1
VALE DRIVE SURGERY, DR U AND DR N RANASINGHE
PATIENT PARTICIPATION (DES) Analysis Report 2013/2014
SECTION 1
Introduction
This report has been written according to the requirements of the Patient Participation Directed
Enhanced Service (DES). Its aim is to provide evidence following the implementation and fulfilment
of the DES requirements for 2013/2014. This report takes into account that consultation, a patient
participation meeting and analysis of the outcome was carried out for 2013 but a full report not
submitted to NHS England.
Key Objectives of the DES
The Patient Participation DES’s purpose is to encourage and promote patient participation, involving
registered patients in the decision-making process which should lead to improved changes of the
practice services in line with patient requirements. The results of the survey show areas where we
need to improve upon or highlight areas within the practice where a better service can be offered.
Accessibility
 The subject of accessibility to the surgery was included in our questionnaire (64 patients
responded) with a positive result, i.e.:
o In general how easy is it for you to enter surgery and move around premises?
Very easily = 59
Fairly easily = 4
Neither easy or difficult
=1
Fairly Difficult = 0
 Lists of our opening times are in the surgery, on leaflets and on the website.
 Our surgery is open 5 days a week.
 Surgeries are held mornings and evenings except for Thursday evening.
 There are two nights when we offer extended hours, i.e. approximately 10 to 12 extra
appointments with the addition of approximately 4 – 6 emergency appointments on those
nights.
 Our GPs follow up patients ensuring continuity of care.
 Range of skills available – we are situated within a health care centre where we can utilise some
of the services offered. We have access to other clinical professionals through our referral
system.
 Modes of contact – we see patients face to face in surgery; doctors will contact patients after
surgery has finished by telephone consultation; any urgent telephone calls the doctors will deal
with during surgery; from 2.0 – 5.0 Mondays, Tuesdays, Fridays our telephone is directed to
Barndoc which will respond to patient enquiries.
 In future, our surgery is planning to open Mondays, Tuesdays and Fridays in the afternoon
where a receptionist can take telephone calls and carry out administrative procedures for any
calling patients.
 Vale Drive surgery has a web site where people may leave messages.
 The surgery is planning to conduct electronic prescribing when the doctors have had training.
SECTION 2
Component 1 Develop a Patient Reference Group (PRG)
To conduct a patient reference group we first did a survey where our practice developed a
questionnaire (see Appendix A with statistics from returns) to be completed anonymously and
handed out to our patients as they came for appointments both in 2012/13 and 2013/14. In
2013/2014 we handed out 100 forms to a cross section of our patients and 64 were completed. To
Analysis Report of Patient Participation DES AS AT 9.2.14
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encourage patient participation in the Patient Representative Group meeting, letters were handed
out, patients were asked verbally, a message was inserted into our LED in the waiting area and an
invitation to participate printed onto prescriptions. Appendix B shows our Patient Participation
Invitation letter. We held a patient reference group meeting in January 2014. The table below
illustrates the ethnicity of both participants and of those who agreed to participate:
Ethnicity of Participants
White British
Other Asian Background
Other white Background
Indian/British Indian
British/Mixed British
Patients with Learning Disabilities
Invited but did not attend
4
1
2
2
1
Ethnicity of Patients who had agreed to take part in the Forum
African
3
Black Caribbean
1
British/Mixed British
6
Indian/British Indian
3
Italian
1
Other Asian Background
1
Other White Background 3
White British
4
1
Consideration will be given to informing patients at the point of registration of our annual Patient
Representative Group and how their involvement would be most useful.
Health Factors
One hundred questionnaires were distributed to patients (APPENDIX A but without the results)
actively taking into consideration patients with various categories of health conditions.
Approximately one hundred letters of invitation were handed out to patients at the reception desk
and in the doctors’ and nurses’ surgeries (see APPENDIX B). Of the 22 patients who agreed to
attend the Patient Participation Forum, 11 patients came and out of those the following had long
term conditions:
 Cancer
1
 Coronary Artery Disease
1
 Epilepsy
1
 Diabetes
2
All social categories were included when completing questionnaire and letters of invitation and the
following noted:
 Mums with children
1
 Carers
1
 Retired
5
 Doing Paid Work
3
 Housewives
1
Component 2 Agree Areas of Priority with PRG
The following were agreed with the PRG:
 Reduce the waiting time for consultations.
