Local Patient Participation Report
March 2014
Waterloo Health Centre
5 Lower Marsh, London, SE1 7RJ
Practice Business Manager: Ms Rona Sian
T: 020 7928 4049
Waterloo Health Centre, Patient Participation Group Report, March 2014,
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Executive Summary
The following report outlines requirements for a Local Patient Participation Report to satisfy
the PP-DES 2013 – 2014 requirements as directed by the;
THE NATIONAL HEALTH SERVICE ACT 2006
The Primary Medical Services (Directed Enhanced Services) (England) (Amendment) Directions
2011 Insertion of new direction 12A - “Patient Participation Scheme”.
Practice Business
Manager
Rona Sian
Number of doctors
Number of patients
7
8820
The practice has a virtual Patient Reference Group. This means that patients are invited and
encouraged to give their feedback via surveys on various aspects of the practice in a number of
ways. The current number of PRG Members is 15 and recruitment is on-going.
Summary Outcomes & Action Plan – PPDES Year 3 Results
Agreed action plans:
 Reviewing our repeat prescription service
 Improved use of IT for communication with our patients and streamlining our administrative
processes
 Improve our waiting area by reviewing confidentiality, displays of patient information and
updating the seating.
Waterloo Health Centre Local Patient Participation Report 2014
Waterloo Health Centre, Patient Participation Group Report, March 2014,
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About The Practice
We are a busy, friendly and caring general practice based in a street market near Waterloo
Station. We have a diverse population of nearly 9000 patients.
The team at Waterloo Health Centre comprises 4 partner doctors and 2 salaried doctors.
The team also includes 2 Practice Nurses, 2 Health Care Assistants, our Practice Manager,
reception and administrative staff. The team is further complemented by our allied health
professional staff which includes practice based Counsellor, Psychologist, Drug & Alcohol
Worker, Chiropodist and Dietician.
We offer a wide range of general practice services including those for pregnant women,
diabetics, asthmatics, minor surgery and child health clinics. We actively encourage those with
long term health conditions to attend the practice for regular reviews.
Services
IUCD (‘Coil’) Fitting
Implant Fitting
Antenatal Care
Baby Clinic
Vaccinations and Travel Clinic
Chronic Disease Management
Smoking Cessation
Minor Surgery
Dietician
Chiropody
Diabetes Care
Description
Contraception advice is available from all
practitioners. IUCD fitting is available Tuesday
and Friday. Patients should book an
appointment with a doctor to discuss further
The contraceptive implant ‘Implanon’ is fitted by
Dr Morris. Patients should arrange an
appointment to discuss with her further
We provide shared care with the community
midwifery team. The antenatal appointments are
booked with the GP
A walk-in clinic for advice and weight checking.
Vaccinations for all children up to age 5 by
appointment only. This operates on Thursdays
between 1.30 – 3pm
Routine and travel vaccinations for all ages are
available. This is a nurse led service. We also run
flu vaccination clinics in October. Further
information is available at reception.
Regular appointments with our Nursing team to
help manage chronic problems such as asthma
and high blood pressure.
We provide a Nurse-led stop smoking service.
Patients should make an appointment with the
team to discuss.
Our doctors undertake minor surgery procedures
including joint injections and removal of lumps
and bumps. We also perform cryotherapy for
some conditions.
We have a dietician who provides advice on diet
and lifestyle choices.
This clinic runs weekly to deal with common foot
and nail conditions. Patients should ask at
reception for details
We manage patients with diabetes from
diagnosis to long term care and follow up.
Waterloo Health Centre, Patient Participation Group Report, March 2014,
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Psychologist
Counselling
We have a psychologist based 2 days per week to
help manage a range of mental health problems.
There is no need to see a GP
We have a practice based counsellor who can be
accessed by our patients.
