ST HELENS MEDICAL CENTRE
Local Patient Participation Report
&
Patient Survey Report
March 2012
Prepared by:
Catherine Barton
Practice Manager
May 2012
1
BACKGROUND
St Helens Medical Centre is a 5 partner training practice with a main surgery in St Helens
and a Branch surgery in Bembridge. Of approximately 6200 patients registered with the
practice, 38% are over 65 years of age and 19% over 75 years of age. The practice area
includes several holiday parks, caravan parks, and hotels – most open nearly all year
round – and tented sites. A large number of second home owners and their families also
contribute to the increasing temporary resident population.
Opening hours:
St Helens Medical Centre
Monday to Friday, 08.15 - 18.30 hours
Bembridge Branch Surgery
Monday to Friday mornings
Tuesday afternoons
Other afternoons, ad hoc, eg for Pulmonary Rehab
Extended hours - Saturday: 08.30/09.00 - 12.00/12.30
Appointments for both practices may be booked by telephone, fax, email or Online
services
St Helens Medical Centre is committed to a Patient Forum Group for 2011-2013.
Our PRG aims for 2011/2012 were to:
 establish a PRG comprising registered patients
 agree with the PRG which issues are a priority and include these in a local practice
survey.
 collate patient views through a local patient practice survey and inform PRG of the
findings.
 provide PRG with an opportunity to comment and discuss findings of local practice
survey. Reach agreement with the PRG on changes in provision and manner of
delivery of service.
 publish survey report on the practice website
 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
 participate in ad hoc projects as they arise, including larger consultation that affects the
whole Island healthcare.
PRG
What steps did we take to ensure the PRG was representative of our
practice patients?
As there are already organisations, eg LINk, local council, etc. that have access to hard to
reach groups, it was felt these organisations were best placed to facilitate future
discussions. The hard to reach groups would fall under the wider remit of the PCT/CCG in
future consultation exercises. Therefore, following agreement with the PCT and CCG,
2
practices were able to concentrate on patients that expressed an interest in participating in
the PRG, regardless of demographics (see Appendix A).
(NB Christopher Gale, Community Engagement and Partnerships Officer, Help and Care –
Supporting the IW Local Involvement Network (LINk), had requested to attend or send a
representative to the meeting on 17 March, but cancelled, and has asked if he or a
representative may attend on a future date).
As a starting point, at the beginning of January, the practice
 devised leaflets asking for patient participation
 advertised on the practice website
 advertised via posters in the waiting room at St Helens Medical Centre and Bembridge
Branch surgery, and at local pharmacies
 issued word of mouth invitations via doctors and team members
 advertised in the Village Talk column of the County Press
 arranged an open forum meeting on 26 January 2012 for any interested parties @
19.00 hours at St Helens Community Centre
Catherine Barton, Practice Manager, attended the open forum meeting on behalf of the
practice. No-one turned up …
The Practice Manager then asked doctors and staff to put forward names of patients who
might be interested in being part of such a group and who would contribute in the interests
of the community. Letters were sent inviting them to a short, introductory meeting on
*Saturday 11 February at 10.00 hours at St Helens Community Centre. Again posters
were displayed and meeting was advertised in the Village Talk column of the Isle of Wight
County Press.
*As the practice has a predominantly elderly population, the Practice Manager thought
perhaps would-be participants may be deterred by dark evenings and a Saturday morning
might prove more popular.
5 patients attended the meeting, 2 patients sent apologies, but stated their interest.
Minutes of meeting were sent out to all. 1 patient who sent apologies has since
withdrawn. Please see Appendix A for groups represented.
What steps did we take to reach agreement on issues which had priority
and were included in the local practice survey?
First meeting of Group held on 18 February 2012. Members were asked prior to the
meeting to come with their suggestions for questions for the survey (see next page).
