Introduction and Practice Profile ............................................................................................................ 2
Progress on 2012 Action Plan ................................................................................................................. 4
Appointments ..................................................................................................................................... 5
Telephones .......................................................................................................................................... 5
Car Parking .......................................................................................................................................... 5
Other ................................................................................................................................................... 5
Priority Areas for Survey ......................................................................................................................... 6
Survey Development and Administration ............................................................................................... 6
Survey Results ......................................................................................................................................... 7
1. DNAs ............................................................................................................................................ 7
2. Telephones .................................................................................................................................. 7
3. Appointments ............................................................................................................................. 7
Discussion of Survey Results and Proposed Action Plan ........................................................................ 8
1. DNAs ............................................................................................................................................ 8
2. Telephone System ....................................................................................................................... 8
3. Appointments ............................................................................................................................. 8
Agreed Action Plan ................................................................................................................................ 10
Practice Opening Hours ........................................................................................................................ 11
Appendix A ............................................................................................................................................ 12
Appendix B ............................................................................................................................................ 13
Appendix C ............................................................................................................................................ 15
Appendix D ............................................................................................................................................ 16
1

Since the last report, the practice has continued to recruit any interested patients to the
PRG. All new patients are invited to join and information given via their welcome pack and existing patients are also encouraged to participate. Despite this we have only recruited 4 new members this year.
Our current practice profile is shown in the tables below giving numbers of registered patients by age and sex and also those with learning disabilities, ethnic minorities, care home residents, are a carer or have a carer.
Table of practice profile by age and sex
Males 931
Females 814
Total
%
0-16
1745
18.8
Other categories
17-34
981
1001
1982
21.3
35-54
1274
1252
2526
27.1
55-74
1072
1082
2154
23.2
75+
388
508
896
9.6
Total
4646
4657
9303
100
%
49.9
50.1
100
Ethnic minorities
Learning disability
Has a carer
Is a carer
Care Home resident
Males 1
Females 0
Total
%
0-16
1
0.7
832
72
248
270
52
8.9%
0.8%
2.7%
2.9%
0.6%
The PRG now consists of 134 members and the profile of the group is outlined below.
Table of PRG members by age and sex
17-34
3
16
19
14.2
35-54
13
23
36
26.9
55-74
30
30
60
44.8
75+
10
8
18
13.4
Total
57
77
144
100
%
43.6
57.4
100
2

Other categories
Ethnic minorities
Learning disability
Has a carer
Is a carer
Care home resident
2
2
4
4
1
1.5%
1.5%
3.0%
3.0%
0.7%
The group structure has changed little over the past year. There are still more females than males as they tend to visit the practice more frequently and are keener to join. The age distribution of the members also tends towards the older groups. Again these patients tend to attend more regularly and are willing to join. All patient groups with specific needs are represented well apart from the ethnic minorities. Although we do target these patients to become members they are often less keen because of the language barrier.
3

Survey Outcome Action Plan
Difficulty getting an appointment A new nurse practitioner to start on
1/4/12. We will audit free appointment slots weekly and make adjustments as necessary
Being able to book in advance/at other branch of surgery
Reception staff, doctors and nurses to make sure patients are aware of this option when booking appointment or being seen.
Improve telephone service and answering
We are exploring options for a new telephone system when current contract expires in Jan 2013. In meantime have installed new 01305 numbers for patients to use if they chose. Ensure good staffing levels in reception at peak times.
Car parking very difficult at Abbotsbury
Road especially at peak times
Ask council about possibility of making 1 or
2 disabled spaces near door of surgery.
Encourage staff and patients to use alternative means of transport or car share where possible. Provision of bike racks/rings in surgery car park to this end.
Waiting times to see clinical staff within surgery
Warn patients when booking in if a doctor or nurse is running late.
Difficulty reaching doorbell for wheelchair patients
Moving doorbell to a more suitable position
Difficulty booking same day appointment for those unable to ring early due to work commitments
A trial of keeping a few slots available in the nurse practitioner/on-call doctors afternoon surgery which cannot be booked until 10am
4

