Patient Participation Directed Enhanced Service
Shelley Manor Medical Centre
2013 – 2014
Report Proforma:
1. Please describe your practice profile:
DES
component 1
The practice has harvested as much relevant information as possible in order to support the philosophy of the DES, but sadly some of the
suggested information that is listed in this section is questionable as to why and how a practice needs to hold and gather it. However, the
profile of the practice is as follows
The practice list size has changed since last year, increasing from 11,162 to 11,577, a net increase of nearly 4%

Age and Sex – Please see table below

Ethnicity – Please see summary below

Carers – 179 (as at March 2013) – Practice has also signed up for Carers’ LES to encourage support to Carers.

Working Status – not known

Marginalised / Vulnerable Group – not known

Drug users (Data based on Opioid Drug Dependence) – 134

Patients with learning disabilities – 49

Nursing/Care home residents – 139

University students – not known

Smokers – 2,594

Ex/Non Smokers – 7,192
Page 1 of 15
Establish a
PRG
comprising only
of registered
patients and
use best
endeavours to
ensure PRG is
representative
Age, Sex and Ethnicity Profile of the practice
List size at time of research (March 2014) is 11,577
Practice population profile
Age
Total Practice population number
Under 16
17 - 24
25 - 34
35 - 44
45 - 54
55 - 64
65 - 74
75 - 85
Over 85
11577
1712
960
2205
1834
1655
1230
972
702
307
% Under 16
% 17 - 24
% 25 - 34
% 35 - 44
% 45 - 54
% 55 - 64
% 65 - 74
% 75 - 85
14.8%
8.3%
19.0%
15.8%
14.3%
10.6%
8.4%
6.1%
% Over 85
2.7%
Ethnicity
Page 2 of 15
Total Practice population number
1157
7
White
British Group
Irish
White
5431
70
Mixed
White & Black Caribbean
White & Black African
White & Asian
59
82
86
12
0
0
4
Any Other
2.
0.5%
0.7%
0.7%
% Indian
% Pakistani
% Nepalese
% Bangladeshi
0.1%
0.0%
0.0%
0.0%
Black or Black British
14
62
Chinese or other ethnic group
Chinese
% White & Black Caribbean
% White & Black African
% White & Asian
Asian or Asian British
Black or Black British
Caribbean
African
46.9
%
0.6%
Mixed
Asian or Asian British
Indian
Pakistani
Nepalese
Bangladeshi
% British Group
% Irish
% Caribbean
% African
0.1%
0.5%
Chinese or other ethnic group
127
137
% Chinese
1.1%
% Any Other
1.2%
Please give a description of the profile of the members of the PRG which should be representative of the practice
population.
Page 3 of 15
All members of the Patient Representative Group (GRP) including the Practice representatives (GP and admin) were asked to complete a
“PRG Member Profile” in an anonymous capacity. The practice only received 4 responses.
The anonymous records are recorded in the table below. A blank copy of the document can be found in Appendix 2a to this proforma
Question / Responses
Please state your Age
Sex (M/F)
Please state your Ethnicity
1
48
F
English
48
F
2
50
M
3
40
M
4
Caucasian
White
British
English
White
Are you a Carer?
Are you employed or unemployed?
Are you incapable of work due to illness or
injury?
Do you consider yourself to be a member of a
marginalised or vulnerable group? (if so, please
specify)
Are you a Drug User?
Do you have a Learning Disability?
Are you registered blind?
Do you have a physical Disability
Do you reside in a Nursing Home / Care Home?
Are you a University Student?
Is there any other aspect / matter / group you
would like defined?
Do you consider yourself to be a member of this
group?
N
Emp
N
Y
Emp
N
N
Emp
N
N
Emp
N
N
N
N
N
N
N
N
N
N
Y
Y
N
N
N
N
N
N
N
N
N
N
Y
N
N
N
N
N
N
N
N
N
N
5
6
7
8
Y
The membership of the group remained unchanged for this year, 2013 / 2014.
There were a number of significant reasons for this, namely there was little desire from the members of the group to change the dynamics or
the numbers on the group.
The Practice continues to display a poster in both waiting rooms of the premises to raise awareness of the PRG and of the need / desire for
patients to volunteer and to join the PRG. It is bright colourful and eye catching not dull, bland or indifferent.
Page 4 of 15
However, one thing that has emerged in previous years is the need that the role of “Chair” must be filled by the Practice Manager (PM).
