REGAL CHAMBERS SURGERY
Regal Chambers Surgery Patient Reference Group (PRG)
Local Patient Participation Report – February 2014
Welcome to Regal Chambers Patients Participation Report. The
purpose of this report is to inform our patients of the activity and
outcomes of our Patient Participation Group to date.
Regal Chambers Surgery opening times:
Monday 8.00am – 6.45pm
Tuesday 8.00am – 12.45pm and 1.45pm – 6.45pm
Wednesday 8.00am – 6.45pm
Thursday 8.00am – 6.45pm
Friday 8.00am – 6.45pm
Extended hours – last Saturday of each month, alternate Tuesday, Wednesday and
Thursday mornings on a rota according to Partner
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The Patient Reference Group (PRG) met 6 times in 2013/14, and have now established
themselves with a Chair and Secretary. They are in the throes of finalising the
Constitution and Code of Conduct. The age/sex register of patients is amended each
time a new member joins, however, there has been little turnover this year and the group
has remained stable.
Each time a member joins their ethnicity is requested along with information regarding
whether they have a long-term condition or are a carer. However, this information is
entirely voluntary and will account for the disparity between membership numbers and
additional information.
We are aware that there are not a lot of younger members on the PRG. It is Regal
Chambers Surgery policy to write to patients when they reach 16 years of age to invite
them along to a health check. This letter includes information about the PRG. Patients
are also offered this information when they join the practice. Leaflets are constantly
available for patients to take and there is information on our main noticeboard for anyone
who may be interested.
We have varied the days of the week and times of day of PRG meetings in order to make
them as accessible to as many patients as possible. We do find that some older patients
are less likely to attend during the winter months, and that bus services to some
surrounding villages do not allow those who require public transport to attend.
Oct-13
<16
17-24
25-34
35-44
45-54
55-64
65-74
75-84
84+
Male
1
2
3
1
4
3
Ethnicity
White
British
White
Ethnic
Other
mixed
Italian
Declined
Number
26
17
2
1
5
Female
2
4
4
7
12
9
2
Carers
Oct-13
Male
British or
mixed
British
2
Other
ethnic
group
2
Patients with LTC’s
Female
Male
Female
<16
17-24
14
40
25-34
35-44
45-54
55-64
65-74
75-84
84+
1
1
1
1
2
1
2
2
1
2
1
1
The Business Manager, Yvonne Pope, has attended all but one of the PRG meetings and given
either a presentation or report. The only meeting she did not attend, and this was at the request
of the group, was so that they could decide between themselves what the purpose and set-up of
the group would be. This was after an unsettled period between group members.
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Priorities and Engagement
Since the early stages of the formation of the group there has been a significant change in the
patients who actually attend the meeting. The ‘virtual’ group has been very stable but it’s really
only in this past year that there have been the same representatives at every meeting. In the early
stages, it was quite difficult to avoid personal agendas creeping into discussions and so it was hard
to set group priorities. However, the patient questionnaire has always been the driver for
effecting change.
One of the areas we scored most poorly on in our 2012/13 patient questionnaire was around the
telephone system. Therefore, this was an area we set as a priority. In particular, some on-going
concerns had been raised around the greetings messages when patients rang into the surgery. In
2012 the practice had bought a high-tech phone system which has enabled the practice to identity
more accurately peak periods when staff could be relocated to answering phones.
As part of this on-going development, the PRG were invited to suggest the ‘script’ they would like
to hear when contacting the surgery by phone. This proved a really worthwhile exercise.
We also sought help regarding our noticeboards and notices in general. In collaboration with PRG
members we reviewed the wording of messages and these also now have a ‘corporate’ look.
Once again, during 2013’s Flu Campaign, PRG members volunteered to help act as ‘signposters’
and to be available to listen to patient comments.
Jenny Piggott, one of the PRG members, undertook to spend a day with Dr. Fiona Sinclair to see
exactly what the day of GP felt like. She has subsequently written a report which was made
available to patients. (see below)
All notes and presentations from each meeting are sent to PRG members and are also available on
the website.
Patient Questionnaire No. 3
Once again, it was agreed by the PRG that this year’s format should follow that of last years in
order to achieve continued comparison. Three simple questions were asked – ‘What are the
three things you like most about Regal Chambers Surgery?’ and ‘What three things would you
change about the surgery if you could?’ The collection period was from 13.1.2014 – 7.2.2014
The practice provided paper copies of the questionnaire and offered them to patients as they
arrived for an appointment. The questionnaire was also added to the practice website and
patients with mobile phones were texted to let them know the questionnaire was available.
Significantly more responses were obtained this year although patients still did not take part in
huge numbers. Despite questionnaires being given, they were often found left blank on waiting
room chairs. The practice was concerned that continued bombardment of information would
desensitise patients and devalue the use of the texting options and so resisted sending more than
one reminder. It maybe the decision of the PRG that next year they will be more actively involved
in distribution and collection of questionnaires. This was due to be discussed at the first PRG
meeting which follows the availability of the results on 24.2.14. However, due to sick leave, a
follow-up meeting was arranged for 11.3.14.
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The Business Manager collated the information at the end of the collection period and grouped
the results into relevant headings. Please see a copy of the results attached.
The results, as always, are posted on the practice website and in reception, and we will text
patients (who have agreed to be contacted) with the information that the results are available. A
copy of the results are attached.
The Partners and staff have discussed the results and feel that there has been significant
improvement. There remain issues which the practice can do nothing about e.g. parking but will
make every effort to action those areas which are possible e.g. holding the Warfarin Clinic on the
ground floor.
The results have been circulated to the PRG members ahead of general circulation on the practice
website and in the surgery .
Identified Action Points by PRG as a result of the patient questionnaire
The overall comments from the PRG members present were that there had been a noticeable
improvement in general and that they would struggle to find areas to improve. The completed
questionnaires and the combined results were available in paper form and also projected on to a
screen.
After discussion, it was agreed that only 2 areas could be identified as a priority.
1.
Clarification of the ‘Sit & Wait’ clinics which were available. PRG members suggested that
the procedure and justification of this procedure were clarified, why they are necessary,
and how we can improve publication of best use of these appointments.
2. Improve communication of all services available e.g. Saturday appointments and why they
might not appear on-line etc.
In order to make this achievable, Yvonne Pope, Business Manager, has agreed to make the Katie
Duguid, Assistant Manager and Chris Duguid, IT Administrator available to the working party of the
PRG who will take this forward. The plan is that, once gathered, the information will be reviewed
and made more ‘patient-friendly’ if it’s not already absolutely clear.
A Day in the Life of…
At one of the Practice’s Patient Reference Group (PRG) meetings we were offered the opportunity
to shadow a practice doctor for a day. The PRG exists to represent the patients, their concerns,
their positive experiences and problems, to the practice team. The aim being to inform the
practice and try to help improve the service we receive.
So your first response might be “Why would spending a day shadowing a doctor be useful?”.
Well, I am really interested in how we see the service we get; especially whether what we expect,
and what our doctors expect of us, is reasonable and well understood by both sides. Does what
constitutes “reasonable expectations” need greater clarification and communication? So, for me,
the offer to come along and have a sense of the context of practice life seemed ideal. After all I
know what it is like to be a patient but my views of the service I get is affected by what I think it
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can do for me. The experience I thought might help me be clearer in my thinking and know
whether my expectations are reasonable.
I actually spent two half days “shadowing” one of the doctors, a Friday morning and a Tuesday
afternoon. This brief story is written to share with you what I experienced on those two days. It is
followed by some extra notes regarding outcomes and reflections that arose out of my time
“inside the system”.
On Friday….
Today Dr Sinclair is a duty doctor so the main activity of the day is to see, with one other doctor in
the practice, the “sit and wait” patients. There are five hour long sessions throughout the day
with the two doctors seeing, or telephoning, up to 16 people in each slot. For many of us, using
this surgery means ringing the surgery to get a same-day appointment. Duty doctors are also
responsible for sorting the bulk of the repeat prescriptions and organising the home visit rota for
the day.
