AW Surgeries
Patient Participation Report 2012/13
1
1. Developing a structure for a Patient
Participation Group
1.1 Description of the profile of PRG members.
The Patient Reference Group (PRG) is now well established and is
representative of our practice population, as described in last years report.
The PRG is always happy to welcome new members and actively tries to
recruit patients by raising awareness in the quarterly newsletter and on the
PRG page of the surgery website. Several new members have been recruited
since April 2012 and new members are always welcome.
2. Method and Process for Agreeing Areas of Priority
for the Local Practice Survey
2.1 The Practice is required to describe the process it used to
seek the views of the Patient Reference Group in identifying the
priority areas for the survey questions
The PRG has a good awareness of issues important to the practice
population and meets on a monthly basis to discuss these issues. In March
2012 it became clear that there was a problem with telephone access to the
surgery. Both the practice and the PRG were receiving regular complaints
regarding this, particularly regarding the phone lines being constantly
engaged, resulting in difficulties for patients in getting through to the surgery.
2.2 The Practice is required to list the priority areas and confirm
how these match those set out by the PRG
This issue was discussed at the PRG meetings in March and April 2012 and
as this was a pressing issue it was felt that improving telephone access
should be made a priority for the 2012 questionnaire.
Other priority areas were discussed at these meetings and it was agreed that
improving access by putting measures in place to reduce the number of DNAs,
thus freeing up otherwise wasted appointments, and improving accessibility of
information on available services and updates from the practice should both
be made priorities.
The priorities of the Practice and PRG match, as the priorities for both were
set following discussion and mutual agreement.
2
3 Collate views of patients using a survey
3.1 How were the questions drawn up?
The questions were drawn up to include and match the priorities set by the
PRG. This was done by looking at examples of questions from published
patient surveys and adapting them to our own practice population following
consultation with the PRG. For details of questions used in survey see the full
survey published on the Practice website (www.awsurgeries.co.uk).
3.2 How was the survey conduced?
The survey was conducted by the PRG, who during the first week of May
2012 attended the practice and administered the questionnaire to patients
attending the surgery. Time was spent at each of the two sites from which the
practice operates. This approach had been adopted in previous years and
had proved successful. It was agreed with the PRG, that conducting the
survey in this way was appropriate for our practice population and would
encourage completion of the survey and a representative proportion of the
practice population would be sampled. The presence of the PRG at the
surgery served to highlight their existence and helped to recruit patients to the
PRG. It also helped to increase the return of completed surveys, as patients
were encouraged to complete surveys and return them whilst they were still in
the surgery. Patients were also able to discuss any uncertainties they had
about the questionnaire with members of the PRG. 709 valid were returned
which accepting an error level of 5% gives a confidence level between 95%
and 99%.
3.3 Details and Results of the Local Practice Survey
The PRG collated the results of the survey and presented the results at the
PRG meeting in June 2012. The results showed that the majority of patients
make contact with the surgery by phone and preferred to book an
appointment by phone; there were a significant number of patients who found
it not very easy or not at all easy to get through to the surgery by phone; the
majority of patients felt that getting an engaged tone could be frustrating and
would prefer a telephone queuing system with information on their position in
the queue; patients felt that significant reasons for missed appointments were
not being able to get through on the phone to cancel and forgetting the
appointment; the majority of patients felt that text message reminders of
appointments would be helpful and would help to reduce DNAs; most patients
would prefer information on available services in a newsletter with a the
surgery notice board and website coming second and third.
The results of the survey also highlighted some areas where the surgery was
performing well as follows: the majority of patients found the receptionists very
3
helpful or fairly helpful on answering the phone; a significant number of
patients felt that they were always or mostly able to see a doctor on the same
day for an urgent problem; the majority of patients were happy to see the
nurse practitioner, who was appointed following last years survey to improve
access; the majority of patients rated the range and quality of services
provided by the practice as good to excellent and the majority rated overall
satisfaction with the surgery as good to excellent.
The full patient survey results will be published on the practice website
(www.awsurgeries.co.uk) before 31st March 2013.
4. Action Plan – The practice should outline how the
action plan was agreed
4.1 How was the PRG consulted on the proposed action plan?
The results of the patient survey were discussed at the PRG meeting on 16th
May 2012. A representative partner and the PRG discussed the results and it
was recognised that the main area of dissatisfaction was related to telephone
access. Patients were dissatisfied about the difficulty of getting through on the
telephone and frequently getting an engaged tone. It was also felt that
difficulty in getting through to cancel an appointment increased the number of
missed and therefore wasted appointments. The doctors were already aware
of patient dissatisfaction in the area of telephone access and proposed an
upgrade to the telephone system, which had the facility to eliminate the
engaged tone to ensure that every caller got through and which provided and
easy way to cancel appointments 24 hours a day. The proposal was then
discussed in more detail at a PRG meeting on the 12th June 2012 attended by
a substantial number of the PRG (8), one of the partners and a representative
from the proposed new telephone system.
Another area highlighted by the survey was that patients felt that significant
reasons for missed appointments was related to patients forgetting the
appointment; the majority of patients felt that text message reminders of
appointments would be helpful and would help to reduce DNAs. This was
discussed and it was proposed to introduce this service later in 2013. This
was discussed at the PRG meeting in June and after enquires by the surgery
on governance issues relating to this, it was agreed at the PRG meeting in
August 2012 that the PRG would facilitate this service by liaising with the
patients and handing out consent forms devised by the surgery with the first
newsletter in 2013.
