The Molebridge
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Practice
Standard Reporting Template – Patient Participation DES 2014/15
Surrey & Sussex Area Team
Practice Name: THE MOLEBRIDGE PRACTICE
Practice Code: H81618
Signed on behalf of practice
Dr F Florido
Date 20.03.15
Signed on behalf of PPG
1.
Date
Prerequisite of Enhanced Service – Develop/Maintain a Patient Participation Group (PPG)
Does the Practice have a PPG? YES / NO
Yes
Method of engagement with PPG: Face to face,
Email, Other (please specify)
Email and regular face to face meetings with
our patient representative.
Number of members of PPG:
36
Detail the gender mix of
practice, population and PPG:
%
Male
Detail of age mix of practice population and PPG:
Female
%
<16
17-24
25-34
35-44
45-54
55-64
65+
Practice
Practice
19
10
14
15
14
12
17
PPG
PPG
2
7
7
19
21
16
29
Detail the ethnic background of your practice population and PPG:
White
Mixed/ multiple ethnic groups
%
British
Irish
Gypsy or
Irish
Traveller
Practice
PPG
92.33
97.30
0
0
0
0
Other
white
White
Black &
Caribbean
White &
black
African
White &
Asian
Other mixed
4.04
0
0
0
0
0
0
0
0.23
0
Black / African /
Caribbean
/ Black British
Asian/ Asian British
%
Indian
Pakistani
Bangladeshi
Chinese
Other
Asian
Practice
PPG
0
0
0
0
0
0
0
0
2.63
2.70
African
0
0
Other
Caribbean
Other
Black
Arab
Any
Other
0
0
0.7
0
0.08
0
0
0
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:
No representation issues have been identified. All patients are encouraged to join the Patient Participation Group
via our website and newsletters.
Are there any specific characteristics of your practice population which means that other groups should be included
in the PPG? e.g. large student population, significant number of jobseekers, large numbers of nursing homes or a
LGBT community? YES/NO
There are no specific characteristics of our practice population.
If you have answered yes, please outline measures taken to include those specific groups and whether those
measures were successful:
Not Applicable.
2.
Review of patient feedback
Outline the sources of feedback that were reviewed during the year:
Historically we have relied on the annual patient survey provided by CFEP for patient feedback.
Noting the flexibility allowed this year, and in contrast to previous years, we have chosen to reference several
different sources:

We have used the Summary of 50 patient’s feedback provided by the RCGP questionnaires on the Senior
Partner Dr Florido.

We have used the results of the INR Patient Satisfaction Survey carried out internally with 25 patients and
reported to Surrey Downs CCG.

We have accessed the feedback left by patients on the NHS Choices Website.
How frequently were these reviewed with the PRG?
The feedback left by patients on the NHS Choices Website is readily available for all of our patients to see. The
results of the RCGP and INR service feedback have been shared with the PRG by email once on 25th February 2015.
3.
Action plan priority areas and implementation
Priority area 1
Description of priority area:
Clinical care
A comment was made asking for “checkup” sessions and we gave consideration to this as part of the
Health Checks Programme in Primary Care run by Surrey County Council.
What actions were taken to address the priority:
We recruited an additional Healthcare Assistant and sent her on the necessary training courses to
undertake healthchecks in line with the Surrey County Council Scheme. Equipment was also
purchased to undertake the checks.
We are in the process of contacting all our male and female patients aged 40 to 74 to invite them to
book an appointment for a health check. The check-up is provided under the Surrey County Council
Scheme is designed to assess patient’s risk of developing heart disease, stroke, kidney disease, or
diabetes. So far, we have sent 706 letters
During the 20 minute session our Healthcare Assistant considers patient age, gender, family history,
height, weight, and blood pressure through a combination of straightforward questions and simple
measurements. This check-up is aimed at people who do not have an existing serious health condition
and is available to people in the target age range, once every five years. Understanding any risks can
doctors to manage patients’ health before it becomes serious.
In addition to the above we fully engaged with our CCG in implementing an Emisweb upgrade. This
new clinical software allows us to work much more closely with the CCG in identifying and meeting
patient needs by the development of clinical templates that are produced centrally and can be
integrated with other NHS organisations.
Result of actions and impact on patients and carers (including how publicised):
The health-check service has been advertised by Surrey County Council and by the Practice in our
newsletter, on our Website and with notices displayed throughout the surgery.
The success of the programme was such that by December 2014 131 patients had been seen. We
expect the uptake of the health-checks to continue to increase but it will be limited by the fact that
many patients do not respond to the offer.
Priority area 2
Description of priority area:
Getting an appointment
Comments from our INR patient feedback report were broadly in line with previous years’ scores
where 68% of patients were extremely satisfied with opening times and the availability of
appointments.
