Over the past year the practice has been developing a Patient Reference Group (PRG).
The purpose of this group is to identify areas of concern whereby, in the opinion of the members, the Practice needs to implement change or improve the services it offers.
We have tried to ensure that the group members are representative of our practice population as much as possible including patients from a wide number of backgrounds and with specific needs. Our practice profile is detailed below and gives numbers of registered patients depending on age, sex, ethnicity, if they are a carer, care home residents and those with learning disabilities.
Table of practice profile by age and sex
Males
0-16
942
Females 848
Total
%
1790
18.9
17-34
999
1030
2029
21.4
35-54
1311
1290
2601
27.5
55-74
1070
1088
2158
22.8
75+
388
509
897
9.5
Total
4710
4765
9475
100
%
49.7
50.3
100
-
Other categories
Ethnic minorities
Learning disability
Has a carer
Is a carer
Care home resident
947
66
186
114
68
10%
0.7%
2%
1.2%
0.7%
In order to form this group the Practice has been encouraging patients to become members since the summer of 2011. We selected patients from our registers who we felt might be interested in joining and sent them introductory letters of invitation and included an initial survey form for them to complete and asked for their opinions on the way the Practice operates. We invited patients from a wide cross section of the
Practice population, including vulnerable patients, patients with physical disabilities and learning disabilities, carers and those employed and unemployed. 36 of those invited this way have agreed to become PRG members.
We also encouraged patients to join the group by advertising in our surgeries, both at
Chickerell and Abbotsbury Road, reception staff handing out leaflets and forms to patients attending the surgery and via our website.
To date we have 130 members who have agreed to join. The profile of the group is detailed below.
Table of PRG group profile by age and sex
0-16 17-34 35-54 55-74 75+ Total %
Males
Females
1
0
Total
%
1
0.8
Other categories
Ethnic minorities
3
15
18
13.8
13
23
36
26.7
29
28
57
43.8
10
8
18
13.8
56
74
130
100
43
57
100
-
Learning disability
Has a carer
Is a carer
Care home resident
2
2
4
4
1
1.5%
1.5%
3.1%
3.1%
0.8%
Comparing the PRG profile to the practice profile shows that there is slight over representation of females compared to males. This is due to the fact that more females were willing to become members. They generally visit the practice more frequently as well. The PRG also tend to be older than the practice profile with a large representation from the 55-74 age group. Younger patients were also reluctant to join.
Looking at the other categories most groups are well represented apart from ethnic minorities. We did target this group with our initial invitation letters and within the surgery but the vast majority declined. The main difficulty was the language barrier both spoken and written.
We will continue to encourage males, younger patients and the ethnic minorities to become members when new patients register and when existing patients from these groups contact the surgery for any reason.
When completing the proforma for PRG registration, patients were asked what they felt the main areas that the group should focus on for improvement. The pie-chart below shows the breakdown by % of their responses. figure 1-Priority Areas for Survey
They were also asked to highlight any additional areas of concern which they felt needed to be addressed by the Practice. Having submitted their ideas, we invited some of the new PRG members to a meeting with the Partners to discuss their replies with the intention those concerns would be included in a survey which would later be
issued to a wider group of patients in order for us to gather as many replies and opinions as possible. The 3 areas identified to focus on were getting an appointment, car parking and telephone answering and access.
Following the meeting the format was decided for a survey of the wider practice population, the preferred choice being a paper exercise which would be made available to patients, although for those who preferred it, an electronic version was available on our website. This consisted of areas of concern for patients to comment on in an open style as it was felt that this would enable patients to say what they felt about the various aspects rather than closed questions. (See appendices). This was after discussion with members of the PRG and also our experiences of doing patient surveys previously. In the past, many patients have been put off completing long surveys with multiple closed questions, many of which are irrelevant to them. It was felt that keeping the survey short and simple would gain as much information and allow them to highlight areas of concern which may not otherwise be realised. A small number were handed out to some members or our PRG group initially as a trial and the results confirmed this. The opportunity to take part in the wider survey was extended to patients from both our surgeries over a 2 week period. GPs and reception staff alike encouraged patients to complete the survey forms which were freely available in the waiting rooms. The forms were also available by post for any patients who wished to complete them but were unable to attend the surgery. Some members of the PRG group were also contacted by email.
