Taken from; GMS Contract 2014/15, Guidance and Audit requirements, NHS England Gateway reference: 01347
East Anglia Area Team
2014/15 Patient Participation Enhanced Service Reporting Template
Practice Name: Derby Road
Practice Code: D83051
Signed on behalf of practice: Mrs L Summers
Signed on behalf of PPG/PRG: Mrs W Turner
A signed hard copy of the report has been retained by the practice
Date: 26/3/15
Date: 26/3/15
1.
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)
Face to Face, Telephone, Text, Letter
Number of members of PPG: 26
Detail the gender mix of practice population and PPG:
% Male Female
Detail of age mix of practice population and PPG:
% <16 17-24 25-34 35-44 45-54 55-64 65-74 >75
Practice 49 51
PPG 46 54
Practice 22 9
PPG 0 0
13
0
14
4
14
4
11
23
9
31
8
38

Detail the ethnic background of your practice population and PPG:
White
Practice
PPG
British
12655
(76.6%)
Irish
88
(0.53%)
0
Gypsy or
Irish traveller
Other
White
376
(2.28%)
White &
Black
Caribbean
Mixed/ multiple ethnic groups
White &
Black
African
White &
Asian
Other mixed
199
(1.2%)
75
(0.45%)
81
(0.49%)
67
(0.41%)
Asian/ Asian British
Indian
Practice 62
(0.38%)
Pakistani Bangladeshi Chinese Other
Asian
16
(0.01%
20
(0.12%)
0 140
(0.85%)
Black/African/Caribbean/Black
British
African Caribbea n
Other
Black
79
(0.49%)
61
(0.37%)
27
(0.16%)
Other
Arab Any
Other
2
(0.001
%)
55
(0.33%)
)
PPG
*2523 patients have not disclosed/refused to disclose their ethnicity (15.3%)
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:
White
British
Total 25
Age
25-34 0
35-44 1
45-54 1
55-64 6
65-74 7
75-84 10
Mixed
British
0
Black
British
0
Black
African
0
Other
Black
0
Pakistani Chinese Thai Caribbean Total
0 0 0 1
1
26
1
1
6
8
10
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 (Lesbian Gay Bisexual Transgender) community?
At present the practice has a wide mixture of patients, but there is no particular group of patients that stand out.
If you have answered yes, please outline measures taken to include those specific groups and whether those measures were successful:
The practice is trying to engage more young people/young families publicising the event at the local mother and baby group which is right nextdoor to the practice. The practice is increasing the number of patients residing in local care homes; the aim next year is to enhance the input from this group of patients.
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1415 Patient Participation Annex D
2. Review of patient feedback
Outline the sources of feedback that were reviewed during the year:
The practice uses complaints and compliments to help us to provide the service that patients would like. Significant event reviews are also used to improve the service. This year for the first time the family and friends test has been introduced into general practice encouraging patients to tell us about their experiences and they feel we could have improved this.
How frequently were these reviewed with the PPG?
May 2014
December 2014
February 2015
March 2015
3.
Action plan priority areas and implementation
Priority area 1
Description of priority area:
Managing the demand for patient contact with a clinician.
Within this project we looked at routine and emergency GP/nurse practitioner appointments as we felt that patient demand was exceeding practice resources, and it was also felt that the practice needed to review these resources to become more efficient and offer a safer and timelier service to patients.
At the PPG meetings appointments wasted by failure to attend/late cancellation were discussed, the
PPG representatives were shocked at the level of DNAs and it was agreed that this needed addressing.
What actions were taken to address the priority?
 Practice staff contacted other practices, visited them to discuss different ways of running an appointment system. The Dr First scheme, on the day only, and systems combining on the day and pre-bookable appointments were presented to our staff.
 The results of these visits were fed back to the practice for discussion at a staff meeting and to our PPG to get their feedback
 Practice and the PPG alike felt that the Dr First system was inflexible and would not work for our elderly and working patients as this did not enable them to plan ahead. Some of our elderly patients who need accompanying to the practice could not plan this is advance.

It was felt that on the day only appointments would put enormous pressure on the telephone system between 8 and 9.30am causing anxiety to patients and putting pressure on practice staff therefore not really providing the service we want to achieve.

