CHADWICK PRACTICE PATIENT PARTICIPATION SURVEY REPORT 2013/14

The practice established a patient participation Group in 2012, to obtain feedback from patients and include them in identified service redesign. We felt the ability to obtain specific and targeted questioning would be more effective than national questionnaires in influencing change.

Contents

1. Develop a Patient Reference Group

It was felt after discussion in the practice that we would aim to create a ‘virtual’ patient group. This would enable us to involve a larger number of patients from a wider cross-section of the practice.

Practice Profile

Chadwick Practice covers the whole area of Hartlepool. Our practice population varies slightly over time but is currently around 11081 patients, we have seen an increase of approximately 230 patients in the last year.

Look at practice profile – The clinical system was searched to provide details of our age/sex/ethnicity/employment details/long term conditions and carers.

Practice Age Groups

17-24 8% 2% 14% 25-34 12% 35-44 14% 45-54 55-64 16% 65-74 15% 75-84 19% 85+

PRACTICE GENDER DISTRIBUTION

48% male 52% female ETHNICITY INFORMATION Patient Percentage of the Read code Count total (XaJQv) British or mixed British - ethnic category 2001 census 4240 64.00% (XaFwD) White British 3400 51.30% (XaQEa) White British - ethnic category 2001 census 699 10.60% (9S1..) White - ethnic group 369 5.60% (XaJRB) Ethnic category not stated - 2001 census 114 1.70% (9SZ..) Ethnic groups (census) NOS 52 0.80% (XaJQx) Other White background - ethnic category 2001 census 33 0.50% (XaJR2) Indian or British Indian - ethnic category 2001 census 27 0.40% (XaFx1) Other ethnic group 26 0.40% (XaJR0) White and Asian - ethnic category 2001 census 21 0.30% (XaJR5) Other Asian background - ethnic category 2001 census 17 0.30% (XaJQw) Irish - ethnic category 2001 census 16 0.20% (XaJRR) Sri Lankan - ethnic category 2001 census 14 0.20% (XaFwF) Other white ethnic group 13 0.20% (XaJR4) Bangladeshi or British Bangladeshi - ethn categ 2001 census 11 0.20% (XaJR9) Chinese - ethnic category 2001 census 11 0.20% (XaJRC) English - ethnic category 2001 census 11 0.20% (XaJRA) Other - ethnic category 2001 census 11 0.20% (XaJR1) Other Mixed background - ethnic category 2001 census 10 0.20% (XaJRW) Other Asian or Asian unspecified ethnic category 2001 census 10 0.20% (XaFx0) Other Asian ethnic group 10 0.20% (9S6..) Indian 9 0.10% (XaJR3) Pakistani or British Pakistani - ethnic category 2001 census 7 0.10% (XaE4B) Ethnic group not given - patient refused 6 0.10% (XaJQu) Ethnic category - 2001 census 6 0.10% (XaJSP) Oth White European/European unsp/Mixed European 2001 census 6 0.10% (XaJQz) White and Black African - ethnic category 2001 census 6 0.10% (XaJR7) African - ethnic category 2001 census 6 0.10% (9SB4.) Other ethnic, other mixed orig 5 0.10% (XaFwE) White Irish 5 0.10% (XaJQy) White and Black Caribbean - ethnic category 2001 census 5 0.10% (9S3..) Black African 5 0.10% (XaJRm) Italian - ethnic category 2001 census 4 0.10% (9S8..) Bangladeshi 4 0.10% (9S...) Ethnic groups (census) 4 0.10% (9T1C.) Chinese 4 0.10% (XaJRc) Vietnamese - ethnic category 2001 census 3 0.00% (XaJSE) Polish - ethnic category 2001 census 3 0.00% (XaIui) Other white British ethnic group 3 0.00% (XaJSO) Other mixed White - ethnic category 2001 census 3 0.00% (XaJR6) Caribbean - ethnic category 2001 census 2 0.00% (9SB2.) Other ethnic, Asian/White orig 2 0.00% (XaJSS) Arab - ethnic category 2001 census 2 0.00% (XaIB6) Black African and White 2 0.00% (XaFx2) Irish traveller 2 0.00% (XaJSG) Commonwealth (Russian) Indep States - ethn categ 2001 census 2 0.00% (XaJRi) Greek - ethnic category 2001 census 2 0.00% (XaJRa) Black British - ethnic category 2001 census 2 0.00% (9SA8.) Other Asian (NMO) 2 0.00% (XaJSF) Baltic Estonian/Latvian/Lithuanian - ethn categ 2001 census 2 0.00% (XaJRb) Other Black or Black unspecified ethnic category 2001 census 2 0.00% (XaJSQ) Other White or White unspecified ethnic category 2001 census 2 0.00% (XaQEb) White Irish - ethnic category 2001 census 2 0.00% (XaFwz) Asian - ethnic group 1 0.00% (XaJRK) Chinese and White - ethnic category 2001 census 1 0.00% (XaJSV) Israeli - ethnic category 2001 census 1 0.00% (9S2..) Black Caribbean 1 0.00% (XaJRF) Northern Irish - ethnic category 2001 census 1 0.00% (XE2O0) Turkish/Turkish Cypriot (NMO) 1 0.00% (XaFwH) Black - ethnic group 1 0.00% (XM1SF) Greek (NMO) 1 0.00% (9SAC.) Other European (NMO) 1 0.00% (XaJRU) British Asian - ethnic category 2001 census 1 0.00% (XaJRd) Japanese - ethnic category 2001 census 1 0.00% (9S7..) Pakistani 1 0.00% (XaIB5) Black Caribbean and White 1 0.00% (XaJSZ) Latin American - ethnic category 2001 census 1 0.00% (XaIuh) White Scottish 1 0.00%

