The Leys Health Centre Oxford
Patient Participation Report 2012/13
Produced for the Patient Participation DES 2012-2013
This report summarises development and outcomes of The Leys Health Centre Reference Group (PRG)
in 2012/13.
It contains:
A Practice Profile
A summary of our practice profile including patient demographics
It also contains the following sections which reflect the DES components as outlined in the Patient
Participation DES self declaration form 2012/13
1. Establishing a Patient Reference Group (PRG)
A summary of the recruitment process used to ensure that the PRG is of sufficient size to be as
representative as possible of the Practice population.
2. Method and Process for Agreeing Priorities for a Local Practice Survey
The method the Practice adopted to seek the views of the PRG in determining the priority areas for
the Practice, to include in a local practice survey.
3. Details and Results of the Local Practice Survey
A description of the local practice survey and how it was carried out, as well as details of the survey
results.
4. Discussing Survey Results with the Patient Reference Group (PRG)
Details of how the Practice consulted with the Patient Reference Group (PRG)
5. Agreeing an Action Plan with the Patient Reference Group (PRG)
Details of the draft action plan setting out the proposals arising out of the local practice survey
results, how that was agreed and how the proposals can be implemented
6. Publishing the Local Patient Participation Report
Details of where this Report has been published and also details of the Practices opening hours and
how patients can access services
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Practice Profile
The Leys Health Centre is a large, busy, multidisciplinary training practice five miles from Oxford city
centre. It has a patient list of 10,650 serviced by 7 GP Partners plus two further GPs and a registrar.
There are also 3 practice nurses and two Phlebotomists/Healthcare assistants.
Ethnically the Practice population is made up principally of those who would describe themselves as
‘white British’ (over 50%) and ‘white/mixed British’ (18%). The remainder (and who have stated their
ethnicity) come from a wide variety of ethnic groups – see graph below.
The vast majority of patients (88%) have English as their first language. The remainder (and who have
stated their main language) speak a wide variety of languages. The following graph shows these.
However, day-to-day experience also tells us that most of these patients have English as a second
language.
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In terms of gender, the practice population is evenly balanced. However as the next graph shows the
practice has a significantly larger proportion of children and younger adults than older adults.
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1.
Establishing a Patient Reference Group
Develop a Structure that gains the views of patients and enables the Practice to obtain feedback from
the Practice population e.g. a Patient Reference Group (PRG)
DES Component 1
As part of component 1 of the DES Practices are required to establish a Patient Reference Group
comprising only of Registered Patients and use best endeavours to ensure their PRG is representative.
Recruiting to the Patient Reference Group (PRG)
1.1 Process
The Leys Health Centre continued its PRG recruitment this year in order to further improve representation:
1) Surgery decorated with posters in key locations such as the reception desk, pin boards, front door, back of
toilet doors, walls etc.
2) Display stand in reception with balloons, posters, and survey topic/sign up forms, etc.
3) Survey topic/sign up forms were uploaded onto The Leys Health Centre website.
4) Survey topic/sign up forms were published in the November 2012 edition of the Leys News. (This free
newspaper reaches 5,000 plus households in the Leys area.) This was identical in content to the leaflets
used in the surgery.
5) Patients were asked on an ad-hoc basis by doctors if they wished to join the group
6) Doctors also nominated patients from ‘special care groups’ e.g. blind, hard of hearing etc., who may be
interested in becoming members of the PRG. This list of patients was contacted by letter and telephone
and four of them agreed to join the PRG.
A decision was taken at the beginning of the process in 2011 to create a ‘virtual’ PRG and to try and recruit
as many patients as possible to become members. This was in an effort to try and make the PRG as broad
and representative as possible. A strong, positive feature of a relatively large PRG, such as this, is that it
represents a very large range of individual characteristics and needs for the patients themselves, but also
within their extended families
This approach continued in 2012/13 and, in order to reach those who were unable to come into the
surgery, such as frail or care home residents, and the ‘usually well’, who would only attend surgery rarely,
we placed an article in the November 2012 issue of the Leys News. This article advertised that we were
still actively recruiting for new PRG members and included a form enabling people to vote for topics to be
included in our Patient Survey. This free paper reaches nearly 100% of the households in our Practice
catchment area.
New members of the PRG are welcome at any time. This has also been reflected on the practice website
since the launch of the PPG. 16 new PRG members have joined between April 2012 and March 25th 2013,
while we have lost 25 due to natural ‘patient churn’.
The Leys Health Centre’s PRG communication strategy has continued to offer the opportunity to
participate to the broadest possible range of individuals and groups.
The Leys Health Centre is also trying to engage a small sub-group of the larger virtual PRG to become more
directly involved. 7 members of our PRG have agreed to meet with members of the Leys Health Centre for
a broad discussion on the future shape of the PRG. A date for this has yet to be set.
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1.2 Patient groups represented in the Practice PRG.
Patient Reference Group

