Standard Reporting Template Devon, Cornwall and Isles of Scilly Area Team 2014/15 Patient Participation Enhanced Service – Reporting Template Practice Name: Stennack Surgery, St Ives, Cornwall Practice Code: Y01922 Signed on behalf of practice: Fiona Vinnicombe (PPG Lead) Signed on behalf of PPG: Linda Petzing (PPG Chair) 1. Date: 20/3/15 Date: 20/3/15 Prerequisite of Enhanced Service – Develop/Maintain a Patient Participation Group (PPG) Does the Practice have a PPG? YES Method of engagement with PPG: Face to face and Email Number of members of PPG: 75 (Consultation Group 19, Virtual Group 56) Detail the gender mix of practice population and PPG: % Practice PRG Male 48% 31% Female 52% 69% Detail of age mix of practice population and PPG: % <16 Practice 15% PRG 4% (2 not disclosed) 17-24 20% 1% 25-34 -> 8% 35-44 <8% 45-54 40% 16% 55-64 -> 23% 65-74 14% 23% > 75 11% 15% Detail the ethnic background of your practice population and PRG: Practice PRG British Irish 4105 43 16 1 White Gypsy or Irish traveller Other white 503 15 White &black Caribbean 2 Mixed/ multiple ethnic groups White &black White African &Asian 8 22 Other mixed 11 (38% patients & 21% PPG members not disclosed) Practice PRG Indian Pakistani 3 1 Asian/Asian British Bangladeshi 6 Chinese 14 Other Asian 18 Black/African/Caribbean/Black British African Caribbean Other Black 11 1 Arab 2 Other Any other 10 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 continues to actively recruit new members, particularly from the lesser represented groups through our PPG ambassadors talking to patients in our waiting room. We have actively recruited from patients with differing occupational status eg. Full-time work, sick or disabled, retired and in full time education. The Virtual Group is especially designed for those who are unable to commit to meetings, but can be still involved eg. Under 25s and those with young families. Cornwall tends to have a predominantly white, older population with Cornish being a recognised ethnic minority. 11 of our “Other white” members fall into this category. 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 If you have answered yes, please outline measures taken to include those specific groups and whether those measures were successful: 25% of our patient population is over 65. This is therefore represented in our PPG membership. We have patients registered with us from five local Care Homes. We are considering ways of engaging with this group. Four members of the PPG classify themselves as permanently disabled. This enables the group to benefit from their experience in order to improve services eg. Installing a hearing loop. We also have carers represented in the Group. We have recently recruited some younger members to the Consultation Group and our smaller “Working Group”. Its meeting time has been altered to accommodate working members. 2. Review of patient feedback Outline the sources of feedback that were reviewed during the year: Patient Questionnaire designed and managed by the PPG (Action plan generated from this) NHS Choices – Patient Reviews Friends & Family Tests Patient feedback forms in Waiting Room (managed by the PPG) PPG Ambassadors working in the Waiting Room talking to patients Discussion in PPG meeting of Practice Complaints & concerns themes How frequently were these reviewed with the PRG? Every month by the Working Group Every quarter by the Consultation Group By email to the Virtual Group 3. Action plan priority areas and implementation Priority area 1 Description of priority area: Access to Appointments & Continuity of Care – with twelve GPs working across the week, patients can find it difficult to book with the GP of their choice. What actions were taken to address the priority? Each GP has a “Buddy”. This was publicised further in the Practice Leaflet, PPG Newsletter, on posters and flyers. Our Nurse Practitioner led “Same Day Service” for acute problems was explained and promoted through newsletters and posters. The PPG was given an up to date presentation about the appointment scheduling. The release of appointments was discussed and the balance altered by agreement with the PPG and also mindful of our National MORI survey results. A poster showing the working days of each Doctor was publicised Meet & Greet Days held by the PPG in the Waiting Room to inform and listen to patients for feedback and concerns. The PPG was keen to try to reduce “DNAs” to help with capacity. (Unattended appointments) Result of actions and impact on patients and carers (including how publicised): Greater awareness of services & options available eg. “Choose Well” campaign & on the day appointments for acute problems (SDS) More appointments made available within 48 hours Publicised – Revised Practice Leaflet PPG Newsletter Posters Flyers PPG Ambassadors Priority area 2 Description of priority area: Reducing DNAs (Unattended appointments) – were over forty GP appointments and six hours of nursing time per week What actions were taken to address the priority? The PPG was very keen to address this issue. It was agreed that letters would be sent to any patient who DNA’d three or more appointments within a six month period. A follow-up letter would be sent if the patient continued to DNA, subject to the GP’s