Patient Participation Group Profile 2012

Patient participation group (PPG)CGMP Annual Survey 2014

PPG Profile 2014 In November 2014 Cricket Green Medical Practice PPG will have been active for ten years. The group continues to be made up of a mix of male & female patients who have an average age of 63.5 years. The group members throughout 2013/14 have remained the same although we do have a new male member and a new female patient wishes to join the PPG as she was an active member at her last GP surgery. The group range from having no health needs to requiring access to many patient services.

Michael Barron continues as the PPG chairperson. Before retiring Michael was an ambulance person with the London Ambulance Service for thirty years. Michael and Peter Wenham are the drivers for Cricket Green Medical Practice car pick-up service. This is an invaluable service, set up by the PPG, following an identified need by the practice for transporting mobile elderly patients to the practice who would otherwise have been unable to attend. This service has helped elderly mobile patients feel more independent by being able to get out of their homes and not being reliant on other NHS services, for example district nursing or home visits.

Valerie Wenham is the PPG secretary. Prior to retirement Valerie managed the National Trust’s disabled visitors section at Queen Anne’s Gate, London for 30 years. Valerie manages the secretarial side of the group ensuring that minutes are documented and followed-up.

Pauline Blyth started her working life in the publishing industry working in Fleet Street. After having a family she moved to the NHS working as a community equipment manager. She has also worked as a volunteer for the British Red Cross as a first aider and in the local St Raphael’s hospice shop.

Nicholas (Nick) Pizey is currently sits on local NHS boards bringing the patient perspective to this groups. In recent years these have included the Patient Experience Group at St Helier Hospital, the Wolfson Neurorehabilitation Unit Development Advisory Group, and for over ten years, the Better Healthcare Closer to Home (BHCH) Programme, which aims to deliver a Local Care Centre to Mitcham within the next six years. Nick was a Trustee for the Disability Alliance until it recently merged with the Royal Association for Disability and Rehabilitation (RADAR) and the National Centre for Independent Living (NCIL) to become Disability Rights UK in January 2012. Nick is now on one of the sub-committees of the new national body for disabled people. Nick is also a Governor for the Education Unit at the Brain Injury Centre in Banstead, a member of the Board of the Merton Centre for Independent Living. He is also a member of LINk Merton which will become Health Watch Merton at the end of 2012.

Pamela Allen worked for 21 years as senior secretary and latterly as the Senior Planner for a multinational company located in London and Mitcham. Management courses enabled Pamela to not only manage the materials required but also both the production managers in Holland and factory managers in Mitcham ensuring that components were made in time for assembly and to satisfy customer requirements. Pamela also held various roles in smaller industries where her roles enabled her to focus on working with smaller teams. Pamela then worked as a civil servant for twelve years in case working. As well as understanding purchasing and confidentiality Pamela developed understanding surrounding government spending and the use of tax payers’ money.

1 Bekir Yusuf is currently working as a free-lance children and young peoples Community Project Worker and this work is mainly in and around the Merton locality. Bec has also recently taken over from lisa Eve (Clinical services Director) as Project Manager for the WellBeing project run by the practice.

Maria Bentley-Dingwall used to run the production of large-scale events for the Labour Party at their Head Office in London. She spent 10 years working for the London Borough of Merton, as a councillor, and was Deputy Mayor in 1992. She has a thorough knowledge of the workings of local government and the law.

Marjorie Robinson has enjoyed a career encompassing working in accounts/finance with; Royal Insurance company, Blackburn, Blackburn Diocese and British Telecom (BT). Since leaving school she has always enjoyed supporting others with health problems through the church and family centres.

Lisa Eve is the clinician representing Cricket Green Medical Practice on the PPG. Lisa’s roles at Cricket Green are that of Clinical Services Director and Practice Nurse. Lisa holds both a Masters and Bachelor of Science degrees. She has also undertaken recognised degree module courses enabling her to be an independent nurse prescriber and to manage patients with complex medical needs including diabetes, who take tablets and/or insulin. She is also a nurse prescriber.

Cricket Green Medical Practice (CGMP) has been very lucky to have had an active PPG running since November 2004. The PPG is currently made up of eight members who meet face-to-face every six to eight weeks at the practice. The main aim of the PPG is to enable CGMP patients and staff to obtain/provide the best possible healthcare through regular meetings/discussion/surveys.