Are there any specific Minority Groups within the Practice Population?

There are currently no identified specific minority groups within the practice population. As a practice we do capture ethnicity at registration. We also felt it was important that we looked beyond ethnicity and incorporated other areas in an attempt to understand our practice profile and to ensure our practice group was as representative as possible.

What steps has the practice taken to recruit patients and to ensure it is representative of the practice profile?

The request for patient representatives has and continues to be made via the practice web site and via the notice board in the reception area of the surgery. The practice held a couple of Patient Participation Days where members of staff invited patients to join our group which was initially going to be via email contact.

We managed to recruit 92 patients to our group. We found that approximately 50% preferred to be contacted via post. As a practice we felt we did not want to exclude anybody and it was important that there were no barriers to patients taking part.

Using the profile above the practice looked to see if there were any under-represented groups.

Our patient group was made up of the following for age/sex/ethnicity/long term condition/carer CHADWICK VPRG AGE GROUPS

0% 8% 17-24 13% 8% 25-34 35-44 15% 16% 45-54 55-64 65-74 13% 75-84 27% 85+

CHADWICK VPRG GENDER

0%

33% GENDER M F 67%

CHADWICK VPRG LONG TERM CONDITIONS

NO LTC LTC CHADWICK VPRG ETHNICITY

WHITE BRITISH NOT DISCLOSED WHITE BRITISH OTHER

CHADWICK VPRG - CARER

TOTAL CARER

Comparison of the VPRG with the practice profile and description of the differences between the practice population and membership of the VPRG.?

The dominance of one ethnic profile in the practice is reflected in the profile of the representatives. The Age Groups of the group were on the whole representative but patients over the age of 85 appeared to be under represented and also patients in the 65-74 were slightly under- represented when comparing to the practice profile. Males were slightly under-represented in the patient group. After looking at the data – the practice decided to use the clinical system to randomly select patient from the areas we felt were under represented. These were as follows:

Carers Patients 85+ Patients 65-74 Male Patients Patients from Minority Ethnic Groups Learning Disability Patients Unemployed People Housebound patients

This was carried out by searching the clinical system for the above groups and then running a random patient group selection within our clinical system. These patients received a written invitation to the join our patient group. The practice manager also contacted our local Carers Association to ask for help in recruiting carers to our patient group and they were happy to be involved in the process.

