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Foden Street Surgery

Patient Participation Group Report 2013/14

Foden Street Surgery participates in a Direct Enhanced Service for Patient Participation; in essence the surgery is committed to listening to patients to continually improve and monitor our services.

The surgery currently has a small group of patient representatives who meet to discuss the current service provisions and propose changes, improvements and provide constant and updated feedback from the patient population. The group was initially set up in January 2013 by the then Practice Manager, Jenny Woodfint. The group has continued to meet however, during a period of 4 months; no meetings took place due to the position of the Practice Manager being vacant. Therefore, it was not until December 2013 that the meetings resumed.

Continuing Group Development

The result of the “gapping” of the Practice Managers post has, unfortunately, resulted in group numbers dropping however, those who remain are a vocal part of our community and, as such, the group continues to strive for excellence. To address this we are actively seeking new members for the group across the range of patient demographics. In particular, we aim to target patients under 50 years of age and those from differing ethnic backgrounds to accurately reflect our patient makeup as well as the appointment of a dedicated PPG “Champion” from within the Practice Staff. The individual names of group members have not been published due to confidentiality reasons.

Meetings

The first meeting of Financial Year 2013/14 was held on 20 May 2103, chaired by the Practice Manager. A talk was given by a member of North Staffs Carers at which she outlined the role of the carers, accessibility and location. The purchase of new equipment including a 24 hour blood pressure monitor and a dermatoscope was also discussed. The group agreed that these were useful pieces of equipment and would benefit patients and the surgery alike. A copy of the minutes can be found at Appendix A.

The second meeting of the year was held on 24 July 2013 chaired by the Practice Manager. The results of the recent Patient Access Survey were discussed in depth with all in agreement the results were positive. Further discussions took place regarding the Practice/Patient Charter and any other business raised. Copies of the minutes can be found at Appendix B.

The third meeting of the year was not held until December 2013 due to the gapping of the Practice Manager’s post and the arrival of the new Manager. The Practice Manager outlined the Practice upgrades with regard to the new Clinical System (EMIS WEB) and the effect this would have on patient care. It was also decided it would be beneficial to conduct a further survey based on sample questions and the survey ran last year to ascertain what improvements had been made and, indeed, areas which would benefit from further improvement. It was agreed this was a good way forward as it would give the new manager a proper sounding on future developments. Group members were asked to speak freely with regard any issues they may have and, again, minutes of the meeting can be found at Appendix C.

The final meeting of the year was held on 12 March 2014 with the primary reason to discuss the outcome of the recent PPG Practice Survey. The minutes of this meeting can be found at Appendix

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D. The next meeting is scheduled for 1 May 2014 when current members, and those members showing an interest in the group will be invited to attend.

Feedback and Action Plan Review – 2012/13

The group discussed the results of last year’s survey and, in particular, the areas highlighted as needing improvement. As with this year’s survey, the appointment system came under much scrutiny and was highlighted as the main area which required improvement. Points raised last year which have been addressed are as follows:

Action Update/ResponsePractice to review appointment system in terms of amount of pre-bookable appointments and on the day appointments

After a further review, it was decided the current mix of available appointments was sufficient to meet patient needs. However, reception staff have been informed to be more “vigorous” when booking on the day appointments – i.e. is it really needed as an emergency?

Reception team to be trained in how to deal with conflict from patients

All staff have attended Conflict Resolution Training within the past 12 months

Reception team to be trained in the appointment system once any changes are agreed

Reception Staff are now familiar with the appointment system – in particular appointments relating to the medical students.

Practice to consider late night opening The Partners considered this but felt the need for this was minimal when placed against hours worked for clinicians and staff.

Practice to review appointment system when students are present and allow longer for each appointment

Completed. Appointments for the medical student entail a much longer consultation period with subsequent appointment slots “blocked” to allow over running.

Signs placed in appropriate positions for patient toilets

Completed

Antibacterial hand cleanser to be placed in reception area for patient use

Completed

The Way Forward and 2014

It was accepted that 2013 has been a challenging year for the Practice, not least the continued changes in Practice Management, and this has resulted in a somewhat “chaotic” 12 months for the surgery and staff. As detailed below (Patient Survey 2013/14) the results and feedback obtained from patients will be built upon to continuously improve the service we provide. The impact and the input of the Patient Participation Group will be paramount in achieving the goals laid down by the Practice to continue to meet clinical and administrative excellence.

With this in mind, and again as previously stated, the Practice will actively promote the Patient Participation Group with a view to seeking new members to add to the current participants. As a result a Practice “Champion” will be appointed to liaise directly with PPG members on matters and concerns raised and act as a deputy chair in the absence of the Practice Manager. The appointment of the Practice “Champion” will be discussed with the PPG to canvas their views on the suggestion and, indeed, any preference they may have.