I arrived just before 7.30am and Dr Sinclair had already been at work for a quarter of an hour. She
likes to get in early to make sure she is ready when the patients start to arrive.
Task 1: The doctor checks and signs approximately 100 repeat prescriptions that are waiting in the
office. There are two that need to be followed up on the system, so Dr Sinclair goes to her office
to log in and look at the patient records.
There are about 4000 drugs that can be prescribed, all listed in an online database and a 1000
page book!
At 8.02am someone is ringing on the surgery door because it is not open yet!!
Task 2: The doctor starts checking all the requested non-repeat prescriptions for her own patients
and for a doctor who is away, she looks at each patient’s record before signing. There are a couple
of problems with the prescriptions, people needing to come in for tests and a request the practice
cannot meet because the item is not in the “magic book”. All the rest are signed and returned to
reception.
We discuss the overhead associated with prescription signing, the fact that as soon as a
prescription is signed the doctor has accepted responsibility. Although there appears to be
some duplication it is the need to check that is important. For example, it is important to
check that have had any necessary tests, that the drug being requested is appropriate, or
that there is not over prescription going on.
The surgery has just employed someone to manage the prescription system.
Task 3: Dr Sinclair looks at home visit requests to decide which doctors will go out to visit which
patients.
Task 4: Dr Sinclair talks to reception about adding some extra drop in slots to the morning sessions
to ease the afternoon because of other commitments.
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Task 5: Dr Sinclair has a few minutes before she is due to see the first patient and so she starts to
check test results that have been received. They are flagged on the system in different ways so
the doctor can immediately see those that are normal and those that are not, helping her to
prioritise. One patient’s results look worrying and although Dr Sinclair wants to deal with it
urgently she feels it is a bit early in the day to ring and decides to wait until she has seen a few
patients. She looks at a few more results, all of which seem fine.
It is now 8.45 and time to start seeing patients. She has been working non-stop for an hour and a
half before the first patient steps through her door.
The “come and wait” sessions are timed at 8 minutes each but everyone gets the time they need.
Outside Dr Sinclair’s surgery I talk to some of the patients waiting to go in. I also do this on the
Tuesday afternoon and notes from these sessions are given later.
Dr Sinclair sees four patients before stopping to phone the patient with the abnormal results. In
the next half hour she makes three calls to the patient (including one where she arranges to do a
home visit at lunch time), these are interspersed with calls to various health agencies.
Back to the waiting patients. Dr Sinclair sees another seven patients. At one point she comes out
of the office to check something and is stopped in the corridor by the nurse asking for advice.
During the morning she also has to deal with a phone call from the local police.
Although the morning was meant to be split into two blocks of appointments with a small space in
between them, Dr Sinclair has worked straight through.
I left at 1pm, at the end of the morning surgery and just as Dr Sinclair was off to do her lunch time
home visits. Desperate to get home for a cup of tea and feeling exhausted, I asked about her
lunch,
“I will buy a sandwich” She said. …
Tuesday…..
I arrived at 2pm and Dr Sinclair arrived back from her lunch time home visits at 2.15pm.
Straight into the surgery, she opened her pack of sandwiches (were they the ones from Friday that
she had not found time to eat?) and picked up the phone to follow up on the outcome of one of
the visits. Dr Sinclair was not only sorting out the needs of the patient concerned in these calls, but
also the needs of their dependent partner. Several phone calls to various agencies later and
awaiting return calls….
A letter is written and faxed off.
Community matron pops in to discuss a patient .
Phone call to another patient. In addition to their main health problems, this patient has tried a
number of drugs to help with a separate condition and none of the medicines have worked.
However, the Quality Outcomes Framework requires the doctor to address the problem and so, as
this has not been possible, Dr Sinclair has to add an “exception” to the patient’s record to explain
that all possible approaches have been tried and now abandoned, as they have caused the patient
more problems that the condition itself.
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At 3pm Dr Sinclair is due to visit a local care home, where she will see six patients. Just as she is
about to leave the awaited phone call is returned. She answers but a further follow-up call is
planned for later. She is now ready to leave for an estimated hour of visits. The surgery makes
regular visits to care homes in the area and is working with other local surgeries to rationalise
these and reduce the current duplication of effort. However, this negotiation requires some
delicacy as it may result in a reduction in patient choice.
Whilst Dr Sinclair is out on her visit, I spend some time looking at the queuing at reception (as this
is something that has been mentioned at PRG meetings), some brief notes are given below. During
the observation an emergency occurs. Someone comes into the surgery accompanied by two
members of their family, reception immediately calls for one of the duty doctors, who is with the
patient in two minutes. The patient is taken to a room for examination and some primary care.
The receptionist phones for a “blue light” ambulance, which takes twenty minutes to arrive..
Dr Sinclair arrives back from visit at 4.20pm (a little late for her first booked appointment) but
within two minutes the first patient is in her surgery. The last patient of the day leaves at
approximately 6.40pm
At 7pm I left as surgery staff were locking up. Dr Sinclair had some things still to do, including a
further home visit and more outstanding administrative duties. She left at about 10pm, by which
time I was in bed exhausted..
NB During my visits, I did not have access to any patient records or personal information. I was not
in the surgery with patients, only when Dr Sinclair was undertaking administrative and other non
face-to-face activities. I also signed a confidentiality agreement.
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Notes
Talking to fellow patients
I asked about the phone call they made to obtain appointments.
On the Friday morning, all but one of the patients said the phone was answered almost
immediately and the one said they waited less than 5 minutes. A quite unexpected but pleasing
set of responses.
Queuing at reception
Short observation at one minute intervals 15.39 to 16.09 on the Tuesday
15.39-15.50 a person being seen or no one at reception (no one waiting).
15.51-15.52 three people arrive (one goes straight to reception, two queue).
15.52-15.53 two people arrive with emergency. Receptionist is just finishing with person at
window and then goes immediately to emergency and calls doctor. Another person arrives (three
waiting).
15.53-15.54 second reception window opens and deals with queue
16.00
no one at reception.
16.06 – 16.08 person at reception no one waiting.
16.08-16.09 no one at reception.
If no one is waiting to be seen at reception the staff work on administrative tasks. It is impossible
to avoid queues when people arrive randomly. However, even with a major incident, the
reception staff worked cooperatively and efficiently to deal with waiting patients. There was no
evidence of long waits, the longest was approximately four minutes.
Home visits
Everyday doctors make home visits. In addition the practice makes regular visits to residential and
care homes to save those patients having to be brought into the surgery (although one off needs
have to be dealt with by residents making surgery visits, normally accompanied by a member of
the home staff). On the day I was observing, the doctor made nine home visits. Two at lunch time
to individuals, six in the afternoon - all in the same home, and one in the evening.
Who does the doctor care for?
A doctor tries to take the total needs of the patient into account, this includes, amongst other
things, a holistic view of their medical needs (not just what they are asking about today) as well as
how their illness affects and is affected by those around them.
The doctor’s work
The doctor I observed was in at 7.15am on the Friday and was still there at 7pm on the Tuesday
she did go home for the weekend I hope!. Even if these were exceptional days there was no sense
that the lack of time to relax or have a break was unusual. I am not sure this is a healthy lifestyle!
Dr Sinclair is described as part time but this just means, like a number of the doctors at the
surgery, she spends the rest of their working week doing something else, in her case being a
member of the local Clinical Commissioning Group. I agree with the Dr Sinclair when she said that
it helped to make the intensity of the days in the surgery manageable. I think a full time job in the
surgery could be overwhelming.
And finally….
I cannot thank Dr Sinclair and the surgery staff enough. Dr Sinclair was open and free with her
time and energy. Everyone I spoke to was helpful and friendly. I found the whole experience a
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revelation and made me realise just how hard the whole team work. If you want to contact me to
talk to me about any of this article or about the PRG, my email address is jsp38@cam.ac.uk.