 Take some action to minimise children’s disruptive behaviour in the waiting room
 Confidentiality in the reception area.
 Frequency of smear test letters
Information from the following has also been taken into consideration:
Analysis Report of Patient Participation DES AS AT 9.2.14
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
Meeting with the Manager and Senior Nurse in October 2013 of one of the Care Homes who use
this surgery’s services and the following changes were agreed between our GPs and the care
home:
o Instigation of the Gold Standard Framework, including improved communications,
security, pre-planned medication
o Colour coding system for predicted stay in homes, inform GP of change in status of any
resident and recorded on EMIS
o Clearer communication between nurses at home and GP surgery, tightening up on home
visits, urgency matters prioritised, extra telephone available at surgery, tightening up on
prescriptions procedure, pharmacies and instructions from home to GP.

Care Quality Commission related issues (our inspection was in 2013):
Our practice came up to the expected standards on all issues apart from one, “Cleanliness and
Infection Control”. Dr Don Ranasinghe has since provided an audited report to the Care Quality
Commission.
Component 3 Collate Patient Views through the use of a survey
Out of more than 100 invitations we had 64 returns; 22 patients agreed to be part of the PRG and 11
attended. We used the same questionnaire as we used last year
We felt the following will be taken into consideration in consultation with the PRG, for next year’s
questionnaire to help with the final analysis and with how we can improve the service more
effectively:














How old are you?
Are you male or female?
Would you recommend your surgery to someone who has just moved into the area?
Do you keep yourself healthy?
How do you cope with health problems?
Do you understand your health problems?
For minor illnesses, i.e. urinary tract infections, ear-ache, sore throat, etc., would you be
prepared to see a nurse?
Do you know how to obtain test results from your surgery?
How satisfied are you with the 10 minute appointment time?
How long would you prefer for appointments?
Which of the following methods would you prefer to make an appointment, i.e. on line, in
person, by phone, don’t mind?
Thinking of times when you want to see a particular doctor, how quickly do you usually get
seen, i.e. same to next day, 2-4 days, 5 days, I don’t need to be seen very quickly, don’t
know, no response?
How quickly are you offered an appointment with the GP or nurse? i.e. same day or next
day, 2-4 days, 5 days, I don’t need to be seen very quickly, don’t know, no response?
How helpful to you find the receptionists at your GP practice?
Component 4 Provide PRG discussion opportunity
The items considered which would improve the service of the practice were agreed at the PRG, were
fully discussed by all in attendance and are:

Reduce the waiting time for consultations.
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


Take some action to minimise children’s disruptive behaviour in the waiting room.
Confidentiality in the reception area.
Frequency of smear test letters
We allowed each individual to go through the questionnaire and they gave very freely of their
opinions. We are proud to say that the patients were very happy with our survey, especially the
waiting times for appointments and the help they get at the reception desk and from the doctors
and nurses. They pointed out a few things they wanted to improve which are included in the Action
Plan (APPENDIX C)
Component 5 Agree Action Plan with the PRG and Implement Changes
It was agreed at the meeting to inform patients through the LED of appointment delays; consider
notice regarding children running around unheeded, for reception staff to be first point of call for
problems, doctors to write to NLCH concerning greater confidentiality for patients; frequency of
smear test letters.
Component 6 Publicise Actions to be taken and subsequent Achievement
This report will be publicised on our website by Dr Don Ranasinghe. We have already implemented
some of the Action Plan points. We are waiting to hear from the Health Centre Manager about the
confidentiality issue and have sent an email to Ms Julie Chase who has responsibility for the Vale
Drive Health Centre Building. (See APPENDIX D).
We have sent the minutes of the meeting to all the participants which please see at APPENDIX E.
Analysis Report of Patient Participation DES AS AT 9.2.14
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Appendix A
Patient questionnaires for year 2013-2014 (100 given out, 64 returned) and
Bar Charts (in percentages)
1.