The Doctors
Dr Jane Beckley MBBS, MRCGP, DCH, DRCOG, DFFP
Dr Deborah Maynard MA, MB BChir, DRCOG, DFFP
Dr Katy Morris MRCGP, DRCOG, DFFP
Dr Mark Smith MBBS, MRCGP, DRCOG
Dr George Verghese BSc, MBBS, MRCGP, DRCOG
Dr Lucie Berthoud MRCGP, DRCOG
Dr Matthew Dennison BM, DTM&H, MRCGP
Dr Prashanthi Reddy MRCGP, DRCOG, BMchb, DFFP
The Practice Staff
Practice Support Team
Rona Sian Practice Business Manager
Sasha Tonks Patient Services Supervisor
Sonia Sinclair Assistant Practice Manager
Eileen Marriner Practice Secretary
Sue McKone Receptionist/Admin Assistant
June Mah Receptionist/Admin Assistant
Julie Barham Receptionist
Sara Farrell Receptionist
Rachael Singleton Apprentice Receptionist
Practice Nurses
Michele Olphonce Practice Nurse Team Leader
Helena O’Donnell Practice Nurse
Our practice nurses specialise in preventative medicine. Appointments can be made for
immunisations, suture removal, cervical smears & sexual health screening, contraception & family
Waterloo Health Centre, Patient Participation Group Report, March 2014,
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Healthcare Assistants
Debbie O'Connor Health Care Assistant
Claire Goldie Health Care
Assistant planning advice, blood pressure checks, blood tests, ear syringing, foreign travel, asthma
and COPD checks, vaccinations and advice.
District Nurses
The district nurses are based at the Moffat Clinic and can be contacted on 020 3049 5210.
Our healthcare assistants support the nursing team by providing phlebotomy (blood taking) clinics as
well as monitoring blood pressure, smoking cessation, new patient health checks, vascular disease
checks and dressings. They also provide administrative support in the chronic disease management
of our patients.
Additional healthcare staff
Lynds O’Connor - Counsellor
Anita Leslie Drugs & Alcohol misuse worker
Ghazala Khan Dietician
Tim Amour Podiatrist
Jennifer Enuson Health Trainer
Opening Hours Reception Times
Telephone Lines
8.00am – 6.30pm
8.00am – 6.30pm
8.00am – 6.30pm
8.00am – 6.30pm
8.00am – 8.15pm
8.00am – 8.00pm
8.00am – 6.30pm
8.00am – 6.30pm
8.00am – 6.30pm
8.00am – 6.30pm
Monday
Tuesday
Wednesday
Thursday
Friday
The practice also offers extended hours appointments on Wednesday between 18:30-20:00.
These extended surgery times. The practice is open for telephone calls, prescription enquiries
or registration at this time. The SELDOC out-of-hours service will operate for emergencies at
these times.
We have introduced a simple system to improve GP access. Telephone the surgery during
normal working hours and speak to a member of the Reception Team. Arrange for a time for
the GP to call you back who will discuss your problem and arrange an appointment if
appropriate.
You are able to book appointments with our Nursing Team as normal.
Home Visits
Waterloo Health Centre, Patient Participation Group Report, March 2014,
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Home visits are available for patients who are too ill to visit the surgery.
When the Surgery is closed
For urgent health problems outside of our normal surgery hours, patients are advised to call the
SELDOC service on: 020 8693 9066 or go to: www.seldoc.co.uk.
Our nearest walk-in centre: Soho Centre for Health and Care.
Step
Description
Continual Development of
Patient Reference Group (PRG)
The PRG is a representative
group of patients from the
practice. They are responsible
for providing feedback to
surveys and collaborating with
the practice to analyse the
results and agree realistic
change opportunities.
Key areas include but are not
limited to the following:
 Access
 Overall Satisfaction
 Seeing a Doctor
 See a Nurse
 The Reception
 The Surgery
Environment
 Demographics
 Specialised Clinics (e.g.
Flu, Minor Surgery)
Determine Priority Areas
Design & Build Surveys
Patients were presented with a
sample questionnaire from the
National Association of Patient
Participation as a basis for
discussion.