Our new nurse practitioner has been in place for nearly a year now working on Mondays and Tuesdays which tend to be the busier days of the week. This has helped with appointment availability. In addition Dr Turberville-Smith left the practice in November 2012 and has recently been replaced with a new doctor (Dr Kiran) who is working an additional 3 sessions a week to provide extra appointments. It is too early to assess the impact of this change at present but it will be kept under review.
Patients are being made aware of being able to book at either branch of the surgery and in advance if more convenient and more are doing so. Unfortunately the trial of keeping a few slots available for those unable to ring early for a same day appointment was not successful as patients who had rung earlier were sometimes frustrated at being told to ring later and there might be slots available as it was impossible to assess the demand for these on a day to day basis.
Patients should also be informed by the receptionist when booking in if the doctor or nurse is running late or has been called out on an emergency visit.
Our new telephone system which is a 01305 number was installed in January 2013. There are 6 lines available for incoming calls at the Abbotsbury Road Surgery and 2 at Chickerell
Surgery. When all these lines are taken an engaged tone will be heard. At peak times there are good levels of staffing in reception to answer these.
We consulted Weymouth and Portland Borough Council about the possibility of making 1 or
2 spaces available for disabled parking in the 1 hour parking zone outside the surgery in
Holland Road. However it was felt by them that overall it would be detrimental to the situation as these spaces would not be available for use by anyone else including those with young children and elderly patients who do not have a disabled badge. We therefore did not pursue this further. A bike rack with 4 spaces has been installed in the car pack for use by staff and patients. Several staff who do not need cars to visit patients during the day cycle and some who live locally walk to work.
The front doorbell has been moved to a lower position so those with wheelchairs are able to reach it.
5

In autumn 2012 all PRG members were sent by post or emailed a newsletter (see appendices) detailing progress towards the agreed action plan and also outlining issues which they might like to consider as areas for incorporation into the patients survey and for subsequent improvement. The pie-chart below shows the breakdown by % of their responses.
DNAs
Appointments
Time Keeping
Car Parking
Telephones
Practice Information
In addition to this, they were asked to highlight any other areas of concern they felt needed to be addressed by the practice. From the responses received the 3 areas the PRG decided to focus on were DNAs (Did Not Attend), appointments and the telephone service.
After consultation with members of the group it was felt that last year’s survey was productive and easy to administer. It was agreed to develop and administer a practice patient survey along similar lines. Some questions were developed to ascertain some specific information but mostly to allow patients to comment on their experiences in an open style and share ideas and information. This may identify areas of concern which may not otherwise be realised. The questionnaire was kept short as long surveys with multiple questions which may be irrelevant to the individual are often not completed from previous experiences.
A small number of surveys were handed out to some PRG members initially as a trial to ensure that the questions were understood and appropriate information was being gleaned.
This was successful so the opportunity to complete a survey was extended to all patients in
6

both branches of our surgery over a 2 week period in February 2013. Questionnaires were available in paper format at reception and in the waiting rooms for completion, and the survey was also available on-line. PRG members were sent one to complete via post or email. Reception staff in both surgeries encouraged completion.
350 surveys were handed out, posted or emailed and 285 were returned completed. This represents an 81% response rate. Not all patients answered every question and being mostly of an open style the replies were grouped into recurrent themes. The results are detailed in the appendices and the overall themes outlines below.
1.
DNAs
The vast majority (79%) or respondents felt they would find a text reminder of their appointment helpful. Of those who would not, some didn’t have a mobile phone and others felt they had no difficulty remembering their appointments. 78% would be happy to receive such reminders. Suggestions for reducing the number of DNAs included a fine or charge, removing repeated offenders from our list or cancel their future appointments and a poster in the waiting room detailing the number of DNAs the previous month and the amount of time wasted.
2.
Telephones
51% respondents felt the new 01305 telephone service was an improvement on the previous service. This was for a number of reasons including being cheaper especially from mobiles), quicker and easier to remember and dial and being a more personal service going straight to a receptionist. Many patients commented on it generally being a good service with polite receptionists. Some patients felt there was no difference. A small number had difficulty getting through, repeatedly getting the engaged tone at peak times (8am).
3.
Appointments
36% patients had no problems getting an appointment. There were a number of comments about needing to ring early or all appointments being taken and difficulty getting to see their own GP. Also a number of patients wanted to have more prebooking and 48hours slots back as they were finding it difficult to get a routine appointment. These had recently been reduced because of patients complaining that they were unable to get a same day appointment. Some patients wanted online booking to be available.
7