200 surveys were issued/emailed. Of these 162 were returned completed. This represents a 81% return rate. Obviously being of an open question style the results were harder to analyse although it was not difficult to identify most replies into recurrent themes. The detailed results have been provided in the appendices and the main areas needing to be addressed highlighted below.
1.
Getting an appointment
Many patients experienced no problems getting an appointment. A number of patients commented on not being able to book in advance or difficulty doing so. There were also problems with getting an appointment with some named doctors and for a few patients a same day appointment. Also a comment was received about patients at our branch surgery not being able to be seen in our main surgery.
2.
Telephone system and answering
The vast majority were happy with the telephone service and answering. Some patients did experience difficulty getting through at peak times especially around 8am. A few also felt there was a delay in the phone being answered. A number of comments were made of our continued use of a 0844 number and the cost to ring especially from a mobile.
3.
Car Parking
A majority of those surveyed felt that car parking was a problem generally and even worse at peak periods. Many did recognise that we are limited with what can be done to address it, however. A fair number of patients either don’t have a car or said they live close enough to walk to the surgery. Parking close by for disabled patients was also highlighted.
4.
Additional comments
A couple of patients commented on waiting times to be seen and that they would like to be pre-warned if there was likely to be a delay. Also a couple of comments were received from patients who found it difficult to ring early for a same day appointment due to work commitments. One patient also commented that our doorbell is too high for him to reach from his wheelchair.
A large number of positive comments were also made and some of these have been included in our appendices.
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.
Appointments
Another Nurse Practitioner will join the Practice in April. This will hopefully provide additional same day appointments. We will perform a weekly audit of free appointments and review appointment availability on a regular basis.
Some appointments are available to book up to one month in advance as well as others up to 2 days ahead. Obviously some patients are not aware of this.
When booking an appointment we will ask receptionists to inform patients about this facility for routine problems as well as doctors/nurses when advising the patient to book in for review.
Historically patients registered with our branch surgery were only allowed to be seen there. We have recently made provision for patients to be seen at whichever branch is most convenient for them but some patients may not be aware of this yet.
Our patients have a “usual doctor” and when possible we try to see our own patients. Sometimes due to high demand, doctors being part-time, on holiday or having other clinical commitments this goal cannot be met. Unfortunately there is no easy solution to this.
2.
Telephones
The Practice’s current telephone provider contract expires in January 2013.
We are actively exploring the services offered by alternative providers in order to rid the Practice of the 0844 telephone number and provide a much better and improved service for our patients. A decision is to be made shortly.
To try and improve telephone answering and reduce the wait for patients we will look at reception staff rotas to ensure that busy periods are well covered.
3.
Car Parking
Parking at our Abbotsbury Road surgery is and will always be a problem because we have no-where else to go. For logistical reasons it is impossible to extend our car park which is very small. At our request some local street parking was limited to 1 hour to try and increase the available parking for patients but this is available for anyone to use.
In regard to car parking for disabled patients the possibility of having 1 or 2 disabled spaces on the street near the surgery door was discussed and we will ask the council whether this is possible.
4.
Additional Comments
One patient with a physical disability has asked if we could kindly move the doorbell to a position which is more easily accessible from his wheelchair.
We shall address his request without delay.
In terms of waiting times within the surgery it was agreed that if there is likely to be a delay in being seen then the receptionist should inform the patient when they book in how long it is likely to be.
Also the difficulty for patients wanting a same day appointment and not able to ring early was discussed. A suggestion was made of keeping a few slots in the afternoon free that could not be booked before 10am for these patients and we will trial this.
Some PRG members were asked for comments on the draft action plan and their comments were noted and the plan adjusted accordingly. The suggestion was made that staff members could car share or use alternative modes of transport where possible to free up some car parking spaces. Provision of some bike racks was also mentioned.