Patients are also given the
opportunity to provide
comments regarding other areas
they would like to see
addressed.
Practice used My Surgery
Website survey builder to put
together the patient survey
using questions from the NAPP
Surgery Comments /
Experiences
We had an initial drive to recruit
as many people as possible;
however, this is an on-going
process so that any of our
patients, new or current, have
the opportunity to contribute.
In year 1 of the PP DES, patients
gave us three main areas of
priority to focus on.
 Access
 Seeing the clinician
 The surgery
environment
In year 2 of the PP DES, we
looked at the following surveys;
 Seeing a clinician
 Surgery Environment
 Website
In year 3 of the PP DES, we
looked at the following surveys;
 Seeing a Clinician
 Surgery Environment
 Prescriptions
 Patient access
The practice collaborated with
the PRG to agree the questions
in each survey.
We then worked with them both
again in 2012/13 to agree the
next set of surveys and agree
the questions for 2013/4.
Waterloo Health Centre, Patient Participation Group Report, March 2014,
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Input channels available are:
• Surgery Kiosk
• Web Portals
• Laptop
• Paper
• Face to Face
Advertise Feedback Channels
Capture Patient Experience
Each survey can be used on
(published to) one or more of
the input channels listed
above.
Inform patients of the available
input channels and current
surveys, in order to create a
greater number of participation
responses. Types of promoting
include but is not limited to:
 Encouragement slip
given by the doctor
 Posters
 Leaflets
 News Letters
 Encouragement from all
Practice Staff & PRG
 Surgery Website
 Notice Board
Patients complete surveys using
the available input channels as
listed above.


Web Site: open to all
practice patients
Paper
Additionally SMS text messages
were sent to patients advising
them when the survey was
available and means of
accessing it. In recognition that
some housebound and elderly
patients may not have access to
these channels, paper copies of
each survey together with a SAE
were sent to targeted patient
groups.
In order to support the
Reception Team in encouraging
patients to complete the
questionnaires, a member of the
administration team was made
available during some evening
surgeries to encourage patients
to complete the survey and
answer any queries or questions.
This gave some patients the
opportunity to discuss and
understand why their views
were being sought and how the
results could shape future
services.
Additionally, at the end of the
consultation clinicians provided
their patients with a flyer giving
information regarding how to
Waterloo Health Centre, Patient Participation Group Report, March 2014,
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complete the survey.
Produce & Distribute Reports
Results in the form of reports are
produced for each individual
survey and distributed via the
Practice Website, Practice
Meetings, Surgery Notice Board,
PRG consultations.
Collaborate with PRG to
Analyse Results
The Practice Manager will
discuss & analyse the survey
results with the Practice Doctors
and then discuss with the PRG
for further analysis.
Agree Action Plan
Detailed action plans are
created at the end of year two
(2012/13) and the end of year
three (2013/14) of the PPDES
Implement Change
Practice must obtain the
agreement of its local CCG to its
proposals for any significant
change, e.g. change of opening
hours.
The results of each individual
survey were posted on the
practice website. Patients were
informed of this via posters,
leaflets and SMS text message.
Paper copies of the reports were
made available to individuals
upon request.
The Practice Manager and
partners analysed the survey
results. A patient group meeting
was then arranged specifically to
provide an opportunity to
discuss the survey outcomes.
In February 2014 we held a
patient group meeting to review
the last action plan and agree
priorities for the next patient
survey.
An agreed action plan between
the PRG & Surgery was created
after the year one results
(2011/12) according to the
outcome of the analysis from
the results.
A further action plan has been
created following the year two
results (2012/13).
Details of the year two action
plan are provided in the section
Discussions & Action Plans
below. A further action plan has
been created following the year
three results (2013/14).
Details provided in the section
Discussions & Action Plans
below.
Waterloo Health Centre, Patient Participation Group Report, March 2014,
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Approved changes can then be
implemented.
