North Swindon Practice

NORTH SWINDON PRACTICE Report on Patient Participation Project 2011 to 2013 March 2012

North Swindon Practice is participating in a two year project to collate information and feedback from our patients. The practice has set up both a Virtual Patient Participation Group (VPPG) and a face-to-face Patient Participation Group (PPG).

Virtual Patient Participation Group members are copied into the Agenda and Minutes of PPG Meetings and emailed monthly practice newsletters. VPPG members help us with two-way communication on ideas about how to improve our services and understand patient’s priorities and issues.

The Patient Participation Group (PPG) is a committee of patients who meet at the practice regularly to support the practice with patient communication, service development and priorities, play an active part in survey design and analysing results, and helping to reach agreement on any appropriate changes. All VPPG members are welcome to contact the practice manager to apply to be on the PPG.

Our surveys, as well as membership of both the PPG and VPPG are widely advertised on our website www.homegroundsurgery.nhs.uk, via our patient information TV screens, and through monthly patient newsletters. We consider all of our patients to be members of the VPPG already; however, patients can also complete a membership form available either via our surgery website or from reception. This will ensure they are contacted directly each time a new survey or newsletter is added.

We aim to have constant feedback from patients, therefore all of our surveys are available on the website and in the surgery all year round. The list below shows the current surveys. Updated or new surveys may be added from time to time. Feedback from the surveys will be analysed on an annual basis by our Patient Participation Group, and a report posted on the website for comment by VPPG members or any patient of the practice.

We have individual feedback surveys for each of our GPs, Nurses and (recently added) Healthcare Assistants, as well as organizational surveys covering receptionists, opening hours, telephone answering, appointment availability and overall experience. List of Current Surveys

General Comments/Feedback form Opening Hours Patient Experience Telephone Answering Appointments Survey (GPs & Nurses) GP Consultation – Dr Basheer (new) GP Consultation – Dr Cluett GP Consultation – Dr Godfray GP Consultation – Dr McMenamin GP Consultation – Dr Mario (Sofroniou) GP Consultation - Dr Rawlins GP Consultation – Dr Thomas GP Consultation – Dr Helen Williams GP Consultation – Dr Alan Whitworth Nurse Consultation – Eilidh Hambling Nurse Consultation – Kate Black Nurse Consultation – Siobhan Bilko Nurse Consultation – Helen Gooch Health Care Assistant Consultation – Alison (new) Health Care Assistant Consultation – Laura (new) Health Care Assistant Consultation – Sam (new) Health Care Assistant Consultation – Sheilagh (new) Health Care Assistant Consultation – Victoria (new)

The results of the surveys are also shared with patients via our practice newsletter (paper and electronic). We also advertise the PPG and VPPG on our patient information TV screens.

GP/Nurse Surveys:

Amalgamated responses to the GP/Nurse survey are shown below (we have individual surveys for each of our GPs and Nurses). Comments are too numerous to include with this report, but are published on the website and are overwhelmingly positive.

Total Responses

Q1. Were you seen within 10 minutes of your appointment time? 260 Yes 199 No 61 Q2. If your answer to Q1 above was No, how long did you have to wait? 84 Between 10 and 20 minutes 26 Between 20 and 30 minutes 16 More than 30 minutes 42 Q3. Did the Doctor/Nurse spend enough time listening to your description of your symptoms? 260 Yes 257 No 3 Q4. Did the Doctor/Nurse put you at ease during the consultation/whilst examining or treating you? 256 Yes 252 No 4 Q5. Did the Doctor/Nurse explain the reasons for any treatment offered to you? 253 Yes 245 No 8 Q6. Did the Doctor/Nurse involve you in decisions about your treatment and care? 256 Yes 243 No 13 Q7. Overall, did you find the consultation helpful and did it fulfil your needs? 258 Yes 252 No 6 Q8. Did the Doctor/Nurse ask you to make a follow-up appointment to review your treatment? 245 Yes 119 No 126

