Orsett Surgery, 63 Rowley Road, Orsett, Essex RM16 3ET Report prepared by CHATTAN Support Ltd www.chattansupport.com 1
ORSETT SURGERY PATIENT PARTICIPATION DES 2013 TO 2014
This report summarises how the Orsett Surgery ensures 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
Drs D’Mello, Dr Mitchell & Dr Kallil
The Surgery, 63 Rowley Road, Orsett, Essex, RM16 3ET Branch Surgery: 1 King Edward Drive, Grays, Essex, RM16 2GG
www.orsettsurgery.wordpress.com
Orsett Surgery, 63 Rowley Road, Orsett, Essex RM16 3ET Report prepared by CHATTAN Support Ltd www.chattansupport.com 2
ORSETT SURGERY PATIENT PARTICIPATION DES 2013 TO 2014
TABLE OF CONTENTS Report Summary .................................................................................................................. 3
Component 1: Establish a PRG .......................................................................................... 4
Component 2: Agree with the PRG which issues are a priority ...................................... 6
Component 3: Carry out the local practice survey ........................................................... 7
Component 4: Reach agreement with the PRG of changes in provision and manner of delivery of services .............................................................................................................. 8
Component 5: Agree with the PRG an action plan ......................................................... 12
Component 6: Publicise the Report on the practice website ........................................ 13
Confirmation of our opening times .................................................................................. 13
Appendix A: Survey results report ................................................................................... 14
Appendix B: Comments .................................................................................................... 17
Appendix C: Improvement Plan ........................................................................................ 18
Orsett Surgery, 63 Rowley Road, Orsett, Essex RM16 3ET Report prepared by CHATTAN Support Ltd www.chattansupport.com 3
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 Orsett Surgery Patient Group is comprised only of registered patients. It has been running for four years and meets at least every three months. We have also collected a large number of e-mail addresses of patients who wish to be kept informed of the group’s progress. These patients comprise our virtual group and are able to add their views by email.
Component 2: Agree with the PRG which issues are a priority and include these in a local practice survey. The patient group discussed the key issues of importance to patients at the Patient Group meeting held on 24th October 2013. Based on these issues 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 patient survey between 11th November and 1st December 2013 and received a total of 122 responses. The results of our survey can be found 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 6th February 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 6th February 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 by the end of March 2014: www.orsettsurgery.wordpress.com.
We participated in the Patient Participation DES during 2011/12 and 2012 /13.
Orsett Surgery, 63 Rowley Road, Orsett, Essex RM16 3ET Report prepared by CHATTAN Support Ltd www.chattansupport.com 4
COMPONENT 1: ESTABLISH A PRG The Orsett Surgery Patient Group is comprised only of registered patients. It has been running for four years. There are 9 members and they meet at least every 3 months. The Practice has worked hard to develop a Patient Group and have had a core group of members for a significant time.
At a previous group meeting the lack of younger members was acknowledged and an advertising campaign was launched to address this. The reception team were asked to encourage patients to register their e-mail addresses to join the virtual patient group.
Extract of minutes, PRG meeting 30th October 2012 “Virtual Group: Joyce showed a recommended advertising sheet for patients to sign up and said she has been advised other practices had had success by placing this on the main reception desk. DS suggested asking patients using the electronic prescription request service if they would like to join the virtual group. Action: It was agreed Joyce would advertise the virtual group to establish a list of patients willing to join.”
This has been an extremely successful campaign and at the last count there were approximately 100 virtual group members who are informed and have the opportunity to participate in key practice issues by e-mail. The gathering of e-mail addresses continues at the practice to ensure all patients have the option to join the virtual group.”