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Patient Survey 2013/14

Introduction

Patient participation is a unique partnership between patients, GPs and their practice which is essential to and results in high quality and responsive care. Patient Participation Groups (PPGs) work in partnership with their practices to:

● help patients to take more responsibility for their health.● contribute to the continuous improvement of services and quality of care● foster improved communication between the practice and its patient● provide practical support for the practice and help to implement change

In order to engage with and obtain opinions of a wider group of patients the 2013/14 Patient survey was devised in discussion with the patient participation group.

Aims

The aim of the survey is to gain an insight into the views of patients in relation to areas identified by the Patient Participation Group and, if necessary, develop an action plan based on the results received.

Method

During the December 2013 meeting, the forthcoming Patient survey was discussed and, as a result, the Practice Manager handed out sample questionnaires devised by NHS England, the Care Quality Commission and local Practices. It was requested group members spend the time over the Christmas period looking through the questionnaires and making notes on questions they deemed relevant and return to the Practice Manager with additional input. As a result of this time spent by the group, it was agreed a core number of questions based on last year’s survey should be used, with the addition of a number of new questions, to help accurately identify areas of improvement and areas requiring improvement. With this information, a sample questionnaire was agreed upon and 14 core questions relating to various areas agreed upon with the addition of 2 further questions pertaining to patient attitude to the use of other agencies if GP appointments were not available, in particular A&E, Local Pharmacy and Walk in Centres. It was agreed that feedback relating to this area would highlight the success (or otherwise) of the NHS campaigns regarding the use of, in particular A&E, for minor complaints and ailments.

A total of 250 Questionnaires were made available to patients and these were handed to patients by the reception staff throughout the morning and afternoon clinical surgeries.

Out of the 250 available, 92 were completed and returned – a return rate of 37%

The survey responses were inputted into a data tool devised by the Practice Manager and a detailed analysis of the result was undertaken by the Practice Manager.

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Survey Results

Poor Average Good Very Good

Not Applicable

The Telephone System 1% 16% 37% 32% 1%The helpfulness of the Reception Staff

2% 7% 26% 63%

The appointment system 10% 20% 38% 26%The time you had to wait from booking your appointment to it taking place

2% 24% 38% 32% 1%

Availability of appointments 12% 32% 38% 14% 1%Convenience of the day and time of your appointment

2% 26% 42% 29% 1%

The time you had to wait in the surgery

16% 42% 36% 1%

Parking Facilities 1% 38% 40% 14%The amount of time the Doctor/Nurse gave you

7% 41% 51%

The Doctor/Nurse explanation of issues raised

5% 42% 50% 2%

The Doctor/Nurse allowing you to express your concerns or worries

5% 36% 57% 3%

The Doctor/Nurse answering your concerns or worries

5% 35% 54% 3%

The Doctor/Nurse discussing care plans or lifestyle services

8% 30% 42% 18%

The Doctor/Nurse discussing alternatives to GP appointments

1% 14% 23% 34% 24%

Yes No Not SureIf an appointment was not available would you consider using other means of treatment

62% 14% 24%

A&E Local Pharmacy

Walk-In Centre

If YES what would you consider using?

9% 34% 57%

Overall Satisfaction of GP Surgery and Services based on returns and replies received

89%

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Poor Average Good Very Good Not Applicable0

5

10

15

20

25

30

35

40

The Telephone System

The Telephone System


10

20

30

40

50

60

70

The helpfulness of the Reception Staff

The helpfulness of the Reception Staff

5


5

10

15

20

25

30

35

40

The appointment system

The appointment system


5

10

15

20

25

30

35

40

The time you had to wait from booking your appointment to it taking place

The time you had to wait from booking your appointment to it taking place

6


5

10

15

20

25

30

35

40

Availability of appointments

Availability of appointments


5

10

15

20

25

30

35

40

45

Convenience of the day and time of your appointment

Convenience of the day and time of your appointment

7


5

10

15

20

25

30

35

40

45




5

10

15

20

25

30

35

40

Parking Facilities

Parking Facilities

8


5

10

15

20

25

30

35

40

45

50

The amount of time the Doctor/Nurse gave you

The amount of time the Doctor/Nurse gave you


5

10

15

20

25

30

35

40

45

50

The Doctor/Nurse explanation of issues rasied

The Doctor/Nurse explanation of issues rasied

9


10

20

30

40

50

60




10

20

30

40

50

60



10


5

10

15

20

25

30

35

40

45

The Doctor Nurse discussing care plans or lifestyle services

The Doctor Nurse discussing care plans or lifestyle services


5

10

15

20

25

30

35

The Doctor/Nurse discussing alternatives to GP appointments

The Doctor/Nurse discussing al-ternatives to GP appointments

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Yes No Not Sure0

10

20

30

40

50

60

If an appointment was not available would you consider using other means of treatment