All the data collected from the ‘sign up’ sheets was entered into an excel work book in 2012 and cross
referenced with EMIS to allow further information to be included, such as demographics etc. This
allowed the Practice to analyse the comments made and establish how representative the PRG was.
The database has been updated as new members have joined and members have left.
The patient group comprises 244 members
PRG PROFILE
Gender
Employment Status

Male

Female
73

Employed
171

Unemployed

Retired
3
2

Student
1

Not stated
Age

Under 16

16-24
21

25-34
61

35-44
50

45-54
42

Drug users

55-64
18

Care home residents/

65-74
30

75-84
19

85-89
1
Ethnicity
 African
3
 Albanian
0
 Bangladeshi
1
 Black British
0
 Mixed British
37
 Caribbean
2
 Indian
7
 Irish
1
 Polish
4
 Spanish
1
 Other Asian
5
 Other black
2
 White British
127
 Ethnicity not stated 50
 Other white
4
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NK
157
Specific Groups
0
Sheltered housing
0

Representative for above
1

Learning disability
1

Other disability
1

Carers
6
Languages
 Arabic
 Bengali
 Czech
 English
 Hindi
 African
 Polish
 Portuguese
 Punjabi
 Sinhala
 Spanish
 Tagalog
 Turkish
 Yoruba
 Not specified
1
1
1
211
1
0
3
1
1
1
1
3
0
1
18
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2. Method and Process for Agreeing Priorities for the Local Practice Survey
Agree areas of priority with the Patient Reference Group (PRG)
Component 2
As part of component 2 of the DES Practices are required to agree which issues are a priority and include
these in a local Practice Survey.
The PRG and the Practice will shape the areas covered by the local practice survey. The areas covered in
the local practice survey will, therefore, need to be agreed jointly based on key inputs including the
identification of:

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
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Patients priorities and issues
Practice priorities and issues including themes from complaints
Planned Practice changes
National GP and/or Local Patient issues
The process used to seek the views of the Patient Reference Group in identifying the priority areas for
the survey questions.
 The surgery was decorated with new posters and survey topic forms were made available in the
waiting areas.
 Forms to establish priority areas for the Patient Survey were also published in the November 2012
issue of the Leys News.
 Survey topic forms were uploaded onto the practice website.
 All PRG members were contacted via email or post, asking for their feedback on the proposed
questions for the patient survey and updating them on progress made since last year.
 By 19/11/12 only 25 responses had been received and so over 200 ‘telephone call attempts’ were
made to the PRG membership with over 75 PRG members completing the survey over the phone.
The priority areas and how these match those set out by the PRG
The priority areas for the local practice survey were taken directly from the top three responses received
during the consultation phase with the PRG.
Priority areas were as follows:
1 Grounds and Parking
2 No improvements necessary
3 Access to GPs/GP services/Practice Nurses
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23%
22%
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3. Details and Results of the Local Practice Survey
Collate patient views through the use of a survey
Component 3
As part of component 3 of the DES Practices are required to collate patients’ views through a local
practice survey and inform the Patient Reference Group (PRG) of the findings.
The Practice must undertake a local Practice survey at least once per year. The number of questions
asked in the local practice survey will be a matter for the Practice and the PRG to agree. Questions
should be based on the priorities identified by the PRG and the Practice.
3.1 Survey questions