A combined routine and on the day appointment system was devised that would offer a
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service to all of our patients. It became apparent that Mondays had completely different demand after the weekend and new 111 system. The capacity for on the day on Mondays is certainly higher and so resources are protected to reflect this. The system is also designed to embargo appointments to be released on a daily basis to allow management of the demand.
 Patient demand was reviewed again recently by logging all patient contacts through reception. The aim of this was to review whether this demand has changed. We will discuss this with the PPG at the next meeting

Reception staff has received training to ensure that patients are directed to the most appropriate healthcare professional. This could be the GP, the nurse practitioner, the practice nurse, local pharmacist or health visitor

Following discussion with the PPG a complete review of the DNA policy has been undertaken. The practice is taking a firmer stance with those patients who continually fail to attend for their appointments. This should result in an increase in the number of patients available.
Result of actions and impact on patients and carers (including how publicised):

The practice and the PPG are far more aware of different appointment systems, the pros and cons of the different systems
 The PPG are far more aware of the % of appointments that are wasted each year. Patients are being made aware of the impact of their DNAs.
 Reception staff are directing patients to the most appropriate health care professional – as a result patients are receiving quicker treatment
 Data collection has enabled the practice to understand where the demand lies and flex the system accordingly.
 There is now a regular review of the appointment system to ensure efficiency.
Priority area 2
Description of priority area:
Restriction of prescription drugs that can now be bought over the counter
Practices are given a prescribing budget for the year and we are under pressure from the CCG to remain within this budget. Many medications that were previously only available on prescription are now freely available over the counter. The practice felt that the PPG should be involved in advising the practice in rolling out this change. This does enable the patient to immediately purchase these items from the local pharmacy rather than wait for a prescription from their GP.
Often these items are cheaper than the prescription charge. In our March meeting last year (2014)
Dr Hague and a local pharmacist introduced this to the group and we have been following up on this throughout this year.
What actions were taken to address the priority?

This was a difficult policy to introduce to our patients and it was necessary to make them understand the need for this, it released funds into the NHS which could be used for the treatment of more serious conditions. This had to be introduced carefully as it did cause
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hardship to patients on a lower income/the over 60s/under 16s who usually benefit from free prescriptions.
 In consultation with the PPG the following ideas were agreed to disseminate this to our patients.
 An A5 flyer was attached to all prescriptions for a period of 4 months outlining the policy at the types of medicines affected. Those patients who have logged a mobile number with the practice and consent to texting were informed of the policy by text
 Posters were put up in reception, on the website and on the waiting room tv.

To save the patient coming to the surgery and being told that they could not have an item on prescription reception staff contacted them via phone to inform them of this decision.
Result of actions and impact on patients and carers (including how publicised):

Initially patients were unhappy with this policy regardless of us trying to prepare them for this change. However in the conjunction with the PPG we have been able to overcome these problems and improve patient understanding of the issues.

Patients are now taking more control over the treatment of their minor ailments seeking advice from local pharmacies.
 Patients now understand the expertise that pharmacists have in advising them.
Priority area 3
Description of priority area:
Health Education for Patients and Carers
This priority developed following discussions with the PPG about long-term conditions. It was agreed that all patients would benefit from understanding how to stay healthy and to increase resources to aid this. Ultimately this may have a knock on effect on the practice – with patients healthier it is possible that they will be less likely to visit the GP thus affecting demand.
What actions were taken to address the priority?
 The PPG meetings were attended by Livewell Suffolk and Age UK who outlined the services that they had to offer and how patients can access them
 These resources can be very useful for carers and relatives of patients with long term conditions.

We keep our waiting room tv up to date with useful information about health conditions, services etc.

Preventative medicine was discussed including eligibility for the flu, pneumonia and shingles vaccine.

The winter planning project was also discussed where we explained how those with Chronic
Obstructive Pulmonary Disease were contacted by a practice nurse. They were offered advice on medication to be kept at home and when to seek help should their condition get worse.
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 Livewell Suffolk provided handouts to members of the PPG explaining the different services and how patients can be referred. These services included Stop Smoking, Weight Loss and
Adult and Children physical activity courses
 Age UK presented to the group and outlined the services that they can provide to the elderly and their families. These include sources of funding, respite care, helping with power of attorney. Leaflets detailing the help that they can offer was made available in the waiting room at both sites.
Result of actions and impact on patients and carers (including how publicised):
Assessing the impact of this project on patients is difficult to quantify however it is a very important aspect of providing a general practice service. Therefore:

Patients are likely to feel more in control of their health

This knowledge will promote general well-being of patients
Livewell Suffolk offers education around weight loss which is one of the government priorities this year. Health education is all about better wellbeing rather than treatment of the problem.
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):
We have a representative PPG who regularly attend meetings
We agreed priorities that were very beneficial to the practice and patients
Communication between the practice and the patients have improved
The review of the appointment system has continued and is working well
The Saturday Extended Hours service now runs between Derby Road and Pinewood on alternate weeks.
4.
PPG Sign Off
Report signed off by PPG: YES
Date of sign off: 26/3/15
How has the practice engaged with the PPG: Face to face, text, letter, telephone
How has the practice made efforts to engage with seldom heard groups in the practice population?
Very well and professionally
Has the practice received patient and carer feedback from a variety of sources?
Yes
Was the PPG involved in the agreement of priority areas and the resulting action plan?
Yes
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How has the service offered to patients and carers improved as a result of the implementation of the action plan?
Improved practices and procedures, patients are more likely to see a doctor quicker and are more likely to be in control of their health
Do you have any other comments about the PPG or practice in relation to this area of work?
The meetings were well chaired, agendas and minutes made available
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