Some thoughts for the surgery
Texting
Although relatively new patients were all asked on registering a out using text on mobile phones,
patients who have been in the surgery longer do not seem to know about the texting option.
There is potential for getting more patients a form for registering for the online system but
nothing for texting, perhaps something could be put here. Also a way of asking people when they
arrive for appointments may help. I note a blitz on this is being attempted for the flu clinics.
Reception
It does not appear easy for reception staff who are in the public area to see what the queue is like.
Abbi had to lean around the window to see whether there was a queue and this first required her
to think there might be a problem and get up to look. I believe there are cameras but screens are
in the non-public area of reception (I think). Consider small convex mirrors high up on top left
corner of reception “windows” so that a view into the waiting room is possible from seating
position.
Surgery registration
There was some misunderstanding concerning the idea that you are registered at the practice and
the name of “your doctor” is pretty meaningless in the bigger picture. One older patient did not
know who her doctor was and I said that it was not important but if she wanted to know she could
ask at reception (where there was not queue) but she wouldn’t ask (??). I found myself explaining
the system of practice registration several times. I know that this information is on the screens but
I did not notice anyone reading them. Perhaps a “thought for the week” might be a good idea? A
bit like the flu flags – one unusual small and separate information may be noticed..
Analysis
I might be useful to have someone occasionally do some random time analyses of surgery
operations, such as phone calls or queues or waiting times, or patients looking at posters…. just to
inform responses. This might be something the PRG could do if given appropriate guidance.
I know I left this quote at reception on the Tuesday but just in case you did not see it on the notice
board….
“This is the best surgery I’ve been in. Doctors and reception are all friendly and
helpful. The doctors are really thorough, It’s great”.
A patient
With thanks
Jennifer Piggott.
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Notes of the meeting held on 23 April 2013
1
Welcome New Members and apologies
Present : Susan Apthorpe, Michael Taylor, Ginny Wilson, Dianne Groves, Di Blockley,
Lorna Rea, Peter Whybrow, Frances Moreland, Eleonora Martorana, Pat Cherry, Jenny
Piggott, Vida Field.
Apologies: Vivienne Goodwin, Laurel Farrington, David Leal-Bennett, Deborah
Segalini, Jane Cave, Sacha Pierre, Janet Piesse, Judi Billing, Keith Hoskins
2
Review of patient questionnaire results
YP was thanked for analysing and summarising results of the recent survey which
were displayed on the screen grouped by topic and in two columns showing responses
“Thing Liked” and “Things Disliked” . YP advised these now are available on the
surgery’s web site.
In discussion note was made emails received by YP which had been circulated to PRG
prior to this meeting. Fuller discussion in item 3 below.
Discussion points included:
Particularly pleasing to note was made of the improvement of staff on last year.
Patient preferences re access to doctors – age ranges, ratio of women to men, full
time part-time etc..
Monitoring phone message/times - and shortening the surgery message . Consider
change wording from “we are very busy” to you are e.g - 5th in the queue.
Considered constraints on toys, magazines e.g Health and Safety Legislation and Fire
Regulations.
3
Patient expectation : demonstration fo GP workload/offer to shadow GP for the day
Much of the meeting time centred around these issues. There was fruitful discussion
of Primary Care in 2013 and Regal Chambers’ responses to change. GPs present
described increasing national pressure on workload and use of resources and
explained in some detail the current complexities of medicines and prescribing with
patient safety paramount. GP’s also described their monitoring of the appointments
system, “sit and wait” and “passage of care”
It was felt that there is some misconception about Surgery resources. They have not
been reduced but there has been a shift in demand e.g work that was at one time
done mainly in hospitals is now undertaken by GPs and nurses in surgeries. This, like
GP recruitment, Is a national issue.
Comparisons with other surgeries - “how are we doing” ? (presentation available
along with these notes on the practice website)
Points to follow up:
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Encourage on more on line access . text, email web pages
Investigate further repeat dispensing systems (beginning to be used elsewhere)
Volunteer (JP) to take up offer to shadow GP fo day (subject to confidentiality
constraints)
Continue patient education and discussions (item 3 above)
4
Flu 2013 – Planning
The practice will be planning this year’s ‘flu campaign on Tuesday 14th May 2013 at
12.00 noon. If any member of the PRG would like to attend to offer input, please let
YP know as they would be most welcome.
5
Noticeboards – does the PRG want its own? What do you want to know about the
noticeboards?
Not discussed in any detail. No board needed now.
6
Forming a committee?
Item deferred to next meeting
7
AOB
PRG member reported on E & N Herts NHS Trust work towards Foundation status and
encouragement of public to join.
8
Date of next meeting
3 July 2013. 6 p.m. Regal Chambers Surgery
The meeting closed at 7.03 pm
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Notes of the meeting held on 23 April 2013
1
Welcome New Members and apologies
Present : Susan Apthorpe, Michael Taylor, Ginny Wilson, Dianne Groves, Di Blockley,
Lorna Rea, Peter Whybrow, Frances Moreland, Eleonora Martorana, Pat Cherry, Jenny
Piggott, Vida Field.
Apologies: Vivienne Goodwin, Laurel Farrington, David Leal-Bennett, Deborah
Segalini, Jane Cave, Sacha Pierre, Janet Piesse, Judi Billing, Keith Hoskins
2
Review of patient questionnaire results
YP was thanked for analysing and summarising results of the recent survey which
were displayed on the screen grouped by topic and in two columns showing responses
“Thing Liked” and “Things Disliked” . YP advised these now are available on the
surgery’s web site.
In discussion note was made emails received by YP which had been circulated to PRG
prior to this meeting. Fuller discussion in item 3 below.
Discussion points included:
Particularly pleasing to note was made of the improvement of staff on last year.
Patient preferences re access to doctors – age ranges, ratio of women to men, full
time part-time etc..
Monitoring phone message/times - and shortening the surgery message . Consider
change wording from “we are very busy” to you are e.g - 5th in the queue.
Considered constraints on toys, magazines e.g Health and Safety Legislation and Fire
Regulations.
3
Patient expectation : demonstration fo GP workload/offer to shadow GP for the day
Much of the meeting time centred around these issues. There was fruitful discussion
of Primary Care in 2013 and Regal Chambers’ responses to change. GPs present
described increasing national pressure on workload and use of resources and
explained in some detail the current complexities of medicines and prescribing with
patient safety paramount. GP’s also described their monitoring of the appointments
system, “sit and wait” and “passage of care”
It was felt that there is some misconception about Surgery resources. They have not
been reduced but there has been a shift in demand e.g work that was at one time
done mainly in hospitals is now undertaken by GPs and nurses in surgeries. This, like
GP recruitment, Is a national issue.
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Comparisons with other surgeries - “how are we doing” ? (presentation available
along with these notes on the practice website)
Points to follow up:
Encourage on more on line access . text, email web pages
Investigate further repeat dispensing systems (beginning to be used elsewhere)
Volunteer (JP) to take up offer to shadow GP fo day (subject to confidentiality
constraints)
Continue patient education and discussions (item 3 above)
4
Flu 2013 – Planning
The practice will be planning this year’s ‘flu campaign on Tuesday 14th May 2013 at
12.00 noon. If any member of the PRG would like to attend to offer input, please let
YP know as they would be most welcome.
5
Noticeboards – does the PRG want its own? What do you want to know about the
noticeboards?
Not discussed in any detail. No board needed now.
6
Forming a committee?
Item deferred to next meeting
7
AOB
PRG member reported on E & N Herts NHS Trust work towards Foundation status and
encouragement of public to join.
8
Date of next meeting
3 July 2013. 6 p.m. Regal Chambers Surgery
The meeting closed at 7.03 pm
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Notes of the meeting held on 3 July 2013
1
Welcome New Members and apologies
Present :
Michael Taylor, Di Blockley, Frances Morland, Jenny Piggott, Vivienne Goodwin,
Elly Martorana, Laural Farrington, John Machen
Apologies:
Judith Nixon, Lorna Rea, Janet Piesse, Victoria Tizzard, Helen Ruggles, Keith
Hoskins, David Leal-Bennett, Ginny Wilson, Sue Apthorpe, Diane Groves
2
Welcome Laurel Farrington Hertfordshire Healthwatch Herts and to Dr John Machen
(patient).