Notes from meeting:
 Name of group will be St Helens Medical Centre Patient Forum
 Group charter agreed (copy attached to this report at Appendix B), but to be re-visited
as no further suggestions were forthcoming at the meeting
 Members agreed to allow their names to go on the website but no contact details. Any
patient wishing to contact a member of the Forum has to go through the Practice
Manager who will act as a filter.
 How to attract further members. Suggestions were
(a) to approach groups in the area asking if they would like to send a representative
(b) by personal invitation from Practice Manager
3
(c) by personal invitation from an existing member, keeping in mind the need to ensure
the group is representative of the practice population.
Members discussed and agreed to allowing other patients to attend and listen in at
meetings and present an issue if they so wished.
 Agreed objectives of survey were to uncover any areas the practice is felt to be weak
on and to obtain feedback from users as to what they would like the practice to provide.
 It is hoped an outer group will evolve from the survey who will be happy to be consulted
occasionally.
 Other areas of priority: members were asked to email Practice Manager with any
suggestions
How did we seek the views of our registered patients?
As discussed and agreed by the PRG, the survey was circulated as follows:
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Online via website
At St Helens Medical Centre and Bembridge Branch Surgery
Post offices at St Helens and Bembridge (Co-op)
Bembridge churches
Bembridge Library
Pharmacies at Seaview and Bembridge
St Helens Parish magazine
Nursing and Residential Homes
and advertised in the Village Talk column of the Isle of Wight County Press for 3 weeks.
What steps were taken for the PRG to review the survey findings?
Full results, including all free text comments, were circulated to the PRG for review and
comment. The review took place at the second PRG meeting on 17 March 2012.
Patient Survey 2011/2012
The PRG agreed areas to survey with due regard to MORI and previous GPAC surveys
and asked the Practice Manager to formulate the questions.
Areas
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Access – appointments
Premises
Services
Communication
Staffing
Opening hours
Suggestion – survey to be headed:
“If you are completely happy with the service provided by this practice, there is no need to
complete this survey. Tick this box and simply return to St Helens Medical Centre or
Bembridge Branch surgery.”
4
Distribution
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Paper survey to patients presenting at surgery
Paper survey to distribution points, as previously listed
Online survey on St Helens Medical Centre website, www.sthelensmedicalcentre.com
2½ week collection period with closing date of 13 March 2012.
Rate of Return
The Practice Manager collated the responses:
99 completed returned surveys (4 incomplete – pages missing)
Online survey: 5 responses
5
ST HELENS MEDICAL CENTRE
RESULTS OF PATIENT SURVEY 2012
103 questionnaires returned, of which 4 incomplete (pages missing). 5 patients completely happy with service
NOTE: some questionnaires were completed by residents of The Elms/Inver House/The Limes - only certain questions were relevant
1
When did you last see a doctor/nurse/healthcare assistant?
96% Less than six months ago
4% More than six months ago
2 Telephone - the last time I telephoned for an appointment
87% I had no problems getting through and my call was dealt with swiftly and efficiently
0% I got through quickly but was not satisfied with the way my call was dealt with
8% I did not find it easy to get through
1% I don't remember, it was too long ago
3% I never telephone the surgery
4% no response
Comments:
All very kind and most grateful
I don't like having to dial an 08 number and being charged anything up to 60p just to make an appointment just
because I'm not on a BT bill
I had no problems getting through and my call was dealt with efficiently, but not swiftly
The automated service doesn't always work as smoothly as I would expect
Receptionist tends to suggest see the nurse rather than a doctor, which is normally the reason for calling
I tried 3 times to call with no success, so I drove over to check that the surgery was not closed
Sometimes the receptionist asks too many personal questions on the phone, which I feel I should not have to answer
over the phone
Have ticked twice as experience varies
Early morning is difficult. Cannot always get through in time to get an emergency appointment for that day
Long queue to speak to someone at 08.16 am. Very complicated, difficult process to see a doctor for an emergency
call to see someone in the afternoon - could not happen. I had to extract options rather than the options for seeing me
being outlined clearly. Poor patient service - sorry!
6
2 cont.
