Key Information

Patient Reference Group

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Click here to download the full PRG Survey Report 2012 (.doc)

Swanage Medical Practice PRG Survey Report 2012-13

1. Practice profile

Since the start of the PPG DES (Patient Participation Group Directed Enhanced Service) in 2011 the practice has been developing a PRG (Patient Reference Group).

The group consists of a “virtual” group of patients who are contacted by email or post and an already established formal PPG (Patient Participation Group) who has a chair person and who regularly meet at the practice. The meeting is also attended by a GP and the Practice and/or Assistant Manager.

Swanage Medical practice currently has 11636 patients registered. We have eight GPs and are a large employer in the Swanage community.

See Appendix 1 for a table of the practice profile by ethnicity, age and sex.

2. How our PRG Is Representative Of Our Registered Patients.

We made our PRG a representative group by working with our already established patient participation group who is a group of representative patients who actively engage with the practice. There are currently 12 members of this group who attend regular evening meetings at the practice chaired by the PPG Chair and attended by the Practice Manager/Deputy Manager and a GP.

We also recruited patients into our “virtual” PRG by encouraging patients to join the group by advertising in our surgery. We tried to ensure that a broad spectrum of patients were invited by giving out recruitment forms during health visitors, midwifes, nursing, GP and family planning clinics. Recruitment forms (Appendix 2) were also put in the waiting areas, reception staff handed them out to patients attending the surgery and we had a link on our website.

Last year we specifically wrote to age groups 16-24 both male and female to try and encourage them to join our PRG, however, we had a poor response from these age groups. This year we were able to recruit five patients who are 16-24. We will continue to try and encourage this group of patients to join our PRG.

3. Profile of the members of the PRG

Additional information: The PRG membership has representation from the following groups:

Patients who work
Ethnic minority groups
Patients with learning disabilities
Carers
Mental Health Service users
Young families
A selection of patients of all representative age groups

We currently have 113 members of our PRG and also the 12 members of the Patient Participation Group. The profile of the group is detailed below.

Table of PRG group profile by age and sex

	16-24	25-40	41-55	56-65	66-75	76+	Total
Males	2	3	2	10	13	16	46
Females	3	4	14	19	19	20	79
Total	5	7	16	29	32	36	125

Ethnic minorities	3	2.4 %
Mental Health Service Users	1	0.8 %
Learning disability	1	0.8 %
Has a carer	1	0.8 %
Is a carer	3	2.4 %

4. Areas of Priority for surveying the wider population

The PPG DES was initially discussed at a Patient Participation Group meeting on the 2nd of July 2012 where it was agreed the PRG would be asked what they felt were the main areas of the survey should focus on. We considered areas to focus on such as themes from complaints, patient’s priorities and issues and the patient experience at the practice. To agree areas of priority we emailed and wrote to our PRG patients (Appendix 3).

From the responses we received, we deduced that “Getting an Appointment” and “Telephone Answering and Access” were their main areas of priority (Appendix 4)

5. Developing Our Survey

A “working group” meeting with core members of the PRG was held on the 15th October to discuss the areas of priority and start developing a survey on telephone answering, access and appointments, to obtain views of a cross section of the practice registered patients.

We have past experience of producing our own surveys and gaining valuable information and we chose to do this again. Questions were based on existing validated surveys such as those provided by the company Oldroyd Publishing Limited and previous surveys used by this practice and the NHS national survey.

Before it was sent to the wider community the survey was tested on a small selection of patients so we were confident that the reported outcomes would be valid. Surveys were given to all members of the PRG and patients in the wider community.

Surveys were given out in a variety of ways from early November until 31st December:

Via email (or by post for those who have requested this)
In person when collecting prescriptions / coming for an appointment
Via the practice website

We used software from “Oldroyd Publishing Ltd” to create our survey. This included example surveys such as appointment, patient experience and access surveys with standard questions and format.

We were able to custom build a patient survey tool to meet our needs.

(See appendix 5 for survey questions)

6. Survey Results and patient comments

554 surveys were issued/emailed/posted. 161 were returned. This represents a 29% return rate.

(See appendix 6 for survey results and appendix 7 for patient comments).

7. Survey results and action plan

The Survey results were circulated to the partners and the appointments committee members. A number of discussions took place (please see extracts from the partners meetings Appendix 7). It was agreed that the appointment sub-committee would discuss in more detail and look at how changes could be achieved. Their recommendations were taken to be agreed with the PRG.

On the 25th February a meeting was held with the working group of our PRG to discuss the survey results and provide them with an opportunity to discuss the survey findings and to reach agreement on the recommendations for change. There was also a representative from the Appointment sub committee and the Assistant Practice Manager. The following action plan was agreed:

Agreed Action Plan

Survey Outcome	Action Plan
Survey Outcome	Action Plan
The 161 returned surveys reflected that some patients were unhappy with the current telephone triage system and the majority of comments also reflected this.	We plan to make changes to our appointments system by introducing a combination of routine bookable appointments and a daily “sit and wait” surgery. We plan to still offer our telephone triage option. We feel these changes will give our patients more choice and would enable patients to book future appointments. We will advertise these changes widely in a local paper article, via our website and with leaflets at the practice.
We were surprised that 31% of patients found it difficult to speak to a GP urgently as we run an urgent surgery every day.	With the help of our PPG, we plan to produce an information leaflet and advertise in a local paper to help patients understand our appointments system and what is available to them.
In addition, 83% of patients indicated they would like an information leaflet explaining doctor availability and the appointments system.	With the help of our PPG, we plan to produce an information leaflet and advertise in a local paper to help patients understand our appointments system, what is available to them and when there doctor is at the surgery.
Telephone answering - The practice updated to the present telephone system as it allows the reception team to log in to specified groups (i.e. Appointments, enquiries) and answer from various work stations. The reception manager is able to monitor incoming calls to ensure no more than 2 patients are waiting at any time. The system also allows different messages to be set at different times to notify patients when call times may be longer i.e. lunchtime, after 5pm. We felt that the majority of patients did not experience great difficulty getting through to someone on the surgery, however, it was noted that 94% of patients are trying to get through on the phones between 08:30am – 12noon.	We plan to try and help our patients by informing them of the best times to phone in to the surgery for their problem and how the current telephone and answering system works. We plan to do this by way of an information leaflet and articles on our website and local papers.
Access - Only 6% of patients said they experienced difficulty accessing the surgery/reception area and waiting room. The comments suggested that some of the difficulty experienced was with the downstairs treatment rooms.	We already try and ensure that patients with mobility problems have their appointment in the upstairs treatment rooms and we plan to make sure invite letters inform patients to use the bottom door entrance to the downstairs treatment rooms. We are restricted in our current building in terms of layout and space but we feel we have made significant improvements with the space we have.

The rest of the virtual PRG and friends of the practice were informed of the action plan and invited to discuss it with the assistant practice manager (Appendix 8)

The vast majority of the comments were about the appointments system (appendix 7) which were addressed in the action plan. However, some of the other comments followed a similar theme:

Comment Received	Practice Response
Receptionists asking what the problem is….	….Some patients are not happy to give the reason for speaking to a doctor to a member of the reception team. The Practice receptionists are covered by the NHS and Practice codes of confidentiality, exactly the same as all the health care professionals at the surgery. Knowing what your health problem is helps the doctors and staff at the surgery deal with your request more appropriately and helps the doctor to decide who to prioritise for a call back based on clinical need. It helps the doctor gather information in preparation for talking to you.
Staff changing their uniforms too often…..	….Some patients feel that the staff change their uniform too often. We would like to point out that we have had the current uniform for the past 8 years. Some staff, who have joined recently, have a slightly different style but this is due the discontinuation of the original blouse. This style will slowly replace old and damaged uniforms over the coming years. The staff supply their own skirts, trousers and cardigans.
Reception and Admin a smile would help!...	….Generally patients remark on how friendly and happy the reception team are, however comments within the survey stated that it would be nice for the receptionists ‘to smile occasionally’, It should be noted that there are some occasions when the team are dealing with complex issues, and problems of a difficult and challenging nature where a smile is not appropriate. Also, a patient speaking to the receptionist in a pleasant manner is more likely to receive a smile than one being miserable, confrontational or even abusive.
Lack of privacy in the treatment rooms….	….The practice treatment rooms have recently undergone extensive refurbishment. These positive changes will make the patient experience a much better one and have significantly helped with the lack of privacy in the upstairs treatment rooms. We are restricted in our current building in terms of layout and space but we feel we have made significant improvements with the space we have.
Long queues in reception with no privacy whatsoever….	….Unfortunately, due to building restrictions, we are unable to change the layout at out front desk to make discussions there more confidential. However, we have added the barrier to keep waiting patients further away from those patients discussing issues with the reception team and are always happy to speak with patients in a private area if they would prefer.
Provision of Out of hours….	…..Since 2004 the responsibility for the Out-of-Hours services was transferred from the GPs at the practice to the Primary Care Trusts and is currently provided by South Western Ambulance Service NHS Foundation Trust. Calls to the service are received by trained operators who decide on an initial course of action. This can include such things as suggesting the nearest treatment centre, arranging a district or twilight nurse visit, or for any call such as chest pains or difficulty breathing the service will make a direct 999 ambulance request. Other calls are passed to triaging doctors who can request home visits from either General Practitioners or ECPs. A nurse operated unit operates from Swanage Hospital.

8. Practice Opening Hours

Appointments are offered from 8:30am to 12 noon and 2:00pm to 6:00pm, Monday to Friday

Each surgery is made up of telephone appointments and routine appointments (1 telephone appointment to 3 appointments)
Routine telephone appointments are 5 minutes, bookable by the patient for telephone triage. The GPs, where appropriate, then book 10 minute face-to-face appointments for a consultation.

Patients may also book, directly, a 10 minute face-to-face appointment if this has been pre-authorised by their GP

Patients who need to be seen the same day with an urgent medical condition will receive a telephone consultation and, as appropriate, an appointment in our daily duty Same Day surgery. However, this will not necessarily be with their own GP.

Additionally the surgery offers extended hour surgeries on alternate weekdays and Saturdays (6 appointments per session during the week and 12 appointments on Saturdays).

HAVE YOUR SAY

Would you like to have a say about the services provided at Swanage Medical Practice?

Swanage Medical Practice would like to hear your views.

By leaving your email/contact details you will join our “virtual” patient representative group and we will contact you every now and again to ask you a question or two about the services we provide.

Online PRG Contact Form

Name:
Address:
Email Address:

This additional information will help to make sure we try to speak to a representative sample of the patients that are registered at this practice.

Gender:	Male Female
Age Group:

To help us ensure our contact list is representative of our local community please indicate which of the following ethnic background you would most closely identify with?

Ethnic Background:
How would you describe how often you come to the practice?:

Thank you.

Please note that no medical information or questions will be responded to.

The information you supply us will be used lawfully, in accordance with the Data Protection Act 1998. The Data Protection Act 1998 gives you the right to know what information is held about you, and sets out rules to make sure that this information is handled properly.