Input Channel Evaluation Criteria
Input Channels should be
Advantages
thoroughly evaluated for their
suitability for use by patient
belonging to a practice. The
following table describes the
advantages and disadvantages
of each input channel currently
supported for practices. Input
Channel
Paper Surveys
Suitable for a large
percentage of patients across
most services
Known and trusted media
for many patients
Disadvantages
Production, deployment
and collection of surveys
required
Data input required
Public Web Surveys
Instant feedback
Fast deployment of survey
Easily changeable
Limited to patients with
internet access
Limited to patients with the
ability to use technology
Instant feedback
Fast deployment of survey
Easily changeable
Excellent for tracking
feedback for specific
treatments (e.g. specialised
clinics)
Limited to patients with
internet access
Limited to patients with the
ability to use technology
Limited to patients with
email accounts
Limited to patients who
have provided Trust with email
addresses
Email Surveys
Waterloo Health Centre, Patient Participation Group Report, March 2014,
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Phone Surveys
Instant feedback
Fast deployment of survey
Easily changeable
Excellent for tracking
feedback for specific
treatments
Limited to patients with
telephone access
Limited to patients with the
ability to use a telephone
Additional cost to practice
Immediately and
conveniently accessible before
and after appointments
Instant feedback
Fast deployment of survey
Easily changeable
Limited to patients with the
ability and willingness to use a
touchscreen kiosk
Requires suitable physical
location
Instant feedback
Fast deployment of survey
Easily changeable
Immediately and
conveniently accessible before
and after appointments
Portable
Limited to patients with the
ability and willingness to use a
touchscreen tablet
Requires overnight charging
Instant feedback
Fast deployment of survey
Easily changeable
Immediately and
conveniently accessible
following treatment
Limited to patients with the
ability and willingness to use a
desktop PC
Requires suitable physical
location
Requires protection from
being damaged, lost or stolen
Instant feedback (proving
tablet used to input response)
Fast deployment of survey
Easily changeable
Immediately and
conveniently accessible
following treatment
Patients able to converse
with a person, puts at ease
Rapport building
Canvasser must be
independent
Additional resource
required
Patients may be reluctant
to give honest answers to
canvassers
Touch Screen Kiosks
Touch Screen Tablets / Laptops
Standard Desktop
Face to Face interviews
Patient Reference Group
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PRG Membership
Member Profiles
Our ‘virtual’ Patient Participation Group is currently made up of 15 Members of varying age, sex
and ethnic origin, with 2 ‘Chair’ or ‘Lead’ members.
PRG Recruitment & Representation
Recruitment to the Patient Reference Group is mainly via our Patient Forum. The Forum had
been advertised via posters in our reception area, on our website and in our Newsletter. In
addition, 20 invitation letters were sent to patients who had previously attended the forum.
This was followed up with emails by the Assistant Practice Manager.
Details including link to website were published in Newsletter
Note: Feedback is not solely reliant on the PRG, surveys are also completed by other Patients from
the Practice via the surgery kiosk and web portals etc.
PRG Agreement of Priorities
The Group was asked for ideas on developing a meaningful questionnaire that we could ask
patients to complete to enable us to evaluate our services, take appropriate action after
analysis of the questionnaires and, ultimately report back to our Patient Reference Group
following the outcome and agree actions:
To prompt ideas from those present, they were presented with a sample questionnaire from
the National Association of Patient Participation as a basis for the discussion. Some very valid
points were suggested by patients for the practice to bear in mind when designing the
questionnaire:
 The surveys should be relatively short in length and should take no more than 10
minutes to complete
 We established different ways for patients to access the questionnaire as follows: online via or website, email, paper copies posted to housebound patients and a dedicated
PC in the waiting room.

For those who required help to complete the questionnaire (e.g. learning difficulties /special
needs) practice staff were made available to assist.
Results, Outcomes & Findings
Survey results by Input Channel
Input channels
Survey
Website
Total
Seeing a
Clinician
60
60
Surgery
Environment
60
60
Website
60
60
Waterloo Health Centre, Patient Participation Group Report, March 2014,
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Survey
Total
180
180
Summary of Demographics Survey
The following report provides a summary of the demographics for patients that have
completed surveys during the data collection period for year 3 of the PP DES. This includes both
PRG Members and other practice patients.
