Development of Patient Participation Direct
Enhanced Service
For Peverell Park Surgery and
University Medical Centre
July 2011-March 2012
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Contents
1.1 Executive summary
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1.2 Introduction
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1.3 Present situation
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1.3.1 Problems associated with present situation
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1.3.2 Teenagers/students
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1.3.3 Elderly groups
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1.3.4 Ethnic groups
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1.3.5 Disability groups
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1.4 Findings
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1.5 solutions/proposals
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1.5.1 Teenagers/students
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1.5.1.1 Facebook
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1.5.1.2 Fresher fayre
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1.5.1.3 SurveyMonkey
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1.5.2 Elderly groups
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1.5.2.1 nursing/residential homes
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1.5.3 Ethnic groups
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1.5.4 Disability groups
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1.5.5 Use of practice newsletter
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1.5.6 Use of Facebook and website
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1.5.7 Extended hours and opening times
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1.6 Success of widening group participation
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1.6.1 Teenagers/students
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1.6.2 Elderly groups
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1.6.3 Ethic groups
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1.6.4 Disability groups
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2. Survey areas of priority with the PPG and vPRG
2.1 Meeting with PPG
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2.1.2 SurveyMonkey
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2.1.3 Newsletter
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2.2 Findings of PPG survey
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2.3 Agreed areas of priority
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3. Agreed action plan
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4. Review
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Appendices
Appendix a - Plymstats 2010
Appendix b - Implementation plan
Appendix c - Facebook page
Appendix d - patient participation survey
Appendix e- SurveyMonkey results
Appendix f – Newsletters (new style)
Appendix g – Action plan
References
Department of Health Patient Participation Group Direct Enhanced Service
2011/12
Emis search 2011- in house computer system
www.plymstatbrf.24May2010
Official national statistics 2001 Cencus
www.dcca.info
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1.1 Executive summary
Peverell Park Surgery (PPS) and the University Medical Centre (UMC) plan to
participate in the Patient Participation Group Direct Enhanced Service (PPG
DES). To do this communication to all patients will need to be improved, this
will enable a Patient Participation Group (PPG) and a Virtual Reference
Group (vPRG) to be established.
PPS and UMC plan to do this by targeting four main groups of patients to
complete step one of PPG DES. Target groups will be teenagers/students,
elderly, ethnic minority and disability groups.
PPS and UMC plan to use various forms of communication such as
Facebook, emails and letter drops. Barriers to communication have been
identified as under use of technology, cultural and language barriers,
alongside physical disability barriers and location barriers of a branch surgery.
An implementation plan has been produced that will enable the set up of a
pro-active the PPG and a vPRG. Implementation plan will allow completion of
step one to be finalised by the end of October 2011, with review March 2012.
Resources needed include setting up of Facebook page, use of survey
monkey, mail drops, email and man-power of PPG (existing focus group).
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1.2 Introduction
The Department of Health (DOH) has introduced a Patient Participation Direct
Enhanced Service for General Medical Services. Key objectives are “The
purpose of the PPG DES (Patient Participation Group Direct Enhanced
Service) is to ensure that patients are involved in decisions about the range
and quality of services provided and over time, commissioned by their
practice…..”
The purpose of this report is to show how PPS plans to adapt a very
successful ‘focus group’ into a pro-active Patient Participation Group that
involves a cross section of patient’s views across a diverse, large patient
group.
The main focus of the Patient Participation DES is to enable patients to have
a better communication format to express their views and help structure the
services provided by the local health care provider. For the purpose of this
report we have reviewed step one- six of the PPG DES, the key stakeholders
will include teenagers, the elderly, ethnic groups and disability groups. This
cross section of key stakeholders is not a full representation of our patient list,
however for this 1st stage the ‘focus group’ recognised that the four targeted
areas are probably the least represented. We plan to introduce a further stage
which will cover new mothers, working men and women and healthy nonattenders.
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1.3 Present structure
The present structure is that PPS has a very well attended focus group. The
focus group meets once every quarter and has helped PPS over many years
by providing feedback on proposed changes, man power with survey
completion and projects such as flu campaigns. Whilst this group has always
been beneficial and PPS have always appreciated the on-going support of the
group, the DOH proposed outline of the new Patient Participation Group
(PPG) will be more inclusive to all patients and include a wider cross section
of patients. Currently the group is largely made up of retired or semi-retired
individuals. Communication to patients is primarily conducted through a wellreceived newsletter that is published once a quarter. 45% of the practice
profile is made up of 18-23 year olds at the surgery’s branch site the UMC.
1.3.1 Problems associated with present situation
For the purpose of this report we will look at the problems associated with the
present situation in regards to communication for four groups; these four
groups have been identified as being under represented by the current PPG
group.
1.3.2 Teenagers/students
The barriers to communication to teenagers/students currently are lack of up
to date technology. Teenagers and students are computer literature and tend
to favour technical communication methods such as Facebook, text
messaging and emails. Currently the practice does not practise regular text
messaging or emails. Teenagers/ students have busy hectic lives, juggling
school, college/university with social lives, part time jobs and often moving
away from home for the first time.
