Annex D: Standard Reporting Template
London North West Area Team
2014/15 Patient Participation Enhanced Service – Reporting Template
Practice Name: Church End Medical Centre
Practice Code: E84013
Signed on behalf of practice:
Cathy Rakata
Date: 24.3.15
Signed on behalf of PPG:
Miss Iris Brown
Date: 24.3.15
1.
Prerequisite of Enhanced Service – Develop/Maintain a Patient Participation Group (PPG)
Does the Practice have a PPG?
YES
Church End Medical Centre’s PG group was set up in 2001 and became a member of the National Association of Patient Participation
(NAPP) in 2002. In 2012 the group changed its name from Patient Participation Group (PPG) to Patient Group (PG)).
Method of engagement with PPG: We are one of the first practices to have a PG group in North West London and the group has remained active
over the years. We believe in patients having an input in the services we offer. We engage patients via: Face to face , Email, PG meetings, posters
in the practice , on the estate put up by patients and in our local pharmacies, Mjog SMS messages, word of mouth, messages on repeat
prescription, letters, telephone and there is also a PG page on our website www.cemc.nhs.uk titled Have Your Say, which has details of the
forthcoming meetings, educational presentations, minutes, reports and patients feedback , Friends and family tests and patients surveys.
Number of members of PRG: 38
Detail the gender mix of practice population and PPG:
%
Practice
PRG
Male
48.80%
0.33%
Detail of age mix of practice population and PRG:
Female
51.20%
0.60%
%
<16
17-24
25-34
35-44
45-54
55-64
65-74
> 75
Practice
PRG
26%
0%
12%
0.20%
16.3%
0.38%
13.8%
0.44%
13.7%
0.36%
8.2%
1.2%
5.2%
1.0%
4.55%
2.7%
2500
Gender distribution
Ethnicity
2000
50.00%
1500
40.00%
1000
30.00%
Number of Patients
Percentage of patients
60.00%
20.00%
10.00%
0.00%
female
male
Gender
Practice
500
0
PPG
Ethnic groups
Practice
PRG
Detail the ethnic background of your practice population and PRG:
Practice
PRG
British
Irish
948
8
100
1
Indian
Practice
PRG
166
4
White
Gypsy or Irish
traveller
0
0
Other
white
224
3
Pakistani
Asian/Asian British
Bangladeshi
219
1
36
0
White &black
Caribbean
13
0
Chinese
10
0
Mixed/ multiple ethnic groups
White &black
White
African
&Asian
32
22
1
0
Other
Asian
19
0
Other
mixed
815
1
Black/African/Caribbean/Black British
African
Caribbean
Other
Black
1438
1113
56
3
15
0
Arab
26
0
Other
Any
other
2272
1
2500
Ethnicity
2000
1500
Number of Patients
1000
500
0
Ethnic groups
Practice
PRG
We also have a PRG representation from the practice which includes:
GP Partner, Practice Administrator, Practice Manager, receptionist, Practice Nurse and GP Registrars who present educational health topics.
Practice representation is on a rota basis to allow different people to have an input.
Describe steps taken to ensure that the PRG is representative of the practice population in terms of gender, age and ethnic background
and other members of the practice population:
Patient Reference Group (PRG)
PRG group representative of our registered patient population was established in July 2011 as part of the Patient Participation DES.
The purpose is:
 to identify a range of key patients who can be consulted on broader patient issues, services that are provided and practice development.
 To conduct a survey with the input of the group with questions relevant to the above
 To publish in consultation with the group the outcomes of the surveys undertaken and changes the practice has made as a result
 To involve patients in reviewing systems the practice has for gaining and acting on feedback relating to experiences
 To involve the group in reviewing relevant systems that the practice put in place and consider any recommendations made with the wider
team.
Currently the PRG group consists of 38 registered patients and it is open to all registered patients that wish to join.
We encourage patients to sign up to PRG by informing them that we aim to gather patients from as broad a spectrum as possible to get a truly
representative sample. We need young people, workers, retirees, people with long term conditions, people with disabilities and people from nonBritish ethnic groups.
The Patient Group and the Patient Reference Group are advertised in the following places:
1. On our website www.cemc.nhs.uk : Headed: Patient Group with the following Tabs: Patient Reference Group, Minutes of Patient Group
meetings, Presentations of educational topics.