Practice profile/PPG representation CGMP undertook a review of the eight PPG members including their age profile. The average age of the group is 63.5 years. Although two of the three new member’s ages are below 50 years the remaining six members ages range from 64 to 80 years. Age range profile of PPG @ January 2012; 80 & over x 1 70 to 79 & over x 2 60 to 69 & over x 2 50 to 59 & over x 2 40 to 49 & over x 0 30 to 39 & over x 1

The PPG enrolled three new virtual PPG (vPPG) members during 2012-2013 but these new members unfortunately did not engage with the PPG group. It was hoped that the group would have had an effective email community to complement the existing face-to-face PPG. Cricket Green Medical Practice staff are aware of the need for vPPG members and continue to be on the “look-out” for potential candidates.

2 ‘ GP-Call’ - A new appointment system The problem of meeting the demand for clinical appointments is a common problem to all GP practices in the UK, as demand has increased over the past 15 years. CGMP currently offers many more appointments than that recommended in the “GP contract”. Despite this we are still aware that patients have problems at times getting medical advice through obtaining an appointment. In recent years a system based on telephone consulting, as the first method of contact, has been successfully developed. In essence when a patient phones reception requesting an appointment they are given a call back by a GP, usually within 30 minutes. The patient and the GP discuss the medical problem and if it can be dealt with on the phone it is done there and then. If the problem cannot be dealt with over the phone/or not urgent then an appointment with the most appropriate clinician is made, which may not necessarily be on the same day.This new appointment system has been shown to improve continuity, access and care. It means care is available to all, not just those who best know how to negotiate the appointment system. It also means there are always appointments available on any given day. The system has arrangements for those who cannot use the phone or who have communication difficulties. Cricket Green Medical Practice is aspiring to implement this scheme in May 2014.

Agreed area/s of priority for 2013/2014 During the spring of 2013 CGMP considered reviewing the way it provided patient appointments as the demand for clinical appointments was outweighing capacity. ‘GP-Call’ - A new appointment system was discussed at the May 2013 PPG meeting. As introducing this new appointment system would impact upon CGMP patient population, until it was running smoothly from 4-6 months after its start, this project was identified as a potential area of priority. During the summer months of 2013 CGMP had staff changes and the introduction of EMIS web and the ‘GP-Call’ project was put on hold. During December 2013 CGMP management team decided that this project should be started June 2014. At the January 2014 PPG meeting it was agreed that area of priority would be the introduction of the new appointment system. The annual questionnaire was devised which would incorporate information about ‘GP-Call’ the new appointment system and gain patient population ideas/concerns/expectations. This information gained would then be used to help with planning, introducing and maintenance of the new appointment system.

Collate patient views regarding ‘GP-Call’ - A new appointment system through the PPG survey The annual survey was to be undertaken by a questionnaire and would cover; 1. How patients may be currently obtaining information on health & well being and suggestions for improving information gathering, 2. Enquiring if patients know about the PPG and the reason for its existence, and 3. Advertising for new members to join the PPG as a vPPG group.

The finalised PPG questionnaire was reviewed and agreed by the CGMP management team at the weekly meeting held on 21 st January 2014. An agreed survey sample of at least 25 patients was considered.

3 How the GP-Call - A new appointment system survey was undertaken In order to obtain the views of registered patients the PPG volunteered to distribute and collect the patient survey ( Appendix 2). The dates set for the survey were week beginning 27th January 2014. Reception staff also encouraged patients attending the surgery to complete the survey on days that PPG members were unable to attend. A paper survey, undertaken over a three week period would hopefully gather views from a wide range of CGMPs 9,000 registered patients. It was planned to distribute the patient survey to as many patients from our practice population. During the two week 25 survey’s were distributed and returned.

Survey/questionnaire findings

1.0 Survey Methodology

1.1 The Practice survey (appendix 1.) was designed and developed by members of the Patient Participation Group (PPG) and the practice staff PPG staff lead

1.2 To ensure a wide sample of patients participated 4 members of the PPG completed the survey face-to-face with patients during clinic time. The survey was promoted within the practice (appendix 2.) and on the practice website. Practice staff also circulated the survey amongst patients during surgery opening hours

1.3 The survey was also used as an opportunity to promote the virtual patient participation group and encourage patients to sign up.