Q9. In the last 12 months, how many times have you seen a Doctor/Nurse in this practice? 396 1 or 2 times 64 3 to 6 times 134 More than 7 times 198 To help us analyse your answers please tell us a few things about yourself:

Are you male or female? 239 Male 97 Female 142 What age are you? 248 Under 16 11 17 - 24 14 25 - 34 45 35 - 44 50 45 - 54 33 55 - 64 32 65 - 74 30 75 - 84 29 Over 84 4 What is the ethnic background with which you most identify? 238 White British 216 White Irish 1 Any other White background 7 Mixed White & Black Caribbean 1 Mixed White & Black African 0 Mixed White & Black Asian 0 Indian 1 Pakistani 0 Bangladeshi 0 Any other Asian background 2 Black Caribbean 0 Black African 0 Any other Black background 0 Chinese 1 Any other ethnic group 2 Prefer not to say 7

Analysis of GP/Nurse Surveys Questions 1 to 9

Question summary Response summary Discussion with PPG/VPPG summary Q1. Were you seen Yes - 199 23% of patients had to wait more than 10 within 10 minutes of No - 61 minutes. PPG members agreed that some your appointment waiting time is inevitable, and that they time? appreciate being given extra time with the doctor on occasion if needed. Q2. If your answer to 10 to 20 mins – 84 It is clearly a problem that 16% of patients Q.1 no, how long did 20 to 30 mins – 26 who answered this question had to wait you have to wait? More than 30 mins 42 more than 30 minutes. This is addressed in the report below. Q3. did the Yes – 257 PPG members felt that this was a very good Doctor/Nurse spend No - 3 result. enough time listening to your symptoms? Q4. Did the Doctor/ Yes – 252 Again, PPG members felt that this was a Nurse put you at ease No - 4 very good result. during the consultation/whilst examining or treating you? Q5. Did the Yes – 245 Again, a good response. Doctor/Nurse explain No - 8 the reasons for any treatment offered to you? Q6. Did the Yes – 243 Considered an acceptable response. Doctor/Nurse involve No - 13 you in decisions about your treatment and care? Q7. Overall, did you Yes – 252 Considered an acceptable response. find the consultation No - 6 helpful and did it fulfil your needs?

Q8. Did the Yes - 199 This is a useful way for the practice to Doctor/Nurse ask you No - 126 gauge if patients are being brought back to to make a follow-up the surgery by individual clinicians at appointment? appropriate intervals. Q9. In the last 12 1 or 2 times - 64 Again, this is information for the practice in months, how many 3 to 6 times - 134 trying to match appointment availability with times have you seen a More than 7 times - repeat consultation rates, and it is hoped Doctor/Nurse in this 198 that over a long period of time this practice information will become statistically useful. Patient Demographics  50% more females than males completed the questionnaires  Good response from all ages; fewer under 16s and over 84s.  Ethnicity corresponds with the make-up of the practice population

Responses to the Organisational Surveys below discussed at the PPG meeting on 26th March are summarised at the end.

APPOINTMENTS SURVEY Number of Responses: 15

Q1: How easy was it to get an appointment for the time you wanted? Not very easy 13% Fairly easy 46% Very easy 20% I didn't want a specific time 20%

Q2: Were you able to see the GP or Nurse you wanted to see? Yes 46% No 26% I didn't want to see a specific GP or Nurse 26%

Q3: How important is it to you that you see a specific GP or Nurse when coming to this practice? Not at all important 20% Fairly important 46% Very important 33%

Q4: How well do you know which days of the week the GPs and Nurses are available? Very well 0% Quite well 20% Not at all well 46% I don't feel I need to know 26%

Q5: How would you describe how often you come to the practice? Regularly 46% Occasionally 33% Very Rarely 20%

To help us analyse your answers please tell us a few things about yourself:

Are you male or female? Male 26% Female 66%

What age are you? Under 16 6% 17 - 24 13% 25 - 34 20% 35 - 44 6% 45 - 54 13% 65 - 74 20% 75 - 84 6% Over 84 0%