The demographics of the patient list and patient group members as of April 2013 are outlined below:
Patient and PRG group gender
Patient list gender PRG gender
Gender Total % Total %
Male 3536 49% 2 22%
Female 3675 51% 7 78%
Orsett Surgery, 63 Rowley Road, Orsett, Essex RM16 3ET Report prepared by CHATTAN Support Ltd www.chattansupport.com 5
Patient and PRG group age
Patient List age PRG age
Age Range Total % Total %
0 - 15 1401 20%
16 - 35 1421 20%
36 - 45 999 14% 1 11%
46 - 55 1022 14% 2 22%
56 – 65 1049 15% 2 22%
66 – 75 724 10% 3 33%
75 + 595 8% 1 11%
TOTAL 7211 100% 9 100%
Patient and PRG group ethnicity
Patient list ethnicity PRG ethnicity
Ethnic Group Total recorded in Patient records
% Total %
White British 1807 94% 8 89%
Other Black 20 1%
Black African 35 2%
Asian 11 0.6%
Other ethnic group 56 3% 1 11%
TOTAL 1929 100 9 100
Several members of our group also fall within minority categories including those with physical disabilities and long-term conditions.
Orsett Surgery, 63 Rowley Road, Orsett, Essex RM16 3ET Report prepared by CHATTAN Support Ltd www.chattansupport.com 6
COMPONENT 2: AGREE WITH THE PRG WHICH ISSUES ARE A PRIORITY The patient survey was discussed at the patient group meeting on 24th October 2013 to determine and reach agreement with the patient group on the priority issues to be included in the practice survey. They reviewed the results and action plan from the last patient survey, agreed to look at general patient experience and to specifically focus on:
• Patient Information • Dispensary service • Patient Environment • Confidentiality
Survey questions were developed to obtain feedback regarding these areas. Previous questions were also included in the survey to allow progress on these issues to be monitored.
Orsett Surgery, 63 Rowley Road, Orsett, Essex RM16 3ET Report prepared by CHATTAN Support Ltd www.chattansupport.com 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 • Our staff encouraged patients to complete the survey • Providing all patients attending the surgery with a leaflet to take away and read • Texting a link to the survey to all our patients with a mobile telephone number on
their records • E-mailing all patients who had provided us with an e-mail contact address (our virtual
group members) • 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
We carried out the Year 3 survey between 11th November and 1st December 2013 and received a total of 122 responses. The results of our survey can be found in Appendix A.
Orsett Surgery, 63 Rowley Road, Orsett, Essex RM16 3ET Report prepared by CHATTAN Support Ltd www.chattansupport.com 8
COMPONENT 4: REACH AGREEMENT WITH THE PRG OF CHANGES IN PROVISION AND MANNER OF DELIVERY OF SERVICES The results of this year’s survey were reviewed and discussed by our Patient Group members at a PRG meeting held on 6th February 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 6th February 2014
2. Review of patient survey report and agree actions. The survey highlighted some clear areas for discussion, as follows:
a) 87% of patients would like a text message reminder for their appointment. The group felt that only 1% of appointments were not attended each week, on this basis, it was felt to be questionable whether this would be a good use of resources. No action required.
b) Information in waiting area regarding Drs clinic running times. It was felt that LED screens are not easy to read and are too clinical for this practice. ACTION: It was suggested to move the existing magnetic board to the left hand side of the reception desk and provide bigger text.
c) Confidentiality at Dispensary window. DS said it appeared that there were few occasions where the window became crowded. JDM said there may be future changes to the building which included relocating the Dispensary. ACTION: Joyce was asked to price up a Perspex booth to go around the window and identify any problems. Revisit at next meeting.
d) 84% of patient wanted drinking water in the waiting area. ACTION: Water Dispenser to be purchased
e) Collection of a single monthly prescription. 99% of patients would like this service. The practicalities were discussed; JDM said that this would not be practical for the practice to implement.
f) The group commented furthermore on b) above and suggested a sign would be useful in the waiting area to help patients understand why surgeries sometimes run late. ACTION: Agreed to erect a sign reading “Due to the nature of consultations, surgeries may overrun. We appreciate your patience”.
Orsett Surgery, 63 Rowley Road, Orsett, Essex RM16 3ET Report prepared by CHATTAN Support Ltd www.chattansupport.com 9
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. In previous surveys:
You said We did The result in previous years was …
The year 3 update is... Our conclusion is...
