Three Swans Surgery Patient Participation Group Report and Summary of Survey Results
Introduction by Margaret Roper, Chair of PPG, March 2012
“The Patient Participation Group was set up in 2008. It is affiliated to the National Association
of Patient Participation but has always functioned in an informal manner. We have organised a
range of talks on subjects as diverse as avoiding falls to coping with chronic pain, as well as
organising a course on first-aid. In addition we sell second-hand books in the waiting-rooms
and have used the proceeds to purchase fruit and vegetables which we put into the surgery for
a week during February to highlight the 5-a-day campaign. In addition, this month we have
made a donation to the surgery which, when added to a kind donation from a patient, will allow
them to purchase a set of weighing-scales for use during the baby clinics. This will allow
mothers who wish only to have their babies weighed to use the scales without having a
sometimes lengthy wait to see the Health Visitor. It will also free up some valuable Health
Visitor time.
This year it was decided that we should put the Group onto a more formal basis and to that
end we have formally adopted a constitution, a copy of which is on the website or a paper copy
is available at reception”.
The Surgery Population:
In the main, our patient group live in the city and suburbs of our market town.
The Office for National Statistics tells us that:96% are white, and the vast majority of ethnic minorities are white Irish or other. Other
ethnicity groups, according to the 2001 census, are almost negligible. However, we are aware
that this is out-of-date and we now have included patients from India (working on 3 month
contracts for a firm based in the city), Poland, China, Czech Republic, Italy and the Philippines.
We have 110 carers registered as patients
The majority of our patients are in employment
63% of our patients describe their health as good, but 11% described their health as not good.
11% are retired
5% are disabled or have long-term conditions
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Patient Reference Group Recruitment
At the end of September we sent out over two thousand ‘flu invitation letters and enclosed a
flyer advertising our Patient Participation Group and appealing for patients who would be
willing to be contacted by e-mail to form our Patient Reference Group. The following patients
received this communication: All patients under 65 in a clinical risk
 Over 65s
 Pregnant women
 Carers
We also recruited opportunistically in the surgery, and continue to do so, by the use of
flyers, posters and by direction to our website. By this means, we also targeted
 Ethnic minorities
 Parents
We also met with students from a large local school to get their views on how we could
attract and recruit patients of their age group which was age 14-16 year olds.
Profile of Patient Reference Group
In addition all new patients registering are given information about the Patient Participation
Group and Patient Reference Group and invited to join. 170 patients to date have signed
up to the reference group in addition to the twenty patients belonging to the Patient
Participation Group. The Reference Group demographics are made up of 41% female, 59%
male, 78% over 65, 22% under 65. 2% are under 30, 1% are under 20 years of age of which
1 is male, 1 female.
Hard to Reach Groups:
Despite all our efforts, shown above, we have not been successful in obtaining full
representation in our patient group. However, we have achieved this when getting patients to
complete the questionnaire.
We held meetings with our patient participation group and from these, identified the main
priorities, and then the questions, for our annual patient survey.
Patient Survey
Example of identifying one of our priorities: During the Swine Flu epidemic in 2009/10, to
avoid the spread of infection, patients were given telephone consultations with the doctors
instead of face to face appointments.
After evaluating these telephone consultations, it appeared that a lot of patients preferred this
system for minor illnesses as it saved them time, they didn’t always need to come to the
surgery to be seen and they were dealt with promptly .
Subsequently, we have developed our daily Telephone Triage Appointment System whereby
patients who ring in to request a “same day appointment” are phoned back by the Duty
Doctor and given the most appropriate advice/treatment/appointment.
Priority Areas
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In order to identify the priority areas, we consulted with the Patient Reference Group and with
the Patient Participation Group Chair who reported back on behalf of the group with the
following questions:



Our telephone system and how easy is it to get through to the surgery?
Our new Telephone Triage Service - did our patients know about it/had they used it?
Our opening times - were they convenient for our patients or not?
How helpful did the patients find our receptionists?
Accredited Questionnaire:
We adapted the GPA Questionnaire to include the above questions and e-mailed the 170
Patient Reference Group patients and we also asked all patients who came into the surgery
during the week 13th - 17th February to complete a paper copy of the survey.