Stage 2 – Agreeing Priorities

How has the practice sought the VPRG’s views of priority areas?

Using survey monkey the practice emailed a link to patients who had provided an email address to allow them to access a survey online. Those patients who had opted for postal involvement were sent out a postal copy of the survey.

Patients were asked what their health priories were from the following as agreed by the practice partners

Clinical Care – Services Provided (Doctors & Nurses) Getting an appointment Telephone Access Opening Times On Line availability Hospital Services

The group was also asked how many questions they thought would be appropriate for our annual patients survey.

The results were as follows

March 2013 March 2014

How the priorities for the survey were selected – do these reflect those set out by the VPRG?

Following the results of the survey it was agreed that the annual survey would seek the views of patients on the GP Services and clinical care offered by the practice as this was highlighted as the main priority for the majority of the group.

The second highest priority was Hospital Services – it as agreed this would be fed back to our CCG and we will look at a further small survey on this once information is available regarding CCG health priorities for 14/15 are agreed.

The Third highest was getting an appointment. Stage 3

How has the practice determined the questions used in the survey?

A number of questions would focus on the patients’ perception of the clinical services they received and whether they felt they could trust their doctor or nurse and were involved in their care and the decisions being made.

The third highest patient priority was getting an appointment – the survey would focus on whether our services were accessible for patients and how quickly they could access our services.

We used the survey to find out if patients would recommend our practice to their friends or families.

How have the priority areas been reflected in the questions?

The survey contained 13 questions focusing on the priority areas highlighted by the group it also included a section on general satisfaction with the practice and a section for patients to highlight any areas for future development etc.

The survey – how and when it was conducted?

The annual survey was started on 24th February 2014 – this was accessible through the practice website www.chadwickpractice.co.uk. The survey was also undertaken in the practice commencing on 24th February for a two week period surveys were handed out to patients attending the practice reception to book in for appointments etc. To add credibility to the survey the practice used a recognised company – survey monkey. The survey was also emailed to the VPRG members and sent out with a SAE for members who had postal preference.

How has the practice collated the results?

All paper surveys were inputted onto the on-line survey monkey version to enable the results to be collated along with those inputted directly via survey monkey by patients. Copies of the paper surveys have been archived for future reference.

How were the findings fed back to the VPRG?

The survey findings were sent out to the VPRG in March 2013. The results were also added to the practice website. Members were asked to respond with their views on the results of the survey and on a proposed action plan.

Stage 4 – Results

Description of the survey results We received 302 responses. The results show that the majority of patients showed a positive response to the questions. 99% of patients felt they trusted the doctor and 98% felt the doctor listened to them. 98.6% would recommend the nurses at the practice and 99.7% felt the reception/admin team were helpful and polite. 99.3% felt they would recommend the practice to friends or family.

The majority of patients were seen within 2 working days as the graph above shows. Patients were asked how accessible services were to them the results are shown below. Interestingly it would appear that a proportion of patients have not used our telephone consultations or spoken to a doctor or nurse of the telephone, despite these being available. This has highlighted a need for further advertising of these services.

The practice received positive feedback and comments across the board regarding clinicians, staff and premises some examples “I think it’s really good as I get in to see my own doctor within a few days” “Would recommend 100% this practice” “five star doctors” “no problems whatsoever staff are great” “excellent service, am dealt with politely and feel respected by staff” “ Overall whatever my query or request either at reception, with a nurse or doctor it is dealt with in a helpful and professional manner, I feel valued and respected” but there is always room for improvement some comments included –“some doctors run late” “Don’t like how some doctors change your medication without seeing you and I would only recommend certain doctors at the practice” “more phone lines” “car parking”

Full results are available via the practice website.