All very kind, am most grateful
As with a lot of other people, I am on an 'unlimited anytime' phone plan with BT. This covers free calls to 0845 and
0870 numbers, but not to 0844 so I always have to pay for calls to the surgery. Why do you not have an 0845 or 0800
code or 01983 alternative?
3 APPOINTMENTS - missed appointments are a problem for this practice and a constant source of frustration and
irritation for clinicians. Patients can cancel an appointment when the surgery is closed by telephoning 0844 477 2454
and selecting Option 2 or by email sthelens@gp-j84007.nhs.uk. How could the practice reduce the number of missed
appointments?
17% I would find it helpful to have a text reminder
66% I do not need reminding
3% I do not have a mobile phone
14% No response
Comments:
I do not need reminding but a phone reminder might help some older patients
I do not need reminding once an appointment has been accepted, but appointments made by the Medical Centre by
letter are sometimes made at short notice and have in the past not been kept because I was away on the mainland and
unaware of the appointment.
Have you another suggestions as to how the practice could reduce the number of non-attenders?
A series of warnings with constant offenders being removed
Contact by email
This is a problem. Do you write/phone patients who are DNAs?
Charge for all appointments
Reminders are useful. I don't text, but the dentist's reminders on the phone are good. There should be an "app" to
send out calls with only the telephone number and time to be put in.
An appointment card does help as a reminder, and to which surgery you are to go, St Helens or Bembridge
If you can't fine them, then find another way of penalising them, eg never getting a 'same day' appointment until they
have shown they are reliable
Optician rings 48 hours before as a reminder - costly, but may reduce long-term expenditure
Most opticians and dentists phone a reminder the day before the appointment. Presumably this costs less than a
missed appointment. Everyone can make a mistake once. Someone missing an appointment twice should go on a
'black list' and a reminder phoned them the day before.
7
3
cont.
The only thing I can think of is reprimanding persistent offenders
A text message would be a good idea, though personally, I always keep a careful note of appointments and would
phone if unable to keep it
Painful rectal examination!
Shoot 'em!
Remind patients to be sure to make a note of appointment on calendar or notepad so it's not forgotten
You would have a better idea about this than I do
Need to have respect for these appointments. When they do attend, make sure they have to wait.
Try not to encourage them to make appointment so far in advance
Perhaps getting an article in the press about the waste of NHS time and funding would make people think
It can't be assumed that everyone has either a computer or a mobile phone. Have you been able to assess repeated
offenders who would be helped by a reminder phone call?
Ring to remind them like the dentist does, maybe!
If these patients are regular non-attenders then perhaps a telephone reminder would help. Their notes could be colourcoded to alert to the problem
Put up list of how many have missed appointments (they do this in Ryde outpatients and everyone seems very
shocked)
Those who are known to be bad attenders should be offered a reminder call prior to their appointment. If they have
mobility problems, is there a transport system in place that could be used?
4 Opening hours - are these convenient for you?
92% YES
2% NO
6% No response
Comments:
As I do not have my own transport it is so helpful to be able to come to the Bembridge surgery
Would like longer than 1 hour to get test results. Now it is only 1-2.00 pm. If you work this makes it difficult.
St Helens should be open Saturdays (and possibly Sundays) for at least a skeleton/emergency service
It would be helpful if there could be a GP available at St Helens on a Saturday morning
However, Saturday morning appointments for emergencies at St Helens Medical Centre would be welcome
Would like St Helens to be open on Saturday mornings
What about weekend surgeries at St Helens Medical Centre?
The Saturday morning could be longer
8
4 cont.
It would sometimes be convenient to have the Medical Centre open on a Saturday morning
5 This question is for
PATIENTS ARE CARERS
PATIENTS WHO ARE CARED FOR and/or
PATIENTS WITH A DISABILITY
Are you satisfied with the support you receive from the practice?