3
Feedback since meeting held on 23 April 2013
Patient expectation : demonstration of GP workload/offer to shadow GP for the
day : JP reported - date to be arranged.
The other items noted at our April meeting are ongoing:
Comparisons with other surgeries - “how are we doing” ? (presentation
available along with these notes on the practice website)
Action Points to follow up
Encourage on more on line access . text, email, web pages
Investigate further repeat dispensing systems (beginning to be used
elsewhere)
Continue patient education and discussions (item 3, notes of our April
(meeting)
Flu 2013 – Planning
JP reported on the to discussions at the May planning meeting about this year’s
‘flu campaign. Offers came from this group to assist patients in surgery waiting
area on the four Saturdays in October to encourage a smooth flow of people.
Noted that letter to patients about the campaign had in the past been sent out
by the PCT (now dissolved). Concern expressed that any increased cost may not
be funded.
Noticeboards – does the PRG want its own? Extensive discussion of reception
and access. Four people are going to look at “welcoming” and notices.
Forming a committee? To be principal item in agenda for next meeting.
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Staff Changes
YP led discussion of changes including the appointment and training of 3 new
receptionists and current recruitment of urgent care nurse. Changes of shift
patterns and new configuration of hours allow for increased support and time
for whole team to meet together. Systems continue to be reviewed and
updated.
Kings Fund Video
“An Alternative Guide to the new nhs in England”
www.kingsfund.org.uk/altguidenhs
Short video giving sketches of possible views about recent re-configuration of NHS
structure, (and confusion(?) of overlaps and vast number of new roles)
6
Regal Chambers Lift. New one being installed in next few weeks.
7
Forming a Committee
Agreed this would be the principal agenda item for our next meeting which would
give us time for discussion of roles.
8
9
Patient Leadership Group . JP circulated paper on 3 day course she
had attended
and the PLACE briefing and assessment session she had taken part in.
A.O.B. Hertfordshire Healthwatch
LF circulated paper on HHW activities (weekly update 21.6.13) and their current
interest in collecting views of patients’ experience of getting GP appointments
“when you need one” and views on customer service.
There was discussion of the “when you need one” and patient expectations in the
fast changing NHS. Discussion ranged widely and included e.g. increasing work
that might at one time have been done in hospital moving to local surgeries, the
number of patients, demographic change, and changes to Regal Chambers
appointments, telephone and other systems. Agreed: to continue open
discussions.
10
Date of next meeting
Tuesday 4 September 2013. 6 p.m. Regal Chambers Surgery
The meeting closed at 7.03 pm
Patient Participation DES Report 2013/14
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Notes of the meeting held on 3 September 2013
1
Welcome and apologies
Present :
Pat Cherry, Dianne Groves, Vivienne Goodwin, Eleonora Martorana, Frances
Morland, M. Piggott, Jenny Piggott, John Machen Michael Taylor
Apologies: Di Blockley, Vida Field, Margaret Warren, Janet Piesse, Gwyn Jones,
David Leal – Bennett, Keith Hoskins, Ginny Wilson.
2
Forming a committee? (Principal agenda item)
2a What do these Groups do? Information on Patient Reference Groups had
previously circulated to the Group by Yvonne Pope, Surgery Practice Manager,
but not everyone had seen this.
The meeting discussed a web page introduction to Patient Groups
http://www.napp.org.uk/intro.html which listed some of the things these groups
do.
Those listed are: Advising the practice on the patient perspective. Organising
health promotion events. Communicating with the wider patient body. Running
volunteer services. Carrying out research into the views of those who use the
practice and their carers. Influencing the practice or the wider NHS to improve
commissioning. Fundraising to improve services provided by the practice.
The Group agreed to discuss these further and plan priorities Action All
2b The meeting discussed the role of the wider group (YP’s PRG circulation list),
the smaller group present at this meeting and the role of chair and secretary. It
was agreed that terms of reference are be developed and considered.
Action All
2c Consensus was reached (without formal voting) that Michael Taylor would
become Chair and Frances Morland Secretary. These appointments are for one
year ending 2 September 2104.
Action MT/ FM
2d JM, MT & FM drew attention to the Standards in PPG work on The Care
Quality Commission’s web pages and mentioned the possibility of inspection of
the surgery which we may wish to be more aware of at some later date.
Action All PRG
2e The Group wished to record their thanks and appreciation to Yvonne Pope for
all her hard work and support to the Group
2f Further Action Points :
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Check YP’s circulation list and its use by PRG - data protection MT/YP
Produce place name’s for Group to use at next meeting
FM
Write formal Standing Invitation to Surgery staff to attend PRG meetings
MT
Check next meeting 15 October 2013 and surgery room availability FM
Find out about contacts with other PRG’s ( terms reference etc) All PRG
Thanks to Yvonnne for all her hard work and support to PRG
Prepare agenda items next meeting
MT
Action All PRG
Finalise and circulate agenda
(deadline: week before meeting? Take AOB items at meeting?)
Patients views Surgery telephone system? Check with YP
PRG Notice Board – cost ? space? Check with YP
PRG records & archiving space check with YP
3
FM
MT
FM
FM
Brief feedback from previous meeting 3 July 2013
Flu 2013 – Planning
Since the May planning meeting about this year’s ‘flu campaign offers have come
from this group to assist patients in surgery waiting area on the four Saturdays in
October to encourage a smooth flow of people.
Patient expectation : demonstration of GP workload/offer to shadow GP for
the day : JP reported – 2 half days have been arranged and she will write a
report for our next meeting.
4
Date of Next meeting: Tuesday 15 October 2013 at 6pm at Regal Chambers surgery
Patient Participation DES Report 2013/14
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Notes of the meeting to held on Tuesday 15 October 2013
at 6pm at Regal Chambers Surgery
1
Welcome and apologies
Present: Sue Apthorpe, Vivennne Goodwin, John Machen, Elly Martorana,
Frances Morland, Jennifer Piggott, Margaret Piggott, Yvonne Pope, Michael
Taylor.
Apologies: Jane Cave, Gwyn Jones
2
Notes of the Meeting held on 3 September 2013
Approved (with correction of minor typing error).
3
Matters arising (not already on the agenda)
Item 2f: Finding out more about other surgeries.
EM reported she had looked at other a sample of other surgeries’ web sites and
had found variation in content and presentation with Regal Chambers very
comparing well.
JM reported that he had visited two surgeries known to have similar telephone
systems to Regal Chambers and compared certain aspects e.g on waiting times
etc.. and had found Regal Chambers to be good. Some statistics are on display
on the surgery’s screens in the patients’ waiting areas.
JP reported that when she visited this surgery (see item 4 below) she the
opportunity to ask a small number of patients about the telephone system.
4
Feedback from JP on work shadowing
JP’s verbal was very informative with key points : no evidence of problems with
the telephone system, patients waiting/queuing was well managed, 12 hour day
worked by doctor with very few and very short breaks, reception staff - good
atmosphere.
JP thanked all the surgery staff.
Her written report will circulated.
Action YP
5
Report from YP (Surgery Business Manager)
YP gave a verbal report (copy attached)
6
Patient Survey January 2014
Following discussion it was agreed to use similar questions and format to those
in the two previous surveys which asked which three things do you like about
the Surgery Practice and which three do you dislike/want to change. Patients
may complete on line or in the surgery.
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Agreed Conduct the survey in mid -January 2014. Some PRG members may
volunteer to assist with handing out in the surgery. Action All PRG
7
PRG Newsletter 2014
There was brief discussion of some pros and cons. The outcome is consider the
format and produce “Snippetts” which would highlight some of the PRG’s
observations e.g on telephone system and JP’s work place shadowing, and YP’s
reports. Contact to be made with Ginny Wilson about publishing.