GENERAL COMMENTS SURVEY Number of Responses: 69

Is your comment: Positive 72% Negative 14% Neutral 13%

Mostly positive:

All good. All staff pleasant, helpful, always polite. All the doctors and staff are extremely helpful. Would like Saturday morning surgery. Always a great reception and prompt service. Very helpful. Always a very friendly and very satisfactory service. Can always get appointments in a satisfactory timescale. Always been very happy with the service. Always found this practice to be of an excellent standard. A well run friendly practice right across the board. Can't see how anything could be improved, Perhaps some more ink for the pen! Always friendly and happy to help. Always treat me well at reception. Get most treatments here under one roof, also can get to see or talk to a doctor. However always find it difficult seeing different doctors, but then I like continuity. Appointments can be booked easily and you receive an appointment fairly quickly when needed. However, it would be good to book in advance if you need to have another appointment, rather than waiting until the week before. Could do with a few more same day emergency appointments. Always clean and warm. Efficiency, speed and service. Everyone I have come into contact with has been very friendly and helpful, from reception staff through to doctors and nurses. We are very pleased with the experience at the surgery as a whole family. Thanks to all! Everything in the surgery is excellent, cannot fault GPs, Nurses, care etc, all good. Everything OK as always. Always have been sorted. Excellent doctors and staff, always ready to listen. Excellent service. Friendly and reassuring staff. Have always had excellent service and appointments since it opened, never feel rushed. Never have a problem getting an appointment (depending on urgency - always accommodate). Friendly staff. Friendly, Dr Godfray was there with me and Dr Cluett when I was being diagnosed, they were great. Friendly, local, clean and tidy. Generally I am quite happy with the practice. I particularly like the way you can get an appointment quite quickly if needed. However, the dinner time 12 - 1.30 when you are closed for telephone calls is normally the only time I can phone for an appointment due to work commitments. I know other people also find this inconvenient. Good service, but this is my first visit so not sure. Good service. Good service. Have always found the reception staff very helpful and pro-active. However, an observation is that they cannot see the waiting room and deal with any immediate concerns. Having been with you for 10 years now I've seen the practice grow. Despite these changes the service provided is fantastic. I always find all of the receptionists extremely helpful and friendly (particularly with the amount of time I spend here). Doctors, nurses and receptionists are always helpful and have a "can do" attitude. I always feel that the patient's welfare is of the utmost concern and never feel I'm being rushed out of the door. I never mind waiting to see a doctor as I know I will receive the same amount of time and care when it is my turn. Even if there are no appointments I have always managed a telephone consultation with a doctor the same day. I think you are all a Godsend. I am very satisfied with the doctors, nurses and receptionists. I have been treated very professionally with confidence. I like that when you need to see a doctor you can. I like the asthma checks and flu prevention. I think an annual medical for over 50s would be good, as although I have not visited the doctor in the last 12 months a check-up would be appreciated. I like the availability of appointments. Nurse has always been very helpful when I have travelled abroad and required advice. I like the fact that there is no triage nurse, that is why I changed doctors from Moredon Surgery. I like the large waiting area (not sat on top of each other). I like the provision of telephone appointments. Excellent pharmacy next door. I like the system for calling patients in. It is local. I've always had good service here. Receptionists nurses and doctors are great. I'm really happy with the practice. Near to home. Normally friendly and efficient. Easy to get to and park. Quick service, not long to wait for appointment and get appointment quickly. Quite satisfied with everything. Very friendly. Quite satisfied. Receptionists always try and help if possible. Friendly, approachable doctors. Appointments in a timely fashion, you don't have to wait too long. Service is always excellent, no complaints. A very friendly service. The staff always seem happy and very helpful. Every effort is normally made to see you. The doctor ringing has been very helpful so that an appointment can be made if needed. Also the liaison between the practice and the pharmacy is excellent. I'm really happy with the way all Staff always helpful, very accessible. Tea facilities would be good. Staff very friendly. The doctors have helped me. The doctors are all excellent and never rush an appointment, and always take time to listen. Very efficient. Clean and Tidy. Very friendly Very happy with the practice. Very happy with the way we can get appointments quick when the rest of my family need them and very polite staff. A very pleasant surgery. Well received every time we come in. So friendly and helpful. This is by far the best practice I have ever been registered, feel very fortunate. I like the ease of access to a doctor, the quality of all doctors seen here. Receptionists was very happy and smiley.

