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1 Bury Knowle Health Centre Patient Participation (Reference) Group Report March 2013 Produced for the Patient Participation Directed Enhanced Service (DES) 2011/2013 Introduction This report has been produced for patients along guidelines required by the Department of Health Directed Enhanced Service and requested by shire PCT. This report contains the progress that we have made against our Bury Knowle 2011/12 action plan (Appendix I), useful Practice information (Appendix II & III) and summarises the results of our 2012/13 survey (Appendix IV). Bury Knowle has an established Patient Participation Group (PPG). The group feeds back to the Practice areas for improvement from which priorities are established. The PPG contains members from both Bury Knowle Health Centre and our branch surgery Barton and we meet on a quarterly basis. The minutes of which are published on our website. We also have a virtual PPG who we continue to and who participate in the annual patient survey. At present there are 212 members who are happy to be contacted via and who participated in the annual patient survey. In addition all of our patients are welcome to give suggestions/feedback about the surgery at any time. This can be done via our website, or via out suggestion box, located in the waiting room. The focus of the PPG this year has been to take forward the practice plan, which included a pilot to improve access and continuity, both of which were identified as priorities by the PPG last year. This item was the major focus of the 2012/13 Patient survey (please see Appendix IV for the results). In 2011/12 the PPG priority areas agreed were:- Telephone Access Named Doctor System & Access (face to face & telephone) Appointment waiting times Practice opening hours Premises - Waiting area Staff Reception Service Car Parking facilities Patient Education - patient awareness re: website & usage Clinical service satisfaction Overall Satisfaction with the Practice

2 Bury Knowle Health Centre/Barton Surgery PPG Members The patient groups comprises of 212 members Bury Knowle/Barton PPG 32 members have signed up (13 attended the meeting in January This included Sue Holden Barton Community Association Secretary) Virtual PPG 212 members (This group includes those who attend the Barton & BK PPG meetings). The majority of this group are happy to receive s and participate in the annual survey but do not want to be more actively involved. The profile of the PPG members, detailed below, shows that we continue to have a reasonable gender mix, although it remains skewed towards females. However we continue to have a representative within each of the age bands, which is really encouraging. It also shows that we have a good spread with regards to the frequency with which the patients access the surgery. The majority of the patients are white British, so we will continue to promote and encourage more patients from different ethnic groups to attend. PPG Members Profile Attendance Gender Often 75 35% Male 79 37% Occasionally % Female % Very Rare 23 11% Total 212 Total 212 Ethnicity White British % White Irish 5 2% Indian 3 1% Black Caribbean 1 1% Black African 3 1% Chinese 1 1% Other 28 13% Total 212 Age Under % % % % % % % % Over % Total 212

3 Group meetings The quarterly PPG meetings are publicised within both surgery waiting rooms, via our staff, on the practice website (), in the quarterly patient newsletter and via to all of its members. Any patient is welcome to therefore join the group at any time. Our Practice website has 5 pages dedicated to the PPG, which includes patient information/leaflet, PPG meetings, survey results, this report and a Contact us section - in case patients have any queries that they d like to raise. The timings of the meetings have been altered throughout the year, to ensure all patients availability/commitments are accommodated. The meetings are structured so that any suggestion or actions agreed at a meeting are reported on at the start of the next meeting. This ensures that patients are able to track progress on a quarterly basis. At every meeting each patient is encouraged to state their reason for attending and any items that they want addressed or to be raised. All of the meeting minutes can be found on the Practice website All of the Action Plan priorities have been discussed at the PPG meetings. Please see the table in Appendix I for progress to date. The last meeting was held on 16th January 2013 at 6pm at Bury Knowle and the majority of the meeting was dedicated to a facilitated patient focus group to discuss and get feedback on the new appointment system. We offered light refreshments and Dr Holden, Dr Toms and the Practice Manager Claire Crook attended. 13 PPG members attended with several others sending apologies. New Appointment System Patient Focus Group Summary & 2012/13 Patient Survey extracted from the PPG meeting minutes. In 2011/2012 the PPGs (BK, Barton & Virtual Groups) focused on addressing the priorities of the patients and the practice and following a patient survey devised a Practice Action Plan. The plan outlined the practice priority areas for These priorities included improving access and continuity to the patients named Doctor. As a result the Practice has been piloting Same Day Access to named doctors since August In order to assess the successfulness of the pilot the Practice has undertaken a number of patient surveys and held numerous focus groups with staff. The virtual survey response rate was very good 212 patients responded. The results were analysed in house using our Practice website and discussed by the Partners. A copy of the survey analysis is also available on the front page of our practice website. The practice now wished to dedicate this meeting as a patient focus group to discuss the new telephone appointment system Dr Laurence Toms facilitated this part of the