Please note that the reports found on the website display the latest feedback captured and
therefore may contain more results than are summarised in this report.
Results are:



61% of the patients were female
30% of the patients were male
9% gave no response
The percentile breakdown of age category of the patients were






0% Under 16
38% 16 to 44
38% 45 to 64
15% 65 to 74
5% 75 or over
4% No response
Ethnic Group percentages were







66% White
13% Black or Black British
3% Asian or Asian British
3% Mixed
1% Chinese
3% Other ethnic group
11% No response
Representation of Registered Patients
Waterloo Health Centre can confirm that the feedback has been provided by a representative
group of its registered patients.
Survey Results
Waterloo Health Centre, Patient Participation Group Report, March 2014,
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Detailed reports for each survey can be found on our website
http://www.waterloohealthcentre.nhs.uk
All results were discussed with the PRG and relevant practice staff; the key outcomes for each survey
are highlighted below.
Seeing a Clinician
How often do you see or speak to the GP you prefer?






30 % Always or almost always
10% A lot of the time
10% Some of the time
0% Never or almost never
1% Not tried at this GP practice
49% No response
If you need to see a GP urgently, can you normally get seen on the same day?




65% Yes
11% No
18% don’t know / never needed to
6% No response
How good was the Nurse you last saw at?







43% Very good
18% Good
5% Satisfactory
0% Poor
0% Very poor
0% Does not apply
34% No response
Do you know about the Electronic Prescription Services (EPS)?






50% Yes, definitely
6% Yes, probably
13% No, probably not
10% No, definitely not
10% don’t know
11% No response
Environment






97.53% of patients were satisfied that the cleanliness and infection control in the
surgery was either ‘very clean’ or ‘fairly clean’
70.37% of patients said that other patients could overhear what was said to the
receptionist, but they didn’t mind
22.22% of patients said also felt they were overheard, but were not happy about it
2.47% of patients said they were not overheard
97.67% of patients found the receptionist either ‘very helpful’ or ‘fairly helpful’
60.49% of patients completing the environment survey were female
Waterloo Health Centre, Patient Participation Group Report, March 2014,
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Once the surveys had been closed (Jan 2014) and the results collated, we then did the following
to advise patients of the results prior to this meeting:
 Results were posted on the practice website
 SMS text message sent to all including link to results on website
 Slips circulated by reception
 Posters in waiting room
We then organised a patient group meeting to discuss and notified our patients using all of the
above methods.
Most of those present had managed to access the results on line. However for those who had
found difficulties paper hard copies of the results were made available at the meeting.
We then went through a summary of the results of the survey, giving the attendees an
opportunity to discuss the findings and decide on any action plans to take forward. We also
discussed possible initiatives to encourage a greater response to planned future surveys.
A Patient Forum meeting was then arranged to discuss the findings of the surveys.
Most of those present had managed to access the results on line. However for those who had
found difficulties paper hard copies of the results were made available at the meeting.
Issues:
Seeing a Clinician: Our new appointment system has had mixed reviews in the past, 61% of
survey respondents said they get through easily on the phone. And 65% survey respondents
said they get to see a GP on the same day.
EPS Prescriptions: 50% of respondents said they knew about the Electronic Prescription
Service. Those patients who came along to the PGF meeting said they have been having
problems with one of the local pharmacies when it came to collecting their prescriptions when
using the service.
Agreed action points:
We are reviewing our TTT appointment system and will be putting out another survey to patients
and staff. All findings will be brought to patients in the normal way.
The practice has spoken to the local pharmacy to go over existing issues. They are to arrange
additional training for themselves.