Patient Demographics
Both groups of patients’ answers were analysed, 220 in total. 22% were aged 16-44, 26%
were aged 45 -64, 32% were 65-74 and 18% were aged 75 and over. Of these, 54% had
long-standing health conditions, 96% were white, 4% were of other ethnic group. In addition,
38% were employed, 3% were unable to work due to long term sickness, 5% were looking
after their home/family and 47% were retired.
The full results of the survey are available on our website, www.3swanssurgery.nhs.uk.
Inviting patients to discuss the Survey Results
A further e-mail was sent to all 170 Reference Group Patients advising them that the results
were now published on the website and inviting them to attend the PPG meeting on 21
March to discuss the results or alternatively, to send in any further comments or suggestions.
One PRG patient only chose to attend the meeting and one further comment was received
regarding question 10 and the importance of seeing the doctor of choice - the patient said
this depended entirely on why she wanted an appointment - if it is was a one off for an eye
infection it didn’t matter but for a long-running saga she thought it much better to see the
same person so as not to have to start at the beginning every time.
We also sent e-mails advertising the event to the PPG members and put up posters and left
flyers at reception, in the waiting rooms and on our website inviting all patients to attend.
Meeting to discuss Patient Survey Results
As stated the survey results were shared with all 170 members of our group and comments
were invited. In addition, there was a meeting to discuss these:
The PPG meeting on Wednesday 21 March at 6.30 p.m. was attended by 14 patients, 1
patient reference group member, 9 patient participation group members, 3 patients (1
wheelchair bound, 1 with a learning disability), two Partners and two members of staff.
Dr Bond went through each of the questions and presented the findings below:-
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Summary of results
Q1 How easy is it to get through to the practice on the phone?
90% positive
Q2 How helpful do you find the receptionists?
96% positive
Q3 How easy is it to speak to a doctor or nurse on the phone ?
95% positive
Q4 If you need to see a doctor urgently, can you normally be seen on the same day?
59% of those that had tried could
31% had never tried or needed to
7% said no
Q5 We have been developing a Telephone Triage Service at the practice to try to find
the most suitable appointment for our patients. Have you used this service?
Only 32% had used it
Q6 . If you have used our Telephone Triage Service, how satisfied were you with it?
94% happy with it
Q7 Optional - written comments were requested regarding telephone triage service
Q8 When thinking of booking a future routine appointment, how long do you think it is
reasonable to wait for the appointment?
Less than 1 week 35%
1-2 weeks
58%
2-3 weeks
5%
Over 3 weeks
0%
Q9 Are we meeting your expectations ?
74% Agreed
Q10 How important is it for you to see the doctor of your choice
Very important
40%
Important
43%
Not important
16%
Q11 How long did you wait for your consultation to start?
Less than 5 minutes
15%
5 – 10 minutes
38%
11 – 20 minutes
5%
21 – 30 minutes
4%
More than 30 minutes
3%
There was no set time for my consultation 0%
Q12 How do you rate this?
Q13 Are we currently open at times that are convenient to you?
Yes 90%
No 6%
Don’t know 2%
Saturdays would be most popular additional time
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96% Positive
Q14 If no, which of the additional opening hours would make it easier for you to see or
speak to someone
Before 8 a.m.
Lunchtime
After 6.30
Saturday
2%
3%
5%
10%
Q15 Overall, how would you describe your experience of the surgery? 96% positive,
3% fair
Q16 Would you recommend the surgery to someone who has just moved to your local
area?
Yes, definitely 80%
Yes, probably 14%
No, probably not 2%
No, definitely not 0%
Don’t know 0%
Agreeing the Action Plan:
The survey findings were on the whole positive although Dr Bond told the group he was
surprised that only 59% of those surveyed answered that they could have an appointment on
the same day if they needed to be seen urgently but 31% hadn’t tried. An explanation for this
could be the result of having introduced the Telephone Triage System and patients may have
perceived that they could not be seen. However, it is the practice policy to always see patients
on the same day if required.