4 meeting. The agenda was circulated beforehand. The purpose of the focus group was to hear the group s views as patient representatives about this new way of offering our service at Bury Knowle. The focus group were asked some general questions designed to explore their thoughts and feelings about the new system. Dr Toms asked everybody who participated to feel free to talk openly about any positive or negative comments and that this would remain confidential. The focus group was recorded and all patients/staff present consented to this. Dr Toms advised the group that he would be the only person to have access to the recording. Dr Toms asked how people felt about the new telephone service. The responses included:- One patient and her colleagues all of whom worked disliked the new system and preferred the old system as she could choose and plan appointments much better, even if there were a 3 week wait for her named Doctor. She advised that she was often called back at inconvenient times and call backs were difficult if she was at work. Claire replied that it was evident that some workers do not like the new system and we need to address this and we need to get a balance. Dr Toms asked if she would find it helpful to have a specific time for a call back and she replied that it would help but it was still not ideal. Melissa asked whether the patient was aware of the extended hour appointments offered on a Tuesday and Thursday evening and on Saturday morning as these were particularly useful for patients who worked and could be booked directly with reception or online without the need for a telephone call first. Claire also asked whether she was aware of the nurse minor illness service (e.g. nurses seeing patients with a chest infection, UTI etc) offered at the practice every morning and afternoon as these can also be booked directly with reception without the need for a Doctors telephone call first. The patient was not aware of these services. The group then went on to discuss patient education and raising awareness of these services especially to patients who worked. Claire advised the group that the Practice will promote these services more actively. Claire asked for a show of hands regarding how many patients present preferred the option to book their face to face appointments without having to have a telephone call. Out of 13 patients, six people raised their hands. A patient commented that using the telephone was a continual source of worry to him and that he preferred to send an . A patient informed the group that you can use the appointments online service to book an online extended hours appointment or a phone call easily without having to make a phone call and that you could enter information as to what the appointment or call was for. He finds this facility extremely useful. He also sends messages to the Practice/his Doctor via appointments online.

5 The group were informed that any patient who has hearing difficulties, do not speak very good English, has a learning disability or who struggles with telephone calls, has an alert added to their notes so that receptionists are aware to book a face to face appointment without the need to have a telephone call first. These alerts are added by a clinician. A few patients commented that they were very happy with the new telephone system. One patient commented that he received a call at a time not convenient to him. Dr Holden advised the group that she always asks if it is convenient for a patient to talk and if not asks them for another time. She aims to help a patient on the same day that they call and sees them unless it s not convenient for the patient. Claire advised that Doctors do try and call patients back within a two hour window unless there is an emergency. CC/ECF Sue Holden (Barton Community Association Secretary) asked if there was any feedback from the Barton Surgery patients about the new system. Claire said that there had been a mixed response, but overall the response was positive and that this was consistent between Bury Knowle and Barton Surgery. Sue s experience is that in general people find change difficult and challenging especially the very elderly patients but she felt that they would adapt given time and could see the positives. She said that Barton Surgery & the neighbourhood centre always ensure that patients have access to a telephone if they can t use their own. One patient from Bury Knowle said that the new system was ideal for her and her husband as they were both retired and that their GP Justin Amery was fantastic. It was very convenient for them to solve issues over the telephone and not have to come into the surgery. Claire was asked how the GP s feel about the new system. Claire responded that the feelings had again been mixed. One really positive comment made by the GP s is that they are now able to dedicate enough time to cover all the patients issues especially for patients with long term and complex conditions rather than having to ask the patient to return for another 10minute appointment. Dr Holden commented that she really likes the new system and that she d had feedback from mothers with young children and some patients who feel less threatened not having to come into the surgery that they liked the system. A patient asked whether Skype will be used in the future. This facility is not available at the moment and hasn t been considered before. A patient asked whether evening and weekend appointment (extended hour) requests were popular. They were advised that they are and that they can be pre-booked by calling reception or via appointments online.

6 One patient thought that in general the system is much better than it was. A patient who could not attend fed back that he finds it difficult enough talking face to face but he finds it worse over the phone. He understands that calls can be good for Doctors and patients, but it would also be good to know that patients are able to book an appointment directly now and again. A patient directed a question to Dr Toms Is there anything raised in this meeting that changes his opinion about the new system or is news to him? He replied that he was pleased with the positive feedback received and that he could see that further training for GP s and reception staff would be helpful. Claire thanked everybody for attending and welcomed the feedback both good and bad. She invited anybody to telephone or her directly anytime if they had any issues or feedback claire.crook@nhs.net Action Plan 2013/14 As a result of these discussions as well as the individual patient priorities raised at the face to face PPG meetings and surveys, the following action plan has been devised for 2013/14: 1. Review our extended hour appointment compliment in order to better accommodate those patients that work and who wish to continue to book face to face routine appointments. Promote this to our working population. 2. Devise a marketing plan to raise patient awareness and promote the new appointment system and how best to access our services. a. Promote our online appointment booking service for both extended hour and telephone appointments b. Promote nurse minor illness appointments available each day AM & PM. c. Devise a new patient registration pack d. all patients for whom we have an address useful patient information 3. Continue to focus on improving our screening uptake and encouraging patients to attend screening invites breast screening, bowel cancer screening & cervical screening. 4. Review our car parking 5. Investigate VOIP as a solution to improve our current telephone system.