There were also comments on the NHS Choices website where patients expressed views on getting an
appointment. While the majority complained about the difficulty in getting an appointment some
patients expressed an understanding of the pressures being placed on GP surgeries.
What actions were taken to address the priority:
We have tried several strategies to relieve the pressure on appointments:
1) One of the problems the Practice has faced has been the retirement of a Partner. Patients
struggled to get appointments with the remaining Partners and so we encouraged patients to
see the new salaried doctors by displaying messages in waiting areas and by explaining the
issues in a Patient Newsletter.
2) We have also recruited a Nurse Practitioner and, from March 2015, a Physician Associate.
Physician Associates and Nurse Practitioners are highly experienced health care professionals
who are able to diagnose, make recommendations on treatment and refer patients to
specialists and they work very closely with the GPs in the Practice. In addition, our Nurse
Practitioner is able to prescribe. This has freed doctor appointments for patients with more
complex clinical needs.
3) We have recruited a phlebotomist and increased appointments with our Health Care Assistant
so that our more experienced Practice Nurses can focus on more relevant patient care.
4) Our Senior Practice Nurse has continued to triage patients presenting with urgent problems
that could not be seen by a GP, providing safe and effective treatment with the support of
the GPs in the Practice. This measure will have reduced A&E attendances and improved patient
care overall. In addition, our Senior Practice Nurse has received additional training in
diabetes, hypertension and high cholesterol levels and is now able to manage these conditions
independently under the close supervision of our GPs.
5) We have increased the timescale for advanced booking from 8 weeks in advance 12 weeks
ahead. We offer a combination of routine appointments (bookable in advance), “book-on-day”
appointments (bookable on the same day only) and emergency appointments for urgent
problems. In addition, we also have online appointments. We have extended the nurse triage
system which is now offered on a daily basis.
In addition to the steps outlined above we have improved patient access as all our normal GP
appointments are now offered online. We actively encourage patients to register for online services
which includes booking appointments with doctors, ordering repeat prescriptions and patient
registration.
Result of actions and impact on patients and carers (including how publicised):
It has taken time for patients to adapt to the new provision and to realise that appointments with
the Nurse Practitioner are a valid alternative to see a clinician quickly. As patients have started to
book appointment with the Nurse Practitioner we have noticed that frustrations have fallen and
patient satisfaction has increased.
Priority area 3
Description of priority area:
Reception Issues
Patients have complained that receptionists are unfriendly and do not take time to deal with their
issues.
What actions were taken to address the priority:
Reception Staff Should Be Friendlier
We give this matter great importance and remind reception staff regularly that they are the first
point of contact for patients and that it is very important that they present a warm and welcoming
face to patients.
We arranged for customer awareness specialist training for receptionists in how to identify and deal
appropriately with patient needs. All of our receptionists now give their names when greeting patients
both in person and on the telephone, which helps develop a better and closer personal relationship
and, when things go wrong, allows us to identify problems.
We have also installed new telephone equipment that has significantly improved the communication
pathway for both patients and receptionists. This surgery had 2 sites with separate telephone
numbers, which meant that patients telephoning the site that was closed would get an answerphone
message asking them to telephone the site that was open. Now, after the new telephone upgrade, if a
patient telephones the site that is closed the call is automatically transferred to the site that is
open. Also if the telephone is not answered immediately by the receptionist the new system
provides a waiting / queuing facility that minimises the frustration of getting an engaged tone. Music
is played during the wait.
Result of actions and impact on patients and carers (including how publicised):
The positive impact of the training given by the customer awareness specialist was felt immediately.
Staff particularly commented at how practical and useful the training had been. The overall
conclusion indicated that staff had been empowered set a standard for patient contact that they
understood and were prepared to act upon.
So far no patient comments have been received and we believe that it is too soon to assess the
outcome for the telephone initiative.
Priority area 4
Description of priority area:
Opening Times
We have continued to carefully look at longer branch opening. Up to now this has not been feasible
as there is a need to balance the needs of the two geographic areas that are served by the
Practice. It would only be possible to open one site more at the expense of the other and a balance
needs to be reached. The Partners have used their best judgment to be fair in implementing the
current arrangements. Currently both sites open an equal number of days to reflect the fact that
the number of patients at each one of the premises is also practically the same.
What actions were taken to address the priority:
The “normal hours” in General Practice are from 8am to 6.30pm from Monday to Friday. The
Practice as a whole (i.e. Fetcham AND Leatherhead) is open every day between those times
including the lunch time between 1pm and 2pm following patient demand, last year, for opening
during that time. In addition, we are fully engaged with the service of “extended hours” (i.e.
additional opening outside the “normal hours”). We offer both early morning (from 7.30am) and late
evening (after 6.30pm) appointments and we normally exceed the “extended hours” requirements
for our list size by nearly 30%.