In year one it was the PM’s desire that the chair was filled by a patient who was a member of the PRG. This was also important to
demonstrate that the PRG was independent from the Practice but also to demonstrate that the direction of the PRG and thus the patient
participation experience was not being driven by the PM’s agenda
The PRG met in Summer 2013, the 30th July 2013 to discuss the progress of the previous year and to look at priorities for 2013-14.
There was a good attendance and the minutes reflected the diverse range of matters that can affect a practice
The PM updated the group about the progress made on all seven action points in the report of last year’s activity report.
The PM also discussed the progress made with improving the website
3.
Please outline the steps taken to ensure that the PRG is representative of the practice registered patients.
For example:
 How the profile of practice population undertaken
 Advertising in practice and practice leaflet
 Patient participation day/week held to target patients coming into the practice.
 Asking new patients
 Email sent to infrequent attenders.
The has practice set up a number of different and innovative methods in order to recruit members of the public, registered patients, to join
the PRG:
1. Posters were displayed in reception and in both waiting rooms. Posters continue to be displayed in throughout the whole year and
again 2013 /2014.
2. Patients who had provided the practice with a mobile phone number and where it had been recorded in the clinical system were sent
SMS txt messages informing them of the project, encouraging them to become involved
3. During a four week drive, receptionists physically spoke directly to patients in order to inform them of the PRG recruiting campaign
and inviting them to register their interest. This occurred as patients arrived in the building to attend or book a future appointment
4. During “Flu Clinics” there were very large gatherings of patients in the reception areas. Reminder announcements were made
routinely in order to promote interest in the PRG recruitment campaign
Page 5 of 15
Result
Historically the practice obtained the details of just 9 patients who had expressed an interest in joining the group. Sadly, only 5 patients later
committed to joining the group formally and to attend the inaugural meeting in October 2011.
The Practice made a huge effort to promote the PRG and to recruit to it. Despite this, the response from patients demonstrates the apathy
and indifference that the practice encountered whilst trying set up and create a PRG.
Moreover, the PM attempted to visit this matter with the PRG at July 2013 meeting.
4.
Where a category of patients is not represented, please outline the steps taken to attempt to engage with that group(s).
For example:
 Work was undertaken with LINks/ voluntary organisations to engage with the vulnerable groups in the area
The Practice recognised that patient apathy and indifference may well be a huge factor. In view of this the practice was so keen to get any
patients to join the PRG it did not seek to discriminate positively or negatively about any groups, socially, ethnically or otherwise.
As detailed in Question 3 above, the practice was grateful to obtain the names of patients who responded to the resourceful recruitment
campaign. Sadly only five of those nine expressions of interest were able to commit to joining the PRG!
Ironically, one member of the PRG happens to be a member of the LINks organisation.
Andy Hallowell (PM) and the PRG member have met previously to discuss how best to take this project forward, including the “tweeting” of
the links to the electronic version of the patient surveys that had been created in connection to the later aspects of the Patient Participation
DES.
The PM recognises that the dynamics of the group must change and introduce greater numbers to the group.
He is committed to increasing the membership of the PRG and it is his intention to continue to display posters and in 2014 – 2015 will review
the methodology.
He is considering the following innovative ideas:

Improve the Patient Participation section on the Practice website
Page 6 of 15
5.