Action FM
8
Any Other Business
JP passed on a message from Dr Sinclair who will be attending the next Locality
Meeting in Letchworth. MT and FM who have attended previous meetings
encouraged others to attend and meet people from other PRGs.
Agreed: Date and further information to be emailed.
Action YP
Agreed: Linda Dent (Locality Meeting) to be invited to speak to Regal Chambers
PRG.
Action MT
9
Date of Next meeting: Monday 9 December
at 6pm at Regal Chambers surgery
Patient Participation DES Report 2013/14
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Report from Yvonne Pope for Patient Reference Group
The practice experienced a particularly busy summer. At a time when we would usually
expect for things to quieten, we had the busiest summer in living memory!
As we approach the Autumn, it’s time for our annual ‘flu campaign. We are going to be
open every Saturday in October and, depending on the number of patients who take up
these appointments, may need to add some additional sessions in November.
On 5.10.13 we vaccinated 544 patients with flu, 12 with Varicella (shingles) and 11 children
aged 2-3 for nasal flu vaccination. This year has been extremely stressful as the Government
decided to implement 3 new vaccine schedules – Varicella, Flu for 2-3 year olds and
rotavirus. The shingles vaccine is only available for patients aged 70 OR 79. The original
documentation was less than clear and some practices have vaccinated patients aged
between 70 AND 79 thus causing a shortage of the vaccine!
Saturday 12th October saw us vaccinate 379 for flu as well as an additional 18 for with
shingles or under 5’s flu.
We tried something different this year and used a separate mobile phone number solely for
the booking of flu appointments. This relieved the main reception of over 2000 calls. We
have always staggered the posting of invitation letters in order to spread the pain, but this
additional step seemed to work well. We also employed a ‘Saturday girl’ just to deal with
weekend calls.
We have also worked more collaboratively with other Hitchin practices when vaccinating
patients in nursing and residential homes. Rather than 4 practices all go to every home they
have patients registered in, we have divided them up so that we each vaccinate the entire
home. We did Minsden, Benslow and Elmside.
We have had a few PRG members volunteer to come in on Saturdays to collect mobile
phone numbers and email addresses in order for us to reduce the number of letters we
send, and to be able to use our new ‘toy’ – MJog! We have some software on trial for three
months which will enable us to send AND RECEIVE information. We’ll be able to target
patients for whom our information is out-of-date and they will be able to send the
information we need back without being seen (stuff like height, weight, smoking, exercise
etc). Patients will also be able to cancel their appointments by text and the software will
enter the information without the need for a receptionist to deal with it,
Our new receptionists are settling in well. They’ve had a steep learning curve but are all
brilliant.
We interviewed for an Urgent Care Nurse last Friday and have now appointed a new nurse
who is due to start with us sometime in November. This is an essential post for the
management of on-the-day problems.
We have made a slight amendment to the Sit & Wait clinic, in that it’s not just for medical
emergencies. This has significantly affected the number of complaints – there are fewer of
them!
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The Health and Social Care Information Centre (HSCIC) want to link patient information from
all the different places patients receive care in order to provide a full picture. Information
such as postcode and NHS number (but not name) will be used to link information to a
secure system which does not reveal identify, but will enable researchers and those planning
health services to make sure they provide the best care for everyone.
Patients will have a choice of whether the wish their data to be included or not. Please go to
the following website for more information.
http://www.nhs.uk/NHSEngland/thenhs/records/healthrecords/Pages/care-data.aspx
http://www.ehi.co.uk/news/primary-care/8940/care.data-extractions-on-hold
Patient Participation DES Report 2013/14
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Notice of the meeting held on Monday 9 December 2013
at 6pm at Regal Chambers Surgery
Present : Di Blockley, Ellie Martorana, Frances Morland, Maraget Piggott,
Michael Taylor, Ginny Wilson
1
Welcome and apologies
The meeting welcomed Mrs Linda Dent, Public Engagement Lead, E&N Herts
Clinical Commissioning Group to speak to agenda item 7.
Apologies were received from Yvonne Pope and Jenny Piggott
2
Notes of the Meeting held on Tuesday 15 October 2013
Approved
3
Matters arising (not already on the agenda)
3.1 Regal Chambers Flu Jab Sessions held in October
Comments: most sessions went well but on occasions the volumes were a
little difficult to handle with queues developing into the street.
4
Report from YP (Surgery Business Manager)
No report on this occasion.
5
Patient Survey January 2014
The format and content that were suggested at the previous meeting were
confirmed with the addition that the Surgery consider the following i) the
possibility of giving patients the option to patients to respond using text
messaging ii) add any further comment. Iii) mention joining PRG and give
contact detail.
Action YP
It is expected that the Surgery will conduct the survey in mid -January 2014.
Action YP
6
PRG Newsletter 2014
Prior to the meeting FM had contacted GW and JP. GW had published the
previous two newsletters and has now drafted suggestions for part content and
layout. The meeting thanked her for her hard work. JP had emailed FM and
agreed to author some snippets e.g of her visit to the Surgery.
LD, CCG Lead for Public Engagement, agreed to send information to YP and FM
about the recent antibiotics misuse publicity (don’t expect a pill to cure a cold)
for further circulation to PRG and to edit for the Newsletter if there is space.
As the newsletter is 90% ready it may be possible to publish this next week
Action JP GW YP
FM to email JP
Action FM
Patient Participation DES Report 2013/14
7
REGAL CHAMBERS SURGERY
Patient Reference Groups – Locality Meeting.
Next meeting is to be held on 14 January 2014, Goldsmiths Building, Letchworth
6.45 – 8.45pm. FM and EM would like to attend. There will be opportunities for
other PRG members wishing to attend in future.
Action FM.EM
LD spoke briefly to the meeting about patient participation and the Patient
Reference Groups’s background and political developments. She sketched the
structure of the N Herts Clinical Commissioning Group, including an outline of its
budget and decision making process. There are 6 Localites (which are largely
based on GP surgeries and are key for decision making). Dr Sinclair, Regal
Chambers is an elected representative on the CCG.
LD distributed copies of papers to assist our PRG :- i) What is a PRG and N Herts
CCG: ii) Locality Patient Commissioning Groups; iii) Example PRG constitution; iv)
PPG Code of Conduct
Action All
7
Date of Next meeting: Monday 24 February 2014
at 6pm at Regal Chambers surgery
Report from Yvonne Pope 9.12.13
I am sorry I am unable to attend the meeting but, for reasons known only to the NHS
Pensions Agency, I can only work 16 hours a week for a calendar month after taking my
pension. It is essential that I am in the practice for the regular, planned, business meetings
and so am only working Tuesdays and Thursdays until 18th December 2013.
Flu
We have now almost completed our flu campaign for 2013 with only 30 more vaccines left
to administer. We learned a lot this year from doing things differently and will make further
improvements for 2014.
The sharing of nursing homes between Hitchin practices worked really well and we may
consider sharing home visits for flu vaccinations in 2014.
Staff
We recruited, appointed and then lost an Urgent Care Nurse. She accepted the post and
worked here for almost 2 weeks before returning to her previous employer so we’re back to
square one. We’ve not yet decided how we will proceed i.e. try again or look to re-configure
the nursing team.
Xmas and New Year
There will be no booked appointments between Xmas and the New Year. All appointments
will be ‘sit and wait’ with every GP working as Duty Doctor.
Patient Participation DES Report 2013/14
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Regal Chambers Surgery Patient Reference Group (PRG)
Draft Notice of meeting to held on Monday 24 February 2014
at 6pm at Regal Chambers Surgery
AGENDA
8
Welcome and apologies
9
Notes of the Meeting held on Monday 9 December 2013
To amend the notes of the previous meeting to record that YP had emailed her
report on 3 December and to apologise to YP that this had not been noted by
any the Group.
10 Matters arising (not already on the agenda)
11 Reports from YP (Surgery Business Manager)
4.1 To receive the 3rd December Report
4.2 To receive the 9th February Report
12 Patient Survey January 2014
To note the date the was survey conducted and to receive results.