Result of actions and impact on patients and carers (including how publicised):
Patients continue to fully utilise the “extended hours” service which is always fully booked. We
also find the reception desk busy during the lunch hour indicating that there is a need for patient
contact at that time. We will continue to monitor the impact of opening hours and assess patient
feedback.
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)
Free text
The following actions were agreed with the PPG and published in last year’s report:
Action: Communicate advice to patients on how to book a doctor of choice.
Outcome: This was done via notices and in the patient newsletter.
Action: Monitor the impact of opening hours at branch level by continuing to assess patient
feedback.
Outcome: We have done this and no further action is necessary.
Action: Organise training with customer awareness specialist. We arranged for a specialist trainer to
give training to the whole reception team on customer awareness.
Outcome: The training took place in Feb 2014
Action: Increase ability to book appointments to 9 weeks in advance.
Outcome: We have allowed patients to book up to 12 weeks in advance.
Action: Continue to support nurse triage development.
Outcome: The clinical sessions have been re-organised to allow dedicated triage time for the
Practice Nurse every day.
Action: It was agreed that all GP appointments would be offered online.
Outcome: All normal GP appointments are now offered online via the EMIS Patient Access tool.
Action: Organise an assessment of further reconfiguration of the reception area at Fetcham.
Outcome: The assessment took place with the advice and recommendations from several builders.
Unfortunately, due to the structure of the building, the changes proposed did not necessarily
improve the issues raised with regards to confidentiality and no further action was possible. Action in
this area remains under review at the present time and, when NHS funding to improve premises
becomes available, we will take up this issue again.
Action: We were asked to improve signage for the patient toilet at Fetcham.
Outcome: That has now been done.
Action: We were asked to consider increasing the number of female doctor sessions.
Outcome: Consideration was given to the balance of male/female doctors and, following the imminent
departure of Dr Maleque (for personal reasons) from the end of February, the Practice will be able
to increase the number of sessions offered by a female doctor by one full day per week. In addition,
the number of appointments per session offered by the new female doctor will also be increased.
Action: We were asked to increase additional nursing staff and engage with the Health Check
program.
Outcome: We have recruited a phlebotomist and fully engage with the Health Check program via our
trained Health Care Assistant. To date over 131 patients have undergone healthchecks.
Summary of this year’s action plan:
Patient Representative Group Report and Action Plan
Clinical Care
We will continue to conduct patient healthchecks for all our patients aged 40 to 74 and send letters
inviting them to book an appointment. The expectation is that patient interest in this service will
continue. We will also continue our collaborative approach with the CCG in developing the use of
patient templates, searches etc.
Getting An Appointment
From March 2015 a Physician Associate will join the clinical team. From April 2015 it is our intention
to review the provision of female doctor time in the surgery, with a view to ascertaining if there is
scope to increase the number of female doctor sessions. The number of appointments with our
Healthcare Assistant has already increased and we will continue to develop and expand the roles of
our Phlebotomist, Practice Nurses and Nurse Practitioner.
We will also continue to offer appointments up to 12 weeks in advance and exceed our extended hours
quota by 30%.
All appointments will be offered online.
Reception Issues
We will continue to encourage staff, during our regular staff meetings, to be friendly and
approachable when dealing with patients at the front desk and on the telephone. Customer awareness
training has aleady been identified on our training needs assessment and that will take place during
2015.
We will monitor the changes made to the telephone system and hopefully obtain patient feedback in
case there is any further work to be done in this area.
4.
PPG Sign Off
Report signed off by PPG: YES / NO
Yes
Date of sign off:
2nd March 2015.
How has the practice engaged with the PPG:
By email and face to face with our Patient
Representative.
How has the practice made efforts to engage
with seldom heard groups in the practice
population?
No representation issues have been identified.
All patients are encouraged to join the Patient
Participation Group via our newsletter and
website.
We have used the Summary of 50 patient’s
feedback provided by the RCGP questionnaires
on the Senior Partner Dr Florido.
Has the practice received patient and carer
feedback from a variety of sources?
Was the PPG involved in the agreement of
priority area and the resulting action plan?
How has the service offered to patients and
carers improved as a result of the
implementation of the action plan?
Do you have any other comments about the
PPG or practice in relation to this area of work?
We have used the results of the INR Patient
Satisfaction Survey carried out internally with
25 patients and reported to Surrey Downs
CCG.
We have accessed the feedback left by
patients on the NHS Choices Website.
Yes
Clinical Care
We offer patient healthchecks and are in a
position with our upgraded software to work
closely with our CCG.
Getting An Appointment
We have increased the number of
appointments available and made all
appointments bookeable online.
Reception Issues
We have installed new telephone equipment
and receptionists have undergone customer
awareness training.
None