Introduce Facebook page, link to LINks, blogging and Twitter

SMS txt updates to patients with mobile phones

Publish a newsletter in both electronic and paper formats
Please give details of the steps taken to determine and reach agreement on the issues which had priority and were
subsequently included in the local practice survey.
For example:
 The PRG was polled in the following way...........................
 A profoma was developed in which patients were asked what they felt the key priorities were with regard to
services offered in the practice
The PM invited all the existing members of the PRG to attend a meeting in July 2013.
The agenda included a section: Aims and Priorities for 2013-2014 – Discussion
All the invitees were asked to submit ideas they wished to be included in the priorities. This enabled the PM to prepare the agenda and the
invitee to prepare any work in advance to support their case for a priority. The proposals for discussion were:

CQC Volunteer – to assist during the inspection

Carers

Practice Website
The PM was concerned that attendance at the meeting was lower than expected so invited all members to comment on the priorities that had
been discussed. He reminded all members of the PRG that he could not make a decision without first seeking the views of the whole group
The PM was keen to receive a response from all the PRG.
The PM did receive a response from all members, some responded by email and some visited to speak privately with the PM.
Now that the priorities had been set and agreed, he was able to prepare for the next phase of the project, drawing up the surveys in order to
Page 7 of 15
DES
component 2
Agree with the
PRG which
issues are a
priority and
include these in
a local practice
survey
consult with the wider patient population, the patients registered with the practice.
6.
Having set the priorities with the PRG, please describe how the survey questions were drawn up and how the survey
was carried out in order to obtain the views of your registered patients.
The two priorities that were identified and agreed by the PRG were Carers and Practice Website.
The PM prepared two draft questionnaires that he proposed to broadcast to a large number of patients in order to ascertain their views
The two questionnaires are:
1. Carers’ Questionnaire
2. Practice Website Questionnaire
DES
component 3
Collate patient
views through
local practice
survey and
inform PRG of
the findings
The x2 draft questionnaires were circulated by email to the all members of the PRG and responses were requested.
The PM received responses and comments were duly noted and amendments to be made.
Amendments were made and the final drafts circulated.
It had previously been decided in the previous years’ processes that any surveys must be made available in both paper and electronic formats
(use of Survey Monkey).
Paper copies were available at Reception and in the Practice’s seated waiting areas to allow patients to complete them on site.
Electronic copies / links to the survey would be available via the website and also distributed by SMS txt direct to patients who had registered
a mobile phone number with the practice.
This year the PM chose not to use “Survey Monkey” for the e-version of the questionnaire but devised his own in-house solution directly on
the website
In December 2013 the PM published the questionnaires in both paper and electronic formats.
He announced that the x2 questionnaires had been published and distributed. They are available in 2 formats:



7.
Patients can pick up a hard copy in the Reception / Waiting Room area
Patients can complete them on line by clicking on a link on our website – the patient participation page
Distributing the link to the e-surveys to all our patients by SMS txt service to those patients who have mobile phones
Please describe the rationale for using the chosen survey method and the criteria for assessing its credibility that the
processes used for sampling and analysing are sufficient to provide valid reported outcomes
Page 8 of 15
DES
component 3
8.

The written content of this report detailed in the above sections describe the rationale for using the chosen survey method (paper
and electronic) and the criteria for assessing its credibility that the processes used for sampling and analysing the data.

The practice preferred an in-house solution directly on the website this year as opposed to using “Survey Monkey” for the purposes of
the electronic version of the survey

The practice decided to conduct the survey in paper format too for patients visiting the practice.

The analysis of the data remained the responsibility of the practice.
Please give details of the steps taken to provide an opportunity for the PRG to discuss the survey findings to include:



The survey results (both paper and electronic) were analysed and the PM prepared an excel document

PM provided the PRG members with a copy of the report of the findings. The email was distributed to PRG Members with an invitation
and agenda to meet and discuss the findings

The PRG met to discuss the findings in March 2014. The intention was to discuss the survey findings and reach agreement on any
changes to services. Furthermore it was important to agree an action plan to implement changes

Minutes of the PRG meeting were taken and the action plan developed, and distributed to PRG members.