Even though the general consensus was that patient satisfaction was high in respect of access
(appointments & walk in clinics), the practice will continually monitor and review to ensure that
standards are maintained. The methods of review will be via continuing patient surveys and
consultation with our Patient Reference Group.
Subject
Seeing a clinician
Consultation with
clinician
Comment
Getting through on the phone 61%
find this easy
Between 71% of patients felt that
the clinicians are “good” when
asking about symptoms; explaining
tests and treatment, giving you
enough time; involving you about
Notes
Waterloo Health Centre, Patient Participation Group Report, March 2014,
14
your care; listening; treating you
with care and concern
What could be done
to improve the
medical care we
provide
Practice Website
Practice website
Cleanliness and
infection control
Helpfulness
Ethnicity of
respondents
Practice
organisation
Service very good. Clinic seems to
run pretty efficiently and effectively.
This is the best doctors’ surgery I’ve
ever been to. Doctors and nurses
here are wonderful and caring and
considerate
61% of respondents are aware of our
website
Very straightforward for
appointment booking and ordering
repeat prescriptions
68% of respondents fed back the
surgery is “very clean”;
77% of respondents found the
Receptionists to be “very helpful”;
20% of respondents “fairly helpful”
There was feedback from all ethnic
groups and the percentages
reflected those of our patient
population
Undoubtedly one of the best run GP
surgeries in the area
Patient Feedback - Constructive
Subject
Feedback
Speaking to Dr 61% of patients find
on phone /
it easy to speak to a
Appointments
doctor on the phone
What could be
done to
improve the
medical care
that is
provided?
Cut out the
administrative
“middle level”
people. Not the
services it provides or
the people on the
front line providing
that service.
Action
Introduction of GP
Telephone Access has
improved this from last year
Notes
TTT is being
reviewed in April 14
This will include
patient and staff
surveys.
Invested in IT to help
streamline some of the
mandatory admin processes,
e.g. EPS, Docman, new
patient database (EMIS
Web); electronic dictation
software for GPs writing to
the hospital, etc. And EPS
electronic Prescription
Service
Waterloo Health Centre, Patient Participation Group Report, March 2014,
15
GP access
How we wish you
would retain the
walk-in service
Unfortunately internally the
walk-in system is not
working. We’ll try the
system, however, review
with you at the next forum in
6 months’
Review was pushed
back to April 14,
this year to get a
better reflection on
how the new
appointment
system is working.
Refer to above
Customer care
Receptionists should
always be welcoming
and doing their best
to understand their
needs
Receptionists to undergo
customer service and
telephone skills training.
Our reception staff
have been on a
customer service
and ethnic diversity
training course
2013/14
Prescribing
More emphasis on
self-management
and conservation of
drugs
Copy of test
results
Doctors to promote selfmanagement of conditions
including health promotion
displays in waiting room plus
leaflets around selfmanagement of conditions.
Also re-promote minor
ailments scheme.
Continue to be available on
request
More patients are
signing up to EPS
and to order scripts
on line.
Repeat
prescriptions
Actively promote to patients
via posters in waiting room &
local pharmacies, text
messaging patients and
message on repeat
prescription slips
Receptionist give patient
courtesy call
Actively promote to new
patients at point of
registration. Promotional
material in waiting room.
New patients are
given our practice
leaflet which has
full details of our
website. And all
posters refer
patients to the
website for more
information
Copy of test results –
not just verbal on the
phone
Ordering repeat 56% of patients do
prescriptions on not know how to
line
access this service
Practice
website
Practice
website
If GP disagrees with
any notes attached
please reply/discuss
23% of patients are
unaware of our
website
Picture against
names of the team
Not possible with our current
website provider however
this is due for review in the
summer so will incorporate
Waterloo Health Centre, Patient Participation Group Report, March 2014,
16
this suggestion
The PPG DES has opened up channels of communication between the practice team and our
patients and we have welcomed the compliments and constructive feedback.
Waterloo Health Centre, Patient Participation Group Report, March 2014,
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