23 March 2013 Drs Leighton, Khraishi, Ahrin, Beroiz-Oliden, Ruiz-Gutierrez & Munro Aveley Medical Centre, 22 High Street, Aveley, South Ockendon, Essex RM15 4AD The Bluebells Surgery, The Health Centre, Darenth Lane, South Ockendon, Essex, RM15 5LB www.aveleymedicalcentre.wordpress.com Report compiled by CHATTAN SUPPORT Ltd March 2013 Page 1 of 15
Introduction This report summarises the development and outcomes of the Aveley Medical Centre & The Bluebell Surgery patient reference group (PRG) in Year 2 of the DES (2012/13) and is in line with the requirements of the Patient Participation Directed Enhanced Service. The report contains: Profile of practice population and PRG Process used to recruit to our PRG Priorities for the survey and how they were agreed Method and results of patient survey Resulting action plan and how it was agreed Progress made with the action plan Confirmation of our opening times Outlined below are the details of the work undertaken by the Practice to meet each of the six steps within the Patient Participation DES Step 1 Establish a PRG comprising only of registered patients and use best endeavours to ensure PRG is representative Aveley Medical Centre and the Bluebell Surgery have a long standing and extremely successful Patient Group named APPLE. We have been working closely together to improve care for patients for many years. In working towards this DES we wanted to increase the group profile and generate more interest in our group and the work we do. Report compiled by CHATTAN SUPPORT Ltd March 2013 Page 2 of 15
We launched an advertising campaign to recruit new members to the group by: Putting up posters in the practice Offered leaflets to patients attending practice Speaking to patients when they came into the Practice Telephoned patients who we had good communication with to personally invite them to our meetings Placed a message on our website At our PRG meeting on Tuesday 13 th December 2011 we reviewed our membership and agreed that our PRG profile represented the key demographic groups of patients registered on with our Practice but we would like to encourage more members to join. Our recruitment campaign has continued and has been extremely successful; the membership has increased from 13 members in Year 1 to a current membership of 27. We recognise that we have more females than males in our group and have tried to target male patients through individual conversations, however our patient group has a good distribution across the age and ethnicity demographic groups. Patient and PRG group age Patient List age PRG age Age Range Total % Total % Under 16 2543 22 0 0 17 to 30 1933 17 2 7 31 to 44 2316 20 5 19 45 to 60 2477 21 11 41 61 and above 2353 20 9 33 Patient and PRG group gender Patient list gender PRG gender Gender Total % Total % Male 5813 50 10 37 Female 5809 50 17 63 Report compiled by CHATTAN SUPPORT Ltd March 2013 Page 3 of 15
Patient and PRG group ethnicity Patient list ethnicity PRG ethnicity Ethnic Group Total % Total % White British 9671 84 21 78 White Irish 84 1 Mixed White & Black 146 1 1 4 Mixed White & Black 140 Caribbean 1 Mixed White & Asian 64 1 Indian 142 1 1 4 Pakistani 24 0 Bangladeshi 6 0 Black African 964 8 3 11 Black Caribbean 95 1 Chinese 40 0 Other ethnic group 168 1 1 4 TOTAL 11544 100 27 Step 2 Agree with the PRG which issues are a priority and include these in a local practice survey To determine the priorities for the survey in Year 1 of the Patient Participation DES programme we asked all patients attending the practice over a three-week period to indicate which areas they thought were most important to our patients by completing a form at reception. The results of this exercise were presented to the APPLE group by the lead GP for Patient Engagement at their meeting on Tuesday 13 th December 2011. During these discussions the APPLE group agreed which areas should be the focus of the Patient Survey. The outcome of these discussions were then discussed again in a Practice Team Meeting: Our meeting last night with Apple was successful. We had a meeting today in the Practice, and Dr R Arhin did a presentation (using a projector) regarding our Apple Group, and we have decided on a few points we will raise for our patient questionnaire. These issues included: Access to the building Getting an appointment Telephone service Quality of care Report compiled by CHATTAN SUPPORT Ltd March 2013 Page 4 of 15
Following this the survey was developed and shared with the APPLE members to ensure they agreed with the final questions to be used. In Year 2 [2012 to 2013] the practice again discussed the issues to be focused on in the survey with PRG members and it was agreed that there had not been a significant change in priority areas. It was therefore decided to repeat the majority of the questions from the previous survey in the hope that improvements could be demonstrated. Step 3 Collate patient views through local practice survey and inform PRG of the findings Once we had established the priorities we developed the questions using Survey Monkey. The group decided to discuss question options, which would give clear outcomes so that achievable action plans could be developed which would improve the patient experience. We carried out the survey using: Survey Monkey on line Paper forms available at reception We reminded our patients to complete the survey by: Advertising in the surgery using posters Providing all patients attending the surgery with a leaflet to take away and read Texting a reminder to all our patients with a mobile telephone number on their records E-mailing all patients who had provided us with an e-mail contact address Our PRG members encouraged their friends and relatives who are our patients to complete our survey Placing a reminder on the bottom of our repeat prescriptions Speaking to individual patients as they attended the surgery We carried out the Year 2 survey between 7 th January and 3 rd February 2013 and received a total of 213 responses. The results of our survey can be found in Appendix A. Report compiled by CHATTAN SUPPORT Ltd March 2013 Page 5 of 15
