The Mandeville Practice

The Mandeville Practice Local Patient Participation Report

March 2013

The Mandeville Practice is a large GP surgery situated in the south of Aylesbury with a patient population of just under 17,000. The practice boundary is currently split over two areas, one to the south around the Mandeville Surgery site and the other to the north around our satellite site at Elmhurst. The area included within the practice boundary covers a mixed patient demographic population.

The surgery is a member of the Aylesbury Vale Clinical Commissioning Group and plays an active role in the design of new health service developments in the area. In line with the new NHS, we are developing close working relations with social care at Bucks County Council, so that our patients can benefit from a more integrated approach to their health and social needs.

Our Patient Reference Group (PRG) was formed in 2011. Mainly consisting of an email group (but also including interested patients without access to the web) we involve patients in decisions about the range and quality of services provided by the practice and changes to the services that the practice provides.

Practice Opening Times

The surgery doors and phone lines are open from 8.15am to 6.15pm Monday to Friday. Although we are only able to take urgent phone calls between 1pm to 2pm, the doors remain open during this period. From 8am to 8.15am and from 6.15pm to 6.30pm a duty doctor is available if a patient needs urgent medical attention.

Outside these hours patients can contact NHS 111 for advice (when it’s less urgent than 999) or Bucks Urgent Care during specially designated times (such as when the surgery is closed for training). These contact numbers are given on our telephone message, our website, on posters in the surgery and in our patient leaflet.

In response to last year’s patient survey we have now increased the frequency of our late evening surgeries from two to three nights of the week: Mondays, Tuesdays and Thursdays from 6.30am to 8pm. These extended hours sessions are pre-booked appointments for patients who are unable to get to the surgery during the daytime due to work commitments.

1 D:\Docs\2018-04-03\07377cd13e5b40ad3c24c69e93f3b9f3.doc Profile of the PRG

Our ‘virtual’ patient group at the Mandeville Practice currently comprises 133 members which represents 0.78% of our practice population of 16,996. We continue in our efforts to recruit and the group continues to grow.

We use various ways to recruit patients to the PRG: publicity around the practice, we promote awareness of the group during autumn flu clinics, we invite patients to join through our website and practice leaflet and new patients are told about the PRG when they come to register with the practice. We continue to use all these methods at different times of the year to make patients aware of the group and to attract more members.

Practice staff also encourage patients to join whenever the opportunity arises, whether during consultations or when a patient comments on the services at the practice. We view commendations and complaints from patients as an opportunity to invite patients to become more involved in influencing service developments at the practice.

Gender

Ethnicity

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We recognise that we have further work to do to ensure a representative spread of our patients with regard to ethnicity, age and gender and will continue to encourage a broad spectrum of patients to become involved.

Actions Resulting From 2012 Survey

In response to what patients told us in last year’s survey we carried out the following actions:-

. Increased the availability of book-ahead appointments by altering the balance of book ahead to same-day appointment numbers . Improved telephone access to GPs by increasing the number of telephone triage calls for each doctor . Implemented a text messaging appointment reminder service to reduce missed appointments . Extended late evening surgeries from two to three evenings a week . Piloted a support and advice group for patients with COPD

The COPD support and advice group which we ran last summer was a success with patients and we will be looking to repeat this initiative if resources allow.

Planning Our 2013 Survey

In early December 2012 we contacted the patients in our patient representative group. We did this via email and by post and telephone for those without access to the web.

3 D:\Docs\2018-04-03\07377cd13e5b40ad3c24c69e93f3b9f3.doc We asked the patient group which issues they felt should be a priority in our 2013 survey, based on what patients had indicated in last year’s questionnaire.

The areas it was agreed we should focus on were:-

. Patient involvement in deciding what further healthcare services will be bought in this area

. The patient’s experience of the services we offer and the care received at the surgery

Patient Survey 2013

We launched our 2012 - 13 survey in February 2013. This survey was emailed out to our patient group and was posted on our practice website homepage and the webpage for ordering repeat medications. We also encouraged patients visiting the surgery to complete hard copies of the survey.

In all we received 61 responses to this survey, the full report of which can be viewed in appendix 1.

To summarise the survey findings:

. We wanted to know about the experience of being a patient at this surgery. Nearly half the patients questioned said that they were very satisfied with the way their concerns were dealt with by the receptionist and, in all, 85% of patients questioned were satisfied. However 12% were dissatisfied with the way in which their request was handled by the reception team.

. We asked about when the patient last spoke to a doctor or nurse over the telephone how satisfied they were that their concerns were dealt with appropriately and 91% of patients said they were happy with the response. We went on to enquire about how satisfied patients are in general with the medical care they receive at the surgery and 93% responded positively. We are proud of the excellent reputation for clinical care that our surgery has and are pleased that patients recognise this.

