to see a GP and seeing a GP of choice so we felt that the questions were appropriate in the 2014 survey.

 

The results for 2012/2013 were analysed by CFEP and the results were returned to us.  Overall the practice scored 80% of all patients’ ratings showing us to be good – very good – or excellent.

The results of the survey, plus all patients’ comments, either negative or positive, were posted on the practice web site and on NHS Choices for all to see.

The action plan below was set following a meeting with all staff in the surgery.

 

 

Action Bullet Points for 2012/13

 

Opening Hours

  • GP’s to look at running staggered surgeries throughout the day particularly over the lunch hour.

 

Seeing Doctor of choice

  • Design a template on display screen and website as to GP daily availability.

 

Appointment Availability

  • To look at DID NOT ATTENDS that waste appointments.
  • Staff to ensure unwell children are seen on the day if appropriate.
  • Receptionist to encourage patients to use pharmacy advice for minor ailments.

 

Photoboard for all staff

  • To ensure one is on the website and display screen.

 

Telephone Access

  • To look at adding telephone consultation slots on routine appointment days for GP.

 

All of the above action points have been implemented in 2013, apart from the photo board of all members of staff.  Pressure of work has prevented this, plus we have experienced a larger turnover of staff than was expected.  GPs photos are on the web site and display board in the waiting room.  We will endeavour to introduce a staff photo board this year.

 

The new arrangements of staggered surgeries has proved to be popular, so it has continued.     

 

We have introduced SMS texting where patients are reminded of their next day appointments by text to mobile .  This has been successful and has helped to reduce DNA  appointments to an average of 111 appointments per month in the last quarter January 14-March 14, but this number would equate to an extra 7 sessions per month if these patients gave prior notice of non-attendance.  Clinicians will continually educate patients in the importance of cancelling appointments when not required.

 

In the last report Dr Beynon did agree to run educational Diabetic meetings for patients, but these have since been organised by North Hampshire Clinical Commissioning Group, locally.

 

For 2013/2014 this is the result of the latest survey that was distributed in Feb/March 2014:

 

Survey Results       - Survey produced by InTime Data Systems

 

 

National Mean

Our Patients

Positive

Negative

Q1. How good was the GP putting you at ease?

 

 

97.0%

3%

Q2. How good was the GP at being polite and considerate?

 

 

98.2%

1.8%

Q3. How good was the last GP you saw at listening to you?

93.7%

94.5%

97%

3%

Q4. How good was the last GP you saw at giving you enough time?

91.5%

90.6%

92.8%

7.2%

Q5.  How good was the GP at assessing your medical condition?

 

 

94.5%

5.5%

Q6. How good was the last GP you saw at explaining your condition and treatment?

 

 

95.1%

4.9%

Q7.  How good was the last GP you saw at involving you in decisions about your care?

90.5%

90.7%

96.2%

3.8%

Q8.  How good was the last GP you saw at providing or arranging treatment  for you?

 

 

96.1%

3.9%

Q9.  Did you have confidence that  the GP you saw is honest and trustworthy?

 

 

99.4%

0.6%

Q10.  Did you have confidence that the GP will keep your information confidential

 

 

100%

0%

Q11.  Would you be completely happy to see this GP again?

 

 

98.8%

1.2%

Q12.  How helpful do you find the receptionist at your GP practice?

89.1%

87.7%

99.3%

0.7%

Q13.  How easy is it to get through to someone at your GP practice on the phone?

68.8%

81.0%

97.2%

2.8%

Q14.  How easy is it to speak to your Dr or Nurse on the phone at your GP practice?

69.9%

71.4%

84.5%

15.5%

Q21.  How do you rate how quickly you get to see a particular doctor

70.7%

62.5%

65.7%

34.3%

Q25  How do you rate – how long did you wait for your consultation to start?

67.8%

64.3%

66.2%

33.8%

Q29.  How often to you see or speak to the GP you prefer?

 

 

64.0%

36.0%

Q30.  How good was the nurse you last saw at putting you at ease?

 

 

95.5%

4.5%

Q31  How good was the last nurse you saw at giving you enough time?

89.2%

89.1%

92.9%

7.1%

Q32.  How good was the last nurse you saw at listening to you?

89.6%

90.5%

95.5%

4.5%

Q33.How good was the last nurse you saw at explaining your condition and treatment?

 

 

92.5%

7.5%

Q34. How good was the last nurse you saw at involving you in decisions about your care?

 

 

91.7%

8.3%

Q35.  How good was the last nurse you saw at providing or arranging treatment for you?

 

 

94.4%

5.6%

Q36.  Would you be completely happy to see this nurse again

 

 

98.2%

1.8%

Q40. Overall, how would you describe your experience of your GP surgery

 

 

96.5%

3.5%

Q41. Would you recommend your GP surgery to someone who has just moved to your area

 

 

99.3%

0.7%

 

 

Analysis performed on 24/02/14

 

The shaded areas in the poster above show where we are above the mean.

  •  Q3 = 94.5%
  •  Q7 = 90.7%
  • Q13 = 81%
  • Q14 = 71.4%
  • Q32 = 90.5%

 

As can be seen, we are below the National Mean in 5 areas, albeit mainly by very small margins. 

 

We sent this poster plus the whole survey report, that included patient comments, to our virtual patient group for them to report back.