When did you last see a doctor at GP surgery?
Past 3 months = 50
Between 3 & 6 months = 6
More than 6 months = 7
I have never been seen at my present = 1
GP or Health Centre
= 0
2.
If not seen doc on past 6 months, why? Please select all the areas that apply:
I haven’t needed to see a doctor = 9
I couldn’t be seen at a convenient time =0
I couldn’t get to my appointment easily=0
I didn’t like or trust the doctors = 0
Another reason = 0
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3.
How satisfied are you with the opening hours at the surgery?
Very = 43
Fairly = 13
Neither satisfied nor dissatisfied = 2
Quite dissatisfied = 4
Very dissatisfied = 1
Don’t know opening hours = 1
4.
In general how easy is it for you to enter surgery and move around premises?
Very easily = 59
Fairly easily = 4
Neither easy or difficult = 1
Fairly Difficult = 0
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5.
Did you feel you were treated with respect and dignity while you were in surgery?
Yes always = 60
Yes sometimes = 4
No = 0
6. In discussions with your doctor or nurse about your long term conditions....
Did the doctor or nurse take notice of your views about how to
deal with your health problem?
Did the doctor or nurse give you information about the things
you might do to deal with your health problem?
Did you and the doctor or nurse agree how best to manage
your health problem?
Did the doctor or nurse give you a written document about the
discussions you had about managing your health problem?
Would you have liked a written plan summarising your
discussion with the doctor or nurse?
Did the doctor or nurse ever mention that you had something
called a care plan?
Analysis Report of Patient Participation DES AS AT 9.2.14
Yes
No
42
6
Don’t N/A
Know
0
15
50
2
0
9
41
2
4
12
18
23
3
12
15
26
3
15
9
32
1
0
8
7. Do you have any long-standing health problem, disability or infirmity? Please include anything
that has troubled you over a period of time or that is likely to affect you over a period of time.
Yes = 29
No = 30
Don’t know/can’t say = 5
8. On your last visit to your GP how much time did you spend with the doctor?
Less than 5 mins = 3
Between 5 & 9 mins = 26
10-19 mins = 30
20-29 mins = 4
30 – 39 mins = 0
40 mins or longer = 0
Can’t remember = 1
Analysis Report of Patient Participation DES AS AT 9.2.14
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9. The last time you saw a doctor at surgery how good was he/she at each of the following:
V.Gd
Good
Neither Poor Very
Good
Poor
nor
poor
Giving you enough time
46
14
1
0
0
Asking about your symptoms
45
16
1
0
0
Listening
47
11
3
0
0
Explaining tests and treatments
47
11
0
0
0
Involving you in decisions about your care
43
13
2
0
0
Treating you with care and concern
50
11
0
0
0
Taking your problems seriously
47
10
2
0
0
Analysis Report of Patient Participation DES AS AT 9.2.14
Dsnt
apply
1
2
1
4
4
2
3
10
10. Is there a particular doctor you prefer to see at surgery?
Yes = 42
No = 21
There is usually only one doctor at my surgery = 1
11. In the past 6 months have you had enough support from local services or organisations to help
you manage your long-term health condition(s). Please think about all services and organisations,
nut just health services.
Yes = 23
To some extent = 6
No = 4
Don’t know/ can’t remember = 2
I have not needed such support = 15
Not applicable = 13
NB – Patients left out ticking some boxes either by error or by intention and percentages are of
number of boxes completed.
Analysis Report of Patient Participation DES AS AT 9.2.14
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APPENDIX B
VALE DRIVE MEDICAL PRACTICE
VALE DRIVE HEALTH CENTRE
VALE DRIVE
BARNET HERTS
EN5 2ED
DR NALINI RANASINGHE MB MRCP
DR DON RANASINGHE MRCOG
TEL: 020 8447 3566
FAX: 020 8447 3633
2013/2014
Patient Participation Group
Vale Drive Surgery
This year we would like to expand the Patient Participation Group.
This involves attending a meeting and expressing your views about the service. This is simply to
improve our quality of service according to the needs of our clients.