Details of how the practice determined the questions to be used in the survey are detailed in the practice
response 2 above.
The practice based the survey on the top three topics
Detailed survey questions were designed by a GP Partner at the practice who has extensive experience of
research and survey design.
The survey went through several iterations, being reviewed by both GPs and non-clinical staff members,
and then tested on a small number of “guinea pigs” who had not previously seen the survey. While the
survey is no longer available to view, the questions can be seen alongside the results on the practice
website
Survey method
3186 patients were invited to participate in the survey, a three-fold increase on last year:
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2166 patients were texted and prompted to visit The Leys Health Centre website to complete the Patient
Survey or pick one up at the surgery
624 were emailed a copy of the Patient Survey
396 Patient Surveys were posted to patients
(Patient searches were set up to ensure that patients were not duplicated across media)
Printed copies of the Patient Survey were left in reception
The practice website included a link to the survey
Posters were produced and sited around the building encouraging patients to complete the Patient Survey
An article was placed in the January 2013 edition of the Leys News encouraging patients to take part in the
Patient Survey.
Survey rationale

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The Leys Health Centre wanted to try and increase its reach with regard to the Patient Survey and so chose
to fully utilise the text numbers and email addresses, flagged with consent, held on our system.
It was verified that the mobile numbers accurately reflected the demographics of our patient population
between the ages of 16 and 55. Therefore, selecting all these patients would not significantly skew the
results within this age range.
As older patients were not well represented within the text numbers used, patients between 55 and 85
were selected for postal surveys
Advertising in the local paper was designed to capture patients who were registered at the practice but
who do not attend on a regular basis
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Collation of the survey results


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All hard copy answers received were then collated and manually entered into the website survey software.
(The practice still holds all completed paper surveys.)
The website survey software collated the results. The results were circulated to the partners for their
feedback and to all the members of the PRG for their feedback. There was no negative feedback
176 responses were received before the deadline - a 53% increase on 2011/12.
Publication of patient survey

A copy of the survey results are published on the practice website and displayed in the Practice waiting
room (March 2013)
4. Discussing Survey results with the Patient Reference Group (PRG)
Provide the Patient Reference Group (PRG) with the opportunity to discuss survey findings and reach
agreement with the PRG of changes to services.
Component 4
As part of component 4 of the DES Practices are required to provide the Patient Reference Group (PRG)
with the opportunity to comment and discuss findings of the local practice survey and reach agreement
with the PRG of changes in provision and manner of delivery of services. Where the PRG does not agree
significant changes, agree these with the PRG.
Consultation with the PRG on the findings of the survey and any proposed changes highlighted from it.
 The practice emailed or posted a copy of the Patient Survey results to the PRG membership, together with

our proposed Action Plan and asked them to comment, or simply email or post back the form marking it
with the words,” Go Ahead”, if they were happy. Boxes were left in reception to receive the responses.
Some positive responses were received. No amendments were requested nor negative feedback received
within the time period (or since).
5. Agreeing an Action Plan with the Patient Reference Group (PRG)
Agree and Action Plan with the Patient Reference Group (PRG) and seek PRG/PCT agreement to
implementing changes.
Component 5
As part of component 5 of the DES the practice is required to agree with the PRG an Action Plan setting
out the priorities and proposals arising out of the local patient survey. They are also required to seek
agreement from the PRG to implement any changes and where necessary inform the PCT.
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5.1 Action Plan that relates to the survey results and copy of the agreed Action Plan for 2012/13.
66% of patients, who responded to the Patient Survey, agreed with the PPG that ‘Grounds and Parking’
as well as ‘Access to GPs’ were their key topics for 2013. 23% had other concerns .
Parking/Grounds

Nearly half of those who responded to the question, agreed that parking provision at the health centre is not
acceptable and virtually all respondents felt that the situation had got worse over recent years. 7 out of 10
thought that the opening of the dental surgery had inevitably added pressure to the existing parking
problems.

43% of respondents felt that disabled patients were disadvantaged

40% agreed that having more than one wheelchair that carers could use to transport patients from their cars,
would make them less concerned about the availability of disabled parking bays.
ACTION: Explore a suitable location in reception for 2 wheelchairs to help carers transport disabled patients from
their cars to reception and back.