DISPENSARY: Our repeat prescription process is not convenient
We have set up a dedicated e-‐mail address for patients to e-‐mail us regarding their repeat prescription
This service has proven to be popular and usage is growing daily
Minimal comments were received regarding this issue. Patients were keen to move to a single monthly prescription
Electronic prescription requests have proved popular
We will continue to monitor this issue
INFORMATION: You don’t always understand what is going to happen when we request a blood test
We have discussed this in our Practice Team meeting and our Doctors have agreed to explain the procedure more fully and to give an estimation of timings for results to be available
Our Doctors have been providing increased information and we will monitor this with our Patient Reference Group
No comments were received in the Year 2 Patient Participation survey
No comments were received regarding this issue
This issue is resolved
COMMUNICATION: Our doctors sometimes run late
We have discussed this in our team meeting and will communicate delays with patients
In Year 2 88% patients agreed that patients should have enough time with the doctor and they accept this sometimes causes delays
We have improved our signage within the waiting area to better share any information regarding delays
We will re-‐site our information board and use a larger size text to improve communication further
Orsett Surgery, 63 Rowley Road, Orsett, Essex RM16 3ET Report prepared by CHATTAN Support Ltd www.chattansupport.com 10
You said We did The result in previous years was …
The year 3 update is... Our conclusion is...
ACCESS: You sometimes find it difficult to park at The Orsett Surgery
Car park sign has been installed clearly stating parking for visitors to premises only
The PRG members felt it was aesthetically pleasing
Letters are being put on windscreens regarding inappropriate parking
Practice Manager has spoken to the Council to request additional patrols
Visitors to the hospital are still using the car park. Letters have been put on windscreens but patients discard them and it has no effect
Patients are still parking on the yellow lines, which is not because of the car park being full
There has been one accident and one near miss in recent months
It was felt that little more could be done without a large cost implication
Fewer comments were received regarding this issue
The practice will continue to monitor this issue, however, it appears less of a concern to patients than previously
COMMUNICATION: You cannot always hear our doctors when they call you into appointments
We discussed this in our team meeting
Our Doctors now come right out into the waiting room to greet their next patient
No comments were received regarding this issue
This issue is resolved
Orsett Surgery, 63 Rowley Road, Orsett, Essex RM16 3ET Report prepared by CHATTAN Support Ltd www.chattansupport.com 11
You said We did The result in previous years was …
The year 3 update is... Our conclusion is...
ACCESS: You sometimes find it difficult to get an appointment
We have discussed this with our PRG
We are going to manage DNAs better to reduce wasted appointments
A recent review showed that the DNA rate has dropped to approximately 1%
This issue is ongoing but has improved
Orsett Surgery, 63 Rowley Road, Orsett, Essex RM16 3ET Report prepared by CHATTAN Support Ltd www.chattansupport.com 12
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:
• Communication – re-location of information board and increased size of text to improve information sharing
• Confidentiality – consideration of purchase of Perspex booth at reception desk • Patient Environment – installation of water dispenser for waiting area • Information regarding delayed appointments – new signage to inform of possible
overrunning appointments
These issues were formulated into an improvement plan that can be found in Appendix C.
Orsett Surgery, 63 Rowley Road, Orsett, Essex RM16 3ET Report prepared by CHATTAN Support Ltd www.chattansupport.com 13
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: http://orsettsurgery.wordpress.com.
