Patient Participation Directed Enhanced Service 2013-2014

Local Patient Participation Report

Practice Name: CROFT MEDICAL CENTRE

Local Patient Participation Report March 2014

Introduction

Croft Medical Centre is a purpose built practice premises located south of Leamington Spa town centre.

The practice population is approximately 11,000 patients, The age sex population is within national normal limits, the prevalence of chronic long term illness is broadly average in relation to national prevalence

The practice area encompasses representative areas of affluence and socio-economic deprivation. In the area local to the practice there is are large populations of migrant workers and their families from Poland, other Eastern block countries and Portugal.

The practise has 4 partnered GP’s, 3 male and 1 female. There is also 4 part time salaried GP’s who are all female. We are also a training practice and normally have 2-4 GP’s who are supervised by partners through this training programme. Currently we have three registers that are with us for just over 12 months, 2 full time and 1 part time, whom are female.

The Croft MC comprises of two sites, Calder Walk is the main surgery and Bishops Tachbrook is the branch surgery. The branch surgery has a pharmacy. At Bishops Tachbrook the partnered GP’s and salaried GP’s are allocated regular sessions to see BT patients. Consultations are also provided by treatment room nurses, chronic disease management nurses and phlebotomy.

The Survey was offered in both surgeries, but it was decided that due to the differing appointment system at the two sites that the survey would differ slightly. These results will be reflected in the report.

A description of the profile of the Croft members of PRG

The PRG recruited predominately of White British patients over the age of 50, the practice is aware that the geographically local population has significant populations of Asian, Indian and European patients. These patients groups were actively approached at the practice to join the group. Two of our PRG one White British and one Asian British attend the wider PRG to represent the Croft.

The group meets on a monthly basis and we have a core group of 20 patients and 85 patients within the virtual group.

The core group is made up of: Male: 12 Female: 8

35-44: 245-54: 155-64: 065-74: 875-84: 9

Indian Asian: 1White British: 19

The virtual Group is made up of a majority white English, but is represented by patients of Black African, Indian, Pakistani, White & Black Asian and 11 members have used ‘Other’ to describe their ethnicity

Recruitment of PRG

The practice actively sought to recruit representative groups of patients through face to face invitation at the practice, and when new patients registered. We have also had recruitment drives on flu clinic days. We have also tried to rotate times to include evening meetings to reach a wider patient base.

A dedicated notice board in the surgery was established to publicise the group and invite participation. A dedicated section on the website has been created, including forms to register interest and an email address for patients to contact the PRG directly.

Steps taken by the practice to ensure that the PRG is representative of itsregistered patients:

- Recruitment of members to the group was invited by email, reaching wide numbers of the patient population

- Talking to patients when they come to the practice about the patient participation and using flu clinics to hand out information and registration sheets

- Practice website was continually updated with group meeting dates and information, the “virtual patient group” through the website was emailed monthly.

- Local key stakeholder organisations were engaged to seek support and membership, eg. Health watch

- PRG information board and relevant forms at Bishop Tachbrook site

Where a category of patients is not represented, - Local key stakeholder organisations were engaged to seek support and

membership, eg. Children’s Centre User group, Carers group- Local community centre was approached to publicise the PRG and support

engagement. PRG to use BT local newsletter to discuss about PRG - PRG meeting to be hosted at Bishop Tachbrook so PRG that have not

attended that site can view it and it may encourage more members from Bishops Tachbrook branch.

- Practice website was continually updated with group meeting dates and information, the “virtual patient group” through the website was emailed monthly.

- The practice engaged with Health watch with the PRG and conducted a young persons survey. The survey was then presented by young patients and a member of our PRG attended and fed back to the group. The group have agreed to try and build a PRG targeted at young patients, looking at using mediums such as face book, twitter, email & text messaging.

Actions to still be completed – in the future to run a campaign by text message to find out if patents would like to join the PRG – Virtual, meetings, emails updates

Production of PRG newsletter that can be sent out to patients

Agreeing areas of priority with the PRG

Patient Participation Group Meetings were held monthly at the medical centre

Priorities for the group:- Two members of the group attend South Warwickshire Clinical

Commissioning group and report into the PRG and discuss relevant points, for example Croft A&E rates and then discusses from a patient point of view why attendance may be high and how to help Croft reduce this rate, actions agreed and undertaken, rate reduced.

- Communication within the practice – PRG will look at ways of assisting with communication to patients, including introducing information screens, input into website, addressing campaign boards and information boards. Signing off communications to patients where possible.