A majority of those who responded were prepared to use a bus [12 was most often cited] if it stopped outside
the health centre and close to their home and could turn round. They were prepared for this service to run
half-hourly. Falcon Road/Knights Road area was identified as an area poorly served by buses at present. In
contrast 60% were not interested in a ‘dial a ride’ service.
ACTION: Liaise with the local council and bus operator(s) to establish whether existing routes could be adapted to
accommodate patient views.

Almost 6 out of 10 respondents expressed their desire to see the grass area in front of the surgery converted
into additional parking.
ACTION: The practice does not own this piece of land but will liaise with the landlord of the site in order to
establish whether this would be practical/possible. However, funding will be a major issue, even if this is possible.

There were opposing views with regard to creating designated parking in surrounding roads.
ACTION: No action at present

There was a mixed response with regard to the provision of facilities to lock up bikes and motorized buggies
with CCTV coverage. 46% agreed that they would like such facilities but 42% neither agreed nor disagreed.
This could be because 6 out of 10 respondents stated that they do not have access to a bicycle.
ACTION: Practice to contact landlord to see what might be possible. Some respondents made interesting
suggestions about parking which will also be explored.
Access to GPs/GP services/Practice Nurses

Feedback was extremely encouraging throughout this section. 66% of respondents felt that not much needed
to change regarding access to GPs and 72% felt that the steps the practice was making would improve access
to GPs and nurses for appropriate problems. Only 1% disagreed with this.

82%, of those who responded, would be willing to see a Minor Illness Nurse for things such as cough, cold,
earache, etc. Only 7% disagreed/strongly disagreed.
ACTION: We have a new nurse starting in April 2013 who has specialist skills in minor illness and these will be
available to patients in the next couple of months.

69% of respondents felt that providing feedback about whether attendance at Open Surgery was appropriate
for a particular condition would help keep Open Surgery available to patients with urgent problems. Only 8%
disagreed.

67% of respondents would be happy to receive such feedback
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ACTION: We are going to change Open Surgery with the objective of improving access for patients who have
medically urgent problems. We will take patients feedback about Open Surgery into account. This is a major
project requiring many communication strands and staff retraining. We will have to plan carefully and progress will
be announced in the next few months.
We know that demand for appointments is increasing generally and we understand that Open Surgery is very
popular with patients. However, Open Surgery is not always used appropriately. This reduces availability for
patients with medically urgent or serious problems.

There was clear support for reserving a few booked appointments at the start of Open Surgery for those who
work. 68% agreed and only11% disagreed/strongly disagreed.
ACTION: This change will be considered as part of the Open Surgery review

A majority of respondents were happy to receive a telephone call from a doctor if all Open Surgery
appointments were filled prior to 10am. 78% agreed with this approach.
ACTION: This change will be considered as part of the Open Surgery review
Prescription Services

70% of respondents were on repeat medication and 66% of these agreed to prescription requests being made
in writing, via the chemist or the internet, helping to free up the telephones in reception for patients trying to
make appointments. Exceptions to this would be the elderly, housebound, visually impaired or those who
have problems reading or writing.
ACTION: The practice would like to go ahead with these changes to our prescription services as it would promote
patient safety and reduce the risk of error. Therefore, we propose that the changes are implemented on Monday
1st July 2013. These changes will be advertised in advance in the surgery as well as on our website etc.

49% expressed an interest in a voicemail service which would allow patients to leave requests for repeat
prescriptions. Only 12% disagreed/strongly disagreed.
ACTION: This change will be reviewed, and if practical, will be implemented and the changes flagged in the surgery
as well as on our website etc.
About you

There was a broad range of responders - aged from 16 to over 85. However, only 2% of respondents came
from the 16-24 age range. More than half were women. Most were British and English speaking (which
reflects the practice overall).

Over half of respondents attended the surgery regularly. While this may have arguably skewed the results, it
may simply be that those patients who use our services regularly, have stronger opinions on those services
and are therefore more likely to respond.

There was an almost even split between those respondents who had a chronic health condition and those
who didn’t.

Interestingly nearly 3/4 of responders have access to the internet at home and almost everyone has a phone
or mobile at home.