Step 4 Provide PRG with opportunity to comment and discuss findings of local practice survey. Reach agreement with PRG of changes in provision and manner of delivery of services. Where the PRG does not agree significant changes, agree these with the PCT The survey results were collated and a survey results report written (Appendix A). The patient group reviewed the survey results at a meeting held on 21 st February 2013. The group were generally pleased with the survey results and discussed improvement actions with the practice members attending the patient group meeting. Extract of minutes, Patient Group meeting, 21 st February 2013 The biggest problem was telephone access, although all members of Apple present stated that they did not have a problem, although of course, the telephones are always busy at peak periods There were no actions requested by the group that the practice did not agree to. Step 5 Agree with the PRG an action plan setting out the priorities and proposals arising out of the local practice survey. Seek PRG agreement to implement changes and where necessary inform the PCT It was agreed that the following issues would be addressed by the Practice in the coming year: Telephone access Difficulties with parking at peak times Length of Consultation time with doctor Repeat Dispensing An action plan (Appendix B) was developed to allow for more efficient monitoring of progress. Report compiled by CHATTAN SUPPORT Ltd March 2013 Page 6 of 15
The key actions were: Change Telephone Supplier to include notification of queue waiting Manage access to the car park during busy periods Advertise the 10 minute rule and allow patients to book longer appointments if necessary Advertise the repeat dispensing service to ensure wider usage The PRG were generally pleased with the outcome of our Patient Survey and agreed with the results. There were no actions requested by the PRG that the practice would not agree to. The PRG will continue to monitor progress against the improvement plan with the practice. There were no significant changes to our services as a result of the survey findings. Step 6 Publicise the Local Patient Participation Report on the practice website and update the report on subsequent achievement. The expectation is that the year 2 reports posted by practices should build upon the year 1 report, demonstrating how issues raised in year 1 have been addressed. The Patient Participation DES report has been publicised within the Practice and added to our Practice Website: www.aveleymedicalcentre.wordpress.com Progress made with the action plan as of 31 March 2012 You said We did The result is We need to answer the telephone more quickly During busy periods we have allocated extra members of staff to help with telephone calls Year 1 31% found it easy to contact the practice by telephone Year 2 37% found it easy to contact the practice by telephone A new telephone system is being installed in April 2013 which we hope will improve the telephone communication with the practice Report compiled by CHATTAN SUPPORT Ltd March 2013 Page 7 of 15
You said We did The result is Our referrals are often delayed You sometimes don t know what we are doing at Aveley & Bluebell Surgery You occasionally have difficulty parking at our surgery You sometimes want to be able to discuss more than one issue in an appointment You are frustrated with delays in obtaining repeat prescriptions We recruited a new member of staff who focuses on referral documents We produce a practice newsletter We reviewed peak periods within the surgery & discussed this issue with our Patient Group We will clarify our 10 minute rule and why this is in place We have introduced repeat dispensing in our surgeries No comments were received regarding this issue in Year 2 The APPLE group produce a regular newsletter which is shared within the Practice to keep patients up to date with practice news Year 1 92% found it easy to park Year 2 91% found it easy to park We are going to manage the use of the car park by closing it at certain times to prevent incorrect usage Patients will be able to book double appointments if they feel they need longer with a doctor We are going to advertise this more widely to encourage patients to use this service Confirmation of our opening times As a result of the survey we have not changed out opening times. They are: You can call both surgeries between 8am and 6.30 pm The surgery receptions are open from 8 am to 6.30 pm every weekday Surgery times are 8.30 12.30 every morning at both surgeries, 2.00 6.30 every afternoon at both surgeries (Bluebell Surgery is closed from 12.30 on a Thursday) Outside of our opening hours please contact the Emergency GP Service by calling the usual Practice Telephone number and you will be automatically put through Report compiled by CHATTAN SUPPORT Ltd March 2013 Page 8 of 15
Appendix A: Survey results report 213 patients responded to our Patient Survey. One patient submitted an online response via survey monkey and 212 hard copy surveys were collected in the surgeries. These are the results of our survey Age of survey responders 100 50 0 2 26 49 54 82 Number of respondents Under 17 17 to 30 31-44 45-60 61 and above Gender of survey responders Male 62 Female 144 Number of respondents Ethnicity of survey responders Other Chinese Black Caribbean 7 2 2 White Irish 3 Black African 6 Number of respondents White British 193 Report compiled by CHATTAN SUPPORT Ltd March 2013 Page 9 of 15