13 PRG Newsletter January 2014
To thank contributors and note publication date.
To receive comments.
14 Other Patient Reference Groups
7.1 Locality Meeting 14 January 2014 in Letchworth.
To receive feedback - EM, MT,FM
.
7.2 To note patient representation NHS 111 E&N Herts Clinical Commissioning
Group and receive feedback from the meeting held on 16 January - FM
8
Papers circulated (9th December Meeting) by Lynda Dent
Lead for Public Engagement, East and North Herts Clinical Commissioning
Group (CCG)
To consider these with a view to producing our own versions and agreeing them
at, or before, our next meeting.
8.i) What is a PRG and N Herts CCG
8.2 ii) Locality Patient Commissioning Group
8.3 iii) Example PRG constitution
8.iv) PPG Code of Conduct
Comments received
1) The 7th paragraph of the Objectives section can contradict with paragraph 4 of the signed
agreement for each member ?
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2) The 2nd paragraph of the Membership section, we have over 12 members via email? I
thought that the more members were present the better? Can one really specify a maximum
number for this?
9
Date of Next meeting:
11.2. 2014
at 6pm at Regal Chambers surgery
Patient Participation DES Report 2013/14
REGAL CHAMBERS SURGERY
Minutes of the P.R.G. meeting held at Regal Chambers on Monday 24th Feb. 2014 at 6 p.m.
Present: Di Blockley, Elly Martorana, Judith Nixon, Hazel Ospalak, Margaret Piggott, Michael
Taylor and Ginny Wilson.
Apologies had been received from Yvonne Pope and Frances Morland.
1
2
3
4
5
Michael welcomed the group, especially our new member Judith Nixon.
Unfortunately in Yvonne’s absence the meeting had to be shortened to 30 minutes as the
building had to be locked early.
Notes of the meeting on 9th December 2013 were agreed.
Matters arising – we all agreed it was necessary to convene a final meeting with
Yvonne’s supervision before she leaves, even more necessary after such a short
meeting.
Results from the Patient Survey, January 2014 were considered. It was felt that many
patients (and some members of the PRG) did not fully understand the options for
appointments, even the process for “sit and wait” . The on-line booking system was
appreciated and the group wondered whether this could be extended to nurse
appointments.
Other Patient Reference Groups – it was agreed by all that involvement with other groups
is relevant and necessary.
The meeting was abandoned at 6.30. Michael said he would liaise with Yvonne regarding the
date of our next meeting and that all members of the PRG would be informed.
Patient Participation DES Report 2013/14
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Report from Yvonne Pope to Patient Reference Group Meeting 24.2.14
Thank you to everyone who contributed to Patient Questionnaire No. 3. The practice has
reviewed the results and feels that there has been a positive improvement since last year.
Whilst we recognise it is not possible to please every patient, in general we felt that patients
were happier with the staff, systems and services. This has been supported elsewhere too
by a reduction in complaints received to the practice both written and verbal.
I have attached our responses to some of the points made. It would seem that there are
still patients who are unfamiliar with the services and systems available as they are
requesting us to do things which have been in place some time e.g. extended hours, on-line
booking of appointments etc but, fortunately, they are in the minority.
We would ask for the support of the Patient Reference Group in identifying areas of
achievable improvement to work towards in 2014. I would suggest you think about
repeating this questionnaire in Autumn 2014 – preferably during the flu clinic – when we see
close on 2000 patients in order to achieve greater representation of opinion. Although the
response rate has improved on previous years, it is still only about 1% of the list. The
positive side to this is that we could take that to mean that 99% of our patients feel they
have no comment to make as they are satisfied – but that could just be my ‘glass half-full’
side coming out!
We have two new members of staff joining us. Sarah Perry is a new receptionist owing to
the resignation of a receptionist who is going to be working from home in future. We also
have a new Urgent Care Nurse joining us, Lynne Keen. She is a very experienced nurse and
will be offering Urgent Care appointments each day alongside our other Urgent Care Nurse,
Lucy Blevings.
Care.data has been in the news but I understand some sense has prevailed and this is now
being deferred until later this year. We have been very proactive in the practice in having
provided opt-out forms since October 2013. We have also kept patients informed with
updates via the website.
As you may know, I shall be leaving Regal Chambers at the end of March to manage a
practice closer to home (I have already met their Patient Forum Chairman!). Due to some
potential changes locally involving collaborative working between practices, it is not exactly
clear what the plans are for my immediate replacement. I’m happy that the practices will be
able to continue to function in the short-term without a Business Manager as there is a
strong band of Team Leaders to work alongside the Senior Partners to form the
Management Team. The practice is committed in its continued support for the Patient
Reference Group and will send representation to any meetings they are invited to.
Finally, a big, big ‘thank you’ to Ginny for another brilliant job on the PRG Newsletter. Once
again it was full of useful and interesting information and looked fantastic.
Yvonne Pope
21.2.14
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Patient Participation DES Report 2013/14
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Patient Questionnaire No. 3 – January/February 2014
A total of 8950 patients were sent text reminders that this questionnaire was available on-line or in the surgery
168 Responded in the practice
29 Responded on line
Things you like
Things you would change
Staff
Pleasant, polite, friendly, helpful, courteous, cheerful/efficient
Everything ok
Smiling faces
Reception are great
Prompt
Nice/considerate/lovely/patient
Customer care/good service
First contact is working well
Improved reception staff (finally nice ones!)
Telephone manner
Doctors
Having confidence in the treatment given
Doctor always gives me time/very patient
Doctors professional
Nice/helpful doctors
Efficient/good/caring/polite/considerate/great/friendly/brilliant
/excellent/reliable doctors
Personally named GP
Good number of doctors and nurses
Quality of healthcare
Correct diagnosis and treatment/knowledgeable
Very obliging
Availability of GPs/medical assistance
Staff
Two people at reception at all times
To be treated as staff would like to be treated
Reception to be open as well as check-in
Need more staff
Stern/rude receptionist
Reduce queue at reception
4
1
1
3
1
1
2
6
5
13
51
Doctors
Inability to see your own doctor soon
Wait to see your own doctor
Waiting times/running late/keeping to time
Better communication between doctors
Out of hours GP visits
11
8
13
1
1
8
5
2
2
1
2
GP continuity
More time to speak to doctors
Turnover of doctors
Drs to work in shifts for better patient care
Drs to work at night
To have a regular GP/see same GP/own GP
1
1
1
1
1
5
128
1
1
2
1
6
2
1
2
1
Patient Participation DES Report 2013/14
REGAL CHAMBERS SURGERY
Doctors are very thorough/get to bottom of problem
Choice of GP
The new doctors
Utmost dedication and commitment to care
Good with children
Excellent general practitioners
Doctors you can talk to/listen to you
Speed of being seen by appropriate medical person
Not kept waiting
Good follow-up
Nurses
Nursing system/nurse availability
Great/good/excellent/professional nurses
Helpful/kind nurses
Fine nurses
Urgent Care Nurse system
Good with children
Excellent nurses
Caring nurses
4
1
5
2
1
2
4
1
1
1
2
9
2
1
2
1
1
1
Premises
Good facilities/ambience
4
Can see reception
1
Reception in a convenient position
Closeness to where we live/location
Cleanliness/modern/warm/tidy
Good wheelchair access
Welcoming/friendly environment – light and bright
Toys for children
1
21
40
1
11
3
Not having to comeback for same problem
Doctors sometimes seem rushed
More thorough questions and examinations
No, or lack of, continuity
Bring back that family doctor concern
Attitude of named GP
Get more GPs like named GP
1
2
1
8
1
2
1
Nurses
More nurses
More minor illness appointments with nurse
1
1
Premises
Not enough privacy when talking to reception – move sign
back 2 metres
Reading material for waiting room/more up-to-date/better
magazines
Parking
Difficult to access lift – no automatic doors
Warfarin clinic on ground floor
Rooms too warm
Waiting room on first floor is claustrophobic
Waiting room with kids and toys/no children in waiting room
