Patient Participation Group. Waiting Times Audit on behalf of the PPG

Transcription

1 . Patient Participation Group Waiting Times Audit on behalf of the PPG Introduction Background Patient input and feedback into the development, and improvement of the practice is paramount to the practice delivering a truly patient led service; which it aspires to do. A meeting of the PPG was held on the 2 nd October 2014, specifically to consider feedback received from patients via the patient feedback box in the waiting area, patient complaints, and feedback received via the enquiries.pelham@nhs.net address. The feedback received was used to pull together an improvement action plan for the practice. This feedback action plan is attached as Appendix A. More than one patient had provided feedback with regards the length of time they had waited to see their doctor after arriving on time for an appointment. The PPG have asked the practice to conduct an audit into waiting times, to assess the issue, establish what the practice GP wait times are and provide a benchmark for improvement. Purpose To audit the length of time a patient waits to the see their GP once arrived for an appointment. Method The criteria for the audit is as follows: Criteria Measure Reason for Criteria 1 2 Number of GP appointments in a quarter No of minutes patient waits from time of arrival to being seen Using the EMIS clinical system appointment module will run a search of all GP Surgery Appointments Using the EMIS clinical system appointment module waiting time search functionality Establish a base population for the audit Extract wait time results Page 1 of 15

2 Initial Standard Setting Patient Participation Group 1 2 Criteria Number of GP appointments in a quarter No of minutes patient waits from time of arrival to being seen Standard >66 per 1000 registered patients per week <20 mins Reason for setting the standard Key Performance Indicator (KPI) standard Reasonable wait time allowing for emergencies, telephone calls, and interuptions. Preparation and Planning At a meeting of the PPG, the practice was asked to carry out an audit of appointment wait time; this was in direct response to patient feedback received. The audit is to establish what our current wait times are by GP. Page 2 of 15

3 Outcomes Q1 and Q2: Criteria Standard Quarter 2 Quarter 3 Total Outcome 1 2 Number of GP appointments in a quarter No of minutes patient waits from time of arrival to being seen >66 per 1000 registered patients per week per 1000 patients Less than 1 minute % 1-10 minutes % minutes % minutes % minutes % minutes % minutes % minutes % minutes % Total ,691 Page 3 of 15

4 Analysis of Outcomes and Recommendations Number of GP Appointments: There were a number of ways of extracting the number of GP appointments within the EMIS appointments module. Each way produced a different result. The result taken for above is GP Number of Available Appointments by session holder Actual Number of Appointments by session holder Diff +/- Q1 Q2 Total Q1 Q2 Total DCE CH RSR NEL IP Red Locums Total What is particularly interesting is the difference between the number of appointment sessions available for each session holder (GP) and the actual number of appointments they provided. The actual number of appointments provided is 21% more than the number of available appointments. The Key Performance Indicator for appointment availability expects the practice to offer >66 appointments per 1000 patients. We have provided appointments per 1000 registered patients. Page 4 of 15

5 Number of minutes a patient waits from time of arrival to being seen. Total Wait Time over Q2 & Q3 DCE CH RSR NEL IP Red Locum Total Under 1 minute minutes minutes minutes minutes minutes minutes minutes minutes Total Number of Appointments: Patient Did Not Attend (DNA) Page 5 of 15

6 Chart to show the number of minutes wait from arrival for an appointment to being seen by the GP from Apr to Dec 2014: 1% 0% 0% 7% 4% 2% 32% 19% 35% Page 6 of 15

7 Analysis of Outcomes This data shows that 67% of patients are seen by the GP within 10 minutes of their appointment time, nearly half of these 32% are seen either before their appointment time or within 1 minute of their appointment time. 19% of patients wait between 11 and 20 minutes to be seen. 14% of patients attending for an appointment with a GP wait over 21 minutes to be seen. These results reflect a largely positive result so it is important to look a little deeper to see where the negative feedback may stem from. As a collective the GPs fair very well with appointment wait times, especially if consideration is given to the fact that they saw 21% more patients than planned for. Feedback provided by patients did name individual GPs, so in order to demonstrate improvement, and understand the reasons for the wait times, below are the results of the audit by individual GP. Dr Elder (DCE) 0% 0% 7% 2% 1% 0% 23% 25% 42% 65% of patients attending for an appointment with Dr Elder were seen within 10 minutes of their appointment times. Page 7 of 15

8 10% of patients waited more than 21 minutes to see the Dr Elder with nearly ¾ of these being seen within 30 minutes. This is better than the GP average for the practice. 1% of all Dr Elders appointments over the two quarters were not attended by the patient 25 appointments. Dr Hobbes (CH) 1% 1% 0% 9% 4% 11% 16% 31% 27% 42% of patients attending to see Dr Hobbes were seen within 10 minutes of their appointment time; this is lower than the GP average of 65% 31% waited more than 21 minutes, more than half of these were seen within 30 minutes of arrival. This is more than double the GP average of 15%. 2% of appointments with Dr Hobbes were not attended by the patient 27 appointments Page 8 of 15