2.0 Practice Survey Breakdown of Participants

2.1 25 patients participated in the annual practice survey

4 3.0 Practice survey breakdown of responses to question 1.

3.1 How can the CGMP project team keep you informed about this project?

Patient suggestion Patient response numbers Email 10 Text 6 Letter 5 Posters in waiting room 8 Receptionist to inform patients 2 Relatives to inform patients 1

3.2 How can the CGMP project team keep you informed about this project?

Patient suggestion Patient response numbers Email 11 Letter 4 Text 5 Group meetings 2 Precise information given so that appropriate 1 response/s can be made Relatives will inform me 1 Skype 1 Posters in waiting room 1 I do not wish to be involved 1

5 3.3 What are your thoughts on this project?

Patient response numbers Patient suggestion There is such a wait in the mornings waiting 10 to get through on the phone – will this change? Worth a try 5 I do not want to tell a receptionist why I 3 want an appointment What is the cost of the new system? 1 This new system may be very confusing in 2 the beginning I would like a text message to confirm the 1 appointment before I turn up for it Patients with aphasia will have difficulty 1 managing this change Will receptionists be losing their jobs? 1 Ringing the surgery between 8-9am is not a 1 convenient time to call It is not easy to come to the surgery to make 1 an appointment Appointment check in screen needs to be re- 2 positioned so that it is easy to use

Survey findings/conclusion and agreement/action plan with PPG on how to implement the survey findings

The survey findings were reviewed by GP-Call project management team and by PPG members at PPG meeting on 12th March 2014. This meeting gave the PPG members an opportunity to make comments and discuss the findings of the survey in order to identify key action priorities arising from the survey. Following the special PPG meeting a formal agreed action plan was devised. Two key areas were highlighted as requiring action following undertaking the survey (as described below).

6 Cricket Green Patient Participation Group Action Plan Action Theme Key Actions Who needs to Time frame Lead Progress be involved

Patient  Plan, co-ordinate and deliver advertising regarding introducing the new GP- PPG members/ March to September GP-Call Poster, TV, CGMP Website, information Call appointment system GP-Call project 2014 project flyers attached to repeat management team management prescriptions to be produced  Review how information is displayed or available within the practice and Continuous team and be used from April 2014 add to it, when required in order to keep patients up to date with progress/changes regarding GP-Call

 Explore idea of sending out a quarterly bulletin to patients VPPG members Every quarter promoting above (ensure it is are displayed on Patient News board and ensure copies available within practice)

 PPG members to plan information days at CGMP & distribute patient PPG/LAE/ GP-Call One day/month from PPG/ GP-Call information leaflets explaining the need to introduce GP-Call, how it will project April through to project work and how patients will access clinical care at CGMP from June 2014 management team July/August 2014 management Review monthly team  Specific answers to patients survey responses to be uploaded to CGMP GP-Call project March 2014 GP-Call Ensure information is website management team project uploaded management team Report regarding progress Practice Facilities  Consider moving check-in screen (ground floor) to a more open area CGMP March to June 2013 GP-Call due April 2014 Management team project  Consider purchasing mobile phones for clinical and reception staff, linked to management CGMP phone so that more phone lines will be available team CGMP Management team GP-Call project management team

7 Agreed action plan with PPG and CGMP management team/ GP-Call project management team

The above actions were agreed with both the PPG and CGMP Management team/ GP-Call project management team on 5th March 2014. The lead/s for the two key action areas were identified and an understanding of their role/s were facilitated through discussion and questions at this meeting. Timeframe and progress reporting were also agreed. This action plan will be used as a framework to help both PPG members and CGMP Management Team/ GP-Call project management team to prioritise and focus on introducing/maintaining the GP-Call project throughout the year.

Publicised actions and subsequent achievement from 2013 priority area

The 2013 annual survey/questionnaire gleaned information on: 1. continuing to raise awareness of obtaining PPG members for the vPPG group, 2. the need to update the practice notice board, 3. information needed to deliver a community information day, 4. the need to deliver information sessions relating to health and wellbeing.