- Feedback – PRG to give and review patient experience and agree action points with Croft to address. Suggestion box introduced in reception and on website

- PRG to embrace the Bishops Tachbrook site into decision making- Group to address main concerns of patients, highest priory involving

appointment booking system and help Croft address this through survey- How the group will be representative and represent patients at Croft

Medical Centre, continuously look at increasing attendance from different patient sectors, for example working patients, stay at home mothers/fathers providing childcare, ethinic minorities, young patients 16-25 range, patients with disabilities, carers, unemployed patients.

- Changing priorities and how the group responses to these. - Outside influences that can put demands on the Croft services, for

example the PRG are looking at the now approved AC Lloyds development plans, this has direct impact on Croft and will increase patients lists. PRG to assist in development of practice in regards to local developments and will be consulted by Croft about any proposed changes.

Minutes of the meetings are available.

Collating patient views through the use of survey

The PRG were involved in developing a survey to review patients at the Croft Medical Centre and the Branch surgery about; Appointments,

Survey was set up and publicised on the practice website, in the surgery.

- Patients who volunteered for “virtual Patient Group” were emailed to inform them that the survey was now ready to take on the practice website.

- Patients who subscribed to the practice Newsletter were emailed to invite them to complete the survey

- Survey also distributed in the practice, both at the Croft and at BT - Practice website invited people to take the survey with a banner on the

homepage - Emails and Text messages were sent out with the survey on for patients

to complete who had provided email addresses and mobile numbers and agreed to be contacted by the practice.

Total Number of Responses: 794

Croft Medical CentrePatient Participation Group Survey 2013-2014Q1. Overall how would you rate your experience of Croft Medical Centre? Excellent  24%Very Good  33%Good  21%Acceptable  11%Poor  4%Very Poor  2%No response  5%

Q2. How Likely are you to recommend our practice to friends or family if they needed similar care? Extremely Likely  35%

Likely  35%Neither likely nor Unlikely  16%Unlikely  7%Extremely Unlikely  3%No response  4%

Appointments: Following patient feedback we are in the process of revising our appointments booking system to encourage patients to consider whether their medical problem is acute requiring attention the same day. The new system will ask patients with an acute medical problem that needs to be seen on the day to call before 9am so we can prioritise urgent care and for all routine bookings and enquiries to call after 9am Q3. Thinking about the last time you wanted to see a doctor fairly quickly. Were you able to see a DOCTOR on the same day or in the next 2 working days the surgery was open? Yes  68%No  27%No response  5%

Q4.Thinking about the last time you tried to book ahead for an appointment with a DOCTOR. Were you able to get an appointment more than 2 working days in advance? Yes  51%No  43%No response  6%

Q5. Overall, how would you rate the availability of DOCTORS' appointments at Croft Medical Centre? Excellent  13%Very Good  21%Good  21%Acceptable  20%Poor  16%Very Poor  5%No response  4%

Q6. Thinking about the last time you tried to book an appointment with a NURSE. Were you able to get an appointment more than 2 working days in advance? Yes  63%No  26%No response  11%

Q7. Overall, how would you rate the availability of NURSES' appointments at Croft Medical Centre? Very Good  27%Good  30%Acceptable  24%Poor  7%Very Poor  2%No response  10%

Q8. Please let us have any comments or suggestions you may have regarding our appointments system:

Q9) Do you currently receive our text message reminders? Yes  60%No  33%No response  7%

Q10) Would you support the expansion of our text message service to include patient reminders? Yes  86%No  7%No response  7%

Online Patient Services Croft Medical Centre is committed to the development of systems to improve the service offered to our patients. We are considering the expansion of our online appointment booking and prescription ordering service and we are interested to understand the likely demand for this serviceQ11) Do you have access to the Internet either at home or at work? Yes  90%No  5%No response  5%

Q12) Would you use an online appointment booking service? Yes  78%No  15%No response  7%

Q13) Would you use an online prescription ordering service? Yes  78%No  17%No response  5%

Comments or Suggestions Croft Medical Centre are keen to innovate and improve and we would be most grateful if you

could provide any further comments or suggestions below:

About you Q14) Are you male or female? Male  35%Female  60%No response  5%

Q15) What age are you? Under 16  0%17 - 24  4%25 - 34  19%35 - 44  17%45 - 54  16%55 - 64  16%65 - 74  14%75 - 84  4%85 - 89  0%Over 90  0%No response  10%