If an appointment was not available would you consider using other means of treatment

A&E Local Pharmacy Walk-In Centre0

10

20

30

40

50

60



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Comments and Suggestions

A section was included in the questionnaire to allow respondents to make comments or suggestions. The comments/suggestions received are as follows:

I have always received excellent serviceHaving to phone “on the day” is difficult as it usually means not going into work and then not being guaranteed an appointment on the day – resulting in more time off work. More pre-bookable appointments would be of great help.Improved communication between Hospital Consultants and GP Clinics.The overall experience of the surgery is very good.Very helpful reception staffNurses are always very professional, helpful and pleasant.Friendly and helpful staff.Very helpful staff and Doctors.Should be able to make an appointment for the same or next day without having to phone at 8am when you are working.The ability to book an appointment is poor if need one in advance.Staff and Doctors are very polite and listen to what you ask.Considering the pressure Doctors, Nurses and staff are under – the service is very good.Excellent surgery – friendly and helpful staffAll staff very friendly and helpful.Easy to make an appointment for my children however, near on impossible for me – very frustrating at times.

Conclusion

Overall the level of satisfaction with the surgery was high. The percentage of patients who would consider using A&E as an alternative if no GP appointment was available was surprisingly low given the figures produced by UHNS on the matter. However, it was recognised by the Patient Participation Group that there was room for improvements in various areas – not least in the booking and availability of appointments. As a result, and after discussions, an action plan was devised to focus on the main area of concern raised from the survey and during discussions with the PPG.

The Appointment System

Current areas of concern

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Action Plan – 2014/2015

Action Person(s) Responsible Date to be Completed

Appointments:Practice to review the possibility of one day a week late night opening (1800 – 1900hrs)

GP’sPractice Manager

30 Apr 14

Appointments:Practice to review the availability of future appointments – in particular after patients have seen the GP and been informed to “book a further appointment in ***** time)


31 Mar 14

Appointments:Practice to introduce a system of “texting” patients the day before their appointment to help cut down on DNA’s and, if the appointment is no longer needed, allowing patients the time to cancel.

GP’sPractice Manager(PM to confirm as it is believed this is available via EMIS WEB)

31 Mar 14

Appointments:Availability of electronic booking in system


31 May 14

Miscellaneous:The appointment of a PPG “Champion” within the Practice Staff

Practice ManagerPPG Members

30 Mar 14

Staff:Practice to review the wearing of name badges by staff members


30 Apr 14

Building:Practice to review DDA compliance with regard to access to the surgery – electronic doors required (?) as per DDA regulations

GP’sPractice Manager(note – funding of this may be an issue)

31 May 2014

Building:Practice to review the lighting of car park – especially during the winter months


30 Jun 14

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Appendix A

Foden Street Surgery Patient Participation GroupMeeting

Wednesday 20 May 2013Minutes

Present:Margaret Birks (5618)Carole Domanski (1519)Roy Domanski (1521)Arthur Dykes (1601)Jenny Woodfint (Practice Manager - JW)Lisa Burrows (North Staffs Carers Association)

Apologies:C Georgio (1962)J Hawkes (5843)M Lake (2934)C Robinson (1565)D Robinson (4098)D Shardlow (4261)A Twigg (4804)P Whieldon (10005)

2 members of the PPG are virtual members J Williams via telephone and S Hayes (2299) via email [email protected]

1) Minutes of the last meeting: These were approved as accurate

2) North Staffs Carersi. Lisa explained that there are 3 link coordinators across Stoke and

North Staffordshire with one of the team focussing on secondary careii. The team are based at Duke Street in Fenton

iii. They offer 1-1 and group sessions and people can drop in if they wish. They also provide therapies and training. They can arrange for carers assessments which is a full review of the services required by the carer and the cared for

3) Purchase of new equipment: Practice Manager informed the group that the practice had recently purchased new equipment to aid in accurate and timely diagnosis of patients with hypertension through the purchase of a 24 hour blood pressure monitor and the diagnosis of skin conditions through the purchase of a dermatoscope. The group agreed that these were useful pieces of equipment to have in the practice.