. In order to help us with future development of services at the surgery we wanted to get a snapshot of the services which patients and their immediate families had used in recent months. 63% of patients who responded are involved with regular check-ups for long term health conditions. This reflects the fact that a major part of our healthcare in the surgery is about keeping patients well who have underlying health conditions. We were pleased to note that 26% of patients questioned had made use of our late evening surgery appointments. A full breakdown of the services used by patients who responded can be found in our survey report (appendix 1).

4 D:\Docs\2018-04-03\07377cd13e5b40ad3c24c69e93f3b9f3.doc . In the survey we undertook in 2012, our patients showed an interest in learning more about the development of health services locally so we asked patients what information and methods they would find most useful to help them make informed decisions. Patients selected email as the preferred choice of being involved followed by being asked when visiting the surgery and attending a meeting for patients in the surgery.

. Finally, our patient representatives who attend local meetings are patients who put themselves forward for this role. We wanted to know if patients were happy to continue in this way, or if they would prefer that patient representatives were elected. The majority responded that they were happy to continue with self- nomination as at present.

Free-text comments made by patients as part of the survey can be viewed at appendix 2.

Response to the Patient Survey and Contents of the Action Plan

The findings of the February 2013 survey were analysed and an action plan was drawn up. This was then sent out by email to the patient group for their response and comments. The detailed survey response is attached in appendix 3.

The proposed action plan is set out here:

. We will inform patients by email and through contact in the surgery about local health service developments and how patients can become involved in influencing decisions.

. We will hold another open evening in the surgery for our patients to update them on changes within the practice and developments in local health services.

. The Mandeville Practice patient group will continue to be represented on public forums by patients who have put themselves forward for this task.

. Later in the year we will conduct an indepth questionnaire about reception and the handling of patient requests in order to identify any issues.

We would like to take this opportunity to thank all our patients who took part in the above surveys and for taking an interest in the Mandeville Practice.

Dr Gill Beck & Denise Skidmore March 2013

5 D:\Docs\2018-04-03\07377cd13e5b40ad3c24c69e93f3b9f3.doc Appendix 1 The Mandeville Practice Patient Survey February 2013 Number of Responses: 61 Patient Survey February 2013 Firstly, we would like to ask for your experience of being a patient at this surgery. When you speak to the receptionist, in general how satisfied are you with the way your request or concerns are dealt with:- Very satisfied 49% Fairly satisfied 36% Neither satisfied nor dissatisfied 1% Not very satisfied 8% Very dissatisfied 4% No response 2%

When you last spoke to a doctor or nurse over the telephone, how satisfied were you that your medical concerns were dealt with appropriately:- Very satisfied 77% Fairly satisfied 14% Neither satisfied nor dissatisfied 4% Not very satisfied 0% very dissatisfied 1% No response 4%

6 D:\Docs\2018-04-03\07377cd13e5b40ad3c24c69e93f3b9f3.doc In general, how satisfied are you with the medical care you have received at the surgery:- Very satisfied 77% Fairly satisfied 16% Neither satisfied nor dissatisfied 3% Not very satisfied 3% Very dissatisfied 0% No response 1%

In order to help us develop services at the surgery we would like to know which of the following services you or a member of your family has used in recent months:- Childhood immunisations 6% Travel immunisations 4% Minor operations 3% Late evening appointments 26% Joint injections 4% Family planning (including coil fits and implants) 0% NHS cardiovascular health checks 6% Stop smoking clinic 3% Alcohol monitoring questions and advice 0% Antenatal and postnatal care 6% Child development 0% Regular monitoring of long term conditions (eg COPD, diabetes, hypertension, heart disease, asthma, osteoporosis, learning disability, epilepsy, mental health) 63% Rheumatology shared care with the hospital 6% Flu clinics - by appointment and Saturday walk-ins 44%

Do you have any suggestions for services you would like the surgery to consider in the future? – see appendix 2 for these comments

Moving on from the surgery to services in the LOCAL area. Patients are being encouraged to have a say in planning which services they think should be a priority in this area in the future. If you were to get involved, which THREE of the following would you find most useful to help you:- Information on how local decisions are CURRENTLY made 70% Finding out what YOU can do to influence decisions on buying services (commissioning) 54% Information about current services 49% A question and answer session 32% Information about the demographics and health problems we have in this area 34% None of the above 11%

7 D:\Docs\2018-04-03\07377cd13e5b40ad3c24c69e93f3b9f3.doc How would you like to be involved:- By email 47% Asked for your thoughts when visiting the surgery 19% Attend local meetings 6% Attend a meeting for our patients in this surgery 14% I would not like to be actively involved 9% No response 5%

In this surgery our patient representatives who currently attend the public forum have nominated themselves. How do you think our patient representatives should be chosen in the future:- Self-nomination as at present 55% Elected by the patient group 18% Elected by all patients 16% Other 6% No response 5%

If you selected OTHER please enter your suggestion below

Thank you for taking the time to complete this survey. Please look out for the results on our website

