AVELEY MEDICAL CENTRE & THE BLUEBELL SURGERY Drs Leighton, Ahrin, Beroiz, Munro, Saluja, Ruiz-Gutierrez and George Aveley Medical Centre, 22 High Street, Aveley, Essex, RM15 4AD The Bluebell Surgery, Darenth Lane, South Ockendon, Essex, RM15 5LP www.aveleymedicalcentre.co.uk PATIENT PARTICIPATION DES 2013 TO 2014 This report summarises how the Aveley Medical Centre and the Bluebell Surgery ensure that patients are involved in decisions about the range and quality of services that we commission. We proactively engage patients through our patient group and have sought the views of all our practice patients through a local survey. March 2014
AVELEY MEDICAL CENTRE & THE BLUEBELL SURGERY PATIENT PARTICIPATION DES 2013 TO 2014 TABLE OF CONTENTS Report Summary... 2 Component 1: Establish a PRG... 3 component 2: Agree with the PRG which issues are a priority... 5 Component 3: Carry out the local practice survey... 8 Component 4: Reach agreement with the PRG of changes in provision and manner of delivery of services... 9 Component 5: Agree with the PRG an action plan... 10 Component 6: Publicise the Report on the practice website... 10 Confirmation of our opening times... 10 Appendix A: Survey results report... 11 Appendix B: Comments... 17 Appendix C: Improvement Plan... 18 1
REPORT SUMMARY This report details the work undertaken by the Practice to gather feedback from our patient population and to ensure that patients are involved in decisions about the range and quality of services we provide. We believe we have achieved all the components of the Patient Participation DES: Component 1: Establish a PRG comprising only of registered patients and use best endeavours to ensure PRG is representative. The Aveley Medical Centre & The Bluebell Surgery Patient Group is comprised only of registered patients. The patient group currently has 23 members and they meet at least every three months. Component 2: Agree with the PRG which issues are a priority and include these in a local practice survey. The patient group reviewed the previous action plan and discussed the key issues of importance to patients at the Patient Group meeting held on 6 th January 2014. Based on these discussions questions were developed for inclusion in our patient survey. Component 3: Carry out the local practice survey and collate and inform the PRG of the findings. We carried out the Year 3 survey between 20 th January and 2 nd February 2014. 68 patients responded to our Patient Survey. The results of our survey can be seen in Appendix A. Component 4: Provide the PRG with an opportunity to comment and discuss findings of the local practice survey. Reach agreement with the PRG of changes in provision and manner of delivery of services. Where relevant, notify NHS England of the agreed changes. The survey results were collated and a survey results report written (Appendix A). The patient group discussed the survey findings and reached agreement about any changes in provision and delivery of services on 18 th March 2014. None of the changes required NHS England notification. Component 5: Agree with the PRG an action plan setting out the priorities and proposals arising out of the local practice survey. Seek PRG agreement to implement changes and where necessary inform NHS England. The patient group agreed an action plan (Appendix C) and agreed any changes on 18 th March 2014. None of the changes required NHS England notification. Component 6: Publicise the Local Patient Participation Report on the practice website and update the report on subsequent achievement. The outcomes of the engagement and the views of patients are in this report, which was published on the Practice website before the end of March 2014: www.aveleymedicalcentre.co.uk We participated in the Patient Participation DES during 2011/12 and 2012 /13. 2
COMPONENT 1: ESTABLISH A PRG Aveley Medical Centre and the Bluebell Surgery have a long standing and extremely successful Patient Group named APPLE. We have been working closely together to improve care for patients for many years. When the practice initially began working on the Patient Participation DES we reviewed our membership and launched a recruitment campaign to recruit new members. We constantly strive to attract new members through posters, our website and practice newsletter to ensure we are broadly representing the patients. There are currently 23 members and they meet at least every three months. The information below provides demographic information of all patients registered at our Practices and members of our Patient Group. Patient and PRG group age Patient List age groups PRG member ages Age Range Total % Total % Under 16 2527 22% 17 to 30 1923 17% 31 to 44 2298 20% 45 to 60 2515 22% 0 1 2 2 4% 9% 9% 61 and above 2365 20% 18 78% Patient and PRG group gender Patient list gender PRG gender Gender Total % Total % Male Female 5826 50% 18 78% 5802 50% 5 22% 3