Attendance at the surgery We asked how often patients thought that they attended the surgery Rarely 20 Regularly 97 Occasionally 95 Number of respondents Patients who work Car Parking Reception 50% of our responders reported that they work 67% were aware of our extended hours (late night appointments until 8pm on a Wednesday and Saturday mornings at the Aveley Medical Centre) 91% of our responders felt they were able to park their car at the surgery 93% of our responders were happy with the greeting they receive when they enter the surgery Patients told us they knew how they could book appointments; Appointments 200 150 100 50 0 Number of respondents By telephone At reception desk Online via the website Report compiled by CHATTAN SUPPORT Ltd March 2013 Page 10 of 15
We asked our patients how easy it is to contact the surgery by telephone Appointments Easy 77 Not very easy 97 Number of respondents Very difficult 33 We asked how long it usually takes to get an urgent appointment URGENT appointments 171 31 1 Within two working days 8-14 working days 3-7 working days Number of respondents 78% were happy with the time they had to wait to see a doctor for an urgent appointment We asked how long it usually takes to get a routine appointment ROUTINE appointments 86 100 17 1 Within two working days 3-7 working days 8-14 working days More than 15 working days Number of respondents 78% were happy with the time they had to wait to see a doctor for a routine appointment Report compiled by CHATTAN SUPPORT Ltd March 2013 Page 11 of 15
Appointment times Number of respondents We asked how long patients had to wait after their pre-booked appointment time to be seen More than 40 minutes 31 to 40 minutes 21 to 30 minutes 11 to 20 minutes Up to 10 minutes Within 5 minutes 10 20 21 39 44 82 Repeat prescriptions We asked how long patients have to wait to collect their repeat prescription once they have submitted it to the practice Within two working days 135 patients Number of respondents Educational talks Number of respondents In response to our survey last year we introduced educational talks for our patients. We asked which areas they would be interested in: Other Weight loss COPD Heart Disease Alcohol Abuse Smoking cessation End of Life 3-7 working days 49 patients 8-14 working days 2 patients 0 5 10 15 20 25 Other suggestions included Cholesterol, Thyroid and General Health Report compiled by CHATTAN SUPPORT Ltd March 2013 Page 12 of 15
Overall satisfaction We have worked hard to make improvements to the practice following our survey last year. So we asked if our patients have noticed a change in our services improved some improvement no change a little worse worse Number of respondents 0 20 40 60 80 100 Report compiled by CHATTAN SUPPORT Ltd March 2013 Page 13 of 15
Comments Some general comments were made regarding wide ranging aspects of the Practice, some of which are noted below to give a flavour of the patient perception of The Aveley Medical Centre and The Bluebell Surgery Carry on the good work Need more privacy at reception desk Difficult to park on blood testing mornings Could do with more people on reception when busy Doctors are very friendly and thorough I feel the staff are not always appreciated as they work very hard and are pleasant and helpful I am happy with the service at the surgery Find a way to answer the telephone quicker A number counter for blood tests Automatic booking is very good and speeds things along Having to request medication every month for the same medication is a nuisance Blood tests - not private enough, in view of waiting room I think the 10 minute rule and only being able to speak about 1 problem is wrong I think they do a good job overall Would it be possible to have a walk-in hour every morning / afternoon? If I need to see the doctor urgently when phoning at the allotted time it can be difficult to get through Could we have some music in the waiting room? Needs to be deaf awareness when taking calls. Would like option to be able to text appointment requests. Also some doctors talk too fast - please slow down and speak clearly or sign Overall I have been happy with the service received I feel the surgery needs another toilet facility Will you be able to cope when proposed new housing is in place? We have been very happy with the courtesy, care & professionalism shown Report compiled by CHATTAN SUPPORT Ltd March 2013 Page 14 of 15
Appendix B: Improvement Plan ISSUE TO BE ADDRESSED IMPROVEMENT GOAL KEY ACTIONS REQUIRED BY WHOM? BY WHEN? REVIEW DATE Which specific area are you going to focus on? What do you want to achieve? What needs to be done to achieve the goal? There may be more than one action Who is responsible for ensuring it happens? When do you think this will be completed? When will you check on progress? Telephone Access Patients being able to access the surgery quickly Change Telephone Supplier Practice Managers 1 st June 2013 Already ordered new system from B.T Queue waiting advised Practice Managers 1 st June 2013 Car Parking on Blood Days Car Parking Stop patient accessing the surgery/car park/waiting area from 8.30 a.m. Practice Managers 1 st June 2013 1 st May 2013 10 Minute rule Able to book longer/double appointments Advise of this service via newsletter/posters/web site/jayex Board/on repeat prescriptions Practice Managers/IT Manager 1 st June 2013 1 st May 2013 Repeat Dispensing Advise patients of this service As Above Practice Managers 1 st June 2013 1 st May 2013 Report compiled by CHATTAN SUPPORT Ltd March 2013 Page 15 of 15