Denham Medical Centre Patient Participation Group Report

The surgery had been invited by the Dept of Health to establish a Patient Representative Group that would look at the surgery as a whole and agree any issues that are a priority. These are to be included in a Practice Survey, which should be approved by the group. The findings should then be discussed with the group and agree any change in the way the surgery conducts itself or provides and delivers services. The group will then agree an action plan setting out the priorities and proposals coming out of the survey and their implementation.

To enable the practice to form a representative group of patients a search was completed on the age profile of the practice. The practice population is approximately 8060.

Age 20-40 1969 27% 40-60 2418 33% 60+ 2878 40%

Male/female split is 50/50

The PPG should ideally be made up of:-

Age 20-40 3 40-60 3 60+ 4

Forming the Group A poster was put up in the waiting room of both the main and the branch surgeries to invite patients to join our PPG Letters if invitation to join the group were put in the waiting rooms of both surgeries Information and a letter of invitation was put on our website. There was discussion with the GPs, Practice Nurses and Receptionists to inform them of the PPG and to offer encouragement to patients to come forward for the group. Just two patients had answered the invitation put out in the surgery and website. The GPs and PM then spoke to patients individually to invite a representative group. Letters were sent to all the patients who had expressed an interest through the GP, practice manager or practice nurse to invite them to our first meeting. We invited a teenager to the group as we felt it was appropriate that a younger view should be heard. The PPG met.

Establishing priorities for the survey and approve the survey to use and method. One of the group had sent an email with a couple of suggestions for the survey, these being requesting of repeat prescriptions and requesting Home Visits. It was felt by the attendees that these were not a problem and there was no need to include them in the questionnaire. Repeat prescribing through the website was proving to be very popular and effective.

Parking was certainly an issue that patients were concerned about but as we have no control over the allocation of parking spaces, or the lack of them then it was felt that it was not good practice to include something we could not do anything about.

After much discussion it was felt that the way patients are able to book appointments should be looked at. There was general agreement that it may be an advantage to many patients to be able to book on-line, especially for those patients who work. Because of the triage aspect of our booking system, is felt that patients would have to be educated as to what the appointments were suitable for. On-line booking of appointments was covered by the questionnaire that was looked at.

It was also suggested and was approved that the surgery investigates sending text messages to patients to remind them of their booked appointment. It was felt that this was something that could be undertaken as a trial without seeking approval from patients as it was so overwhelmingly welcomed.

The General Practice Assessment Questionnaire that had been sent out with the Agenda was discussed and approved. It was felt that questions 31 to 33 where not pertinent and would not be included.

The questionnaires are to be handed out at each site in a ratio of one third in Iver and two thirds in Denham as per the practice population ratio for the sites. All patients coming in to the surgery on the days the survey is ongoing will be invited by the receptionist to fill in a questionnaire. There were questions about the practice nurses and receptionists, as had been requested by Sheila in her email. There will also be a downloadable one from the website that patients can either fill in online and email back to the surgery or can print off and drop in/ post to the surgery.

The questionnaires will be sent off for analysis and a report sent back for our consideration. 200 questionnaires will need to be submitted for analysis.

The Practice Survey The Practice Survey had been handed out at both sites (Iver Heath, one third and Denham, two thirds) during all surgeries until we had 200 replies to be submitted for analysis. Patients who came up to reception were given a survey to fill in and also receptionists went out to front of reception to hand out questionnaires, as the majority of patients now use the Automated Log in System for their appointment. The Practice Survey had been analysed by a specialist company InTime data.

Each of all 37 Criteria on the Questionnaires was discussed. The findings were discussed in detail. Question 8 findings - about the preferred method of booking appointments at the surgery was discussed at length as this had been one of the criteria that the Group had been keen to change/develop i.e. to be able to book appointments on-line. It was found that only 12.1% would like to book their appointment on-line even though 50% of the questionnaires had been handed out to patients who were in employment and 68% were under the age of 65 years. It was therefore agreed not to pursue this at this time.

The Findings of the Survey The PPG met to discuss the findings of the survey. In summary, the PPG wanted patients in general to know that of the patients who filled in the questionnaires, then the following results were for how patients would describe their experience in our surgery:- Excellent 33.2% Very Good 44.4% Good 19.9% Only 2.6% thought it was less than this (5 questionnaires)

66.3% would definitely recommend our surgery to someone new to the area 32.1% would probably recommend our surgery Only 3 patients 1.6% would not. The comments that patients had added to the questionnaires were also looked at and discussed – only 5 out of 25 had anything but praise for the surgery and 3 of these were suggestions.

In all our PPG felt that this was exemplary and that the staff should be thanked for all their efforts. It was pointed out that the patients who filled in the questionnaires would not necessarily have been in the best of health, therefore not in the best of moods either. That is was a positive document and we were now looking at what we could do even better.

Changes in delivery of service On discussion with the group it was felt that sometimes patients have to wait in the waiting room for longer than expected, since we have merged together as one surgery then one the GPs takes longer with patients and often over-runs. It was felt it would be very helpful for receptionists to speak with patients waiting to update them if there was a delay. Janice agreed to put this on the Agenda for discussion/training at the next Practice Meeting and then to monitor how it was going.

It was also found that GPs were asking patients to come back in a week’s time for a review but patients were unable to book this in advance for the morning. Janice mentioned that it had been agreed with the GPs that they should, in these circumstances, give the patients a note for reception to enable the patient to book in advance. This was also to be raised at the next Practice Meeting as a reminder to GPs and to Reception staff.

It was clarified, that if a patient was a Carer or wanted to be accompanied by a Carer, then appointments could be booked in advance at a convenient time for the patient/carer, in the mornings as well as evenings. This is standard practice in booking appointments with the receptionists.

The main change that the PPG would like to make is to introduce a text messaging appointment reminder to patients. All the patients attending the meeting and the Practice Manager felt that this would be a positive addition to our services.

Action Plan It was agreed to discuss the introduction of the service at the next meeting when Janice would have information from the Medical System provider, Emis, about any software etc needed. The GPs and staff would be consulted about the introduction of the new service to gain any views or helpful information.

Sheila had already worked in a surgery that had used text messaging and has experience of the necessary protocols etc.

It was agreed that the aim would be to introduce the new service to use by the Autumn 2012 to enable patients to be reminded of their flu jabs.