Patient and PRG group ethnicity Patient list ethnicity PRG ethnicity Ethnic Group Total % Total % White British 9302 80% 16 70% White Irish 82 1% Mixed White & Black 173 1% Mixed White & Black Caribbean 159 1% Mixed White & Asian 147 1% Indian 149 1% 1 4% Pakistani 28 <1% Bangladeshi 5 <1% Black African 958 8% 2 9% Black Caribbean 81 1% Chinese 56 <1% Other 488 4% 4 17% Several members of our group also fall within minority categories including those with physical disabilities and long term conditions. 4
COMPONENT 2: AGREE WITH THE PRG WHICH ISSUES ARE A PRIORITY In Year 1 [2011 to 2012] of the Patient Participation DES programme we determined the priorities for the survey by asking all the patients who attended the practices over a threeweek period, to indicate which areas they thought were most important to our patients, by completing a form at reception. The outcome of this exercise was discussed with the Patient Group and these key issues formed the basis of our survey in that year. In Year 2 [2012 to 2013] the practice again discussed the issues to be focused on in the survey with PRG members and it was agreed that there had not been a significant change in priority areas. It was therefore decided to repeat the majority of the questions from the previous survey in the hope that improvements could be demonstrated. At our Patient Group meeting on 6 th January 2014 we reviewed the previous action plan and discussed progress against the key issues (see table below). We then agreed the areas we would like the survey to focus on in this year s survey. The key issues covered in our Year 3 survey were agreed as: Access Booking appointments Access telephone service Reception service Additional clinical services Patient Information 5
In previous years: You said We did The result in Year 1 and 2 was The update in Year 3 is Our conclusion is We need to answer the During busy periods we Year 1 31% found it easy 37% found it easy to This issue remains a telephone more quickly have allocated extra to contact the practice by contact the practice by concern and we will members of staff to help telephone telephone continue to encourage with telephone calls Year 2 37% found it easy to contact the practice by telephone We have introduced online booking to offer flexibility and also to ease the patients to use online booking as an alternative to telephoning the surgery A new telephone system is being installed in April pressure on the telephone service 2013 which we hope will improve the telephone communication with the practice Our referrals are often We recruited a new No comments were No comments were This issue is resolved delayed member of staff to focus received regarding this received regarding this on referral documents issue in Year 2 issue in Year 3 You sometimes don t We produce a practice The APPLE group produce a 45% patients know about We will continue to work know what we are doing newsletter regular newsletter which is the APPLE group to raise awareness of the at Aveley & Bluebell Surgery shared within the Practice to keep patients up to date with practice news 73% patients know about our practice website APPLE group and what we do for patients 6
You said We did The result in Year 1 and 2 was The update in Year 3 is Our conclusion is You occasionally have difficulty parking at our surgery We reviewed peak periods within the surgery & discussed this issue with our Patient Group Year 1 92% found it easy to park Year 2 91% found it easy to park 83% found it easy to park This issue is not resolved but is not considered a significant concern by the patient group We are going to manage the use of the car park by closing it at certain times to prevent incorrect usage You sometimes want to be We will clarify our 10 Patients will be able to There was one comment This issue is not resolved able to discuss more than minute rule and why this is book double appointments regarding this issue this but is not considered a one issue in an in place if they feel they need year significant concern by the appointment longer with a doctor patient group You are frustrated with We have introduced repeat We are going to advertise Some comments were We are going to investigate delays in obtaining repeat dispensing in our surgeries this more widely to received regarding delays this further to ensure the prescriptions encourage patients to use in obtaining repeat process is efficient this service prescriptions 7
COMPONENT 3: CARRY OUT THE LOCAL PRACTICE SURVEY We carried out the survey using Survey Monkey on line Paper forms were available at reception for patients who preferred this method We reminded our patients to complete the survey by Advertising in the surgery using posters Providing all patients attending the surgery with a leaflet to take away and read, giving the online survey web link Texting a reminder to all patients with a mobile telephone number on their records E-mailing all patients who had provided us with an e-mail contact address Our PRG members encouraged their friends and relatives who are our patients to complete our survey Placing a reminder on the bottom of our repeat prescriptions Speaking to individual patients as they attended the surgery We carried out the Year 3 survey between 20 th January and 2 nd February 2014. 68 patients responded to our Patient Survey. The results of our survey can be found in Appendix A. 8