We unfortunately only received one comment back, which commented that the survey results gave an excellent baseline for us to progress further our healthcare service.  The patient also wished to thank all of the staff for the excellent care they had given to him since he became one of our patients.

 

A meeting was set and included all GPs, all nursing staff and all non clinical staff to enable us to discuss the results and formulate an action plan for the coming year.

 

Our priority was to look at the questions where we were below the mean and to look at the patients’ negative comments.

 

  • Q4. – at 90.6% we are only 0.9% below the mean – GPs will always endeavour,  where possible, to allow sufficient time and will always go over the 10 minute consultation time if appropriate.

 

  • Q12. – At 87.7% we would like to see this as a higher percentage and all agreed that this is an on-going training issue with all staff. We will use the voice recorder as a training tool and get staff to listen to themselves. They will then be questioned as to how they could have done better and be guided by the practice manager where necessary.                  ACTION  PM immediately

 

  • Q21. – This scored 62.5% with 65.7% of those gave an answer of Good. If patients wish to see a particular doctor then this may often mean a wait for a routine appointment with that doctor.  If the patients problem is more urgent then they are offered a same day consultation by telephone with the duty doctor – who will always see the patient that day if appropriate and necessary – or if the problem can wait, then they are offered the soonest appointment with any doctor.  The nurse practitioner will rewrite the principles of telephone triage and same day urgent appointment requests in our practice leaflet, include it on our surgery website and on our digital display screen in the waiting room  It was felt that patients do not fully understand the principles of URGENT appointments and ROUTINE appointments.   We felt that this might help with booking of same.

ACTION N/P 1 MONTH    

(dependent on print runs at our printers)

 

  • Q25. – At 64.3% we are 3.5% below the mean and feel we could do better.  Staff are trained to inform patients if the doctor is running late, when they book in, so the patient is aware.  This may be because the doctor has had an emergency present or a previous consultation has taken longer than the 10 minute norm.  When patients check in on the touch screen this can be difficult for staff to see when patients arrive – if they are busy or on the telephone – staff will be reminded that they must inform all patients on a regular basis if the doctor is running late and give apologies.

                                                     ACTION P/MANAGER IMMEDIATELY

 

  • Q31. – At 89.1% we are only 1% below the mean.  Nurse appointments are timed according to the type of appointment eg chronic disease management, dressings, immunisations etc.  If a patient is with a GP and they require an urgent procedure such as an ECG then this can take precedence over booked appointments and staff will be reminded to explain to patients why they are being kept waiting or on occasions feel their consultation was shorter than expected.

                                                            ACTION P/MANAGER IMMEDIATELY

 

  The survey produced 27 patient additional comments in total and of these 11 were pointing out minor concerns on our service.   The practice team spent a significant amount of time in discussing these and looking at improving in these areas.

2 of the 11 were relating to reception staff –

i)               patient was not happy with having to discuss their medical issues on the telephone with receptionists.  Staff will only ask for a brief outline of a patient’s problem when the patient asks for a same day urgent appointment and is offered a telephone triage.  This brief outline helps the doctor to prioritise their calls as to the most urgent.  If a patient does not wish to give this information the staff will accept the patient’s wish and not give an outline to the doctor.

ii)             Patient was not happy to use the touch screen to check in and would prefer to see a “friendly face” to acknowledge them

DISCUSSION/ACTION

i)              Reiterate these points to reception staff in training sessions

ii)             Patients are never forced to use the touch screen and staff are more than happy to greet the patient and check them in.

 

2 Related to opening hours

i)              Patient thought it would be more helpful to have Saturday morning appointments to fit in with work commitments.

ii)             Patient would prefer evening appointments at the surgery.

DISCUSSION/ACTION

i)               These were also action points from last year and from those we altered our templates to have a GP running over a lunchtime session and starting a 8.30am session to help patients with work commitments.

 

 

 

7 Related to hospital referrals and waiting times.

 

DISCUSSION/ACTION

 

These issues are regularly discussed at liaison meetings with the Hospital clinical directorate and is a continuing issue that is constantly under discussion.

 

As previously stated, with the formation of a Beggarwood Patient Participation Group, a representative of which would be attending the North Hampshire Clinical Commissioning Group’s Patient Participation Meetings where these sort of issues can be raised and brought to the attention of the Commissioners who would have greater authority with the local hospitals to raise these issues on behalf of all local patients.

 

In 2014/15 we will be actively seeking any patient who would be willing to join such a group to enable our patients to have a wider voice locally. Any patient that would be interested to contact the Practice Manager.

 

The opening hours of the Beggarwood Surgery are:

 

Monday - Friday       08.30-18.00

 

From 8am -8.30 am and 18.00 – 18.30pm  urgent patients telephone calls are automatically transferred to a duty doctor and then normal Out Of Hours (6.30pm - 8.30am) urgent telephone calls are advised to ring NHS 111 service.

 

Doctors run routine morning and afternoon surgeries Monday-Friday.  For urgent requests for on the day appointments patients are directed to a GP led RAPID ACCESS CLINIC where telephone calls are triaged for either advice by telephone or on the day appointment with GP or Nurse Practitioner as appropriate.

 

The Beggarwood Surgery has not entered into arrangements under an extended hours access scheme for 2013/14.

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