PPS has an additional barrier to communication in that the majority of
teenagers/students are seen at the University Medical Centre (UMC) branch
site. This is a relatively small surgery that houses two Practices; there is little
wall space to be able to promote any form of health promotion or encourage
communication and participation from students.
1.3.3 Elderly groups
PPS main branch has a patient list made up of 32% of patients over the age
of 75. 1.5% of over 75 year olds reside in a residential/nursing home or are
classed as housebound (Emis search 2011-in house computer system).The
barriers to communication to these patients are that a majority will not have
access to the internet or have the technical ‘know how’ for social networking
such as Facebook or Twitter. Due to being in a nursing/residential home or
being housebound patients rarely visit the surgery, all communication is
conducted through letters or GP visits.
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1.3.4 Ethnic groups
As of 2001 Ethnicity in Plymouth was below national average. Up to date
figures are not available.
“1.6 % Plymouth had a small proportion of people from ethnic minority than
the region as a whole or England 2001 (2.3% and 9.1%)”
www.plymstatbrf.24May2010 GOSW Regional Intelligence Team (appendix aplymstats 2010)
The largest ethnic population of Plymouth is Chinese. The area of Peverell
Plymouth houses 14% of the total Chinese population of Plymouth. (Source:
office for National Statistics 2001 census).
The Chinese population are recognised as being low users of the NHS; it is
thought this is mainly due to their own beliefs and use of non-Western
medication. Language and cultural barriers make it difficult to engage Chinese
elders.
1.3.5 Disability Groups
Disability Groups can come under many categories; barriers to
communication can be physical or mental disabilities. Patients with a sight,
hearing or speech impediment may struggle with the usual day to day forms
of communication used such as letters and questionnaires. Physical
disabilities may mean that a patient rarely attends the surgery; so has little
contact with health professionals and services that the Practice promotes.
Mental health disabilities can mean that patients who fall into this category
have little say on how they would like to see their services run.
PPS has good disability access to the premises on the ground floor and
participates in the ‘hearing loop’ scheme, alongside regular use of deaf
interpreters. However little consideration is given to patients with a sight
impediment. Current focus group meetings are conduct in the upstairs
meeting room without disabled access.
1.4 Findings
It is clear to see that to enable PPS and the UMC to partake in the PPG DES
the current focus group will need to be expanded and a wider selection of
views from patients canvassed; creating a Patient Reference Group (PRG)
and Virtual Patient Participation Group vPPG.
Consideration needs to be given to the 455 of patients between the ages of
18-23 years who attend our branch site the UMC.
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1.5 Solutions/proposals
1.5.1 Teenagers/students
To reach teenagers/students we have looked at our use of technology. We
currently under use the information technology we have. Feedback from our
current focus group suggested the use of a more structured IT approach. We
plan to do this via several different methods. (Appendix b- implementation
plan to establish PPG and vPRG)
1.5.1.1 Facebook: We plan to set up a Facebook page for the UMC to reach
students and a Facebook page for PPS. Up dated information can be placed
on a Facebook page offering students and teenagers the ability to take part in
on-line questionnaires. First stage implemented: www.facebook.com;
University Medical Centre (PPS) (Appendix c- Facebook page).
1.5.1.2 Freshers Fayre: Fresher’s week at the start of September gives the
surgery an ideal opportunity to start engaging students. We will seek
permission to use email addresses and text messaging, inviting students to
join a vPRG (virtual Patient Reference Group) or the traditional PPG.
Meetings can be held at the UMC if required. The UMC website has been
widely advertised on all forms of communication to fresher students, including
a leaflet published and placed in prospectuses for the University of Plymouth
(UoP). Contact has been made with the UoP student body who plan to include
a 90 minute video clip of the UMC informing students of services and how to
get involved with vPRG.
1.5.1.3 Survey monkey: With the help of the PPG we would like to establish
a vPRG that will cover a cross-section of students and teenagers. The aim is
to use such tools as survey monkey to canvas opinions.
1.5.2 Elderly Groups: To enable PPS to gain a cross-section of views; the
views of the elderly will need to be canvassed; it is planned to do this via:
1.5.2.1 Nursing/residential homes: With the help of the PPG we would like
to contact the four main nursing/residential homes and seek permission to
visit and discuss issues/views on a one to one basis with patients in
residence.
1.5.3 Ethnic minority groups: PPS would like to concentrate on engaging
the Chinese population during the first stage of implementation. The Chinese
population are known to be private and reserved; with that in mind we would
ask that the PPG make contact with Devon and Cornwall Chinese
Association; www.dcca.info in the first instance to seek opinion of best
approach.
1.5.4 Disability Groups: To enable initial contact a mail drop will be
conducted with an invitation to join the vPRG or PPG. Invitations will include a
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choice of preference on how to be conducted i.e. via email or letter. For those
who have been identified with a sight impediment we would need to seek
advice from Plymouth Primary Care Trust on how best to reach this group.