It is important to recognise that there were multiple priorities and that there were two surveys. The findings of both surveys were
analysed and discussed at the meeting.
The PM provided the GP partners with a copy of the report of the findings. The results were later discussed at a partner meeting.
In summary the findings of the two surveys were discussed and these identified a number of Changes, and Challenges
 Response was poor but provided the practice with intelligence to make informed decisions
 May need to repeat Carers’ Questionnaire to a more focussed group – the listed Carers themselves.
 On-line Services (e.g. bookings and prescription requests for repeat medication) would free up phone lines but also enable
bookings / cancellations to occur when surgery is closed
9.
Please give details of the action plan setting out how the finding or proposals arising out of the local practice survey can
be implemented and, if appropriate, reasons why any such findings or proposals should not be implemented.
Page 9 of 15
Collate patient
views through
local practice
survey and
inform PRG of
the findings
DES
component 4
Provide PRG
with
opportunity to
comment and
discuss
findings of local
practice survey
practice
survey. Reach
agreement with
PRG of
changes in
provision and
manner of
delivery of
services.
Where the T
DES
component 5
The Action Plan was agreed at the aforementioned meeting (detailed above).
It was agreed that the following matters listed below will form the Action plan and the implementation
Findings of Survey 1 – Practice Website
 Intelligence gathering
 The level of response was poor. The practice received 14 paper responses and 33 via on-line.
 What did we learn / what do we know now?
1. Information available and “signposting” is good but could be better
2. Services at Shelley Road (e.g. Phlebotomy)…information that Shelley Road is not Shelley Manor
3. Need for a better Nurses’ page regarding services, forms etc.
4. GPs who have a special interest. PM advised group that the term “special interest” is usually with reference to a GP
who has an additional / specific qualification accreditation of specific field such as minor surgery or dermatology; and
cannot be confused with a GP who has a liking or a flavour for looking at a specific clinical matter.
Findings of Survey 2 – Services for carers
 Intelligence gathering
 The practice has only 171 carers from a patient list of 11,200, yet 71% of responders’ say they are a carer!
 All new carers get a “Carers Pack” – which includes contact details for the local authority to become a registered carer and be
assessed.

