2015 PPG Report Meadows Surgery

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Standard Reporting Template – Patient Participation DES 2014/15

Surrey & Sussex Area Team


Practice Name: The Meadows Surgery, Temple Grove, Burgess Hill, West Sussex, RH16 1QA


Practice Code H82003


Signed on behalf of practice    Dr Simon Gankerseer            Date  21.3.15


Signed on behalf of PPG                        Date




  1. Prerequisite of Enhanced Service – Develop/Maintain a Patient Participation Group (PPG)



Does the Practice have a PPG? YES / NO


yes


Method of engagement with PPG: Face to face, Email, Other (please specify)


Virtual PPG via e-mail



Number of members of PPG:


2811





Detail the gender mix of practice, population and PPG:


Detail of age mix of practice population and PPG:


%

Male

Female

Practice

50

50

PPG

 46

 54



%

<16

17-24

25-34

35-44

45-54

55-64

65-74

>75

Practice

 20

 9

 12

 14

 16

 13

 10

 8

PPG

 2

 6

 17

 21

 21

 16

 13

 6



Detail the ethnic background of your practice population and PPG:



White

Mixed/ multiple ethnic groups

%

British

Irish

Gypsy or Irish Traveller

Other white

White Black & Caribbean

White & black African

White & Asian

Other mixed

Practice

 96

 1

 1

 2

 1

 1

 1

 1

PPG

 95

 1

 1

 3

 1

 1

 1

 1





Asian/ Asian British

Black / African / Caribbean

/ Black British

Other

%

Indian

Pakistani

Bangladeshi

Chinese

Other Asian

African

Caribbean

Other Black

Arab

Any Other

Practice

 1

 1

 1

 1

 1

 1

 1

 1

 1

 

PPG

 1

 1

 1

 1

 1

 1

 1

 1

 1

 






Describe steps taken to ensure that the PPG is representative of the practice population in terms of gender, age and ethnic background and other members of the practice population:


The PPG is the practice population defined by those who have access to e-mail primarily although survey sheets were offered to patients attending the practice. The results are a collation of information from all sources although our e-mail results dominate. Before embarking on this process the ethnicity and demographic of our e-mail enabled patients was analysed to ensure there was a good match to the practice population. The  percentage figures presented are rounded up and therefore will add up to more than 100% of the population.


Are there any specific characteristics of your practice population which means that other groups should be included in the PPG? e.g. large student population, significant number of jobseekers, large numbers of nursing homes or a LGBT community?   YES/NO


No


If you have answered yes, please outline measures taken to include those specific groups and whether those measures were successful:




NA



  1. Review of patient feedback

Outline the sources of feedback that were reviewed during the year:



NHS Choices feedback

I Want Great Care feedback

Letters of complaint/compliment from patients

NHS friends and family handouts

Online patient survey

Critical event reviews

Suggestions box feedback



How frequently were these reviewed with the PRG?



Annually as per PPG vote



How often should we contact you.JPG

  1. Action plan priority areas and implementation for 2015/16

Priority area 1


Description of priority area:


Access to GP services 8-8 7 days a week


What actions were taken to address the priority:



The government is currently piloting extended opening across a number of sites in the UK. These GP surgeries are opening 8 till 8, 7days a week and currently cover 500,000 people. The funding for this is the much publicised 50 million pounds which works out at 100 pounds per patient per year to provide unlimited access during the extra hours. We were not big enough to bid for the initial funding but if this is offered to the whole county then we will be extending opening hours and recruiting more doctors to provide the extra sessions. We are not currently in a position to offer any more opening hours without damaging the existing provision of care.


Result of actions and impact on patients and carers (including how publicised):




Feedback to patients on the progress of this project will be publicised on our website, via our electronic noticeboard and on flyers in the surgery.



Priority area 2


Description of priority area:


Local Minor Treatment Centre


What actions were taken to address the priority:



We have been in discussion with the other GP surgeries in Burgess Hill regarding the future plans to build another 3000 houses in the "Northern arc" of the town. Part of this discussion has been for an out of hours treatment facility based at a currently undecided location in the centre of town. Funding has not been identified for this project but we will continue our discussions.


Result of actions and impact on patients and carers (including how publicised):




Feedback to patients on the progress of this project will be publicised on our website, via our electronic noticeboard and on flyers in the surgery.



