Smethwick & Hollybush Medical Centres Patient Participation Report 2012/2013

Smethwick & Hollybush Medical Centres Patient Participation Report 2012/2013 Under initiatives issued by the Department of Health in 2011, GP Practices were asked to form Patient Participation Groups (PPGs with the following key objectives: 1. The purpose of the initiative is to ensure that patients are involved in decisions about the range and quality of services provided and, over time, commissioned by their practice. 2. It aims to encourage practices for routinely asking for and acting on the views of their patients. This includes patients being involved in decisions that lead to changes to the services their practice provides or commissions, either directly or in its capacity as gatekeeper to other services. 3. It aims to promote the proactive engagement of patients through the use of effective Patient Participation Groups (PPGs and to seek views from practice patients through the use of a local practice survey. 4. The outcomes of the engagement and the views of patients are to be published on the practice website. 5. One aspect that we wish to focus on is excellent access into the practice, and also from the practice to other services as coordinator of care, facilitating access to other health and social care providers. 6. Access has many dimensions; the relative importance of these will vary according to the specific needs of the registered population. These dimensions include: lists being open to all hours of opening with the ability to be seen urgently when clinically necessary, as well as the ability to book ahead continuity of care range of skills available access to different professionals a choice of modes of contact which currently includes face-to-face, telephone and online access, which the Practice plans to develop further as technology allows geographical access, enabling care as close to home as possible. 7. We wish the Participation Group (PPG to be representative of the practice population, which would feed in its views alongside the findings from the surveys and agree with the practice the priority areas for possible change. 8. This would result in an action plan to be agreed between the practice and the PPG. 9. A properly constituted survey will be carried out amongst the Practice s patients looking at a broad range of areas which will include convenience of access along with patients experience of the treatment and service they receive, etc. Page 1 of 19

Step 1: Develop a PPG Our Patient Participation Group has been established for a number of years on a voluntary basis. In April 2011 the group was made up of 6 patient members: 4 male 2 female all aged 55 and over from a White British background During the 2011/2012 year we actively recruited members to better reflect the demographics of the patient population by: Promotion of the PPG in the waiting room. Development and promotion of a new Practice website. Promotion by word of mouth via existing members of the group Invitation by clinicians within their consultations Change of meeting time from afternoon to evening to enable those with employment, education and caring responsibilities to attend. As a result of these actions we recruited 4 new members and the group gained representation from: patients of Indian and Black African ethnic origin patients in the 15-44 age group parents of young children Whilst this was a positive start, we recognised that we needed to recruit more patients from the younger age groups, patients who are housebound and those with mental health and learning disabilities. Over the past year we have made a concerted effort to further engage with under represented groups, for example by making links with local schools, making contact with housebound patients and working with the families and carers of patients who need additional support. Unfortunately, despite these efforts our membership actually reduced as one member left the group due to personal circumstances. The surgery would still like to gain a more representative cross section of patients that reflect the demographics of our population and this forms part of our action plan which follows later in this report. Practice Demographics The Practice has 10,046 patients made up of 4,935 (49% males and 5111 (51% females, which is fairly evenly split across each age group except for those aged 70+ where there are noticeably more females than males (Figure 1. The majority of patients fall within the 20-49 yrs age groups (21.5%. Interestingly there are a similar number of elderly patients as there are young children, with 7% of patients being aged 70+ yrs and 6% being aged 0-9 yrs. We have a wide ethnic mix of patients which reflects the diverse population living near to the Practice s two surgeries in Smethwick and Quinton. The majority of patients are White British Page 2 of 19

followed by Indian, White Other and Caribbean origins. There is quite an even split between patients from Black, Asian and mixed backgrounds. The Practice also serves patients residing in five nursing and residential homes in the locality. Many of these patients are housebound. In addition we have 25 patients on our validated learning disabilities register who are invited to an annual health check appointment. Age and Gender Age and Gender Number of patients 1000 500 0 No. % No % No % No % No 0-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80+ Male 673 604 797 731 698 584 412 270 166 Female 642 581 718 740 711 536 482 393 308 Age in yrs Male Female Figure 1 Page 3 of 19