What did we learn
1. Responses to Q4 of the survey shows pack is working
2. Not all Carers have internet access
Action Plan and Implementation
Page 10 of 15
Agree with the
PRG an action
plan setting out
the priorities
and proposals
arising out of
the local
practice
survey. Seek
PRG
agreement to
implement
changes and
where
necessary
inform the
PCT.
1. Practice to look at the following
Website
1. Branding / Logo
2. Photography
3. Layout
4. Content
5. Technology
6. Overall Design
Carers
1. Review content of “Carers Pack” for the new carers to the list
2. AC to set up regular “internet clinics” where a consulting room can be used on agreed dates and carers can book an
appointment. AC will oversee the event and allow carer to use internet or landline to make enquiries, conduct caring
research or access services
3. Repeat the survey with the actual existing registered carers in order to ascertain opinions of carers are sought
2. Implementation
i.
ii.
To be implemented in the 2014 – 2015 financial year.
Progress reports to be submitted to PRG at regular meetings throughout the year.
10. Please provide a summary of the evidence including any statistical evidence relating to the findings or basis of proposals
arising out of the local practice survey.
Page 11 of 15
DES
component 5
A full breakdown and scrutiny of the statistical information used to analyse the findings for each survey can be found by contacting the
practice. Meanwhile a summary is provided below
Practice Website Questionnaire Analysis
1. 85% of responders were aware that we had a website.
2. 65% of responders had visited the website.
3. On a scale of 1-10 (1 poor, 10 excellent) the average score rating the website was 8
4. There were 8 points raised detailing the helpful/ informative nature of the website from 7
responders (see responses to Q4)
5. There were 10 points raised detailing the not helpful or areas in need of improvement of the
website from 6 responders (see responses to Q5)
6. There were 14 points raised suggesting additions to website from 5 responders (see responses
to Q6)
7. On a scale of 1-10 (1 poor, 10 excellent) the average score rating the easo of navigating
around the website was 8
8. 60% of responders would like the website to feature practice and general health news
9. There were 2 suggestions for helpful additions to the website from 2 responders (see
responses to Q9)
10. 52% of responders would like the website to feature a link to self referral websites e.g. CRUSE,
Page 12 of 15
Agree with the
PRG an action
plan setting out
the priorities
and proposals
arising out of
the local
practice
survey. Seek
PRG
agreement to
implement
changes and
where
necessary
inform the
PCT.
Carers’ Questionnaire Analysis
1. 71% of respondents considered that they look after someone who without their help would not be able to manage.
2. 59% of all respondents (83% of carers) had been assessed or would like to be assessed by the local authority.
3. 27% of all respondents (38% of carers) considered that they can talk to, or have access to the GP or any other medical people who
attend the person they cared for.
4. 35% of all respondents (50% of carers) considered that they knew where to get help from, such as telephone numbers and websites
that may enable them to apply for finance, respite, support groups or, any other help/training.
5. 35% of all respondents (50%of carers) said they would come to surgery to have direct contact with people who are extremely
knowledgeable about carers and the important role that they play?
6. 48% of all respondents (68% of carers) welcomed communication from the surgery Carers’ Lead in the form of telephone
conversations, letters, leaflets or booklets?
7. 29% of all respondents (42% of carers) considered that they needed equipment to help them you look after the person that they cared
for; and they knew who to contact?
8. 38% of all respondents (53% of carers) would like to receive regular contact or updates/newsletters from the surgery and Carers’ Lead?
9. 20% of all respondents (28% of carers) are young carers, (under the age of 18)?
10. 64% of all respondents (90% of carers) felt that they looked after their own health. (They take care of themselves too)
11. Please give details of the actions which the practice intend to take as a consequence of discussions with the PRG in
respect of the results, findings and proposals arising out of the local practice survey.
Page 13 of 15
Please see the above action plan summarised in Section 9 of this document, there were minutes taken of the meeting held with the PRG
12. Where any changes will have contractual implications have these been discussed with the PCT? If not please describe
your proposals for discussion.
For example:
Changing extended hours to Saturdays will require PCT approval
None
13. Please detail the opening hours of the practice premises and how patients can access services throughout the core
hours.
The practice is open to the public every weekday from 07:00 to 17:30. There is a duty Dr available on-site until 18:30.
Between 17:30 and 18:30 the calls are handled by the OOH service – SWAST, now under the banner NHS 111.
Should an emergency arise between 17:30 and 18:30 then the OOH service contact the duty Dr directly whereupon the duty Dr will contact
the patient.
This matter was highlighted at the Practice’s QOF Visit in 2011 / 2012.
The PCT insisted that the 17:30 to 18:30 period that the practice is closed must be a priority for the PRG to consider last year. This was duly
done and not deemed as a priority for the PRG.
14. If the practice offers extended hours, please give the times at which individual healthcare professionals are accessible to
registered patients.
The Practice provides extended opening hours every weekday from 07:00 to 08:00 in accordance with the Extended Hours DES.
This is for routine pre-bookable appointments.
However, if a patient arrives between 07:00 and 08:00 and requests to see a Doctor, then where there is an unfilled appointment then the
appointment can be utilised.
Page 14 of 15
15. Publicise the Local Patient Participation Report on the practice website
The Practice website is http://www.shelleymanorsurgery.co.uk
Patient Participation submission, the Practice now has a Patient Participation section on the site which will include details of the PRG and the
work that it does.
As detailed in earlier sections of this report it is the Practice Manager’s intention that the website is improved to enable greater participation
and for it to become a working tool for future patient participation in subsequent years and not just for the period of the PP DES.
The PM hopes to look at a Practice Facebook page, link to LINks, blogging and Twitter
Page 15 of 15
DES
component 6
Publicise the
Local Patient
Participation
Report on the
practice
website and
update the
report on
subsequent
achievement