Dates of PPG meetings are also advertised there as well as other documents. There is also a form that patients can complete if they wish to join
the group
2. We send MJOG text messages to patients informing them about future PPG meetings where we encourage them to join the PRG.
3. Posters in the surgery
4.
Jayex board in the surgery
5. Life Channel
6. We encourage patients at the PPG meetings to invite their Friends & Family to attend.
7. Opportunistically face to face when they attend surgery reception staff inform patients of the group and in consultation with doctors and nurse as
well.
8. On NHS Choices under performance
9. PG designated Notice Board in the practice entrance lobby where information posters are put up
Are there any specific characteristics of your practice population which means that other groups should be included in the
PPG? e.g. a large student population, significant number of jobseekers, large numbers of nursing homes, or a LGBT
community?
Yes.
We have a large number of immigrant communities ie: Somali, Eastern Europeans and also a lot of single parent families etc whom we
actively encourage to participate in PG meetings. We also encourage parents to come with their teenage children.
If you have answered yes, please outline measures taken to include those specific groups and whether those measures were
successful:
During consultations,
At reception-face to face
Text messages to Somali community
Through the Somali link worker
Female Genital Mutilation (FGM) presentation at the PPG meeting to encourage attendance from the community
At Ante Natal and Post-natal clinics
At baby immunisation clinics`
Measures were successful – we now have regular 5 to 6 representation from these groups at our meetings while in the past we had
none. The last meeting we had 22 patients which consisted of 4 Somali, 2 Polish, 2 teenagers (17&19) and 2 single mothers.
We have found that attendance from various communities is encouraged by the educational topic that’s been presented at the meeting.
Eg: when we had the FGM presentation a lot of Somalis and young people attended and when we had Diabetes, Prostate and Breast
Cancer, Contraception and prevention of STD presentations we had over 40 patients attending from various groups of patients
representing most categories.
2.
Review of patient feedback
Outline the sources of feedback that were reviewed during the year.
We received patients’ feedback from the following sources:
- responses and comments left in Patient Survey done over Autumn/Winter months of 2014
- comments from Friends and Family test in person and on line on our website www.cemc.nhs.uk
- In-house practice patient surveys
- complaints and suggestions received from patients face to face, email or via post
- complaints and suggestions received through our website
- complaints and suggestions posted on NHS Choices
- comments and publication on Primary Care website (GPOS)
- issues and suggestions raised by patients at our Patient Group meetings
- GP Survey 2104/15 – which patients could do in person at the practice, via post or online on our website
- We also had a patient survey done in our locality. We are part of Harness locality which has 21 practices whose aim is to work in
partnership with the community to transform primary care in a sustainable way that positively impacts on the health and wellbeing of
the local population.
Harness Survey
Report 2014v3-f.pdf
How frequently were these reviewed with the PRG?
There is a Matters Arising standing item on the Rolling Agenda of PPG meetings where issues like appointments, telephone system
or any other issues patients may have are discussed. Our PPG meetings take place four times a year. We also look at the other
sources of feedback and if there is a recurring theme we discuss it with the PRG.
Minutes of PG
17.6.14.rtf
3.
Action plan priority areas and implementation
Priority area 1
Description of priority area: Telephone queuing system
What actions were taken to address the priority?
Telephone access has been an issue and it’s always discussed at the PPG meetings.
When 5 years ago we changed our telephone system to 8 channels- due to patients complaining that they had problems with
getting through to the surgery over the phone we hoped that would sort telephone issues out. The system worked for a while and
then patients started complaining that the phone were not being answered and that they were being kept in a queue for a long
time.
We had a meeting with the telephone company in October 2015 and we agreed to reduce the channels to 4 – so that the phones
can be answered in a timely manner. We now have dedicated staff just answering phones. We now only have 4 lines coming in
with 4 waiting.
While 4 receptionists are on the phone to patients the other 4 patients calling are placed in the queue. Waiting in the queue did not
work as well as we expected it to work with patients complaining that they were often waiting in a queue as number 1 for a long
time ( sometimes up to 30 minutes).
The practice has decided to abandon the queuing system and try engaged tone when all 4 lines are busy. The practice consulted
with the PPG on 24th March 2015 and it was agreed to trial it for 6 months starting from May 2015 and discuss progress in the
November meeting.