The PPG successfully secured funding from Merton Priory Homes to resource Community Info Day and heath info sessions. The CGMP/PPG Community Information Day was held on June 22nd. Over 100 local people &patients attended. There was representation from Age UK, Diabetes UK, British Heart Foundation, LiveWell, Merton Council Healthy Walks, Chair based Zumba class and the local community police. The local MP, Siobhain McDonagh, held a surgery for the afternoon during the open day.

Following the CGMP/PPG Community Information Day the practice notice board management was taken over by the administration team from CGMP. There are now filing cabinets with colour coded folders holding specific information regarding: Wellbeing, Youth needs, NHS information, and CGMP specific information.

A spin-off from the CGMP/PPG Community Information Day was to secure funding and a project manager for the CGMP Wellbeing project. This project has managed to secure the LiveWell team offering health sessions at CGMP six days per week. The LiveWell sessions are open to patients of any local GP practices and not just CGMP practice.

Updated report covering subsequent achievement from 2013 survey priority area.

8 A year on from the 2012 survey we are very privileged to have an active PPG and a new project manager managing the WellBeing project. We are planning a joint venture with the PPG group where we will offer an open coffee morning for patients/people who live locally to the practice. We were unsuccessful in obtaining funding to provide weekly chair based zumba classes but we now have potential funding streams that we can apply for. The practice continues to be aware of the need to recruit both new PPG & vPPG members in order for the PPG as a whole to be representative of different ages/ethnicity/gender etc.

Updated report covering subsequent achievement from 2012 survey priority area As a practice we continue to promote the local out-of-hours service, community pharmacy minor ailment service and we provide a daily urgent care clinic run by all clinicians. With the extended hours direct enhanced service (DES) ceasing two years ago our practice continues to offer extended opening hours until 8pm on two nights per week plus Saturday morning opening in order to meet patient appointment demand.

CGMP 2014 opening hours The practice continues to be open six days per week as follows; Monday Tuesday Wednesday Thursday Friday Saturday 8am-8pm 8am-8pm 8am-7pm 8am-8pm 8am-7pm 9am-12mid-day Extended Extended Extended Extended Hours Hours Hours Hours Clinicians Clinicians Clinicians Clinicians Dr Chana Dr Dr Otley All Doctors Patterson available on a rota Health Care Nurse Lisa Nurse All Nurses & HCA Assistant Eve Catherine available on a (HCA) Spence rota

Appendix 1. vPPG Advertisment

WOULD YOU LIKE TO BE A PATIENT IN THE KNOW? Do you take pride in your local practice?

Would you like to give your feedback on your experience of the practice?

9 Do you believe in being kept informed?

Do you want to have your say on local health services?

Would you like to know more about the range of services and activities available in the community?

Then why not get involved with the NEW Cricket Green Virtual Participation Group (vPPG) and be kept up to date via email or your mobile and the vPPG online network.

Please ask at reception for a practice survey form . Many Thanks

Lisa Eve Michael Barron Clinical Services Director Patient Participation Group Chair

10 Appendix 2. Patient Questionnaire

CGMP Patient Participation Group Survey 2014

GP Fi GP-Call - A new appointment system The problem of meeting the demand for clinical appointments is a common problem to all GP practices in the UK, as demand has increased over the past 15 years. CGMP currently offers many more appointments than that recommended in the “GP contract”.

Despite this we are still aware that patients have problems at times getting medical advice through obtaining an appointment.

In recent years a system based on telephone consulting, as the first method of contact, has been successfully developed.

In essence when a patient phones reception requesting an appointment they are given a call back by a GP, usually within 30 minutes.

The patient and the GP discuss the medical problem and if it can be dealt with on the phone it is done there and then.

If the problem cannot be dealt with over the phone/or not urgent then an appointment with the most appropriate clinician is made, which may not necessarily be on the same day.

This new appointment system has been shown to improve continuity, access and care.

It means care is available to all, not just those who best know how to negotiate the appointment system.

It also means there are always appointments available on any given day.

The system has arrangements for those who cannot use the phone or who have communication difficulties.

Cricket Green Medical Practice is aspiring to implement this scheme in May 2014.

11 Questi As part of our investigation into this possible scheme it would be useful to know:

1. How can the CGMP project team keep you informed about this project? 2. How can we involve our practice patient population in these changes? 3. What are your thoughts on this project?