Mostly negatives:

Please provide a list of doctors at the practice in the main area and take the old one down. Get rid of the music from screen it is very depressing. Change the music and the children's cartoon. My previous visit I had bad diarrhoea and lumps in my throat but was a waste of time, Dr less than supportive (locum of salaried). Made me hesitant to call this time. Good points - phone system and friendliness of staff. You could improve the period over 12:30-1:30 when you can't ring for appointments. Receptionist was not particularly friendly, but was not rude. Waiting time of over 20 minutes, receptionist did not warn of this, no apology for the wait either from any staff member. It would help if receptionists could let patients know if there is going to be a delay in seeing the doctor, recently I had to wait 1 hour when I was feeling particularly unwell. Smile! Sometimes have to wait quite a few days for an appointment to see the doctor you want to see. Sometimes it is very difficult to get appointments, people cannot arrange their illness around appointment availability. Sometimes very long wait. The practice is far worse since it has got bigger, cannot get to see "original" doctor, always locum, quick appointments but speed not quality. Increase the amount of female GPs. Opening times to be later and on weekends. The receptionists have improved greatly in the past 2 months or so! A change of staff maybe. Have been 50 mins late in to see GP previously, leaving 2 children waiting on the doorstep!! No apology from GP!! The waiting area could be made more friendly and less formal. Very accessible. Telephone appointments are great for poorly children and can save an appointment visit. However waiting times could be shorter- last time waited 35 minutes. Get rid of the music from screen it is very depressing. Your receptionist today is always polite and helpful but a couple of the others found to be quite rude and unhelpful and generally not nice. You say 3 days for prescriptions but often it takes 4 or usually they end up getting lost and it would be nice to stick to the one doctor instead of seeing a different one every time I come in and having to explain my situation every time.

OPENING HOURS SURVEY Number of Responses: 33

Q1. How satisfied are you with the opening hours at the surgery? Very 30% Fairly 39% Neither satisfied nor dissatisfied 9% Quite dissatisfied 18% Very dissatisfied 3%

Q2. Do you know what hours the surgery is open? Yes 78% No 21%

Q3. Would you like the surgery open at additional times? Yes 63% No 30%

Q4. If you answered Yes to Q3, what additional times would you like the surgery to be open? More early mornings 18% More late evenings 30% Saturdays 39% Sundays 18%

To help us analyse your answers please tell us a few things about yourself:

Are you male or female? Male 27% Female 63% What age are you? Under 16 12% 17 - 24 6% 25 - 34 15% 35 - 44 3% 45 - 54 27% 55 - 64 9% 65 - 74 15% 75 - 84 3% Over 84 6% PATIENT EXPERIENCE SURVEY Number of Responses: 19

Q1. If you are a wheelchair user or have a physical disability, how easy do you find getting into the surgery from the car park and surrounding footpaths? Very easy 26% Fairly easy 21% Not very easy 0% Not at all easy 0% Not applicable 36%

Q2. If you are wheelchair user or have a physical disability how user-friendly do you find the internal layout of the surgery? Very good 31% Fairly good 10% Not very good 0% Not good at all 0% Not applicable 36%

Q3. How clean is the surgery building? Very clean 47% Fairly clean 42% Not very clean 0% Not at all clean 0% I haven't noticed 5% Q4. In the Reception Area, can other patients overhear what you say to the receptionist? Yes, but I don’t mind 52% Yes, and I'm not happy about it 10% No, other patients cannot overhear 5% I haven't noticed 26%