Opinions regarding that move amongst patients have always been divided but practice’s view is that with getting engaged tone
instead of waiting in a queue patients do not lose money while waiting and the patients at the meeting agreed after a long
deliberation.
We have swapped repeat prescribing duties- a member of admin staff who used to do repeat scripts has been released to cover
reception duties while an HCA has taken over doing repeat prescribing. Again this will help with answering phones and covering
reception
Result of actions and impact on patients and carers (including how publicised):
We are yet to implement the new system. It was discussed and agreed at the PPG meeting. We have started advertising on
JAYEX board, Website, Posters in the practice, MJOG text messaging, on repeat prescription and word of mouth.
The dedicated bypass line for health emergencies used by carers, ambulances, STARRS, hospitals, external health care
professionals and the elderly (named doctor) has been notified by letter and we have not had any complaints about it so far.
Priority area 2
Description of priority area: Appointments ( Demand and Capacity)
What actions were taken to address the priority?
Access is a growing problem in most GP practices throughout the country and we are no exception. We have had problems with
recruitment for an extra doctor which has been going on for 2 years. In February 2015 we finally managed to recruit a doctor to
work full time.
Our practice is located in an area of high deprivation with a population consisting mostly of ethnic minorities with multiple health
problems, high unemployment and inability to self-manage minor illnesses. And as such they want to see a doctor for minor
ailments which could easily be self-managed hence the demand for appointments is very high.
To address the on-going issue with appointments availability CEMC has taken the following steps:
- introduced dedicated clinics ( diabetic, CHD, asthma, post natal, antenatal, joint injection, cryo/minor surgery, IUCD clinics) so
that patients with similar issues are not scattered all over the sessions but dealt with by a doctor specialising in a given field in one
clinic
-the HUB - offers extra doctors and nurses appointments in a sister practice. When all the appointments at CEMC are finished
patients can have an appointment booked in a neighbouring practice. (part of the prime minister challenge fund)
-nurse practitioner - since the introduction of NPs.sessions we have noticed a huge improvement in doctors’ appointments
-employed a doctor – full time doctor has been recently employed which should have an immense effect on the number of
appointments we are able to offer
-employed another receptionist – this will help especially with answering the phones first thing in the morning and throughout the
day
- swap of repeat prescribing duties- member of admin staff who used to do repeat scripts has been released to cover reception
duties while HCA has taken over doing repeat prescribing. Again this will help with answering phones and covering reception.
Result of actions and impact on patients and carers (including how publicised):
-
We have noticed a significant improvement in the number of appointments available.
In the past all appointments for the day would be gone before 9.00am but now we still have appointments available for the
day well up 11.00am and some days up to midday.
Patients have already started noticing the change and have commented on the ease of getting an appointment so late in
the day for the same day especially.
Priority area 3
Description of priority area: High attendance at A&E and Urgent Care Centre (Reported on Primary Care Website)
To audit hospital & UCC notifications
What actions were taken to address the priority?
We have noticed a high rise in A&E and UCC attendances in the past 12 months and some of these are in hours when the
surgery is open. We have disc used this with our PG group who felt that there should be more publications and education done.
We have as a result been trying to educate patients in the use of A&E. Whenever a patient attends A&E for minor ailments or for
a condition that could have been dealt with by a GP we write or telephone the patients to find out why they felt the need to attend
A&E instead of coming to the surgery (some the reasons given are: could not get appointment, difficult to get through the phone or
its near my work) . We are trying our best to discourage patients from attending A&E inappropriately and also Urgent Care Centre
within practice’s opening hours. We have been encouraging them to use the HUB or the Walk-in-Centre instead.
We have been advertising the HUB, to be used within practice’s opening hours and UCC and Walk-in centre out of hours, when
the practice is closed. We do it via MJOG text messaging, on the website, posters, on repeat prescriptions, answering machine
message and post.
We have been encouraging patients to see NP for minor ailments instead of attending A&E or UCC. We have also been asking
patients who say they could not get through for the time that they called so we can look at increasing our capacity of receptionist
at that time.
Result of actions and impact on patients and carers (including how publicised):
We have been advertising the HUB to be used within practice’s opening hours and Care UK and Walk in Centre when the practice
is closed. We do it via MJOG text messaging, on the website, posters, on repeat prescriptions, answering machine message and
post. Elderly patients and children are seen at the practice at any time within surgery opening times. And also patients with
chronic illnesses to make it easier for carers. We also use our extended ours sessions to accommodate carers who have to bring
their loved ones after work.