If you would like to join the group, please complete your details below and give this letter to the
receptionist on the desk:
Name _________________________________________________
Date of Birth ____________________________
Telephone Number ________________________________
Email Address _____________________________________
Thank you
Dr Don and Dr Nalini Ranasinghe
Analysis Report of Patient Participation DES AS AT 9.2.14
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APPENDIX C
ACTION PLAN
Item to be Actioned
What Action to be Taken
Completion Time
Sometimes wait to
see doctor in surgery


Reception staff to speak to the patients.
Message written on LED in waiting area
Immediate
Immediate
Disruption by children
in waiting area


Patients to speak to reception staff
Reception staff can speak to children’s carer,
send message to doctor immediately using
computer
 Consideration of putting up a notice in
waiting area, in consultation with CLCH
manager
Contact CLCH manager with suggestions
Immediate
Confidentiality at
reception desk
Informing patients at
registration of our
PRG
Reassessing our
questionnaire
Access to Surgery
Electronic
Prescriptions
Frequency of smear
test letters


Staff to be informed
What method to use i.e. letter, email




To do a draft
Send out by email/letter
Receive feedback from PRG
Doctors planning to have receptionist staff
telephone & reception area all day Monday Friday
Patients able to order via web
Doctors will do after training
Doctors advised patients to consult with
them and bring letter into the surgery



Analysis Report of Patient Participation DES AS AT 9.2.14
Immediate
Within 2 months
i.e. 10th April
Within 3 months,
i.e. 10th May
Within 2 months
i.e. 10th April
Within 4 months
i.e. 10th June
Within 3 months
i.e. 10th May
Within 6 months
Immediate
Outcome
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APPENDIX D
Email re Confidentiality
Medical ValeDrive (NHS BARNET CCG)
Sent: 06 February 2014 13:24
M
To:
julie.chase@clch.nhs.uk
M
Cc:
josephine.chan@clch.nhs.uk; Ranasinghe Nalini (Barnet PCT)
Dear Julie
Dr N Ranasinghe and Dr D Ranasinghe held a Patient Participation Group Meeting which was a cross
section of people in our surgery. This followed a survey we conducted giving out questionnaires to
the patients for them to give us their feedback on the service we give. At the meeting which
followed, one of the issues which arose was that of confidentiality. This was raised some time ago
and a yellow line was drawn at about a foot or so from the reception desk. This was so that patients
would not crowd round the reception desk, making it difficult for patients to speak to the receptionist
with any degree of confidentiality. This line was removed and the problem of lack of conficentiality is
now prevalent.
We are making a request on behalf of our patients, with their consent, that some sort of
confididentiality measures may be put in place please. Maybe a metal stand could be the answer as
they have in Edgware Hospital? Please let us know your thoughts on this and copy your email into
Dr. Nalini Ranasinghe if you would be so kind.
Johanne Carstairs
Receptionist on behalf of
Dr N and Dr D Ranasinghe
Vale Drive Surgery
Vale Drive, Barnet
Herts EN5 2ED
Analysis Report of Patient Participation DES AS AT 9.2.14
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APPENDIX E
PATIENT PARTICIPATION GROUP for 2013/2014
Notes of Meeting of Wednesday 22nd January 2014
Present:
Patients: 9 female, 2 male
Doctors: Dr Don Ranasinghe, (Partner) Dr Nalani Ranasinghe (Partner & Chair of
Meeting)
ITEM
Nalini Ranasinghe warmly welcomed and thanked the patients for attending the
meeting. She explained that the analysis sheet given to every participant was in
response to the detailed questionnaire handed out to patients during 2013.
Time was given for the group to read this paper. There were no concerns pointed out
and there were no suggestions made to improve the service further.
1.
Q Nalani Ranasinghe asked the group if they would like to say anything about
appointments.
1.1 Points Raised
 One patient asked whether it would be possible for the surgery to be open on a
Saturday.
 The doctors informed the group that they are not planning to do this until the
whole of North Barnet get together and come to some agreement. They were also
informed that during 5 working days we have around 10 emergency appointments
available daily giving same day access to patients.