Priority area 3


Description of priority area:


Out of Hours Healthcare


What actions were taken to address the priority:



We have been very concerned about the quality of the new 111 replacement for NHS direct. There is evidence that 111 has been a major factor in the NHS crisis this winter and has made a large number of unnecessary referrals to hospitals, ambulances and GP's. In response to these shortcomings the contract with 111 has been altered to add telephone advice from doctors and nurses through local teams. This will come into force on April 1st and should go some way to improving the "Out of Hours" experience.


Result of actions and impact on patients and carers (including how publicised):



Feedback to patients on the progress of this project will be publicised on our website, via our electronic noticeboard and on flyers in the surgery.



This is our current action plan with proposed actions.

Issue Raised

Action proposed

Saturday, Sunday and evening opening.

The government is currently piloting extended opening across a number of sites in the UK. These GP surgeries are opening 8 till 8, 7days a week and currently cover 500,000 people. The funding for this is the much publicised 50 million pounds which works out at 100 pounds per patient per year to provide unlimited access during the extra hours. We were not big enough to bid for the initial funding but if this is offered to the whole county then we will be extending opening hours and recruiting more doctors to provide the extra sessions. We are not currently in a position to offer any more opening hours without damaging the existing provision of care.

Action.

Apply for funding to offer 8-8 opening 7 days a week.

Local minor treatment centre.

We have been in discussion with the other GP surgeries in Burgess Hill regarding the future plans to build another 3000 houses in the "Northern arc" of the town. Part of this discussion has been for an out of hours treatment facility based at a currently undecided location in the centre of town. Funding has not been identified for this project but we will continue our discussions.

Action.

Maintain dialogue with regional health authority to push for local minor treatment centre. Feedback to patient group via e-mail and website.

Out of hour emergency care.

We have been very concerned about the quality of the new 111 replacement for NHS direct. There is evidence that 111 has been a major factor in the NHS crisis this winter and has made a large number of unnecessary referrals to hospitals, ambulances and GP's. In response to these shortcomings the contract with 111 has been altered to add telephone advice from doctors and nurses through local teams. This will come into force on April 1st and should go some way to improving the "Out of Hours" experience.

Action.

None possible as 111 is outside of our control but will now include medically qualified operators for the first time. Even if we manage to extend our opening to 8 till 8 there will still be a need for high quality emergency cover and we will continue to take the government to task over this issue.

Our reception area and waiting room are looking tired. There have been longstanding issue with privacy at the front desk and queues form at peak times or of a receptionist has to deal with a complex problem.

Action.

Our Waiting room will have a de-clutter this year and will be redecorated. We will apply for funding to move the phlebotomy room and utilise the space next to reception as a quiet room for sensitive issues. We will increase the reception hours and focus on keeping the queues down with a fast-track pickup for prescriptions and letters.

The TV slides are too small and cluttered to read

Action.

Check the slideshow and correct the cluttered slides.

The reception telephone message is not friendly.

Action.

Training session for telephone operators

The Front door to the surgery is loose making a draught. This makes the waiting area cold

Action.

Replace the front door with one which is not loose.

The waiting area is too hot and lacks fresh air

Action.

Reception staff to monitor temperature and adjust ventilation accordingly.

The Waiting area smells

Action.

Repeat steam clean of carpets. Increase ventilation to waiting area.

The wait for Non-urgent appointments is too long.

Action.

Increase the number of clinical sessions per week to see patients.

Reduce the wasted appointments by;

chasing up patients who do not attend without telling us, providing printed material on how to chase a hospital appointment, asking patients the nature of their problem before booking so they can be triaged to appropriate care.

The Parking area floods.

Action.

Clear drains in the parking area.

Request for Skype "virtual" appointments

Action.

Trial of webcam use for a GP to assess effectiveness vs risks of this method of consultation.

The booking in system does not work very well

Action.

We are unable to customise this software but we will feed your comments back to our supplier and discuss possible changes we could make (including changing to another company!)

.


Progress on previous years

This is our completed action plan for 2014/15

Issue

Agreed proposal

Result

To address the long waiting times for routine appointments.

Where doctors are taken out of clinical work we will employ the same named locum doctor. This gives some continuity and means the replacement doctor fully understands the local health service and workings of the practice.

The doctors will only attend meetings where there is a statutory obligation to do so preferring to focus their attention on clinical practice.