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> << --- >> An easier method of prescription review without the need to trouble the Dr,use up valuable appointment time and visit the surgery so often as many drugs are prescribed long- term. << --- >> Autism support. << --- >> Being able to make a same day appointment without waiting in for a call back from a doctor. << --- >> Better travel services - we were forced to go to Hemel Hempstead for injections recently. << --- >> Dietician Podiatry << --- >> Dietry/ excercise advice << --- >> Hyperchondriacs' Half Hour << --- >> More flexible booking system for making appts! << --- >> pain clinic group to see if there is anything that helps with chronic pain << --- >> Podiatry Diatician << --- >> Saturday emergency service follow-up appointments after treatment << --- >> Saturday surgery Well woman and man health check clinic << --- >> To give opportunity to non members of the Patient Group to feed in to the Group their views and ideas about health subjects that is either bothering them or with which they are currently experiencing. Thank you. << --- >> Weight loss clinic << --- >> Yes....PLEASE train your receptionist staff to be less hostile!!!!! Its a very unwelcoming place when you are feeling unwell, however the Doctors are marvellous, esp Dr Beck, but the overall feel of the place is unpleasant, only due to staff attitude towards patients. The appointment system also really needs looking at, I came to make an appt but was advised the Doctor would call me sometime later in the morning to see if my symptoms warranted an appointment. I walked across to my car a second later only to see that there was a missed call, during the one minute the receptionist was telling me I would be called later in the morning!! The phone was on silent out of respect because I was in a surgery. I am really hoping the Doctor will try and call me back otherwise I have to drive back and start the whole horrible process again. (The reason for not phoning is because each time I've called in the past it's cost in excess of £10 per call which is too expensive, but that's another issue) It seems extremely unfair to be treated in this way and really doesn't give alot of confidence in my local surgery, so I hope things will get better in the future. << ---

9 D:\Docs\2018-04-03\07377cd13e5b40ad3c24c69e93f3b9f3.doc Appendix 3 The Mandeville Practice Response to Feb 2013 Patient Survey Number of Responses: 30 Response to Feb 2013 Patient Survey 89% of patients expressed a wish to become more informed about local health issues - how decisions are made to buy services and how to have a say in the process. We will keep patients informed via email and through contact in the surgery. We also plan to hold another open evening to address some of the comments raised in this survey and to bring patients up to date with developments in the practice and changes in local health services. Agree with this action 100% Disagree with this action 0%

On the local public forum, the people who represent you as a patient of the Mandeville Practice have nominated themselves. We will continue to use this method as indicated by the majority of patients in the survey. Agree with this action 96% Disagree with this action 3% No response 1%

10 D:\Docs\2018-04-03\07377cd13e5b40ad3c24c69e93f3b9f3.doc If you would like to take this opportunity to nominate yourself to represent our patient group in local meetings please enter your name and contact details below:

Names and details of nominees noted

Finally, 12% of patients surveyed said they were dissatisfied with the way their requests or concerns were dealt with by the receptionist. This is contrary to feedback we have received in other questionnaires so we do need to look into this further. We wish to undertake a more indepth questionnaire about reception. Agree with this action 73% Disagree with this action 23% No response 4%

Do you have any further comments to make on these actions arising out of the recent patient survey? These comments can be viewed at appendix 4

Thank you for sharing your views. Please look out for the full local patient participation report on our website: www.mandevillesurgery.co.uk

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>> << --- >> By a thought-out criteria formulated by the professional staff at the surgery which will invite all patients to attend the clinic over a two or three months period,this will weed out those not committed or cannot make time and then allow elections to take place amongst the user-group using the thought-out criteria above. In case there are no takers or too many takers then self-nomination can prevail. Thank you. << --- >> Ho would I like to be involves also - asked for thoughts when visiting the surgery, via website and attend a meeting in surgery << --- >> How to be involved via website and meeting in surgery << --- >> I have stated 'self-nomination'simply because I cannot conceive of any other realistic way to nominate. Unless patients know each other we cannot feasibly vote for someone. << --- >> I think it's vital that a broad range of health issues and demographic groups are represented - perhaps it would be a good idea to identify any gaps and consider how to 'plug' them. << --- >> Please note 3 options were not available re How would you like to be involved. Therefore, I would have ticked these 3 options..... Email, Attend meeting in the surgery, Asked at surgery. << --- >> Reform PPG. << --- >> The 'radio buttons do not allow me to choose 3 possibilities. Re patient representatives. At the AVCCG meeting of31/1, it was very apparent that v. few lay folk had truly nominated themselves. In my case, I had my initial offer turned down and was subsequently invited. Half a century of chairing voluntary councils/committees has taught me that, at the AGM, you only get the right folk elected if you've fixed it in advance.If left to chance, there is no guarantee that the 'best' folk will turn up. << --- >> To be involved - also to be asked for thoughts when visiting the surgery << ---

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