 There is also a telephone consultation service available after surgery hours or
during surgery hours if deemed necessary.
1.2 Q Discussion about the 111 Service. Patients unsure when it is in operation. A query
about ringing for a doctor at the surgery out of opening hours.
Answer:
 The doctors explained that the core hours were between 8.00 a.m. and 6.30 p.m.
 On Mondays, Tuesdays and Fridays from 2.00 – 5.00 p.m. the telephone is
transferred to Barndoc when our GPs are making home visits and doing other
administrative work.
 On Wednesdays, the telephone is manned from 8.30 a.m. until 6.30 p.m.
 On Thursdays our core hours are from 8.0 a.m. to 1.00 p.m.
Barndoc Service consists of a group of doctors operating out of Finchley Memorial
Hospital in North Finchley. A nurse would answer a 111 call and Barndoc provide a
weekend service. The first point of contact for a patient requiring a doctor out of
surgery hours would be 111. 111 can call an ambulance; direct patients to hospital or
weekend centres or tell them to go to the GP. 999 is for absolute emergencies like a
patient having a stroke or a heart attack. Nalani Ranasinghe drew attention to all the
publicity, particularly on TV about the symptoms of an impending stroke.
1.3 Future Opening Hours
 Dr Don explained that our surgery plans to man the telephone during core hours
except for Thursday when the surgery is closed for half a day.
Analysis Report of Patient Participation DES AS AT 9.2.14
ACTION
15
ITEM
 The group were reminded that our surgery has extended surgery opening hours on
Monday and Wednesday evenings.
ACTION
2.1 Q A patient asked why nurses no longer take blood in the clinic as they used to do
“in the old days”.
Answer
 Nurses have no time to do blood tests. We have nurses operating from Monday to
Thursday. The reason blood tests are no longer carried out in the clinic is because
nurses only have 15 minutes per patient and in that time they need to record
every transaction with their patient on computer and sometimes need to check
and research information.
 The nurses or doctors do take blood from frail and elderly patients if it is urgent.
2.2 Q Why is there not a blood testing centre at Vale Drive?
Answer
 The practice does not have any control over setting up this service for Vale Drive.
 This practice is renting accommodation from Central London Community Health.
3.
Q Would it be better to have, at our surgery, a “walk in” centre?
Answer
 We discussed this and our patients preferred the appointment system rather than
coming in the morning and waiting for several hours to be seen.
4.1 Q Patients are often not seen at their appointment time – why?
Answer
 Dr Don said that sometimes one patient, by virtue of his/her problem, may take
longer than the stipulated 10 minutes consultation time.
4.2 Q If the doctor is running late, can they let the waiting patients know?
Answer
 It was agreed by all that it would be a good idea for there to be a message on the
LED (the electronic screen on the wall adjacent to the reception area) if the
doctors are running late. ACTION TO BE TAKEN
 Patients were advised always to feel free to ask the reception staff if there is and
why there is a delay in appointments.
 We have a system in place to communicate with the doctors if there is any urgent
problem or if there is disruption in the reception area.
 The doctors explained to the group that against each patient is the time they
booked in and how long they have been waiting so clinicians are aware of delays
and will send a message to reception staff if necessary.
4.3 Q What to do with children running around and upsetting some patients?
Answer:
 It was suggested that a notice be put up to ask that children be kept from running
around by their carers. This will be considered.
 The receptionists can send a note to the doctors that the patients be seen quickly
without them having to wait.
 Sometimes the receptionists can help in the waiting area but only if they are very
discrete.
Analysis Report of Patient Participation DES AS AT 9.2.14
Either
doctors
or
receptio
nists
NR/DR
16
ITEM
 One of the group suggested having a box of toys but unfortunately the CLCH will
not allow this because they may carry infection and would need to be regularly
sterilised.
 All the group were in agreement that the first point of help with any problems
relating to stress caused by other people’s children should be the receptionist.
4.4 Q Confidentiality issues were brought up
 Patients may want to ask reception staff questions about their clinical results,
speak about their medical problems or ask some advice which they wish to keep
confidential but this is difficult at the reception desk.