Patient Participation DES Report 2013/14
1
6
8
2
1
1
1
2
REGAL CHAMBERS SURGERY
Easy access/spacious/comfortable
Rooms easy to find
Quiet
Easy to get good parking
Upstairs area
6
1
1
2
1
Waiting area
The surgery is big
1
2
Appointments
Ease of getting/booking an appointment/availability
Fast waiting times
Ease of getting/flexibility of same day/Sit & Wait appointments
Text messages re appointments
Option to have telephone appointment/callback
Always seen on time
Variety of appointment/clinician options
Quick appointments
Young children seem to get priority
Good opening hours
Diabetic management service
27
1
40
2
6
2
3
2
1
1
1
External lighting poor after dark
Comfy seats when waiting/sofa
More toys/children’s play area
More children’s books
Become more like a medical centre with own x-ray and
ultrasound machinery
Cold water dispenser on 1st floor in summer
To have a clock
Some relaxing music upstairs to drown out noise of road
Walls are a bit bare – feels sterile
Depressing floor and wall colours
More modern/decorate
Water dispenser
Clearer signposting
More patient toilets
Lack of seating for midwife area
Toilets
Upstairs waiting area
Better seating arrangements
Appointments
Appointments by phone impossible
More last minute appointments
Appointments early morning/after 6.00pm and at weekends
Availability of appointment for same week/routine
Length of time to wait for an appointment
Appointment system
Better availability/options
More book on the day appointments
Making an urgent appointment
Telephone appointments spread more throughout day
Less waiting for same day appointments
Patient Participation DES Report 2013/14
1
5
7
2
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
19
18
12
2
4
1
1
1
1
REGAL CHAMBERS SURGERY
Can book on-line/ease of system
Ease of getting a home visit
15
1
Telephones
Quick to contact via phone
Helpful recorded messages/know where you are in queue
Telephone system and being able to queue
Telephone system much better/impressive
1
2
1
5
Appointment availability in the morning
Be able to book Sit & Wait the day before
Shorter turnaround for appointments
On-line appointment booking
Sit & wait can take a long time
Appointment system not patient friendly
To see children more quickly in sit and wait
Only open ‘on-line’ appointments 1 week in advance
Be able to book Sit & Wait on-line
Access to on-line appointments Monday morning
Next day on-line appointments
Make it possible to make face-to-face appointments
Sit and wait does not provide continuity
Be able to book nurse appointments on-line
Impossible to get early morning or late evening appointments
Stagger appointments instead of everyone given the same
time
Own doctors to cover out-of-hours
Duty Doctor service at weekends
Long queue for Warfarin clinic
Quicker emergency clinic – more doctors
Telephones
Less waiting time/getting through on phone
Being able to phone for an appointment easier
Telephone/queuing system
Long preamble when phoning practice/telephone message
Ansaphone open after 8.00am
Telephone system confusing to elderly
Look into telephone upgrade
Patient Participation DES Report 2013/14
1
1
2
1
3
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
27
1
5
3
2
1
2
REGAL CHAMBERS SURGERY
Phones being open lunchtime
Difficulty when phoning
Telephone booking system
Would prefer not to have to wait in a queue to speak to
receptionist
To be able to speak to nurses on the phone
Improve awful telephone booking system
Systems
General organisation and management
4
Use of self check-in
Very good/wide range service
6
2
Speed of repeat prescriptions
Efficiency of Saturday flu clinics
Check in without having to queue/touch screen facility
Ordering prescriptions on line
Good to have all the information
Web access
Good communication
Electronic reminders/texts
Good patient support – regular check-ups
Helpful/informative information screens
Blood testing available
The ability to speak to trained staff who know what they’re talking
about
2
2
3
1
2
1
1
5
1
1
1
1
Systems
Unable to contact surgery during lunch hour
Midwives should allow you to book latest appointment when
earlier ones are not booked up
More GPs or nurses available to fit coils
Being able to book closer appointments on-line
On-line system not as easy as phoning
More interesting health info on TVs
A way for Sit & Wait to check in on screen
Updates on if doctors/nurses are running late
Would like to be able to email GP with small queries
Order prescriptions by phone
Repeat prescriptions take a long time
Self-log-in machines working
TV screens too small
General administration
Get rid of booking in machines – they never work
Text reminders/seasonal public health updates
Twitter account
Nurse appointments on line
Internet option did not work
Vague/generic text messages re results
Patient Participation DES Report 2013/14
3
1
1
1
1
1
1
1
1
1
1
1
2
2
2
3
3
1
1
1
1
1
1
1
1
2
REGAL CHAMBERS SURGERY
Quicker referrals
What is the point of the results line? You need to see a GP
anyway
Dietary advice for weight loss
On-line options to make appointments
Reliability of automatic booking service
Longer opening hours
Unable to order prescription if due for a review
Test results line available for longer period
Repeat prescription arrangements unclear/slow
Only contact patients when all results are in. Texts are
confusing as you don’t know which ones they apply to
General
Always made to feel at ease
Access to Food Bank
Great selection of services
Good team who are capable and pleasant to deal with
Clear and prompt service
Very pleased with practice
Getting an appointment and seeing a doctor has greatly improved
Refurbishment has made a big difference
Overall service
Feel that you will do your best to give the help needed
The personal and dedicated attention to the patient that make
patients feel they are important and well cared for
Every time I have come out feeling looked after well and the
amount of personal attention is great
Friendly service
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General
Specifically stated ‘Nothing ‘
Might be nice to have a cup of tea
Internet access in waiting room
Always room for improvement
To see more patients talking to each other
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Advertise ‘Sit & wait’ more
Charge for visits
Crowded at times
I feel like a number of the staff now know me and that is great
– it would be good if more patients felt like me
Check wording and grammar for on-line questionnaire
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Has a ‘did not attend’ on record as did not know how duty
doctor system worked
When unable to provide treatment make a referral rather than
some suggestions of places that might help
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Patient Participation DES Report 2013/14
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REGAL CHAMBERS SURGERY
Opening hours
2
To be assured to be put in the right hands with health problems
Thank you
When I was having chemotherapy the reception staff offered me a
separate room to wait in
Efficient service
3
1
Whole operation not customer friendly and outdated. Not set
up for those who work
When x-rays are taken, make them available rather than
patient having to pay for them again
Free wi-Fi
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Patient Participation DES Report 2013/14
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REGAL CHAMBERS SURGERY
Patient Questionnaire No. 3 – January/February 2014
A total of 8950 patients were sent text reminders that this questionnaire was available on-line or in the surgery
168 Responded in the practice
29 Responded on line
Things you would change
Staff
Two people at reception at all times
To be treated as staff would like to be treated
Reception to be open as well as check-in
Need more staff
Stern/rude receptionist
Reduce queue at reception
Doctors
Inability to see your own doctor soon
Wait to see your own doctor
Waiting times/running late/keeping to time
Better communication between doctors
Out of hours GP visits
GP continuity
More time to speak to doctors
Turnover of doctors
Regal Chambers Surgery response
There are never fewer than 2 people at any time. One may
be out of view temporarily, but there are always at least 2
with our secretaries offering additional support at peak
times each day.
This will be addressed during in-house training
Reception and check-in are always open at the same time
Due to the current constraints in primary care this is not
possible at the present time.
This patient did not identify the receptionist concerned
We have re-organised staff timetables in order to provide
the most staff at the busiest times.
The majority of patients canvassed wanted same day access
which, obviously, affects the ability for us to provide
routine, pre-bookable appointments.
Each patient is given the time their medical condition
requires.