21% YES, I am satisfied
0% NO, I am not satisfied
79% Not applicable
Comments:
As you have asked this question we must assume that all known carers and cared for patients are flagged on your
computer. If not already done, would it be possible to have carer's contact number if at a different surgery. Could
carers please be made aware of therapy sessions by giving them Isle of Wight Carers Branch telephone number
533173. Thanks
6 USE OF PERSONAL INFORMATION - do you feel confident that the surgery manages your information appropriately?
63% YES
0% NO, I don't feel confident
32% I don't know how my personal information is used
5% No response
Comments:
I assume you do not make the information available outside the practice for any commercial purpose?
It is an amazement to me what cold callers focus on. How on earth do they know things?
7 PREMISES - Apart from shortage of car parking spaces and issues around soundproofing upstairs at St Helens
Medical Centre, do the practice premises meet your expectations?
92% YES
5% NO
3% No response
Comments:
There is not a lot of space for pushchairs on busy health visitor mornings especially
Text message or email …??
9
7 cont.
Could be a little smarter!
The stairlift does not owe you anything!
I was a bit disappointed that recently my little grandson was staying with us and he was not too well. I had boasted
about how good our surgery was for getting appointments. However, when I tried to get him one I was told, nothing
doing, go to St Mary's. Other than that I am quite happy.
I find the tele advertising very irritating. I accept the reasons for it, but the style of repeated sections of it are annoying
and intrusive when I want to feel calm and relaxed before seeing a doctor/nurse. Some of the main content is
informative and well presented, but the 'jingles' are a problem as I prefer a peaceful environment.
Bigger and more comfortable waiting rooms
Seating upstairs could be improved (comfortableness). The things on the tele are just irritating, relaxing music would
be better.
You have a problem with the light over the back door at St Helens. As a nearby resident, the light shines through our
property and you cannot use the garden in the evening because the light blinds you and you cannot see obstacles that
may be in the way. Could you please 'direct' it towards the ground. This should correct the problem. Staff parking on
the road causes problems for all residents as then patients cannot park, and there is no movement of cars all day.
I would like the heart-related clinic to be downstairs
No privacy at reception at Bembridge or St Helens. Upstairs waiting area at St Helens is hot, airless and very
depressing.
Too hot, airless and constant television
8 SERVICES - How can we let you know about new services or flu clinics?
24% via the practice website
64% posters at the surgeries/local pharmacies and around the villages
50% Village Talk column, County Press
34% parish magazines
22% practice newsletter (to be reintroduced)
30% white slip on repeat prescription
8% mobile phone text
7% other - please specify
4% No response
Comments:
The practice newsletter should be available by subscription email
A letter in the post
10
8 cont.
e-mail
Through The Limes Residential Home
Email works best for me. If I did not have email, direct mail would be the only certain way.
The Beacon
9 FACTS ABOUT THE PRACTICE - DID YOU KNOW?
50% the practice has a website www.sthelensmedicalcentre.com
19% the practice produces and regularly updates the patient information booklet which is available from reception
40% you can order a prescription online or by email: prescriptions@gp-j84007.nhs.uk or by fax 01983 874800
35% you can book an appointment online with the doctor (not same day) through our website
19% You can email a query online or to our practice email address, sthelens@gp-j84007.nhs.uk
75% There is a patient check-in screen in the entrance hall at St Helens Medical Centre which saves having to queue at the
reception desk
68% There is a healthcare monitor in the waiting room at St Helens Medical Centre which will measure your height, weight,
BMI and blood pressure
40% If you do not need to see the doctor face-to-face, you can ask the doctor to ring you
38% The doctors offer Saturday morning appointments at Bembridge Branch surgery from 08.30 or 09.00 hours
38% You can make an appointment to see the nurse at Bembridge Branch surgery on Monday and Friday mornings
46% The Health Care Assistants offer daily phlebotomy (blood test) appointments at St Helens Medical Centre and a
fortnightly session at Bembridge Branch surgery
51% A doctor will always see you if you need an urgent 'same day' appointment
56% Nurse is available on the phone, 13.00-14.00 hours, Monday, Wednesday, Thursday and Friday, to discuss test results
or answer any queries, Tel: 0844 477 2454, select Option 4
65% The practice employs two Nurse Practitioners/Prescribers who can see patients for acute conditions, eg chest
infections, sore throats, minor skin conditions, ear infections, eye problems, etc and issue a prescription if required.