9 Dr Ramesh (RSR) Patient Participation Group 25% 1% 1% 0% 0% 0% 0% 5% 68% 93% of patients attending to see Dr Ramesh were seen within 10 minutes of their appointment time, which is much higher than the GP average. Just 2% waited more than 21 minutes, to be seen from arrival, which is much lower than the 15% GP average. 12% of appointments with Dr Ramesh were not attended by the patient 83 appointments. Dr Ramesh had the highest number of unattended appointments over the period by some margin. Dr Elangovan (NEL) 19% 1% 0% 0% 0% 0% 3% 30% 47% Page 9 of 15

10 77% of patients were seen within 10 minutes when they attended to see Dr Elangovan; this is higher than the GP average. Just 4% waited more than 21 minutes to be seen, which is lower than the GP average. 5% of appointments with Dr Elangovan were not attended by the patient 63 appointments. Dr Prentice (IP) 1% 0% 9% 4% 4% 17% 15% 28% 22% 21% of patients were seen within 10 minutes, 49% were seen within 20 minutes of arrival. The GP average for the practice is 65%. 51% waited more than 21 minutes to be seen, more than half of these waited more than 30 minutes. 1% of appointments with Dr Prentice were not attended by the patient 19 appointments. Page 10 of 15

11 Dr Reddy (Red) Patient Participation Group 1% 1% 0% 0% 0% 21% 8% 31% 38% 69% of patients were seen within 10 minutes, of arrival to see Dr Reddy, this is slightly higher than the GP average. 10% waited more than 21 minutes to be seen, 4/5 waited less than 30 minutes, this is lower than the average for the GPs of 15%. 4% of appointments with Dr Reddy were not attended by the patient 63 appointments Locum GPs (Locum) 1% 1% 0% 0% 0% 15% 3% 42% 38% Page 11 of 15

12 Over the period July to December 5 locums worked on a regular basis for the practice, together they covered the role of a full-time GP Dr Finch who was absent for the period. As collectively they were covering a full-time GP, they are grouped together in this audit for ease of comparison. 80% of patients were seen within 10 minutes of arrival to see a locum doctor; this is much higher than that for the average GP. Just 5% waited more than 21 minutes to be seen, which is an improvement on that of the average GP of 15%. 1% of appointments with a Locum were not attended by the patient 29 appointments. Recommendations The findings of this audit be shared as a discussion document with the: o Patient Group (PRG) o Virtual Patient Group (vprg) o GPs The GPs to use as a discussion tool and agree: o Reasons for high wait times o Limiting factors o Share best practice o Benchmark for realistic improvement. Outcome of this meeting to be discussed at the next meeting of the patient group, when the action plan is reviewed. Re-run the audit for Q4 Page 12 of 15

13 Second Data Collection Patient Participation Group Criteria Standard Quarter 2 Quarter 3 Quarter 4 Total Outcome 1 2 Number of GP appointments in a quarter No of minutes patient waits from time of arrival to being seen >66 per 1000 registered patients per week Less than 1 minute minutes minutes minutes minutes minutes minutes minutes minutes 9 4 Total Page 13 of 15

14 Appendix A Patient Participation Group PRG Priority Action Plan for 2014/15 Priority Area Method By Who By When Will continue to grow the Virtual PRG. Complete d Support the practice to encourage patients to provide join the virtual PRG. Approval given for the Virtual PRG invitations to be used to invite patients to join. 1. Improve patient representation Use the virtual PRG to compliment the work of the PPG and help provide discussion topics for meetings. Provide feedback to the NEL PPG Bi-annual meetings about our progress to encourage other practices to have Virtual PRG and make it normal for patients to be invited for feedback this way. PMG Next meeting date provisiona lly 22 nd January 2015 Virtual invitations published and are being handed out. Review meeting layout and name. Trial holding less formal meetings such as a coffee morning or tea and Chat. 2. Improve waiting to see the Doctor times Change the location, trial holding the meetings on the ground floor making it feel more accessible. Ask the practice to carry out an audit of waiting times. Once the audit has been carried out use this as the bench mark for improvement and a learning tool for the GPs. PMG Audit for next meeting 22 nd January Page 14 of 15

15 Priority Area Method By Who By When Promote using the TV screens the need to book a longer appointment for complicated or multiple problems, to help ease the problem Invite the virtual PRG to make recommendations as to how to assist. Use the PPG newsletter to address the problem and explain to patients what the group are doing to help the practice improve Draft of patient informatio n screen to present at next meeting Complete d 3. Reduce the number of hospital admissions Continue to invite patient feedback using the feedback post box in the waiting area. Need to provide patient education to help them access the right service. Over the years it has become confusing for patients to know where to go because departments keep changing their name. A simple quick reference guide available in the waiting area and on the TV screen and website would help. The PPG and virtual PRG will try to support the work of the Community HCA when appointed to make her aware of any local groups or centres which offer day time activities or befriending services for isolated or lonely people. PMG PPG members Draft reference guide to present at next meeting Reference guide approved by Partners and provided to those patients most at risk of admission Page 15 of 15