It is planned that implementation of the first stage will be conducted by the
End of October. (Appendix b – implementation plan).
1.5.5 Use of Practice newsletter:
The surgery has an established newsletter that is issued quarterly. A review of
the newsletter has identified that:
1. newsletter needs to include opening hours and any planned closures,
including extended hours. The Practice have not always made available what
health professional is accessible until now, but plans are to include this
information on all literature in future. At all extended hour sessions a GP and
a nurse is available.
2. information on how to join the vPPG or PPG
3. option to allow patients to feedback views via email or in writing
4. information on any changes made to the surgery
1.5.6 Use of Facebook and website
As with issues identified above the practices’ website and Facebook accounts
would include all points in 1.5.5.
1.5.7 Extended hours and opening hours
The Practice uses it’s Facebook page and website to advertise opening hours
and extended hours available, these are also advertised in the surgery.
The PPG identified the need to advertise extended hours and opening times
on the newsletter in a more informative layout, new format have been added
to the last newsletter but further work needs to be put in place to ensure that
all extended hours options are advertised in advance.
1.6 Success of widening group participation:
1.6.1 Teenagers/students
The use of Facebook and the website have proven to be very successful for
teenagers and students. The UMC Facebook account has 34 members for its
vPRG.
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1.6.2 Elderly Groups;
First contact with this patient group has not been very successful with no up
take.
A decision was made to wait until the ‘flu’ campaign to contact this group of
patients again, it was felt that it would be a better use of resources to include
a sentence or two on the annual flu letters sent out. This is planned for
September 2012. It was also felt that Sister Tracey Allen might be more
successful engaging with this group of patients when she did her housebound
visits to patients.
1.6.3 Ethnic Minority group: Members of the PPG approached the local
community of Chinese residents through Hope Baptist Church, the community
expressed no interest in joining at present. It was suggested that the surgery
promote the PPG through surgery publications and await contact from
interested parties.
1.6.4 Disability groups: PPS have 21 friends through Facebook , PPS
continue to promote it’s website and Facebook page.
2. surveying areas of priority with the PRG and vPRG and patients.
2.1Meeting with PPG:
A meeting was held with the current PPG to discuss how opinion for areas of
priority for the PPG could be attained. A patient participation survey was
produced for both the UMC and PPS. Appendix d- patient participation
survey.
Three questions were asked to 100 patients:
1. What do you think are the most important issues on which we should
consult our patients?
2.If we were able to offer more appointments what type of appointments
would you like more of?
3. What type of things would improve the ‘patient experience’?
2.1.2 Survey monkey
A survey monkey questionnaire was placed on the UMC Facebook account to
canvas opinion from students.
2.1.3 Newsletter
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The PPG newsletter has had a regular news feature on how to join the PPG
and vPRG and details on the aims of the PPG. Patients are invited to contact
the surgery and feedback or join the vPPG.
The news letter is published on the website for the UMC and PPS, and is also
published on the UMC’s and PPS’s Facebook page.
Newsletters are printed and placed in reception areas of both surgeries.
2.2 Findings of patient participation survey:
Peverell Park Surgery and the University Medical Centre
Importance of issues patients wanted to be consulted on:
41% clinical care
41% getting an appointment
18% patient experience.
Appointments : % of patients questioned said they would like to see more
appointments in:
17% minor surgery appointments
36% routine
12% chronic disease
15% emergency appointments
Feedback: what things would improve the ‘patient experience’
Patients asked for:
1. Reception staff to wear name badges
2. Recycling bin for old batteries for such things as hearing aids.
3. More notice for minor surgery appointments, giving two weeks whenever
possible
4. More appointments available.
2.3 Agreed areas of priority.
Having reviewed the findings of the patient survey and the results of the
SurveryMonkey questionnaire- appendix -e- SurveyMonkey results with the
GPs at the surgery and the PPG the agreed areas of priority were:
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1. more appointments for all types of consultations
2. prioritise the ‘patient experience’ requests ie name badges and recycling
bins.
3. Agreed action plan
A Partnership decision was made to recruit more clinical staff. The Partners
have committed to recruiting an additional Nurse Practitioner and a practice
nurse to improve the amount of appointments available to patients at the UMC
and PPS.
Further actions include the purchase of recycling boxes for both surgeries,
name badges being provided for reception staff and a change tp GP rota to
establish a new structure to include more opportunity for minor surgery
appointments.
These decisions have been communicated through the surgery’s newsletter
Appendix f- Newsletter 1,2,3 and publication through the surgery’s website
and Facebook pages, newsletters are also available in both reception areas.
A copy of this report is available in both reception areas and has been
uploaded to the surgery’s website.
Appendic g- action plan for implementation of areas of priority.
4.Review
PPS and the UMC plan to review areas of implementation at the end of May
2012. A continued campaign of recruitment to the PPG and vPRG will remain
in place through, literature, Facebook and websites. The current newsletter
letter will be adapted / amended to include further information reference
surgery changes and services offered, including extended hours.
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Appendix to follow on hard copy
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