COMPONENT 4: REACH AGREEMENT WITH THE PRG OF CHANGES IN PROVISION AND MANNER OF DELIVERY OF SERVICES The patient group and virtual group members were asked to consider the previous improvement plans that had been developed and how patients had responded to these improvements. The results of this year s survey were reviewed and discussed by our Patient Group members at a PRG meeting held on 18 th March 2014. The findings were also shared with our virtual group members by e-mail. Members were asked to consider what actions should be included in the improvement plan in response to this year s survey results. Extract from Patient Group meeting minutes 18 th March 2014: SURVEY RESULTS Dr Munro went through the survey results. We were quite disappointed that only 68 patients completed the survey We were quite pleased that 75% of the responders were aware of our extended hours although we will advertise more on our website, newsletters. We will advertise more with booking on-line appointments, perhaps advertising on the Jayex board and in the next newsletter. It was mentioned that we have got quite a number of elderly patients who probably wouldn t use the on-line booking for appointments. Getting through on the phone had much improved since we have had the call waiting put on our telephone system. At least you know how long you have got to wait and where in the queue you are. APPLE was pleased with the greeting they receive now when entering the surgery. With regards to the waiting time for repeat prescriptions David asked was this within two working days from putting the prescription into the surgery or from when it s in the chemist. (Would need to check on this). Dr Munro was quite shocked that the patients wanted another Educational talk on Diabetes as this was what we had it on last time. Dr Arhin has agreed to give a talk on Dementia. Dr Munro also thought it would be useful if we gave a talk on Cancer Screening. Dr Munro is quite happy to talk about Cervical screening and Bowel screening. Dr Munro explained that are figures are not that good but that goes will all surgeries in the area. Hopefully it will highlight how important it is to have this test done. Dr Munro explained with the Bowel screening that if you fit into a certain age group you will be sent an invitation twice but if you fail to respond you will not be contacted again. The process is done centrally and not done 9
by the Practice. Olga mentioned that she didn t fit into the age group but she asked to be tested they sent her out a pack. Parking seems to of improved since last year s survey. It was quite devastating news that only 45% of the patients knew about the Apple Group. This obviously needs work on by the Practice and also the Apple Group. It is on the Website already but perhaps we can put this in our next newsletter and advertise more in the patient s waiting room and on the Jayex board. Overall the group thought this was a good survey and an improvement from last year. COMPONENT 5: AGREE WITH THE PRG AN ACTION PLAN It was agreed that the following issues would be addressed by the Practice in the coming year: Access Increase use of online booking Patient Information increase knowledge of extended hours Repeat prescriptions Patient Engagement Increase patient awareness of the APPLE group These issues were formulated into an improvement plan that can be found in Appendix C. COMPONENT 6: PUBLICISE THE REPORT ON THE PRACTICE WEBSITE The Patient Participation DES report has been publicised within the Practice and added to our Practice Website: www.aveleymedicalcentre.wordpress.com CONFIRMATION OF OUR OPENING TIMES As a result of the survey we have not changed our opening times. They are: You can call both surgeries between 8am and 6.30 pm The surgery receptions are open from 8 am to 6.30 pm every weekday Surgery times are 8.30 12.30 every morning at both surgeries, 2.00 6.30 every afternoon at both surgeries (Bluebell Surgery is closed from 12.30 on a Thursday) Outside of our opening hours please contact the Emergency GP Service by calling the usual Practice Telephone number and you will be automatically put through 10
Number of responders APPENDIX A: SURVEY RESULTS REPORT 68 patients responded to our Patient Survey. These are the results of our survey: Age of survey responders 40 35 30 25 20 15 10 5 0 17 to 30 31-44 45-60 61 and above Gender of survey responders Female 69% Male 31% Ethnicity of survey responders White Irish Black Caribbean Black African White British 0 10 20 30 40 50 60 70 Number of responders 11
Number of responders Number of responders Attendance at the surgery Regular - more than 5 times per year Occasional - 1-5 times per year Rare - less than once a year 0 5 10 15 20 25 30 35 Number of responders 41% of responders told us they work 75% of responders were aware of the Practice s extended hours from 6:30 8:00 pm on a Wednesday and 8:00 12:00 pm on a Saturday. Responders were aware of the different ways to book appointments 70 60 50 40 30 20 10 0 By telephone At reception Via the website How long does it take you to get an appointment? 40 35 30 25 20 15 10 5 URGENT appointment ROUTINE appointment 0 Within 2 working days 3-7 days 8-14 days More than 15 days 12