Q16) Ethnicity? English  78%Irish  1%Scottish  0%Welsh  1%African  0%

Carribean  0%Black other  0%Chinese  0%Indian  5%Pakistani  0%Bangladeshi  0%Asian other  0%Other (please specify)  6%No response  9%

Q17) Do you have a long term condition i.e. asthma, diabetes, heart disease Yes  38%No  57%No response  5%

THANK YOU FOR TAKING THE TIME TO COMPLETE THIS SURVEY – YOUR VIEWS ARE IMPORTANT TO US

 

Croft Medical CentreBishops Tachbrook PRG Survey 2013-2014

Number of Responses: 65Dear Patient,The doctors and staff at Bishops Tachbrook Branch Surgery and Croft Medical Centre work hard to provide patients with the highest quality healthcare. We are always keen to learn how we can improve our service to you and how you perceive our surgery and staff. A short survey has been devised and will be reviewed with the PRG. This survey will take no longer than a couple of minutes to complete. Please answer all of the questions and click 'Send Survey' when you are done.Q1. Overall how would you rate your experience of Bishops Tachbrook Branch Survey? Excellent  56%Very Good  32%Good  10%Acceptable  0%Poor  0%Very Poor  0%

Q2. How Likely are you to recommend our practice to friends or family if they needed similar care? Extremely Likely  67%Likely  29%Neither likely nor Unlikely  3%Unlikely  0%Extremely Unlikely  0%

Appointments: Following patient feedback we are in the process of revising our appointments booking system to encourage patients to consider whether their medical problem is acute requiring attention the same day. The new system will ask patients with an acute medical problem that needs to be seen on the day to call before 9am so we can prioritise urgent care and for all routine bookings and enquiries to call after 9am Q3. Thinking about the last time you wanted to see a doctor fairly quickly. Were you able to see a DOCTOR on the same day or in the next 2 working days the surgery was open? Yes  89%No  10%

Q4.Thinking about the last time you tried to book ahead for an appointment with a DOCTOR. Were you able to get an appointment more than 2 working days in advance? Yes  93%No  6%

Q5. Overall, how would you rate the availability of DOCTORS' appointments at Bishops Tachbrook Branch Surgery? Excellent  33%Very Good  44%Good  10%Acceptable  6%Poor  4%Very Poor  0%

Q6. Thinking about the last time you tried to book an appointment with a NURSE. Were you able to get an appointment more than 2 working days in advance? Yes  61%No  27%No response  12%

Q7. Overall, how would you rate the availability of NURSES' appointments at Bishops Tachbrook Branch Surgery? Very Good  32%Good  32%Acceptable  23%Poor  3%Very Poor  1%No response  9%

Q8. Please let us have any comments or suggestions you may have regarding our appointments system:

Q9) Do you currently receive our text message reminders? Yes  29%No  61%No response  10%

Q10) Would you support the expansion of our text message service to include patient reminders? Yes  69%No  20%No response  11%

Online Patient Services Croft Medical Centre,including Bishops Tachbrook Branch Surgery is committed to the development of systems to improve the service offered to our patients. We are considering the expansion of our online appointment booking and prescription ordering service and we are interested to understand the likely demand for this serviceQ11) Do you have access to the Internet either at home or at work? Yes  69%No  24%No response  7%

Q12) Would you use an online appointment booking service? Yes  58%No  35%No response  7%

Q13) Would you use an online prescription ordering service? Yes  58%No  35%No response  7%

Comments or Suggestions Croft Medical Centre and Bishops Tachbrook Branch Surgery are keen to innovate and improve and we would be most grateful if you could provide any further comments or suggestions below:

About you Q14) Are you male or female? Male  35%Female  56%No response  9%

Q15) What age are you? Under 16  0%17 - 24  7%25 - 34  4%35 - 44  6%45 - 54  16%55 - 64  16%65 - 74  24%75 - 84  15%85 - 89  0%Over 90  0%No response  12%

Q16) Ethnicity? English  83%Irish  3%Scottish  0%Welsh  4%African  0%Carribean  0%Black other  0%Chinese  0%Indian  0%Pakistani  0%Bangladeshi  0%Asian other  0%Other (please specify)  3%No response  7%

Q17) Do you have a long term condition i.e. asthma, diabetes, heart disease Yes  41%No  49%No response  10%

THANK YOU FOR TAKING THE TIME TO COMPLETE THIS SURVEY – YOUR VIEWS ARE IMPORTANT TO US

Providing the PRG with an opportunity to discuss survey findings and reach agreement with the PRG on changes to services

A meeting was held with the Patient Participation Group to review the survey findings.The results of the survey were emailed to the “virtual patient group” through the website inviting comments / discussion The practice staff team also met to review and discuss the results of the survey.