They also conduct medication reviews and deal with repeat prescriptions
15% No response
Comments:
On a number of occasions, when my husband has ordered on line, the prescription has not been ready
You can book an appointment online … but it doesn't work!
It is so frustrating being limited to 1.00-2.00 pm M W Th F to speak to a nurse - not very convenient at all
Clearly better publicity for the services above I have not ticked!
11
9 cont.
What are we not doing that you would like us to do?
More phlebotomy at Bembridge
Make results (via nurse) easier, not just at 1.00 pm
Signing up for appointments online. The website has spelling mistakes, faulty grammar and inconsistencies. It's not
professional
I have been using Boots online prescription service, but unfortunately requests seem to take a low priority position in
your office system, meaning it takes about two weeks to reach the chemist. I shall try your own online service and see
if it's any quicker? Surely there should be no difference in the 'fast' electronic service?
I thought results could only be relayed one day a week. Pleased to see it is 4 days
Regular complete check-up of health and review of all medication, particularly if you have ongoing problems
Re therapies at Q5 - I think the doctor has to refer patients (carers) to carers' office for therapies and I believe a form is
available for this purpose
Post test results (save telephone time)
Physiotherapy after first appointment - had to wait 3 weeks before next appointment
I think you are doing pretty well as you are - if it isn't broke, don't fix it!
Occasionally emailed repeat prescriptions 'go missing'. This can be irritating and inconvenient
More preventative work/checks. My husband is 72, hasn't been to the surgery for years - no prostate/cholesterol/blood
pressure/blood sugar tests - surely it would save money in the long run. 13.00-14.00 to speak to a nurse for results pretty pathetic option - we may be retired but still have a life - longer time to catch a nurse should be available. Don't
be too proud of what you offer. It's OK, but "casual" users are not catered for and can feel "a bit of a nuisance".
However, I am sure you have plenty to do with people who require attention. I have witnessed the input of (poor) Dr
Cooney at an address in Meadow Drive and I don't know how he manages to smile!!
I and I'm certain many others, would very much like the custom of addressing adults as Mr/Mrs to return. The
familiarity of christian names appears patronising to people of a certain age. I would not, on entering a consulting
room, greet with 'Hello, Jim". I would show some respect and address as Dr .... his title. His and mine as Mrs have
been well earned!
10 Every now and then we want to be able to ask groups of patients about how things are working at the moment or
about our plans for the future. If you are happy for us to contact you when we are doing this, please enter your details
below. This information will be used solely for this purpose.
58 patients said they would be happy to be contacted
Comments:
12
If I thought you would listen I would give you my info! Surely that says it all!
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ST HELENS MEDICAL CENTRE
PROPOSED ACTION PLAN FOLLOWING PATIENT SURVEY
February/March 2012
AND DISCUSSION WITH PATIENT FORUM
17 March 2012
GP RESPONSE – PRACTICE MEETING 27 March 2012
ITEM
GP RESPONSE
TIMEFRAME
TELEPHONE - Take steps, if possible, to provide an
alternative number (non-084) for patients to call the
surgery – agreed. Timeframe: as soon as possible
DNAs (Patients who do not attend an appointment
and fail to notify the surgery)
 First-time offender - write to patient – gentle tone.
Flag patient record. Write to patient following 3 DNAs
(addendum: need to agree timescale).