CONFIRMATION OF OUR OPENING TIMES As a result of this survey we have not changed our opening times, they are:
• You can call or visit the Orsett Surgery between 8.30 am and 6.45 pm weekdays
• Surgery times are 8.30 – 11.30 each weekday morning, and 4.00 – 6.30 pm each
afternoon at the Orsett Surgery
• You can call or visit the King Edward Drive Branch Surgery between 9.00 am and 1.00
pm each weekday
• Surgery times are 9.00 – 10.30 each weekday morning at the King Edward Drive Branch
Surgery
• 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
Orsett Surgery, 63 Rowley Road, Orsett, Essex RM16 3ET Report prepared by CHATTAN Support Ltd www.chattansupport.com 14
APPENDIX A: SURVEY RESULTS REPORT 122 patients responded to our Patient Survey, the results of which are below
Age of survey responders
Gender of survey responders
Ethnicity of survey responders
0
10
20
30
40
50
60
Num
ber o
f res
pond
ers
17 to 30 31 - 44 45 - 60 61 and above
Male 29%
Female 71%
White British
Other
0 20 40 60 80 100 120 140 Number of responders
Orsett Surgery, 63 Rowley Road, Orsett, Essex RM16 3ET Report prepared by CHATTAN Support Ltd www.chattansupport.com 15
Appointments – clinic running board in the surgery The practice continues to experience a high level of missed appointments. In response to previous patient feedback we have installed a running time update board in the reception area to advise our patients of any appointment delays. We wanted to know what our patients think of this:
Appointments – text reminders system
We are considering introducing a text message reminder system which sends an automated reminder text to the patient’s mobile phone the day prior to an appointment.
• 87% of responders said they would like this service Dispensary In response to previous patient feedback we are considering introducing a ticket queuing system where patients take a number and sit and wait for their number to be called.
• 64% of responders said they would support this development Doctors can group medications onto one prescription so repeat prescriptions can be collected in one monthly visit
• 99% of responders would like to collect their prescriptions together, once a month Premises
• 86% responders would like drinking water to be made available in reception • 56% patients thought the surgery was very clean, 44% thought it was clean
Receptionists
• 56% patients thought the receptionists are very helpful • 39% thought they were fairly helpful
Yes
No
0
20
40
60
80
100
120
140
Have you seen this? Do you find it helpful?
Would you prefer it in a more central
position?
Should we consider an LED version?
Num
ber o
f res
pond
ers
Orsett Surgery, 63 Rowley Road, Orsett, Essex RM16 3ET Report prepared by CHATTAN Support Ltd www.chattansupport.com 16
Patient confidentiality – can you be overheard at reception?
Doctors
• 83 patients had seen a doctor for a routine appointment in the last six months • 6 had completed the GP survey that had been sent out
How likely are you to recommend this GP Practice to someone else? There were too few respondents for the Friends & Family Test score to be statistically significant.1
1 117 respondents completed the Friends & Family Test (FFT). For more details about the FFT go to http://www.england.nhs.uk/ourwork/pe/fft/
Yes, but I don't mind 67%
Yes, and I am not happy
33%
0
10
20
30
40
50
60
70
Extremely likely Likely Neither likely or unlikely
Unlikely Extremely unlikely
Num
ber o
f res
pond
ents
Orsett Surgery, 63 Rowley Road, Orsett, Essex RM16 3ET Report prepared by CHATTAN Support Ltd www.chattansupport.com 17
APPENDIX B: COMMENTS Some general comments were made regarding wide ranging aspects of the Practice, some of which are noted below to give a flavour of the patient perception of the Orsett Surgery
I A very pleasant, understanding and helpful practice I Always well
treated with consideration and help I Could we spend a little more time
with the doctor? Each ailment I have to book separate appointments I
An excellent surgery I All the team are friendly and efficient but are
appointment times realistic? I Best I have experienced in 52 years I
Excellent service - has probably saved my life! I I like the onsite
pharmacy, it is very convenient for me I It would be nice not to have to
wait 3 weeks for a non urgent appointment I Keep up the good work
everyone I
Orsett Surgery, 63 Rowley Road, Orsett, Essex RM16 3ET Report prepared by CHATTAN Support Ltd www.chattansupport.com 18
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?
Communication
Improve patient awareness of key information in the waiting area
Re-location of information board Practice Manager
March 2014
Increased size of text on messages on the information board
Reception Team With immediate effect
Confidentiality Increase patient satisfaction with confidentiality at the reception desk
Obtain quotes for supply and installation of Perspex booth at reception desk
Practice Manager
July 2014
Patient Environment Improved patient experience Purchase and installation of water dispenser for waiting area
Practice Manager
September 2014
Information Improved awareness of possibility of delays following patient’s requests for enough time with doctor
Installation of new signage to inform of possible overrunning appointments
Practice Manager
July 2014