Survey Outcome
Difficulty getting an appointment
Being able to book in advance/at other branch of surgery
Improve telephone service and answering
Car parking very difficult at
Abbotsbury Road especially at peak times
Waiting times to see clinical staff within surgery
Difficulty reaching doorbell for wheelchair patients
Difficulty booking same day appointment for those unable to ring early due to work commitments
Action Plan
A new nurse practitioner to start on
1/4/12. We will audit free appointment slots weekly and make adjustments as necessary
Reception staff, doctors and nurses to make sure patients are aware of this option when booking appointment or being seen.
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.
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.
Warn patients when booking in if a doctor or nurse is running late.
Moving doorbell to a more suitable position
A trial of keeping a few slots available in the nurse practitioner/on-call doctors afternoon surgery which cannot be booked until 10am
The practice, including the Branch Surgery, is open from 8am to 6.30 pm Monday to
Friday. During these times patients can contact the surgery by telephone, come into the surgery by person to request services or contact us by email.
Extended hours from 7.30-8am and 6.30-8pm are offered by all partners on a rotational basis Monday to Thursday mornings and Monday to Wednesday evenings.
The Doctors in attendance at these times vary from week to week depending on the practice rotas and GP availability (annual leave and other commitments). Below is a guide to availability:
Dr Hewett: 7.30-8am Tuesday, Wednesday and Thursday mornings, Wednesday evenings 6.30-8pm on a rotational basis.
Dr Priestley: 7.30-8am Monday and Tuesday mornings, Tuesday evenings 6.30-8 pm on a rotational basis.
Dr Brown: 6.30-8pm Tuesday evenings on a rotational basis.
Dr Turberville-Smith: 7.30-8am Monday morning, Monday evenings 6.30-8pm on a rotational basis.
Dr Ward: 7.30-8am Monday and Tuesday mornings, Monday and Tuesday evenings
6.30-8pm on a rotational basis.
Dr P J Hewett The Surgery
Dr H S Priestley 24 Abbotsbury Road
Dr C A Brown Weymouth
Dr R J Turberville Smith DT4 0AE
Dr A J Ward Tel: 0844 4772540
Dr I A Ismail Fax: 0844 4772538 www.abbotsburyroadsurgery.co.uk
Tel: 01305 780806
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Dear ~[Title Last Name]
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 are setting up a virtual patient representation group so that you can have your say. We will ask the members of this representative group some questions from time to time, such as what you think about our opening times or the quality of the care or service you received. We will contact you via e-mail 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 ethnic groups.
We would like to invite you to join our group, and if you are happy to do so, we would be grateful if you would kindly complete and return the enclosed contact form and questionnaire, please feel free to add any further comments or observations on the reverse of the form.
Of course, if you would prefer not to take part then I would be grateful if you could let me know so that you are not contacted unnecessarily in the future.
Yours sincerely
Mrs Carol Woodward
Practice Manager
24 Abbotsbury Road, Weymouth, Dorset DT4 0AE
Telephone 0844 477 2540 Fax 0844 477 2538
Dr P J Hewett
Dr H S Priestley
Dr C A Brown
also at
36/38 Lower Way, Chickerell
Dr R J Turberville Smith
Dr A J Ward
Weymouth, Dorset DT3 4AR
Dr I A Ismail (Telephone number as above)
Dr S J Lane
August 2011
Dear Patient
Patient Reference Group
We are setting up a patient reference group to give us feedback on the range and quality of our services and to tell us where we can improve.
Our aim is to reach a wide range of patients so we get views from across our population. To make it as easy as possible for you it will be a virtual group. This means most of the communication will be through email and completing online surveys. However, we will make sure those without internet access can also take part.
What will be involved?
The main role of the group is to give feedback through a survey. It asks patients a series of simple questions about how we are doing.
We want to post the right questions, so the group will be asked to tell us what questions we should be asking. We will then publish the survey results along with our proposal to improve the areas it highlights as a need for change. You will have the chance to let us know if you agree with our plans. At the end of the year we will publish the results of our achievements.
What will I have to do?
If you are interested in helping us to improve, simply complete the attached form and return it to us. We have included some more background information that may answer any other queries.
Thank you in advance for your help.
The Practice Team
ABBOTSBURY ROAD SURGERY
Contact form
If you are happy to be part of the patient representative group please complete the form below and return it to the Practice as soon as possible.