 Investigate possibility of 24 hour cancellation line
(currently patients can cancel an appointment out of
hours 18.30-08.00 only)
 Investigate texting service
 Agreed
 As soon as possible
 Agreed
 July 2012
 Agreed
 As soon as possible
 Agreed, but may have limited use
with predominantly elderly population
 July/August 2012
OPENING HOURS
 Proposal to alternate Saturday surgeries between St
Helens and Bembridge –
 Not agreed. Currently GPs work
alone without a receptionist and St
Helens is not suitable from a security
and safety aspect. For further
discussion
 Next meeting – June 2012
14
HOW PERSONAL INFORMATION IS USED
 Publish leaflet – distribute to Forum members and to
patients who said when completing the survey they
do not know how their personal information is used
SERVICES
 Make more use of The Beacon to advertise services
 Posters at residential/nursing homes advertising flu
clinics (for those patients who are able to get out and
would like to attend a clinic) - agreed
PREMISES
 General consensus is that the Life Channel* is
irritating – proposal to replace with freeview TV to
show for example, Wimbledon, The Olympics
 Play Classic FM in waiting rooms – agreed. Radio
will be incorporated in downstairs refurbishments
 Agreed
 As soon as possible
 Agreed
 At next opportunity
 Agreed
 August/September – when
advertising flu clinics
 Agreed.
 Life Channel will be switched off for
the time being, although contract
states it must be on during surgery
opening hours …
 Agreed
 June 2012 for St Helens upstairs
waiting room and Bembridge Branch
surgery.
 September/October 2012 for
downstairs waiting room following
refurbishment.
 When refurbishing back office, reception and waiting
room, investigate installing a ‘dome’ which absorbs
sound and addresses confidentiality.
OTHER
 Improve/replace nurse test result service 13.00-14.00
hours – agreed. Suggestion: nurse telephone slots?
 Agreed
 September/October 2012
 Agreed
 As soon as possible
15
*The Life Channel was initially installed as an all-Island initiative showing Department of Health approved material for patient education
purposes. With small waiting rooms/areas, the ‘noise’ helps to ensure there are no confidentiality issues with patients overhearing
consultations.
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Appendix A
ST HELENS MEDICAL CENTRE
DEMOGRAPHICS
Practice Population as at March 2012:
Registered population is made up of the following groups:
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Adults
Single adults
Parents
Teenagers
Children (under 16)
Elderly (over 65s)
Workers
Carers
Disabled (physically)
People with learning difficulties
People with chronic diseases
Mental Health service users
Forces veterans
Residents of nursing/residential homes
Drug/alcohol users
Ethnic minorities – Polish, Spanish, Chinese, Philippino, Black North
African, Indian, Russian, Black East African, Thai, Romanian, Dutch,
German, Portuguese, Malaysian, Iranian
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Appendix A (cont.)
Patient Forum currently comprises 6 members, as follows:
Male/Female:
5 female, 1 male
Age Band:
2 females aged 65 and over
1 male aged 55-65
1 female aged 55-65
2 females aged 45-55
Ethnicity:
5 White British
1 White Dutch
Groups represented:
Male adult
Female adult
Single adult
Parent
Worker
Retired
Over 65s
Residential Home residents (elderly)
Carers
Cared for
Disabled
Mental Health
Forces Veterans
Long-Term conditions
Diabetes
Sight Loss
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Appendix B
ST HELENS MEDICAL CENTRE
PATIENTS’ GROUP CHARTER
AIM:
To enable communication between the service providers, the group, and the
wider population.
To promote a patient perspective and enable patients to access and make
the best use of available care.
The group will
help to improve services on behalf of all patients without bias or prejudice by:
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Actively participating in the work of the group
Representing all views
Listening to others
Agreeing the agenda and priorities with the practice representative
Coming to a consensus
Influencing decisions made within the practice and the wider health
community
 Co-operating with other groups to maximise influence
 Being transparent and respectful in all that we do
 Being aware of the needs of others within the wider community
The practice will
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Nominate one main contact
Consult on matters relevant to the practice and health community
Participate in active dialogue with the group
Inform the debate
Listen to and consider the views of the group
Feedback on issues raised.
We will respect all our patients and their absolute right to complete
confidentiality. We will not disclose any information that could benefit or
identify any individual patient or engage in discussions that could be seen as
doing this.
19