Answer
 This is a recognised problem and over a year ago a yellow line was drawn on the
floor at a distance where patients could feel they had some privacy to speak to the
receptionist. Unfortunately the CLCH did not agree with this action and the line
was withdrawn. One of the patients asked that the notice referring to the line by
taken away in both surgeries.
 One of the group suggested a ticket system for appointments. After discussion it
was agreed not to take up this suggestion.
 It was felt that there should be a way of patients being able to speak to reception
staff with a degree of confidentiality and Nalini Ranasinghe will take this to Central
London Community Health. ACTION
 NR explained that reception staff have been advised not to use patients’ surnames
on the reception desk or on the telephone to try and maintain confidentiality and
that that they use a soft voice when talking to patients.
 Reception staff cannot safely and with confidentiality give out patients’ results on
the telephone while on the front desk, but there is a facility to transfer the call to
the back desk to give confidentiality.
ACTION
RECEPTI
ON
STAFF
NR
4.5 Q One of the patients asked the receptionist for the results of her husband’s medical
tests.
Answer
 The doctors explained their reception staff have been earnestly advised they must
not give results to anybody other than the patient unless the patient has given
written permission for this to be done. It is illegal to do this. If the reception staff
have any problems with such circumstances, they should always refer to one of the
doctors.
 CONFIDENTIALITY – It was agreed by the entire group that Dr Nalini Ranasinghe
put to the CLCH that our patients are concerned about confidentiality in the
waiting area. Action to be taken as in 4.4.
5.
Q Fasting Blood Tests
One of the group brought to this meeting his anxiety about hospitals making
appointments as late as 12.30 a.m. for fasting blood tests and the patient discomfort
thus ensuing.
Answer
 The hospital system was explained to the group and if anyone has a problem they
were advised to write to the Patient Advisory Liaison Service.
6.
Q Why am I sent so many smear test letters?
Answer:
Analysis Report of Patient Participation DES AS AT 9.2.14
Patients
tell
17
ITEM
 The smear test letters are sent out by the NHS and not by the GP. Nalini
Ranasinghe suggested that anybody who feels they are being sent either too many
letters or too few letters should bring them to the surgery and GP will advise and
help patient.
7.1 Q Electronic Prescriptions – when are we going to do them?
Answer This service will be available when the doctors have gone on training.
7.2 Prescriptions Generally
Doctors explained that reception staff have been advised that, unless a patient is
housebound, that telephonic prescriptions are not acceptable. This is solely to prevent
prescribing errors.
8.
Website
Dr Don reminded the patients that we do have a website which was explained to the
group (www.valedrivemedical.nhs.uk) for those who are not aware of this. Patients
wishing to book appointments via the website should first access the website and then
register and when accepted will be able to do some of their transactions on line. To
access the website one should type in the web address or “Vale Drive Surgery”.
9.
Q Is there a system whereby the hospitals and the GP’s can liaise about a patient?
Answer:
 Doctors advised that the hospitals and the GPs can liaise with each other by
phone.
 Results of investigations are received every day by the doctors on-line.
 The doctor will arrange for a patient to come in for an appointment if they
consider the result abnormal. This relates to results which have been carried out
at Barnet, Chase Farm or Finchley Memorial Hospital.
 Nalini Ranasinghe always asks patients to ring the surgery for blood results, for
example, 2 to 3 days after having had them done. This is to make sure that we
have received the results as there have been instances where the results have not
been received by us.
10. 
The agreed actions summarised by the doctors and the group were:
o If the doctors are running late, this will be written up on the LED in the
waiting room.
o Consideration to be given to putting up a notice concerning the
responsibility of parent/s/carer/s for the safety of children running
around the waiting area.
o The first point of call would be the receptionist if any of our patients
were anxious about any disturbance in the waiting area.
o The doctors would approach North London Community London
Community Health concerning greater confidentiality for patients.
o If a patient is receiving smear test calls which she thinks are too
frequent, she is to ask the doctor to look into this.
Nalini Ranasinghe thanked the patients again for their participation and informed
them they would eventually be receiving a note of this meeting.
Analysis Report of Patient Participation DES AS AT 9.2.14
ACTION
doctor