Q5. How helpful do you find the receptionists at the surgery? Very helpful 31% Fairly helpful 63% Not very helpful 0% Not at all helpful 0%

Q6. How useful/interesting do you find the patient information displayed on the TV screens? Very useful/interesting 31% Fairly useful/interesting 47% Not very useful/interesting 15% Not at all useful/interesting 0%

Q7. Are there any things you particularly like about the practice? All staff seem friendly Dr Cluett and Dr Thomas! Early appointments, telephone appointments when I'm working. Relaxed and friendly. Familiar doctors not always changing Friendly and courteous receptionists and telephonists. Doctors make a point of listening to you before offering diagnosis or treatment. Usually able to make appointments at reasonably short notice. Friendly staff Have answered Q1 and Q2 for a pushchair. It is easy to get to, parking always available Never a problem getting an appointment Overall an excellent practice. The best I have had in my life. We are well looked after Yes it's a nice big waiting area Yes, I like a lot about the practice. Excellent pharmacy. Drs efficient and friendly Q8. Are there any areas where you think we could improve?

Back area of waiting space always a bit dark Perhaps all the reception staff should be trained by Mrs Bartlett. The footpath access from Thames Avenue/Pharmacy is a fairly steep slope for the disabled/wheelchair user and could be slippery in frosty weather. What about an epilepsy clinic? It would be a good idea. And if some psychology courses were held nearby on No.11/24 bus route.

To help us analyse your answers please tell us a few things about yourself: Are you male or female? Male 26% Female 52%

What age are you? Under 16 5% 17 - 24 10% 25 - 34 15% 35 - 44 10% 45 - 54 21% 55 - 64 10% 65 - 74 15% 75 - 84 0% Over 84 0%

TELEPHONE ANSWERING SURVEY: Number of Responses: 16

Q1. How do you rate the way your call was dealt with by the staff member answering the call? Very Poor 0% Poor 0% Fair 18% Good 18% Very Good 31% Excellent 31%

Q3. In the last 12 months, how many times have you TELEPHONED the practice? Once or Twice 12% Three to Six Times 43% Seven to Ten Times 37% More than 10 Times 6% Q4. Do you have any general comments about accessing the practice by telephone?

Always happy with the service, Dr telephone consultations very helpful. Disagree entirely with surgery using expensive 0844 premium number system. It becomes even more costly when one has to be placed in a queuing system which can be quite frequent. Earlier line accessibility would be better Good! It is fine. It would be nice if patients could make an appointment more than 8 days in advance. Stop using the 08444 number! Very good - easy and good instructions.

Q5. Are there any areas where you think we could improve? I wish I could get through over lunch. As last question - use normal telephone number No Not leaving messages on answerphones. Trying to get appointments is a big problem! Yes when they ask you the problem and take your name so others in the waiting room can hear your problem

To help us analyse your answers please tell us a few things about yourself: Are you male or female? Male 37% Female 62%

What age are you? Under 16 0% 17 - 24 18% 25 - 34 25% 35 - 44 12% 45 - 54 12% 55 - 64 12% 65 - 74 6% 75 - 84 6% Over 84 0% A PPG meeting was held on the 26th March 2012 where the agenda centred around the results of this first full survey. The answers to each question and an analysis of the results were discussed and scrutinised at length, results are as follows:

1. The fact that the practice is closed to incoming calls except for emergencies over the lunch-time period causes problems for some patients who can only phone for appointments during their lunch-hour.

Action: The practice has agreed to accept non urgent incoming calls on 4 days each week, but will retain the emergency calls only system on Wednesday lunchtimes due to staff training. Timeframe: Amendments to staffing hours, rotas and lunch-times will be required, therefore the change will not be able to be implemented until week commencing 30 May 2012

2. Information displays on the TV screens are too small, too busy and change too quickly for many patients to read them. Text would be easier to read if it was in black and white.