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4) Practice information leaflet – JW explained that the surgery had produced a leaflet to cover all the essential information required and that this was a temporary measure until the standard documents to be used by all practices in Stoke on Trent were developed. All raised concerns about the size of the font and JW explained that a large print document could be made available if requested. Carole asked about the leaflet being printed on alternative coloured paper which JW confirmed would be available if requested

5) Practice/Patient charter – It was agreed to discuss this in the next meeting due to time constraints

Next meeting: Wednesday 24th July 3pm – 4pm – Foden Street Surgery

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Appendix B

Foden Street Surgery Patient Participation Group Meeting

Wednesday 24 July 2013Minutes

Present:Margaret Birks (5618)Carole Domanski (1519)Roy Domanski (1521)Arthur Dykes (1601)J Hawkes (5843)C Robinson (1565)Jenny Woodfint (Practice Manager - JW)

Apologies:C Georgio (1962)M Lake (2934)C Robinson (1565)D Robinson (4098)D Shardlow (4261)A Twigg (4804)P Whieldon (10005)

2 members of the PPG are virtual members J Williams via telephone and S Hayes (2299) via email [email protected]

1) Minutes of the last meeting – these were approved as accurate

2) Practice Manager Leaving – JW explained to the group that she would be leaving but that someone else would be taking over the post and would take on the PPG

3) Access survey results – JW showed the group the results from the patient survey questionnaire. The results of the survey were positive however there was disagreement from the PPG that only 1 person was unable to get through on the telephone as all had experienced difficulties between 8am and 5 past 8 with appointments being gone by 5 past 8. There was a suggestion that some appointments could open later in the day so that people especially older patients not able to get up and call for 8am would be able to get an appointment. One member of the group raised that it would be useful to be able to book appointments on line. JW explained that this was not currently possible with the clinical system but that

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the surgery was looking to have a new system installed later in the year and this would be possible then.

4) Practice/Patient Charter – A copy of the patient/practice charter for Goldenhill medical practice was shown to the group. This was approved for use and should be adapted for Foden Street Surgery

5) AOB – a. One member of the group raised that they had heard staff telling patients not

to come as they would be too late for their appointment. JW explained that the practice policy is that if a patient is 5 minutes late then they would be seen at the end of surgery. JW to remind staff that this is the case

b. One member of the group raised that when requesting prescriptions online they had been prevented from ordering as it was too early. JW to contact website developers about this

c. One member of the group asked whether prescriptions can be amended so that they receive the same amount of each medication. JW explained that some medications are restricted in how they can be prescribed but that patients can ask if they feel their medications are out of sync and the practice will reconcile this for them

d. One member of the group asked if it would be possible to have a security light on the car park as you are unable to see at night

e. One member of the group asked about the possibility of having the touch screen back as the current system of using tokens is unhygienic. A patient had been in the waiting room coughing over their hands and handling the token. JW assured the group that the tokens were wiped over with antibacterial wipes after each surgery.

6) Date and time of next meeting – JW explained that the next meeting would be arranged by the new PM and someone would be in contact with them to agree a date and time

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Appendix C

FODEN STREET SURGERY – PATIENT PARTICIPATION GROUP MEETINGThursday 19 December 2013

Present:Margaret Birks (5618)June Hawkes (5843)Shawne Shanahan (4260)Ian T Hodkinson (Practice Manager)

The Practice Manager opened the meeting by welcoming those in attendance. Although attendance was poor, it was decided to go ahead with the meeting due to the length of time which had passed since the last meeting of July 2013. The members present took the time to introduce themselves and welcome new member Shawne, into the group.

1. Practice Brief:

The Practice Manager briefed those present on the current structure of the Surgery and forthcoming changes. It was explained to members the surgery is due to receive an update to the EMIS clinical system mid-February with EMIS WEB being the preferred option. It was stressed the change over from one system to another should have no detrimental effect on patient care however, as with on new systems a period of education for staff would be required and therefore the members were asked to “spread the word” to other patients of the need to be patient with staff as they learn EMIS WEB.

2. Patient Questionnaire:

The Practice Manager expressed the desire to complete a further Patient Questionnaire to ensure the voices of all patients are heard. It was stressed that time is of the essence to agree a format and, as a result, members present where given a selection of questionnaires currently available and asked to highlight the areas they feel are pertinent to the local community at large. It was further agreed a maximum of 18-20 questions would be posed and this would target two age groups – under 40 years of age and over 40 years of age. It was hoped this approach would be beneficial to the makeup of the patient population and help highlight specific areas which affect differing age groups. Members were asked to return their question selection by the first week of January to ensure the necessary pre work can be done prior to distribution to patients.