This year we have increased our additional locum sessions and provided more appointments than ever before but demand continues to outstrip supply.

To maintain the current system of emergency on day appointments.

The practice will continue to offer emergency surgery appointments where patients are prioritised by; chest pain/critical symptoms, babies and then order of arrival.

This is now an established protocol for emergency surgery.

To raise awareness of existing appointment availability

The doctors will continue early bird surgeries and will continue to advertise these through the practice leaflet and message boards in the surgery. We will not restrict access to these surgeries.

We will mail-shot all our patients on e-mail with the survey results and opening times.

This has been completed

To improve the time keeping during surgeries

The clinical staff will continue to keep interruptions during clinical sessions to a minimum.

Patients arriving late will be asked to rebook.

Patients attending with relatives will be asked to rebook.

Doctors will focus on starting on time and postpone phone calls etc. until after surgery.

This has been implemented. Our main source of delay now is dealing with complex and multiple medical problems in a 10 minute appointment.

When a patient has a test

They will be informed that all abnormal results will be actioned urgently which means they will be contacted by the surgery. Patients will be asked to contact the surgery after a few days to check their results if they have not already been contacted.

This is now our procedure. In addition our new system will text patients when results are back.

When a patient calls for an appointment

The reception staff may ask the nature of the problem where appropriate in order to book an appointment with the most appropriate member of staff.

Current process

E-mailing the practice

Will be rolled out by creating a shared reception mailbox and then publicising this in our practice leaflet, on our notice board and via e-mail. Direct e-mails to the doctors will be by invitation only and unsolicited email will be passed directly to reception for triaging.

Action SG: 1.7.14

Completed and is active.

Survey comment: Improve access for blood pressure testing

We will review the use of space within our waiting area to include an area for an automated blood pressure monitoring station.

Action SG 1.7.14

Project cancelled due to funding pressures.

Survey comment: Review availability of early morning blood tests.

We will look at the uptake of our early morning blood tests to see if they could be reserved for fasting tests by diverting other tests to later in the morning.

Action RB 1.7.14

Increased capacity created by offering 7am slots for blood testing

Survey comment: Concerns over difficulty in getting an appointment

We will review our current appointment system to make sure that we are allocating sufficient appointments to patients with long term conditions vs. patients presenting with urgent problems.

We will also undertake an audit of the reasons why patients are attending their GP to determine how much work has been moved into general practice from hospital outpatients.

Action RB 1.7.14

We continue to be overwhelmed by work moved into GP appointemts from the hospital without prior consultation. The 111 telephone service has significantly increased demand for  urgent appointments for minor illnesses.


PPG Sign Off

see response to online questionnaire:

yes or no.JPG


Report signed off by PPG: YES / NO


NA as virtual PPG


Date of sign off:


21.3.15


How has the practice engaged with the PPG:


The practice contacts all patients with a current e-mail address to ask their opinion on which areas of care they would like us to focus on. This information and from other sources is collated into an action plan which is then circulated for discussion. All feedback is published for scrutiny and the action plan for the forthcoming year is agreed. The response to the action plan is published and a summary added to this report.

How has the practice made efforts to engage with seldom heard groups in the practice population?

Our elderly and housebound patients have increased representation by use of e-mail. Carers and families of patients with dementia are included in our PPG. Patients with mental health issues and anxiety problems are able to participate where they might struggle in  face to face setting.

Has the practice received patient and carer feedback from a variety of sources?

Yes

Was the PPG involved in the agreement of priority area and the resulting action plan?

Yes

How has the service offered to patients and carers improved as a result of the implementation of the action plan?

2014/15: Increased appointments via extra locum cover. Triaging of patients in emergency surgery. Reduced interruptions and delays during surgery. SMS texting of appointment reminders and results notifications. Email access to the practice. Increased capacity for early morning blood testing.

Do you have any other comments about the PPG or practice in relation to this area of work?

Our Patients have been very generous with their time helping us to formulate our action plans. Whilst including such a large population in discussions is cumbersome it does offer a unique opportunity to involve everyone in the process. We continue to collect email addresses to expand our PPG.





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Meadows Surgery,
22 Mar 2015, 02:45
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Meadows Surgery,
22 Mar 2015, 02:46
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Meadows Surgery,
22 Mar 2015, 02:42