How were the VPRG given the opportunity to comment? The VPRG were given access to the results of the survey either in paper form or via a web link dependent on the type of contact they had requested. This included an action plan asking if they agreed with the planned actions following the survey and also the option to feedback comments to the practice regarding the results and action plan. STAGE 5 What agreement was reached with the PRG of changes in provision of how service delivered?

ACTION POINT REASON DEADLINE TELEPHONE INCREASE CAPACITY FOR 01/09/2015 CONSULTATIONS – APPOINTMENTS - EASIER INCREASE ADVERTISING ACCESS FOR PATIENTS - INCREASE USE OF EASIER FOR PATIENTS AS ELECTRONIC THEY DO NOT NEED TO PRESCRIPTION SERVICE COME BACK TO PRACTICE TO COLLECT PRESCRIPTIONS AND IF THEY ARE ON SYSTEM1 ONLINE THEY CAN ORDER ELECTRONICALLY.

01/04/15 MOBILE SMS (TEXT) THIS HAS BEEN SLOW TO REMINDERS/CONTACT TAKE OFF DUE TO PATIENTS NOT KEEPING NUMBERS UP TO DATE – THE PRACTICE INTRODUCED AN ADVERTISING CAMPAIGN LAST YEAR BUT THIS HAS NOT IMPROVED GREATLY. CARRY ON ADVERTISING TO PROMOTE THE SERVICE VIA THE WEBSITE AND IN PRACTICE 01/06/14 GREATER USE OF PATIENT THE QUESTIONNIARE HAS PLANS WITHIN SHOWN THAT SOME CONSULTATONS PATIENTS DO NOT FEEL INVOLVED IN DECISIONS ABOUT THEIR CARE. THE USE OF CARE PLANS WILL HOPEFULLY HELP PATIENTS BECOME MORE INVOLVED IN THEIR OWN CARE. 01/08/2014 INFORMATION FOR THE QUESTIONNAIRE HAS PATIENTS – QUARTERLY SHOWN THAT SOME NEWSLETTER PATIENTS ARE UNAWARE OF THE SERVICES WE OFFER. THE PRACTICE WILL INTRODUCE A NEWSLETTER WHICH WILL BE AVAILABLE ON THE WEBSITE AND IN PRACTICE AND WE WILL CFWD ALSO ENCOURAGE FROM 13/14 PATIENTS TO LEAVE US – EMAIL ADDRESSES FOR COMMENCE THIS PURPOSE 14/15 YEAR AGREE PRIORITIES WITH CONTINUE DEVELOPMENT PATIENTS GROUP FOR OF PRACTICE NEXT YEAR 01/08/14 Were there any significant changes not agreed by the PRG that need agreement with the PCT?

No

Are there any contractual considerations that should be discussed with the PCT?

No

PRACTICE INFORMATION

OPENING HOURS

MONDAY – FRIDAY 8.00 AM TO 6.OO PM

Our patients are registered with the practice and are free to consult with any of our doctors. Our nurses also offer a range of clinics as well as appointments for minor ailments. To make an appointment please telephone us or drop into the surgery. Please see website for further information.

GP Working Patterns

Dr Brash – Monday, Tuesday, Wednesday

Dr Howe – Monday, Tuesday, Thursday & Friday

Dr Pradeep – Monday, Tuesday, Wednesday & Friday

Dr Sunkavalli – Monday, Tuesday, Thursday & Friday

Dr Garcia – Monday, Tuesday, Thursday & Friday

We are open from 8am until 6pm Monday to Friday. We also offer a number of appointments from 7:30am during the week and on Saturday mornings with our GPs who attend the sessions on a rota basis. Please contact reception for further details.

Please note: We are closed on Sundays and Public Holidays.

Out of Hours

If you require assistance outside of our working hours, please call 111.

STAGE 6 Publicise actions taken in Local Patient Participation Report – available on Practice Website – submitted to NEPCSA (North East Primary Care Services Agency)