authorisation. The importance of cancelling an unwanted appointment was highlighted in the PPG Newsletter and up to date DNA figures were displayed in the waiting room each week. The new on-line booking system was introduced and this was promoted as another option, which allows patients to cancel their appointment 24/7. Result of actions and impact on patients and carers (including how publicised): It has been noted that once patients have received a letter they generally either attend or cancel their appointment. The number of letters being sent each month has reduced significantly from being over 20 per month originally down to 7 in February 2015. This has in effect released additional GP appointments, improving access and continuity of care. This continues to be publicised on posters and newsletters as well as on our new electronic calling system. The Practice & PPG continue to monitor the loss of nursing hours due to DNAs. Priority area 3 Description of priority area: Waiting time for Appointments & Queues in the Waiting Room – Patient feedback and surveys raised the issue of GPs running late. The Reception desk often has queues of patients. What actions were taken to address the priority? Making patients aware as to why a doctor may be running late – Although appointments are only 10 minutes, the doctor will spend the appropriate length of time with the patient if necessary and therefore may over-run. Patients may also book double appointments if they feel it necessary. This information was publicised by the PPG Ambassadors, Newsletters, Practice leaflet and also through staff training with the Reception team. Reception when possible to inform patients if a doctor is running late. This is also going to be assisted by a new IT system which will inform the patient when they book in or whilst they are waiting, to be installed during 2015. Patients being seen in the SDS may have a wait due to clinical priority. Awareness of this through newsletters and Reception team. Through local community group talks, the PPG Chair has been able to give explanations for issues that have been raised around this subject. Queues regularly form at Reception. This is often patients wishing to book in who do not want to use the “Arrivee” electronic checking in screen. PPG Ambassadors have actively shown patients how to use this system and thereby reducing queues and their wait. User Guide Posters have been produced by the PPG and displayed in Reception. The new on-line booking system and medication ordering has also been introduced this year and promoted by the PPG in the Waiting Room and in the local community. Result of actions and impact on patients and carers (including how publicised): Over 2000 patients have registered to use the on-line services, with over almost 1200 regular users. This helps reduce not only queues, but also volume of phone calls. Patients feel more confident to book a double appointment if necessary. PPG Ambassadors “Queue walk” in order to help patients use the IT options, thereby reducing queues at the Reception desk. New IT during 2015 will make patients more aware of waiting times. 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): The issue of patients not being able to hear when they are called due to the size of the waiting room – As a result of patient feedback, the PPG installed microphones for the clinicians to use, however this proved unsuccessful as some felt uncomfortable using them. An electronic calling system was then trialled as an alternative. The PPG collated the feedback for the Practice to make a decision on its purchase. The system also enables information to be displayed in the waiting room. The PPG has been instrumental in producing patient friendly information for the slide show being displayed between calling patients. The PPG continues to take an active role in the annual flu clinics by members working with the surgery staff to manage the large numbers of patients being seen and to take the opportunity to talk to and listen to the patients. The PPG continues to work to improve communication and therefore inform patients of the services available through the revised Practice leaflet, Newsletters, publicity and their on-going presence in the waiting room. 4. PPG Sign Off Report signed off by PPG: YES Date of sign off: 20/3/15 How has the practice engaged with the PPG: How has the practice made efforts to engage with seldom heard groups in the practice population? Local school talks by PPG & Practice staff, introduction of Young Persons Clinic, use of Social media. Has the practice received patient and carer feedback from a variety of sources? Patient survey, PPG survey, PPG feedback forms. Carers are represented on the PPG. Was the PPG involved in the agreement of priority areas and the resulting action plan? Yes - totally How has the service offered to patients and carers improved as a result of the implementation of the action plan? As above – a better balance of appointments released, reduction in DNAs, reduced queues, better informed patients. Do you have any other comments about the PPG or practice in relation to this area of work? The PPG has worked extremely closely with the Practice and has a very good working relationship with all clinicians and staff.