65% of respondents have access to a car or motorbike and 36% have access to a bicycle. 31% did not have
their own transport.
ACTION: Since the last Patient Survey we have increased our efforts to collect patients’ email addresses and mobile
numbers as it plainly offers improved ease and speed of communication, as well as having the “green” advantage
of saving paper.
One example of this is the addition of an email address request to our registration form.
Next year we will look to increase the respondents in the 16-24 age range to more accurately reflect our patient
population and also try and target patients who attend the surgery less frequently.
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Summary of Action Plan / Points
Area for Action
Proposed
Grounds and Parking


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
Access to GPs/GP
Services/Practice Nurses


Prescription Services

Patient Information

Wheelchairs accessible to carers in reception
Liaise with council and bus operator(s) re.adaptation of existing bus routes
Liaise with landlord re. converting grass area in front of the surgery to create
additional parking
Liaise with landlord re. provision of facilities to lock up bikes and motorized
buggies
Utilise skills of new nurse starting in April 2013,who has experience in
treatment of minor illnesses such as coughs, colds, earache etc
Open Surgery to be completely reviewed in order to improve access to
patients who work and those who have medically urgent problems. Deadline,
December 2013. Any changes to be advertised in advance
Prescription requests to be only made in writing, via the internet or the
chemist. Exceptions to this will be the elderly, housebound, visually impaired
or those have problems reading or writing. Deadline 1st July 2013. Change to
be advertised in advance.
Prescription voicemail service to be reviewed and, if practical, implemented.
Any changes to be advertised in advance.
Continue to collect patient email and mobile numbers and gain consent for
use.
5.2 Method used to consult with the PRG to agree the Action Plan.

As our PRG is a virtual group, the practice either emailed or posted the results of the Patient Survey and
proposed action plan to them in early March 2013. They were given a defined period to feedback their
views prior to publishing the final report. Some positive responses were received. No amendments were
requested nor negative feedback received within the time period (or since).
5.3 Updates on progress against 2011/12 Action Plan
 All our doctors. Who work in the afternoon, take appointments until 6pm at least once a week
 We have updated our website and practice leaflet to highlight the availability of double length
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
appointments, when needed, and the weight management advice provided by our Practice Nurses
One of our nurses is now able to give Zoladex injections
As a pilot, we are offering some patients, who have had a stroke or who have had heart disease, a review
appointment with a Practice Nurse instead of a doctor.
Additional information
 A member of staff from The Leys Health Centre also attended the LINKs meeting held on 28th November
2012 in Eynsham and the OCCG meeting in Oxford on 11th December 2012, together with a representative
from the PRG.
 A separate meeting was held with an interested member of the PRG on 7th December 2012.
6. Publishing the Local Patient Participation Report
Details of where this Report has been published and also details of the Practices opening hours and
how patients can access services
6.1 This report has been published on The Leys Health Centre website www.theleyshealthcentre.co.uk
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6.2 Practice opening hours and details on how Patients can access services during core hours (8am6.30pm)
Access to services is by personal visit or telephone call during reception opening times:
Monday
08:30 – 20.15
Tuesday
08:30 – 18.00
Wednesday
08:30 – 18.00
Thursday
08:30 – 18.00
Friday
08:30 – 18.00
Saturday
08.30 – 10.30
Between 8.00-8.30am and 6.00-6.30pm, Border Medical provides a telephone service for patients calling in. Calls
requiring GP attention are forwarded to the Practice’s duty doctor via a dedicated mobile phone number.
Where a Practice is commissioned to provide Extended Hours the Practice is required to confirm the
times at which patients can see individual health care professionals
6.3 Extended hours and details of access to Health care Professionals.
1
The Practice provides additional GP appointments as follows on a rota basis:
Appts from 18.30 – 19:45
Appts from 8:30 -10:30
Monday evening
Saturday morning
2. The Practice provides additional Practice Nurse appointments on a rota basis:
Appts from 18:30-20:15
Monday evening
In accordance with the action plan agreed with the PPG, these extended hours appointments will be reserved
primarily for those who are unable to attend the surgery during “normal hours”.
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