Are you happy with the time it takes to get a ROUTINE appointment? 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Extremely happy Happy Neither happy nor unhappy Unhappy Extremely unhappy Are you happy with the time it takes to get an URGENT appointment? 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Extremely happy Happy Neither happy nor unhappy Unhappy Extremely unhappy How long after your pre-booked appointment time do you normally wait to be seen? Less than 5 minutes Up to 10 minutes Up to 20 minutes Up to 30 minutes Up to 40 minutes Up to 50 minutes Up to 1 hour More than 1 hour Number of responders 0 5 10 15 20 25 13
How easy is it to get through to the surgery by telephone? Difficult 20% Easy 37% Not very easy 43% Are you happy with the greeting you receive when entering the surgery? Extremely unhappy Unhappy Neither happy nor unhappy Happy Extremely happy 0 5 10 15 20 25 30 35 40 Number of responders How long do you have to wait for a repeat prescription? 3-7 days 30% Within 2 working days 70% 83% patients said they were able to park at the surgery 14
Number of responders We asked our patients if they knew we have the following clinics: 70 60 50 No 40 30 20 Yes 10 0 Minor surgery Smoking cessation Diabetic retinal screening We occasionally hold educational talks and asked which issues patients would be most interested in: Asthma Number of responders 0 2 4 6 8 10 12 Alcohol abuse Anxiety Osteoperosis Weight control Smoking cessation Heart Disease COPD End of life Dementia Diabetes Do you know about our website: www.aveleymedicalcentre.co.uk? 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Yes but I have not visited the website Yes and I have visited the website No 15
Our Patient Participation Group is called The APPLE Group. The patient group is an effective way for patients and GP surgeries to work together to improve services and promote health and quality of care. 45% patients knew about The APPLE Group. How likely are you to recommend this GP Practice to someone else? Too few responders completed the Friends & Family Test to make it statistially relevant. 1 Extremely unlikely Unlikely Neither likely nor unlikely Likely Extremely likely 0 5 10 15 20 25 Number of responders 1 66 respondents completed the Friends & Family Test (FFT). For more details about the FFT go to http://www.england.nhs.uk/ourwork/pe/fft/ 16
APPENDIX B: COMMENTS Some general comments were made regarding wide ranging aspects of the Practice, along with suggestions of how the services can be further improved. Some of these are noted below to give a flavour of the patient perception of the Aveley Medical Centre & Bluebell Surgery: Doctors, nurses and reception staff all very helpful Everyone I know who uses another practice can't believe the trouble we have getting appointments It has taken quite a few years for this practice to perform as well as it does now We need more receptionists at front desk to deal with regular queues This is the only practice in the local vicinity to offer so much Sort out the pharmacy - it is truly terrible Very helpful staff It is a very busy practice - how many more patients can join? Good service Trying to get through by phone is a nightmare and when you do get through there are no appointments left People coming from too far outside Aveley are causing overcrowding There are increasing problems with repeat prescriptions at the pharmacy Thank you for the good service 17
APPENDIX C: IMPROVEMENT PLAN ISSUE TO BE ADDRESSED IMPROVEMENT GOAL KEY ACTIONS REQUIRED BY WHOM? BY WHEN? Which specific area are you going to focus on? What do you want to achieve? What needs to be done to achieve the goal? There may be more than one action Who is responsible for ensuring it happens? When do you think this will be completed? Extended Hours Improve patient awareness of these appointment sessions Advertise extended hours on the website and in the next practice newsletter Practice Manager May 2014 Online appointment booking Increase use of online facility Advertise online booking on the website, in the newsletter and in the waiting area Practice Manager May 2014 Encourage patients to sign up to use online booking Reception Team With immediate effect and ongoing Repeat prescriptions Ensure the process is efficient Investigate the repeat prescription process to identify any delays Practice Manager May 2014 Patient Information and awareness Improve patient knowledge of support and services available to them Educational talks to be arranged on Dementia and Cancer Screening Dr Munro / Dr Ahrin September 2014 Increase patient knowledge of the role and purpose of the APPLE group Advertising campaign using website / newsletter / Jayex board / posters APPLE group members June 2014 18