What was discussed and agreed.

Survey Uptake:

Uptake has significantly increased on previous year, due to the engagement with patients within the practice and also due to email and texting patients to undertake survey. For next years to engage with younger patients and encourage a larger uptake from this group. We received 0% under 16’s and 4% (Croft) & 7% (BT) in the age group from 17-24 years

Representation:

The survey was sent out to all patients with email addresses and valid mobile telephone numbers and handed out through engagement within the practice. It was also available on the website. All ethnic groups were targeted. 78% of responders detailed themselves as English, 6% as other, 5% as Indian, 9% as no response and 1% as Welsh (Croft) & 83% % of responders detailed themselves as English, 3% as other, 7% as no response. 3% as Irish and 4% as Welsh (BT). For next year we will look at providing some of the questionnaires in relevant languages according to our patient ethnicities.

Survey Subject

The survey was to see how patients perceive the surgery and how the surgery services can be improved from a patient view point. 17 questions were asked of patients, including comments.

Ideas and Solutions

It was agreed through feedback and discussion that the practice with the support of the PRG would work on a number of fronts to engage the practice population and practice in ways to improve services offered by the surgery, it was agreed these will include the following themes, (using the Croft survey figures)

- Improving patient information/communication - Look at the patient experience being achieved by the practice in both

surgeries - Appointments, 27% of patients were unable to see a doctor the same day

or next 2 working days.43% of patients said they were unable to get an appointment more than 2 working days in advance. 21% of patients felt that appointment availability at the Croft was poor or very poor. 26% of patients felt that they were unable to get an appointment more than 2 working days in advance. 9% of patients rated poor or very poor on availability of nurse’s appointments.

- Looking at the purpose and interest patients have using systems such as text messaging to remind patients of appointments. 86% of patients agreed that they would like the practice to increase their use of text messaging to them.

- Improving ease of use of online appointments, website information, services on line for patients, as the survey indicated that 78% of patients would like to use online booking and prescriptions.

When reviewing the BT Figures, it is apparently that the patients require

different services and communications. All patients that undertook the survey rate the BT practice good or above, all patients would recommend the surgery (Except 3% who indicated that they would neither likely nor unlikely), 89% of patients said they could see a GP the same day or next 2 working days with only 10% saying they couldn’t. On book ahead appointments 93% of survey takers said they could book an appointment more than 2 working days in advance, with 6% that said they couldn’t. 4% of patients rated the doctors & nurses’ availability poor and the rest of the patients found it acceptable and over. The survey at BT also showed some differences on how they would like to be communicated with. 69% would like to us to expand the test messaging service and have access to internet at home. 58% would use online appointments and prescriptions.

Therefore it was agreed that we need a more substantial action plan for Croft, Calder Walk, but to ensure that BT is considered within any changes. The branch surgery’s separate survey shows that there is a difference with patient service between the two surgeries and we need to ensure that the BT services are looked at separately to ensure that the good results continue and are enhanced.

Agreed action plan with the PRG and seek PRG agreement to implementingchanges

Patient Participation Action Plan – for Croft

Survey Finding Agreed Action Action by who

Action by when Date completed

Perception of Croft with patients – 78% of patients rated the Croft good and above. 17% of patients rated the Croft acceptable to very poor. 70% of patients said they would recommend the Croft to friends and family where 10% said it was unlikely/very unlikely. 16% were neither likely or unlikely. Comments were reviewed

Increase communication within both practices. The PRG feel that patients are unaware of all the services that are on offer. *Increase awareness on induction of new patients. Ensure practice gets the right information from patients *Produce regular patient news letters - texting and emailing *PRG – Produce a newsletter * Staff name badges * Clinicians information board with their pictures, job title, and specialities * Patients aware of triage services

PRG & PM

PM & reception manager

PM

PRG

PM PM

PRG & Reception

June 2014 – and ongoing.

End April 2014.

End April 2014.

May 2014.

End April 2014.End April 2014.

June 2014 – and ongoing.