The attendance at A&E and UCC have been fluctuating but we have noticed some changes which are very encouraging as below:
A&E and UCC attendance audit 2014-15
Number of patients
250
200
150
100
50
0
Months
Progress on previous years
If you have participated in this scheme for more than one year, outline progress made on issues raised in the previous year(s):
1. Emis Access- booking appointments online. :
1535 (19%) patients are registered for online booking and the number of daily online bookings still rising. This a 6% (1339)
rise from the previous year.
We are now looking at extending online booking for travel and immunisations clinics and this will go live from 1st May 2015.
We keep on actively advertising Online Access (on website, via text messages, on LED board, via leaflets, posters, during
registration for new patients, by word of mouth)
- We are constantly increasing the number of slots available for online booking as demand rises
- Embargoed slots for on the day booking are lifted at 8.00am and the telephone lines open 8.30am , so patients who needs an
appointment on the day can start book online and avoid calling the surgery.
- Patients are now also able to book two appointments online at the same time, this makes it easier for them if they need to book
multiple appointments (e.g. 1 with a doctor and 1 with a nurse)
2. Ability to book appointments in advance– Patients are able to book appointments up to 4 weeks in advance. We ensure
that advance bookings are available on the system for 4 weeks ahead for those that need an appointment in advance which
allows patients and the practice to plan ahead. This ongoing and we have to keeping on monitoring to ensure appointments are
available. So far its been good especially with the new doctor on board.
3. Waiting time to see a doctor - On going, We continue to inform clinicians to work faster where possible and inform patients
when a clinician is running late. This ongoing as clinicians inform us that it is difficult to always conclude a consultation within
10minutes as patients present with differing medical problems hence.
4.
PPG Sign Off
Report signed off by PPG: YES
Date of sign off: 24th March 2015
How has the practice engaged with the PPG:
How has the practice made efforts to engage with seldom heard groups in the practice population?
The practice has always actively sought feedback from patients. At the beginning of every year the practice invites the PG to
come up with health topics, disease or otherwise that we would like to know more about to enable us to self-care or effectively
look after someone with the condition as carer. There has been presentations from PCT (health politics), Age UK (elderly care)
and health presentations on Diabetes, Sexual Health, Cancers, Menopause, Dementia, Rheumatoid arthritis, Depression, Asthma,
Hypertension, Children immunisations and many more. The various topics attract different groups of patients even those who
rarely come to the meetings.
Has the practice received patient and carer feedback from a variety of sources?
The PG has been involved in a variety of sources to feedback:
- Complaints /Suggestions from various sources
- Patient surveys done in the surgery
- The national patients survey
- NHS Choices
- Harness Locality Survey
- Patient letters
- Emails
- Through talking to Reception staff and Doctors or Nurses
Was the PPG involved in the agreement of priority areas and the resulting action plan?
The PG were involved in agreeing the priority areas and the resulting action plan. The priority areas where identified during the
year after the practice survey The action plan was discussed and agreed at the meeting on the 24 th March 2015.
How has the service offered to patients and carers improved as a result of the implementation of the action plan?
Changes has been made as a result of patient feedback:
- The practice has employed an additional Doctor to make it easier to see a doctor – the results have already been positive
with appointments often available till later on in the day. Will continue to monitor.
- An extra receptionist has been employed to answer phones so that phones are answered quickly – if phones are not been
answered on time there is a beeping sound that goes off on the practice managers’ phone to alert her – so far the PM
reports that the beeping sound has not been noticeable as before. Will continue to monitor.
- We continue to speak to other patients about the inappropriate use of A&E attendances and direct them to the walk-in
centre or UCC
- The stopping of telephone queuing system is yet to be introduced and we will feedback to the practice regarding this
change.
Do you have any other comments about the PPG or practice in relation to this area of work?
- The PG are very happy to be involved and being given the opportunity to feedback
- we feel valued that the practice listens to our concerns and suggestions
- we always look forward to the meetings as we always learn something new, be it the topic being presented or in
participating and group interaction.
- we feel privileged and thank the practice for giving us the time to air our views and working together for the good of the
practice and patients .
- we speak to patients in other surgeries and they don’t get to meet with their practice doctors and staff like we do.