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Foden Street Surgery3. Staffing Issues:

The members present raised the issue of staffing levels within the surgery and expressed concerns staff on reception were being pushed to their limits regarding workload. This concern led to the question as to why the self-registration facility was not in use as it would ensure reception staff has the flexibility and time to deal with the more pressing issues rather than spend time “arriving” patients for appointments. The Practice Manager agreed to raise this with the GP Partners at the next management meeting.

4. Patient Population/Available Facilities:

The group members questioned the patient population and ceilings on the number of patients the surgery can have safely registered on a per GP ratio. Members expressed their concern due to the current new build of housing within the Practice catchment area which, inevitably, will lead to a higher patient population. This led to a further question of whether or not the Practice has the available facilities and capacities to except a higher number of patients without having a detrimental effect on patient care. The Practice Manager agreed to look into the matter and discuss concerns with the GP Partners at the next management meeting.

5. Visual Information:

The Practice Manager agreed to look into the use of the Television in reception to promote current NHS and Local initiatives – such as the Waste Medicine Campaign and the Seasonal Influenza Vaccinations.

6. AOB:

As there was no further business, the Practice Manager closed the meeting at 3.15pm.

7. Date and Time of next Meeting:

No date or time for the next meeting was set however, the Practice Manager will arrange with members once the Patient Questionnaire is finalised.

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Appendix D

FODEN STREET SURGERY – PATIENT PARTICIPATION GROUP MEETING

Thursday 19 December 2013

Present:Margaret Birks (5618)June Hawkes (5843)Ian T Hodkinson (Practice Manager)

Apologies:Shawne Shanahan (input via letter)

The Practice Manager opened the meeting by welcoming those in attendance. Although attendance was poor, it was necessary to discuss the outcome of the recent Practice Survey to enable publication as per current CCG requirements.

1. Patient Questionnaire:

The Practice Questionnaire had been completed during the month of February 2014 and the results (see attached) were discussed between members present. It was agreed that the return was low in relation to available questionnaires (92 returned out of 250 available – 37%) however it was accepted we cannot force people to complete or indeed, complete correctly and fully. As a result the Practice Manager informed those present only those questionnaires returned fully completed had been used. The overall satisfaction with the surgery had seen a slight rise over survey’s undertaken in previous years and to this the group were pleased as it reflected the surgery was constantly showing improvements in a wide range of issues which patient feel strongly about. However, as with past survey’s, the main area of concern for all has been, and continues to be, the appointment system. Therefore, it was agreed the main focus of the forthcoming year was to concentrate on ways to improve and enhance the system.

2. PPG “Champion”

The Practice Manager raised the issue of the appointment of a Practice PPG “Champion” to liaise direct with PPG members and act as a deputy “chair” in his absence. This suggestion was welcomed by the group members present and it was agreed, as the group would have direct access to the Practice representative, they would have an input into who this may be. Suggestions are welcome by no later than 30 March 2014.

3. Practice Action Plan – 2014/2015

The Practice action plan is detailed below:

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Action Person(s) Responsible Date to be Completed

Appointments:

Practice to review the possibility of one day a week late night opening (1800 – 1900hrs)

GP’s

Practice Manager

30 Apr 14

Appointments:

Practice to review the availability of future appointments – in particular after patients have seen the GP and been informed to “book a further appointment ***** time)

GP’s

Practice Manager

31 Mar 14

Appointments:

Practice to introduce a system of “texting” patients the day before their appointment to help cut down on DNA’s and, if the appointment is no longer needed, allowing patients the time to cancel.

GP’s

Practice Manager

(PM to confirm availability of this via EMIS WEB)

31 Mar 14

Appointments:

Availability of electronic booking in system

GP’s

Practice Manager

31 May 14

Miscellaneous:

The appointment of a PPG “Champion” within the Practice Staff

Practice Manager

PPG Members

30 Mar 14

Staff:

Practice to review the wearing of name badges

GP’s

Practice Manager

30 Apr 14

Building:

Practice to review DDA compliance with regard to access to the surgery – electronic doors required (?) as per DDA regulations

GP’s

Practice Manager

31 May 2014

Building: GP’s 30 Jun 14

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Practice to review the lighting of car park – especially during the winter months

Practice Manager

4. AOB:

A number of other issues were raised in relation to Staff and Building requirements and these are covered in the Action Plan at para 3.The Practice Manager informed members present of the need to build up membership of the group and, as such, a “recruitment” drive will be taking place over the next few weeks. However, current members listed who have not attended a recent meeting will be invited to the next one as detailed below.

5. Date and Time of next Meeting:

Whilst no firm date has been set for the next meeting, a provisional date of Thursday 1 May 2014. Current group members will be invited along with any other patients who have shown an interest in becoming part of the group.

There being no further business, the meeting was closed at 1445hrs.

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