A discussion then took place about the Telephone Triage
System. Only 32% of patients who answered the survey had used it but of the 32% surveyed,
94% were happy with it. The attendees at the meeting suggested the practice try to make
more patients aware of the Triage system and how it works. They suggested it be highlighted
on the practice website, in the practice leaflet, on posters in the surgery, and by writing an
article in the next practice newsletter.
The surgery opening hours were discussed and although 90% of the patients surveyed were
happy with the current opening times, it was felt that possibly not all patients were aware of the
available extended hours which are early morning appointments, later evening appointments and
alternate Saturday morning appointments. Charlotte Gilbert, Deputy Practice Manager, reported
to the group that she publishes the extended opening times and the Saturday morning surgery
dates in advance on the website and they are also mentioned in the practice leaflet.
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The
receptionists offer these appointments routinely to patients and particularly to any who have
difficulty attending appointments in normal working hours.
Question 8 was regarding booking ahead a future routine appointment, “how long do you think it
is reasonable to wait for an appointment”
35% surveyed thought less than a week was reasonable whereas 58% were prepared to wait 12 weeks. It was thought reasonable, by those attending, to wait up to two weeks for a non
urgent appointment to see their preferred doctor.
Question 10 - 83% responded that it was important to see their preferred doctor. However this
was not always possible and Dr Bond explained that although three doctors are full time, five of
the doctors are half time so the wait to see these doctors might be longer.
Patients are
registered with the practice and are encouraged to have a usual doctor of their choice and
another doctor (preferably one full time and one part time known as the “buddy system”) who
they would be happy to see in the event their usual doctor was not available. This is to provide
continuity of care.
The Patient Group also requested more information about what was available to them when the
surgery was closed and the options of the Out of Hours Service, the Walk In Centre from 8
a.m. - 8 p.m. 7 days a week, A & E at Salisbury Hospital for emergencies and telephone
advice from NHS Direct were all discussed. The group thought this information should be more
widely available for patients. The Out of Hours information is available for our patients on a
pre-recorded message on the practice telephone system when the surgery is closed. It is also
advertised in the practice leaflet, on the front door and on the website.
RESULTING ACTION PLAN
The resulting action plan was e-mailed to the PRG members for approval.
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AIM
ACTION
To make more patients aware of the
Advertise in the practice leaflet and give
Telephone Triage Service
prominence on practice website
Write an article advertising the service for the
next practice newsletter.
Action by CC and CG
To be completed by end of April 2012
To advertise further the early morning, later
Information already on the website
evening and alternate Saturday morning
Put up notices in the waiting rooms and
appointments
receptionists to inform patients
opportunistically.
Action CG to put up notices within 1 week
and brief Reception team at their next
planned meeting.
To ensure patients know their options if they
This information is on the practice website, on
need advice or to see a doctor when the
our practice leaflet and on our surgery door
surgery is closed
but include an article in the next practice
newsletter too.
Action CC
Encourage patients to see two doctors in the
Highlight in the practice leaflet for new patients
practice so there is always one they know if
registering.
their usual doctor is away.
GPs to encourage the “buddy system” with
any patient who they know usually only sees
them.
All actions to be reviewed at the next
meeting of the Patient Participation Group.
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Our practice list is open to new patients.
Our Opening Hours are:Monday
8.00 a.m. to 7.30 p.m.
Tuesday
8.00 a.m. to 6.30 p.m.
Wednesday
8.00 a.m. to 6.30 p.m.
Thursday
8.00 a.m. to 6.30 p.m.
Friday
7.30 a.m. to 6.30 p.m.
Saturday (alternate) 8.30 a.m. to 11.00 a.m.
Patients may book appointments with doctors or nurses by ringing the surgery or by calling in to
the reception desk. We offer face to face and telephone appointments. If you require a same
day appointment, you may initially be offered a telephone appointment with the duty doctor who
will arrange the most appropriate appointment for you. It is hoped to be able to offer electronic
appointment booking in the future.
Extended Opening Hours - additional appointments available with a doctor.
Monday
6.30 p.m. to 7.30 p.m.
Friday 7.30 a.m. to 8.00 a.m.
Saturday (alternate) 8.30 a.m. to 11.00 a.m.
All doctors participate in the extended hours rota. Please ask the receptionist if you would
like to see a named doctor.
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