Step 2: Agree areas of priority During the 2011/2012 year the following four areas of priority were agreed: Access how patients feel about accessibility of appointments Reception the level of service provided at reception. Telephone the level of service provided to patients telephoning the practice. Satisfaction how satisfied in general patients are with the service provided by the Practice. A patient survey was carried out and an action plan drawn up as a focus of areas for improvement over the 2012/2013 year. At the PPG meeting held on 1 st October 2012 the action plan was reviewed and progress updated: Issue Action(s Update as at 1 st October 2012 Improve access via the telephone system Improve access to test results Improve privacy in waiting room Support reception team in developing their customer service skills Widen the membership of the PPG to be more representative of the Practice population Investigate the purchase of additional hardware. Review phone system capability for redirection options Review staffing levels to provide additional cover during busy periods. Investigate increasing online access to services. Investigate online access to test results Review times that results are available Review layout of waiting room Review position of telephones Promote option to ask for private area Source training opportunities Operations Manager to provide ongoing support and mentoring to staff. Create links with local schools Investigate ways to involve housebound patients who may not have access to the Internet Working with the families and carers of patients who need additional support. New phone system being commissioned Additional member of staff assigned to answering phones during busy morning period Online access to appointments, repeat prescriptions, updating contact details, sending non urgent messages to the practice along with SMS text reminders of appointment times being rolled out over the next 3 months. Online access to care records is being rolled out over the next 3 months along with SMS text messages to advise patients that their test results are normal or inviting them to contact the surgery to make an appointment. Patients must sign up to these services. Times that results are available will be reviewed with the new phone system is installed. Complete remodelling and refurbishment of waiting room and reception area completed February 2012. Dedicated telephone room built to ensure privacy of phone calls. Notices displayed advising patients to ask if they need to move to a more private area. Protected learning time used for promotion of customer service skills on an ongoing basis. Feedback and support given during staff appraisals New phone system to include call recording to be used for training and monitoring purposes all staff are supportive of this. July 2012 - Links made with local primary school. Currently developing a range of activities to deliver in partnership with local schools cluster. September 2012 - Patient newsletter promoting the PPG and providing a contact number for the chairman was sent out with a flu vaccination invitation letter to 2500 households. October 2012 - PPG members attended Saturday flu clinics, which were attended by many patients who are housebound or have multiple health problems and were brought to the surgery by family members who are not usually able to attend during the working week. November 2012 promotion of PPG now part of presentation displayed on TV in waiting room at SMC. November 2012 implementation of Practice Twitter account Page 4 of 19

It was agreed that a great deal of work had taken place since the last survey took place but that the four areas of priority from the previous year should still remain as the focus for the coming year. This would allow time for the impact of any changes to be monitored and outstanding actions to be completed. Step 3: Collate views through a survey At the meeting held on 1 st October 2012 members of the group considered what was important to them about the GP service and were asked to agree on a questionnaire which would be the part of the patient survey. A discussion took place about the issues that had been raised over the past year, and the progress of the action plan to date. The group agreed to re-distribute the Patient Survey completed in October 2011 again in October 2012. This would allow the new data collected (October 2012 to be compared to the baseline data (from October 2011. From this action, the data would provide more validated results along with an indication of the impact of the actions already taken and would better inform the 2012/2013 Action Plan. A Real Time patient survey was carried out during three weeks in October 2012. As with the previous year the date was planned to include the October half term holiday, when it was anticipated that more parents of school age children would be visiting the surgery. The survey was held at both the Smethwick Medical Centre and our branch surgery, Hollybush Medical Centre in order to ensure that as wide a cross section of patients as possible would be included. The survey was also carried out during two Saturday flu clinics held at The Smethwick Medical Centre. The clinics were attended by members of the PPG and the Practice Manager who all served refreshments, encouraged patients to complete the questionnaire and engaged them in discussion about the work of the Group, with the aim of encouraging new members to join. In total 165 surveys were completed over the 3 week period (20 more than the previous year and the results can be found at the end of this report (Appendix 2. Step 4: PPG has the opportunity to discuss findings of survey The survey was analysed and a summary report prepared showing the results from both the Smethwick (SMC and Hollybush (HB surgeries. The survey showed that whilst most patients continued to book their appointments either by phone or in person there was an increase in the number who preferred to book online, rising from 6.9% to 12.61% at SMC and from 6.9% to 22.22% at HB. This indicated that the promotion of online services was beginning to have a positive impact. There was no significant change to patients opinions regarding getting through on the telephone to access appointments, telephone consultations and test results, which tells us there is still room for improvement. In order to address this issue a new telephone system has been commissioned and will be installed during March 2013. The system will have enhanced features, including caller options to better distribute incoming calls, along with an interactive booking system. We continue to promote online access to appointments, repeat prescription ordering, non urgent messages and access to care records. We are also encouraging patients to sign up for SMS text reminders and notifications. It is anticipated that over the coming year a positive impact of these initiatives will be demonstrated as they will provide a range of alternatives for patients to contact the Practice and access information thus reducing the volume of telephone calls coming into our reception. Page 5 of 19