Action: This was discussed at a previous meeting. The practice agrees to undertake a major overhaul of the information displayed on the screens, to include increasing the size of the text displayed, giving consideration to text being black on white (as opposed to coloured), limiting the display to one notice and one cartoon and increasing the amount of time between screen changes to allow plenty of time for information to be read. Timeframe: Before Summer PPG meeting on 6th August 2012

3. Some patients value continuity of care and sometimes do not feel that they are seeing their own registered GP quickly enough. However, other patients felt perfectly happy to see any GP. Some patients are not aware that they can see any GP, not just their own registered GP.

Action: The practice is currently recruiting 2 new GP partners, which will reduce the number of on-call days for the existing partners and increase their availability in terms of bookable routine appointments. Timeframe: Summer of 2012 Action: A future edition of the practice newsletter will cover how to get the best from the practice appointments system, including informing patients that they can see any GP and not just their registered GP. Patients will also be encouraged to transfer registration to one of the new partners to even-out GP workload and improve continuity. Timeframe: April or May issue of the Practice Newsletter Action: The practice will consider giving GPs access to one or two appointments which can be booked (by the GP only) further ahead than 8 days to allow for continuity of care. Timeframe: The Practice Manager will add this as an Agenda item for a future Practice meeting, outcome to be reported back to PPG meeting on 14 May 2012 4. PPG members felt that the practice should be able to take firmer action with regard to patients who fail to attend appointments and asked about the possibility of imposing fines.

Action: The Practice Manager explained that the practice is not allowed to levy such charges on patients. Patients who repeatedly fail to attend for appointments are already routinely written to and advised that they may be removed from the practice list for repeated failure to attend. It was agreed that in addition to publishing the number of patients who fail to attend in the monthly newsletter, the practice will convert this data to the number of GP/nurse sessions lost (eg, 180 missed appointments is equivalent to 12 entire GP surgeries). Timeframe: In time for the April 2012 newsletter. Action: The practice will run a campaign to collect more patient mobile telephone numbers and will routinely remind all patients who have provided a mobile telephone number of their appointments, unless the patient has chosen to opt out of this service. Timeframe: Ongoing, starting from April 2012

5. An explanation as to why the practice continues to use an 0844 number should be made available via newsletters, the website and the patient information system.

Action: Practice Manager to include this information on the practice website, also on the patient information TV screens. A leaflet will also be given to new patients advising them that the 0844 number is in use. Timeframe: Before the end of April 2012.

6. Receptionists should advise patients if a GP or Nurse is running more than 30 minutes late.

Action: To be discussed at the next team training session on Wednesday 18 April 2012 Timeframe: To be implemented before the end of April 2012.

7. On one of the surveys 10 patients said they weren’t happy that their conversation with the receptionist could be overheard by other patients queuing behind them.

Action: The group discussed the possibility of installing a “self check-in” screen, which would reduce the number of patients queuing at reception. Purchase of the necessary equipment was agreed. Timeframe: As soon as possible.

8. The Parish Council and Link Magazine could be approached to see if it is possible for the practice newsletter to be distributed with their publications.

Action: Practice Manager to approach Parish Council and Link Magazine to see if this possible. Timeframe: Before the end of May 2012. 9. There is no water drinking facility in reception, and this would be valued by patients.

Action: The Practice Manager to obtain quotations from local companies who provide mains connected water dispensers. If the practice is unable to meet the costs at this time, the PPG to be asked to suggest fund-raising ideas at the next meeting. Timeframe: Before next PPG meeting on 14th May 2012

10. Patients waiting in reception can find it difficult to locate rooms when called.

Action: The Practice Manager to arrange for signs to be put up indicating the layout of the consulting rooms. Timeframe: As soon as possible!

10. Opening hours were discussed by the group, but the need to make changes was discounted on the basis that the number of patients requesting Saturday opening was too small to be significant. Members of the group appreciated the current arrangements, particularly being able to attend for a blood test at 7.30am in the morning, and being able to see a GP up to 6:30pm on most days, and 7:30pm on Mondays, as well as early in the mornings.

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