Patients are encouraged to contact the Business Manager
with any concerns about Out of Hours GPs who have visited
them
We have bookable telephone appointment slots
We are a training practice which means that more junior
GPs will only stay for between 3 months – 1 year
Patient Participation DES Report 2013/14
REGAL CHAMBERS SURGERY
Drs to work in shifts for better patient care
Drs to work at night
To have a regular GP/see same GP/own GP
Not having to comeback for same problem
Doctors sometimes seem rushed
More thorough questions and examinations
No, or lack of, continuity
Bring back that family doctor concern
Attitude of named GP
Get more GPs like named GP
Nurses
More nurses
Premises
Not enough privacy when talking to reception – move
sign back 2 metres
Reading material for waiting room/more up-todate/better magazines
Parking
Difficult to access lift – no automatic doors
Warfarin clinic on ground floor
Rooms too warm
Waiting room on first floor is claustrophobic
Waiting room with kids and toys/no children in waiting
room
External lighting poor after dark
Comfy seats when waiting/sofa
Patients are encouraged to make appointments with the
same GP for the same problem.
This is sometimes necessary in order to allow a problem to
settle.
Each patient is able to book with the GP of their choice so,
if they prefer to see the same doctor, it’s possible for this to
happen. We rely on patients to tell us who they would
prefer to see.
This will be fed back to relevant GP
This will be fed back to relevant GP
Due to the current constraints in primary care this is not
possible at the present time.
Unfortunately, patients ignore this sign
We are happy to receive donations of magazines
We are unable to change this
This is in the process of being changed
Good idea – we will review room availability
Lights are on a timer – we can review this
Due to infection control, we are unable to have fabric seats
Patient Participation DES Report 2013/14
REGAL CHAMBERS SURGERY
More toys/children’s play area
More children’s books
Become more like a medical centre with own x-ray and
ultrasound machinery
Cold water dispenser on 1st floor in summer
To have a clock
Some relaxing music upstairs to drown out noise of road
Walls are a bit bare – feels sterile
Depressing floor and wall colours
More modern/decorate
Clearer signposting
More patient toilets
Lack of seating for midwife area
Toilets
Appointments
Appointments by phone impossible
More last minute appointments
Appointments early morning/after 6.00pm and at
weekends
Availability of appointment for same week/routine
Length of time to wait for an appointment
Appointment system
Better availability/options
More book on the day appointments
Making an urgent appointment
We are happy to review this
We are happy to accept donations of books – most of ours
are taken.
There are very specific building requirements to house such
services and these premises would not conform to the
regulations
However tempting, this could be a Health and Safety risk
with water spillage
We are happy to consider this
We are constrained by licensing laws regarding the playing
of music in public.
This person did not specify so difficult to know what exactly
We don’t know what in particular about the toilets?
We offer extended hours appointments which start at
7.00am and also ones which finish at 8.00pm
In order to provide 2 Duty Doctors each day, it means that
fewer routine appointments are available. We can’t
provide both unfortunately.
This seems to contradict the majority opinion that we offer
a good variety of availability and options.
Patients can be seen the same day in Sit & Wait surgeries
Patient Participation DES Report 2013/14
REGAL CHAMBERS SURGERY
Telephone appointments spread more throughout day
Less waiting for same day appointments
Appointment availability in the morning
Be able to book Sit & Wait the day before
Shorter turnaround for appointments
On-line appointment booking
Sit & wait can take a long time
Appointment system not patient friendly
To see children more quickly in sit and wait
Only open ‘on-line’ appointments 1 week in advance
Be able to book Sit & Wait on-line
Access to on-line appointments Monday morning
Next day on-line appointments
Make it possible to make face-to-face appointments
Sit and wait does not provide continuity
Be able to book nurse appointments on-line
Impossible to get early morning or late evening
appointments
Stagger appointments instead of everyone given the
same time
Own doctors to cover out-of-hours
There are 4 telephone appointments available each hour
There is no wait for same day appointments
You can book Sit and Wait for the next day
We have on-line appointment booking
Unfortunately, we cannot predict what is wrong with each
patient and so there may be delays if a patient is
particularly unwell.
Children are identified as ‘Baby’, ‘Toddler’ and ‘Child’ so
that the Duty Doctor can see and prioritise according to
urgency of the problem
Our appointments are available up to 2 months in advance.
All appointments are available. It will be that they have all
been taken if there are none available to see.
True, but it’s the responsibility of the patient to see the
same GP each time.
Our nurses have different areas of expertise and booking
appointments on line would run the risk of a patient
booking to see a nurse who would be unable to give them
the treatment they wanted.
These are very popular
Patients are brought down to Sit & Wait in groups at 30
minute intervals.
This option was removed in a previous GP Contract
Telephones
Less waiting time/getting through on phone
Patient Participation DES Report 2013/14
REGAL CHAMBERS SURGERY
Being able to phone for an appointment easier
Telephone/queuing system
Long preamble when phoning practice/telephone
message
Ansaphone open after 8.00am
Telephone system confusing to elderly
Look into telephone upgrade
Phones being open lunchtime
Difficulty when phoning
Telephone booking system
Would prefer not to have to wait in a queue to speak to
receptionist
To be able to speak to nurses on the phone
Improve awful telephone booking system
Systems
Unable to contact surgery during lunch hour
Midwives should allow you to book latest appointment
when earlier ones are not booked up
More GPs or nurses available to fit coils
Being able to book closer appointments on-line
On-line system not as easy as phoning
More interesting health info on TVs
A way for Sit & Wait to check in on screen
Updates on if doctors/nurses are running late
Would like to be able to email GP with small queries
Order prescriptions by phone
Repeat prescriptions take a long time
This is necessary to avoid patients speaking to the wrong
person.
This was last done 18 months ago.
In order to provide more staff throughout the day, we have
a reduced staff at lunchtime.
We no longer have a telephone booking system
Nurses do have telephone appointments available
We no longer have a telephone booking system
The practice is open from 8.00am – 6.30pm but, in order to
provide more staff throughout the day, we have a reduced
staff at lunchtime.
The current system is one which has been requested by the
midwives.
We have 2 GPs who are able to do this.
The practice has a generic email address
E82075.regalchamberssurgery@nhs.net but GPs do not use
this routinely.
For reasons of patient safety this is not possible.
We have a member of staff dedicated to processing the
Patient Participation DES Report 2013/14
REGAL CHAMBERS SURGERY
repeat prescriptions each day. Our turnaround time is 72
hours.
Self-log-in machines working
TV screens too small
General administration
Get rid of booking in machines – they never work
Text reminders/seasonal public health updates
Twitter account
Internet option did not work
Vague/generic text messages re results
Quicker referrals
What is the point of the results line? You need to see a
GP anyway
Dietary advice for weight loss
On-line options to make appointments
Reliability of automatic booking service
Longer opening hours
Unable to order prescription if due for a review
Test results line available for longer period
Repeat prescription arrangements unclear
Only contact patients when all results are in. Texts are
confusing as you don’t know which ones they apply to
General
Specifically stated ‘Nothing ‘
Might be nice to have a cup of tea
Internet access in waiting room
Always room for improvement
This is done already
Our clinical provider is working on a solution to this.
Currently, our results come in in batches and we accept
that this can be confusing for patients.
A GP will always phone a patient if they are concerned. The
results line is for patients to use.
We are open from 8.00am – 6.30pm with extended hours
from 7.00am – 8.00pm and Saturdays throughout each
month
This is for patient safety
Our clinical provider is working on a solution to this.
Currently, our results come in in batches and we accept
that this can be confusing for patients.
Indeed – which is why we like to conduct these
questionnaires.
Patient Participation DES Report 2013/14
REGAL CHAMBERS SURGERY
To see more patients talking to each other
Advertise ‘Sit & wait’ more
Charge for visits
Crowded at times
I feel like a number of the staff now know me and that is
great – it would be good if more patients felt like me
Check wording and grammar for on-line questionnaire
Has a ‘did not attend’ on record as did not know how
duty doctor system worked
When unable to provide treatment make a referral
rather than some suggestions of places that might help
Whole operation not customer friendly and outdated.
Not set up for those who work
When x-rays are taken, make them available rather than
patient having to pay for them again
This has been addressed
Patient Participation DES Report 2013/14