A meeting was held including GPs, practice manager and some members of the PRG to discuss the results of the survey and devise an action plan.
1.
DNAs
As the vast majority of respondents would find a text message reminder of their appointment useful and would be happy to receive reminder it was felt that it would be worth actioning this. Up to date mobile numbers and contact details would need to be collected and consent given for such reminders to be sent. Also it was felt that those who would be happy for messages to be left on answering machines could be reminded that way if they do not have a mobile. As charging patients who DNA is not an option it was felt that a letter sent to the patient after 3 DNAs highlighting the fact would be appropriate. Also a poster in reception and each of the waiting rooms detailing the number of DNAs the previous month and the number of hours of wasted doctor and nurse time and a note to cancel unwanted appointment might make some patients realise the consequences of their actions.
2.
Telephone System
The majority of respondents appear to be happy with the new telephone service with it either being an improvement on the previous one or no difference. Some patients had difficulty getting through at peak times getting the engaged tone.
However it was recognised no system is ideal and at peak times this will happen sometimes without unlimited lines (there are 8 incoming in total) and receptionists.
Making sure reception is always well staffed at peak times and that answering the phone at these times is prioritised was suggested. 2 patients were unaware of the new number. This has been publicised in the surgery on posters, in the local press, on our facebook and twitter pages and on our website and patients who ring our old number are informed of the new number.
3.
Appointments
After a number of complaints from patients and also to try and reduce the DNA rate the number of slots available for booking before the day were reduced. However this has proved unpopular in the survey with a fair number of patients wanting the old system back. Unfortunately there is no appointment system which is going to suit everyone’s need as some patients like to book ahead for work and other commitments and others like to be able to ring up and be seen on the day. On balance it was felt that returning to the old system was probably the best option.
Increasing the number of sessions available at Chickerell was also discussed and subject to staffing levels this can be increased. There is an increasing population at
Chickerell and our current surgery has only one doctors consulting room. A new
8

surgery with more space would address this (subject to funding etc) but not an option in the short term. Unfortunately getting an appointment with the patient’s own GP was difficult for some. This is a difficult area to address as sometimes due to high demand, being part time, on holiday or having other clinical commitments this cannot be met. In terms of same day appointments it is also important that the nurse practitioner is filled with suitable patients to leave slots free for GPs to see more complex cases. Posters in the waiting rooms to advertise what conditions they can deal with were also suggested.
Some PRG members were asked for comments and any additional suggestions on the proposed action plan. The return to the old appointment system was popular. It was also suggested that a new buggy area was made in the waiting room as the current arrangement with buggies being left in the porch was hazardous for elderly patients with walking aids and wheelchair users.
9

Text message reminders acceptable to most patients
To reduce the number of DNAs useful and Ask patients for up to date mobile numbers and contact details and consent to send SMS messages and /or phone a landline and leave a message if necessary. Send text/phone day before appointment to remind them.
Poster in waiting rooms and reception detailing the number of DNAs each month and the amount of doctors and nurses time wasted. Also request to cancel any unwanted appointments.
Receptionists to prioritise telephone answering at peak times
Some patients having difficulty getting through on telephone at peak times
Difficulty getting same day appointment Ensure nurse practitioner appointments are filled with appropriate patients. Poster in waiting rooms and reception to advertise conditions they can manage
Difficulty booking in advance
Difficulty getting an appointment at
Chickerell
Return to old system with increased 48hour and prebook slots
Providing staffing allows have doctor for 10 sessions at Chickerell
Porch can become congested with buggies Create area in waiting room for buggies instead
10

The surgery is open from 8am to 6.30pm Monday to Friday. During these times patients can contact the practice by telephone, come into the surgery in person or contact us by email.
Extended hours from 7.30-8am and 6.30-8pm are offered by all partners on a rotational basis from Monday to Thursday. The Doctors in attendance at these times vary from week to week depending on rotas and GP availability (annual leave and other commitments).
Below is a general guide to availability:
Dr Hewett: Tuesday, Wednesday and Thursday mornings, Wednesday evenings on rotational basis.
Dr Priestley: Monday and Tuesday mornings and Tuesday evenings on a rotational basis.
Dr Brown: Tuesday evenings on a rotational basis.
Dr Ward: Monday and Tuesday mornings and Monday and Tuesday evenings on a rotational basis.
Dr Lane: Thursday evenings on a rotational basis.
11

PATIENT REPRESENTATIVE GROUP
We would like to know how we can improve our service to you and how you percieve our surgery and staff.
To help us with this, we have set up a patient representative group so that you can have your say.
We will ask the members of the representative group some questions from time to time, such as what they think about our opening times or the quality of care or the service received. We will contact you and keep our surveys succinct so it shouldn’t take too much of your time.
We aim to gather around a hundred 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 and people from non-British ethic groups.
If you are happy for us to contact you occasionally by e-mail please advise us of your e-mail address.
Alternatively, please ensure that we have your correct address and telephone number.
If you prefer you can download a sign up form as a pdf document from our Website – www.abbotsburyroadsurgery.co.uk
– print it out, complete it and return it to the practice.
The results of our survey will be published on our Website at the end of March and will also be available in our waiting rooms – please ask for a copy.
12