When asked how they found physically getting into the surgery it was pleasing to see a positive response. This year 98.2% of patients found getting into SMC very or fairly easy compared to 95.4% last year. At HB this was 96.3% compared to 93.11%. Patient s told us that cleanliness has improved over the past year. At SMC 99.10% of patients said that the surgery was very or fairly clean compared 91.95% the previous year. At HB the number of patients who thought the surgery was very clean rose from 53.45% to 81.48%. Privacy in our waiting rooms is very important and at Smethwick we have moved our telephones to a dedicated call room. It is pleasing to see that the number of people who say they can be overheard and are not happy about it has reduced significantly from 34.48% to 18.92% at SMC and from 29.31% to 18.52% at HB. In an effort to reduce this even further signage will be put in place to advise patients they can ask to speak to a receptionist in a more private area if they prefer. Over the past year we have made significant investment in improving the layout of the SMC reception and waiting room and will be reviewing facilities at HB over the coming year When we asked patients whether they found our receptionists to be helpful, friendly and polite it was encouraging to see that the vast majority felt that they were (details are contained in Appendix 2 of this report. The previous year s survey told us that we were not being proactive about telling patients if the Doctor or nurse was running late. We discussed this with our team as an area for improvement and displayed notices asking patients to check at reception if they had waited for more than 15 minutes. This year s survey showed that more patients are being told if a clinic is running late with an increase from 35.63% to 53.15% at SMC and from 29.31% to 48.15% at HB. We will continue to support the development of our team and one of the features of the new telephone system will be call recording, which the team have agreed with be useful for training purposes, self reflection and the sharing of best practise. The number of patients who are satisfied with the service they receive from the surgery has increased from 72.42% to 82.88% at SMC and from 79.31% to 88.89% at HB. When we asked patients if they would recommend the surgery to someone new in the area we saw an improvement on last year from 58.62% to 73.88% this year for SMC and from 75.87% to 87.04% at HB. Overall the survey for this year showed an improvement in many areas which is most encouraging. With the support of our PPG we will continue to work on our areas of priority over the coming year with the aim of further improvement for the benefit of both our patients and staff. Page 6 of 19

Step 5: Agree action plan and seek agreement with PPG The PPG has agreed the following action plan: Issue Action(s Target Completion Date Improve access via the telephone system Implement new phone system. Implement phone system capability for caller options (e.g press 1 for appointments, 2 for test results etc Implement Patient Partner (option to book, review and cancel appointments using telephone keypad Continue to review staffing levels to ensure adequate cover during busy periods. Continue to promote online access to services to reduce number of incoming phone calls. Improve access to test results Continue to promote online access to test results Promote sign up for SMS text notification Promote sign up for online access to care record April 2013 Ongoing Ongoing Improve privacy in waiting room Continue to promote option to ask for private area Ongoing Support reception team in developing Source further training opportunities Ongoing their customer service skills Widen the membership of the PPG to Continue to develop links with local schools Ongoing be more representative of the Promote PPG by use of SMS text messages and emails as Practice population patients sign up to these services Step 6 The results of the Survey including this report have been published in the following ways: On the practice website www.smethwickmedicalcentre.co.uk NHS Choices website A display in the waiting room Copies given to members of the PPG A copy has also been submitted to Sandwell PCT/Sandwell & West Birmingham CCG Page 7 of 19

Appendix 1 Current Access Arrangements The Practice offers patients access to appointments with Doctors, Advanced Nurse Practitioners, Practice Nurses and Health Care Assistants plus other specialist services at both The Smethwick Medical Centre in Smethwick and the branch surgery Hollybush Medical Centre in Quinton. In addition to core opening hours the Practice provides extended opening times four evenings per week. The surgery is staffed from 8am each day and the reception opening times for both surgeries are: Smethwick Medical Centre Hollybush Medical Centre Open Close Open Close Monday 8:30am 8:00pm 8:30am 6:30pm Tuesday 8:30am 8:00pm 8:30am 6:30pm Wednesday 8:30am 8:00pm 8:30am 6:30pm Thursday 8:30am 6:30pm 8:30am 8:00pm Friday 8:30am 6:30pm 8:30am 5:00pm Our reception is staffed during these opening times but we only accept emergency telephone calls between 1pm and 2pm (1pm - 3pm on Fridays at Smethwick MC. Appointments can be made in person, by telephone and online via our website www.smethwickmc.co.uk or www.patient.co.uk (patients must register at the surgery for secure online access. We offer a number of pre-bookable appointments, with on the day appointments released each morning at 8:30am When all of the appointments available for the reception team to book have been used we offer a call back service for patients who feel they require urgent attention on the day. Patients who are physically unable to attend the surgery due to illness or disability can request a home visit. Page 8 of 19

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