It was also clear from the survey that the patients preferred method of
communication about services and changes in the survey was by newsletter
and it was proposed that the surgery continue to support the patient panel in
the production of their quarterly newsletter.
4
5 The Practice is required to produce a clear
Action Plan that relates to the survey results
5.1 What was the agreed action plan
1.To install a new telephone system as soon as possible.
Following discussion and debate at the meeting on 12th June 2012, attended
by members of the PRG a partner and a representative from the telephone
company, it was agreed that the surgery would go ahead with the proposed
new telephone system as soon as possible. It was agreed that this should
result in Improved patient access, callers never receiving the engaged tone,
easy delivery of important messages (e.g. arrangements for flu injections or
changes to opening times), increased efficiencies by automating call
management and ease of cancelling appointments with a dedicated
cancellation line.
It was agreed that there would be an 01384 number as an alternative to the
0844 number for those patients who preferred to use a local number. This
number however would not have the functionality of the queuing system and
may result in an engaged tone. The new telephone system was installed in
July 2012.
2. To introduce text message appointment reminders.
It was also agreed that the surgery would devise a consent form for text
message reminders and introduce a text reminder service with a view to
reducing the number of DNAs. Consent forms for this service will be
distributed from February 2013 with a view to introducing the service later in
the year.
3. To continue to support the PRG in the production of their quarterly
newsletter and ensure that information on new services and any changes to
services would be highlighted in the newsletter. Copies of the newsletter
would be displayed prominently in surgery and receptionists would hand the
newsletter to patients at reception. Information on new services and any
changes to services would also be posted on surgery notice boards and put
on the surgery website in accordance with patient preferences on how they
wished to receive this information.
5.2 Are there any aspects that were not agreed?
After full discussion and consultation taking account of the views of both the
patient panel and the partners the action plan was fully agreed.
5.3 Are there any contractual considerations to the agreed
actions?
To ensure that the use of the proposed new telephone company’s 0844
number complies with Department of Health Guidelines.
5
This was discussed with Surgery Line (the proposed new telephone company)
who advised that the use of their 0844 number was compliant with
Department of Health Guidelines. They explained that research they had
undertaken had shown that, on average, over an average length call it is no
more expensive for a patient in the UK to call a GP practice on a nongeographic number than it is to make an equivalent call from the same phone.
There are, of course, multiple landline and mobile tariffs available in the UK
today, and the market is evolving rapidly. In view of this, Surgery Line advised
that they would continue to monitor the marketplace on behalf of their GP
customers and should the Regulations or their view of compliance change
significantly, they would inform us immediately.
Governance issues relating to text messaging were discussed with Paul
Couldrey, Associate Director of Information Governance
Black Country Cluster on 16/7/12. He advised the need for patient consent to
receive text messages.
6. Publishing the Local Patient Participation Report
6.1 The Practice is required to provide details of where the Local
Participation Report has been published
The Patient Participation Report has been published on the Practice website
www.awsurgeries.co.uk and a copy is displayed on the PRG notice board in
the waiting room of both surgeries.
6.2 The Practice is required to confirm Practice opening hours and give
details on how Patients can access services during core hours (8am6.30pm)
Our normal opening hours are as follows:
Monday - Friday
8.00am – 6.30pm
Extended hours surgeries
6.30pm – 8.00pm (Tuesday and Wednesday
only)
We regret that we are only able to offer extended hours appointments at
Albion House Surgery due to contractual restrictions on the opening hours of
Withymoor Surgery.
Patients can access services by telephone, on-line booking or in person at the
surgery.
For full details on opening hours and how patients can access services please
see Practice website www.awsurgeries.co.uk.
6
7. Update on Achievement from 2011 – 2012 Action
Plan
The main priority from the 2011 – 2012 action plan was improving access by
opening up a quarter of morning and afternoon surgeries for advance booking
and employing a full time nurse practitioner to deal with minor illness. The
overall impression is, that since implementing this action plan there have been
less complaints, regarding obtaining an appointment. 90% of patients who
completed the 2012 – 2013 survey found that when booking an appointment
the time that they were able to get was either very convenient or fairly
convenient. 57% of patients who completed the 2012 - 2013 survey felt that
they were always or mostly able to see a doctor on the same day if necessary
and a further 26% felt that they were sometimes able to access this service.
The introduction of the nurse practitioner service for minor illness may explain
why some patients felt that they weren’t able to access a doctor in an
emergency, as cases of minor illness are now directed to the nurse
practitioner. The survey has shown that the majority of patients (71%) are
happy to see the nurse practitioner for minor illness and so it can be
concluded that the introduction of this service to improve access has been
successful.
Promoting the internet booking facility was also a priority for last year and it is
noticeable that there has been a considerable increase in the use of the
internet booking facility with 15% of patients saying they preferred to book an
appointment this way and 22% of patients saying they found the service
useful in the latest survey. There are still a significant number of patients who
have reported that they have never used this service so although we have
made progress in this area, more work raising awareness of internet booking
needs to be done.
7