Name: ………………………………………………………………………………….
Address: ………………………………………………………………………............
…………………………………………………………………………………………..
Postcode: ……………………………………………………………………………...
Email (if applicable): ………………………………………………………………….
The following information will help to ensure we speak to a representative sample of the patients registered at the Practice.
Are you? Male □ Female □
Under 16
35
65
– 44
– 74
□ 17 – 24 □ 25 – 34
□ 45 – 54 □ 55 - 64
□ 75 – 84 □ Over 84
□
□
□
Which of the following ethnic background do you represent?
White
British Group
Mixed
White & Black Caribbean
Asian or Asian British
Caribbean
Chinese or other ethnic
Chinese
□ Irish
□ White & Black African
□ Pakistani
□
□ White & Asian □
Indian
Black or Black British
□ African
□ Any other
Which of the following areas should we focus on (please tick all that apply):
Getting an appointment
□ Bangladeshi □
□
□
Clinical care
Telephone answering and access
Waiting room facilities
Customer service
Timekeeping
Patient information
Opening times
Parking
Other (please specify)
Thank you. Please note that no medical information or questions will be responded to. The information you supply us will be used lawfully, in accordance with the Data Protection Act,
1998. The Data Protection Act 1998 gives you the right to know what information is held about you, and sets out rules to make sure that this information is handled properly.
A total of 162 completed questionnaires were received out of the 200 issued. This gives a response rate of 81%. The responses were analysed and comments grouped.
The tables below show the results. Not all patients replied to every section and some made additional comments.
COMMENT
No problem
Difficulty/unaware advance booking
Would like different surgery times
Difficulty getting named doctors appointment
Difficulty same day appointment
Delay in getting prebooked slot
More late appointments
(after 5.30pm)
Generally difficult
Would like on-line booking
Chickerell patients unable to be seen at Abbotsbury
Road Surgery
NUMBER OF
RESPONSES
93
19
2
19
11
1
1
7
2
1
COMMENT NUMBER OF
RESPONSES
No problems
Difficulty getting through at peak times (8-8.30am)
Delay in answering the phone
Difficulty using due to hearing problems
0844 number a problem due to cost
109
27
4
1
8
% OF RESPONSES
57%
12%
1%
12%
7%
<1%
<1%
4%
1%
<1%
%OF RESPONSES
67%
17%
2%
<1%
5%
COMMENT
No problem
Difficult at peak periods
No car/not applicable
Awful
More spaces needed
NUMBER OF
RESPONSES
26
21
30
50
14
% OF RESPONSES
16%
13%
19%
31%
9%
All fine.
Only joined practice in October 2011 and very pleased with the service I receive.
No problem with anything.
Happy with everything.
Staff are very helpful.
Everything OK.
No improvement needed.
Very happy with the service and everything.
No complaints. This surgery is the best. I went to another nearer home but wanted to come back.
You are excellent.
No complaints. You all do a good job – thanks!
No problems, very happy.
Everything is to my satisfaction – well done!
No improvement needed – very good always.
The patients are looked after with care, effectiveness and efficiency.
No problems at all.
No problems with anything, it’s fine as it is.
Everything is perfect.
Happy with everything.
Happy with everything – pleased the nurse practitioner has her own room at last!
Very pleased with the service. Easy to get an appointment.
Really great staff – always helpful.
Love the website!
You all deserve a pat on the back for the way the surgery performs.
No problems.
Very Happy.
Very Happy
I don’t have any problems with the surgery. The staff are very good as is their customer service.
I think you all do a great job
After living in London this surgery is perfect.
Staff are accommodating, obliging and courteous. At last the nurse practitioner has her own room!
Very happy
Very happy with all aspects. Your staff are wonderful!
No complains about anything! I can always get an appointment.
Happy with everything, but please could the doorbell be moved to make easier access from my wheelchair!
No problems with anything.
Happy with everything about my Doctors surgery!
Very happy
After living in London, Chickerell surgery is perfect
I can’t think of any areas needing attention
Very good service in a happy and clean environment, quick appointments with little waiting time