TH
We have installed a bicycle rack to the rear of the surgery car park to provide 4 spaces for staff and patient use. Some staff now cycle regularly although it is more difficult for those needing to visit patients during their working day carrying equipment.
After contacting Weymouth and Portland Borough Council, we felt that it would not be worth pursuing trying to make 1 or 2 spaces in the 1 hour parking area close to the surgery in Holland Road for disabled use. These would not be able for use by anyone else including those with small children and elderly patients not holding a disabled badge.
Our new nurse practitioner started on 1/4/12 providing extra appointments at the start of the week when demand is usually higher. Dr Turberville-Smith will be leaving us shortly and a new doctor working increased hours should be starting in January. This should provide a further increase in the number of appointments available. Also for those unable to ring early due to work commitments booking the nurse practitioner the following day is now available as well as the usual pre-book and 48hours slots with the doctors.
With the installation of our new computer system in July, we have been exploring some of the new data now available to us and the extra features we can use. During August, 341 and
September, 268 patients did not attend a booked appointment. This equates to 56 hours and 44 hours respectively. These appointments could have been used by other patients who wanted to be seen and were a waste of the doctors or nurses time. We now have the facility to send SMS text message or email reminders to patients to try and reduce these numbers.
Obviously patients would have to sign up to the scheme and it will not be suitable for all.
Hopefully a reminder will jog memories and if the appointment is no longer needed it can be
13

cancelled. We feel this is worth exploring and if you agree please can you tick the DNAs box below.
With our current telephone provider contract due to expire in the next few months, we are negotiating currently with other providers. We will be having a 01305 number and hopefully similar features to our current service allowing for callers to be directed to the right person as much as possible.
We have installed a doorbell which is at a suitable height for wheelchair users at the front door. Reception staff have been instructed to inform patients if a doctor or nurse is running late or has been called out on an emergency and there is likely to be a delay in being seen.
In order to develop our patient survey which will be administered early 2013, we would be grateful if you could indicate with an X, the areas which you feel merit further improvement.
Appointments
DNAs
Car parking
Information about the practice
Time keeping
Opening times
Waiting rooms
Telephone service
Customer services
Clinical care
Other (please specify below)
14

We would be grateful if you could spend a few minutes of your time completing this survey around the 3 areas identified as being a priority by our patient reference group. This is so we can improve our service to you. This is completely confidential and anonymous.
DNAs
A large number of appointments are wasted because the person “did not attend” or DNA.
With our new computer system we are able to send SMS text message reminders of your appointment.
1.
Would you find this useful?
Yes No
2.
Would you be prepared to receive such reminders?
Yes No No mobile phone
3.
Do you have any suggestions we could use to reduce the number of DNAs?
Telephones
We recently had a new 01305 number telephone system installed.
4.
Do you think this provides you with a better service in terms of ease of getting through to the surgery and telephone answering? Please can you give reasons and any suggestions for further improvement.
Appointments
5.
Please could you comment on your experiences in getting an appointment and give us any suggestions on how we could improve.
Thank you for taking the time to complete this questionnaire.
15

A total of 285 surveys were received out of the 350 issued which gives a response rate of 81
%. The responses were analysed and for the open style questions grouped together on broad themes. Not all participants answered every question and others made several comments for each question.
Would find text reminder useful
Prepared to receive reminders
225 78.9 54 18.9 n/a
223 78.2 28 9.8 29
Other comments/ suggestions
n/a
10.1
Phone on landline for those without mobile
Charge (like dentists)
Remove patients from list after 3 DNAs
“Black list” offenders
Poster in waiting room with details of number DNAs etc
Text 30-60mins before appointment
Sign in waiting room to cancel if appointment not needed
Cancel future appointments
Email reminders
Sticky backed appointment cards
Text back from patient to confirm appointment
Walk in surgery
Survey those who DNA
12 4.2
21
4
4
2
2
1
1
4
1
1
1
1
7.4
1.4
1.4
0.7
0.7
0.4
0.4
1.4
0.4
0.4
0.4
0.4
16

New system better
Good service
Polite receptionists
No difference
More receptionists to answer phone at peak times
New number engaged at peak times
Old system easier
Unaware of new number
Automated ring back service
145 50.1
17
10
6.0
3.5
19
3
6.7
1.1
10
4
2
3
3.5
1.4
0.7
1.1
No problems
Back to old system
Need to ring early or appointments gone
Difficult to get a routine appointment
Having to ring back to book
Getting to see own GP
Easier to get appointment in person rather than on phone
Difficult to get an appointment if you work
Same day appointments difficult
Need more appointments at
Chickerell
Offer appointments at both branches
Phone appointments
Difficult to get an appointment on a Monday
103
36
34
9
2
19
2
7
6
2
2
1
2
36.1
12.6
11.9
3.2
0.7
6.7
0.7
2.5
2.1
0.7
0.7
0.4
0.7
17

18