* Patients aware of extended hours * Extended hours used for patients that cannot get into surgery in working hours for routine appointments * In house television screens – ensuring communications for patients and information about the services *LED screen used daily advising when GP are running late. No later than 20 minutes of the clinician running late * Reception staff training on customer service * Dedicated reception manager that manages the reception staff and standards * Quality assurance of telephone calls between patients and reception staff – reviewed and discussion to enhance our telephone communication with patients * Consider holding patient events – targeting different groups

manager

Reception manager

PRG & PM

Reception manager

Reception manager

PM

Reception manager

PM PRG

June 2014 and ongoing.

June 2014.

End April 2014 and ongoing.

June 2014.

April 2014.

June 2014.

End June 2014.

Appointments, 27% of patients were unable to see a doctor the same day or next 2 working days.43% of patients said they were

Advanced appointments to be on the system 4-6 weeks in advance

A review of appointments being offered in the practice

Partners, PM & APM

Partners, PM & APM

April 2014.

End April 2014-03-21

unable to get an appointment more than 2 working days in advance. 21% of patients felt that appointment availability at the Croft was poor or very poor. 26% of patients felt that they were unable to get an appointment more than 2 working days in advance. 9% of patients rated poor or very poor on availability of nurse’s appointmentsA new appointment system was introduced into the surgery in December 2013.The appointment system has addressed the acute patient care for on the day provision. Any patient that has an acute medical need is telephoned or seen on the day. However patients and the PRG feel that the advanced booking system is not working and either

verses patient numbers.

Look at whether there needs to be an increase in the amount of appointments on offer

Ensure phlebotomy appointments are running in line with SLA, if not then extra resource is allocated to phlebotomy

Reception staff to inform reception management team when they don’t have any appointments to offer patients for this to be addressed immediately and patients not asked to keep telephoning back

Patients are asked to telephone at 9am onwards for routine on the day appointments, patients feel that this is a difficult time due to school run, work etc.

Increase awareness of online services

Partners & FM & PM

APM, Nurse Manager

Reception Manager &PM

PRG & PM

PM, APM and

May 2014.

End April 2014

April 2014.

End April 2014.

From April 2014 and ongoing.

patients

Improving ease of use of online appointments, website information, services on line for patients, as the survey indicated that 78% of patients would like to use online

and help patients to register – look at emailing and texting the details so patients can log on and register

Gather more patients email addresses and mobile numbers

Website – Banner to ask patients to update information

Obtain mobile and email addresses on registration

Use newsletters and posters, including at pharmacies to asking patients to register on line and send in their up to date information

Ensure we still target patients that do not want to use technology

Text reminders to be sent about appointments, health checks, flu vaccinations,

Texts in different

reception staff

PM

PM

Reception manager

PRG & PM

APM

APM

April 2014 and ongoing.

April 2014.

April 2014 and ongoing.

April 2014 and ongoing.

End April 2014.

April 2014

April 2014

Continue to provide a 1st class service at Bishop’s Tachbrook

languages

Review appointments to ensure all patients can be seen

Explore more ways in of recruiting new patients from BT to the PRG

PM APM

PM PRG

End April 2014.

April 2014

Details of the proposed action plan were published:- on the practice website- newsletter- in the practice.- Through Virtual Patient Group- Planned through public events in other venues

Update on Patient Participation Plan 2013. A&E Survey Croft had one of the highest A&E attendance rates per 1000 population. This has now started decreasing and has been represented by the figures discussed regularly at the South Warwickshire CCG wider group. 2 PRG representatives attend and A&E is still reviewed regularly by the group and the practice. Dr J Foster who specializes in acute medicine, now leads the practice in addressing A&E attendance. This includes communications to patients who inappropriately attend A&E. Dr Foster personally contacts these patients and educates patients on use of A&E. The surgery has also increased acute and triage appointments for patients and advertise these appointments on their website. Patients use these appointments instead of going to A&E. The practice is continuously working on A&E attendance and recently contacted all patients that attended A&E to gain further information.

Opening Hours

Core Opening Hours of Croft, Calder walk: 08.00am to 6.30pm surgery open

Telephone Hours 08.00am to 12.30pm then 1.30pm to 6.30pm T 01926 421153On line appointment system available 24 hoursOn line prescriptions ordering http://www.croftmedical.co.uk

Extended Hours Alternate Mondays, Tuesdays evenings 6.30pm to 8.00pm (Routine appointments)

Bishop’s Tachbrook core opening hours: Mon, Wed & Fri 9.00am to 1.00pm Tues & Thurs 1.30pm to 5.30pm surgery open

Please see our website www.croftmedical.co.uk