Report of the GP Monitoring Visit to Family Practice, 75 Cardiff Rd, Dinas Powys, CF64 4JT Tuesday 29 th January 2013. Practice Representatives Anne Griffiths, IHM - Practice Manager CHC Visiting Team Mr John Viney (Lead) Mrs Jennifer Robbins Practice Overview The Family Practice is based in a Health Centre that was pupose built some years ago, situated on Cardiff Road in Dinas Powys. It shares the property with a separate practice known as the Group Practice, which has had its own CHC Monitoring Visit. The large waiting room is shared, but two individual reception areas exist. There are currently 2,450 patients registered, and its list is open. The partnership consists of two female doctors, who work alternate hours maintaining regular cover and undertaking emergency visits. These are: Dr Rhian Llewellyn Dr Ann Cherry Two Practice nurses are also based at this Practice, one being a Clinical Nurse Specialist. Patient Experience Patient Survey Response In total 57 surveys were returned to the Community Health Council from patients out of a total 100 distributed. This represents a 57% return rate. A sample of survey results are included in this report. With just one doctor on duty, seeing a patient every ten minutes, we were only able to meet three people, who were waiting during a half hour period. Doctor Cherry had been called out to an emergency, so some patients had been telephoned and provided with a later appointment. All patients interviewed expressed positive views about the Practice. 1
Access, Reception and Waiting Area The opening times for the Practice were visible on the main door, entering from the front. Access can also be gained by a side door that has some steps, although ramps are available for disabled patients. The Out-of-Hours Service telephone number and information was also visible. There is a very small car park at the front of the building, with additional parking available in the local side streets. Public transport, in the form of buses, is within walking distance and the area is served with regular buses going to and from Cardiff. The counter at Reception is open, and is at a dual height to conform to the Disability Discrimination Act regulations. Privacy would be an issue if a patient wanted to talk at Reception, but any telephone calls, needing privacy, could be taken in a rear section, according to the Receptionist on duty. The shared waiting room was clean and tastefully decorated. It was noted that electric sockets were not covered to make them child-safe. There was a large notice board, with posters neatly arranged and up to date. Although shared with the Group Practice, the Practice Manager told us she had been assigned oversight of this facility. On another wall, leaflets featuring all manner of health related subjects were available. A Complaints Procedure notice was amongst the information provided and also information regarding the Community Health Councils Advocacy Service. Key for the following graphs: Less than a yearless than 5-10 a year years 5-10 years Less than a year Less 15 than - 510 years a year 15-5 - 10 years Over years 10 yearsover Very 10 years 1-5 years Over 10 years How would you rate the 1 - following: 5 years Over How would 10 years you rate the following: Access: i.e. ramps, steps etc. Cleanliness of Waiting Area 75.9% = Less 75.9% than a year 5-10 years Less = 47.4% than a year = 1 24.1% - 5 years Over 10 years 1 = - 47.4% 5 years Less than a year = 50% - 10 years Less than a year 5 = 5.3% - 10 years 1-5 years = Over 0% 10 years 1-5 years Over = 0% 10 years 47.4% 5.3% 47.4% 5-10 ye Over 10 How would you rate the following: Information on Display How would you rate the following: Seating Arrangements 68.4% 31.6% Less than a year 1-5 years 40.4% 12.3% 7.0% = Less 68.4% than a year 5-10 years Less = 40.4% than a year = 1 31.6% - 5 years Over 10 years 1 = - 40.4% 5 years = 50% - 10 years Less than a year 5 = 12.3% - 10 years = Over 0% 10 years 1-5 years Over = 7.0% 10 years 5-10 ye Over 10 2
Chairs were placed in rows, with some sited around the outside of the room. Several chairs had arms, however the majority did not. All were at the same height and had either black fabric seating or the newer chairs were made of an easy clean plastic. Low tables had glossy magazines available and on one side, childrens play toys including a large plastic slide and building bricks were observed. The plastic toys and bricks appeared extremly dirty, and were in need of a good clean. I ran my finger along the top and greasy dirt came off easily. The Practice Manager informed us that the other Practice had oversight of these, but of course children from both surgeries play with them. There is no hearing loop system in operation. The Practice uses Language Line for patients who do not speak English. Patients are verbally called in to see the doctor. A Patient Participation Group has ceased running and a suggestion box is not supplied, although in the Practice leaflet, suggestions are welcomed and invited. Meeting with Practice Representative Feedback on visit. The inadequacies of the building itself was a major discussion point. Lack of office space and private examination rooms are a negative aspect. The infrastructure of the building has been an issue for many years, with plans to move when a suitable alternative location is found. The Practice Manager shared some news that, at last, she felt some progress was being made that would result in a restructure of the Practice and relocation of the surgery. It is likely that the Group Practice and Family Practice will once again form one partnership. Discussions are taking place about a new surgery being built on a Local Authority-owned site. Although these discussions are in the early stages, she felt positive that all sides are working to achieve that goal in the forseeable future, depending on planning and funding support. The Practice Manager gave the visiting team a tour of her restricted office space which is shared with a secretary and receptionist. Private conversations and meetings take place in unsuitable smaller examination rooms. This feedback session was held in one of the smaller examination rooms. Patients may contact a GP in an emergency by telephone or by attending the surgery. Any changes to service are conveyed by poster, using luminous paper and a Post-It note placed on prescriptions. Repeat prescriptions can be accessed within 48 hours by post, fax or face-toface. The use of the telephone for this purpose is discouraged except for older patients. Doctors and qualified nurses review medication at six monthly and yearly intervals depending on the patient. House calls made last year numbered 256, but the total to date this year is 351. Included amongst the services provided at the clinic are: Antenatal Child Developement Well-Woman Clinic Family Planning Podiatry Health Checks for patients over 75 who have not seen a Doctor for three years. Information and help for carers 3
With University Hospital Llandough located nearby, other services are accessed here, including physiotherapy. A Counsellor attends the clinic once a week for sessions. Some cooperation is provided by voluntary organisations and information on these is available on the notice board. The Practice does not make patients aware of a chaperone service but the Doctors will ask if they require this service when appropriate. The surgeries are open for same day appointments on Monday, Tuesday and Wednesday mornings from 08:30 until 11:00, with pre bookable appointments at other times. Patients needing advice from the doctor are diarised, and at an appropriate time, the doctor will return the call. There is no facility for leaving answerphone messages but recorded information is available after hours. House calls need to be requested and are fulfilled where practicable. During the meeting with the Practice Manager, it was explained how personal and intimate the Health Care Professional / Patient relationships were within this Practice, eminating from a small patient base which allows for staff to get to know their patients and their family needs. The questionnaire results support this verbal onservation. Patient Questionnaire Results The satisfaction rating in all areas of the survey was very high, and in some cases, exceptional. Patients thought the opening times, appointment system and waiting times were satifactory. Seating arrangements and toilet faciliies showed marginal disaproval but the service standards of nurses scored 100%. It was clear from comments at the Surgery and the questionnaire results, that the Health Care professionals within this practice are very much appreciated. One lady commented they have all been very nice and helpful. How would you rate your experience of this GP practice? Very Very = 83.9% Very Very = 12.5% = 3.6% = 0% = 0% = 0% The following are a sample of the overall comments received from patients at this practice: Very I think the reception staff could be a little more friendly on the phone and a smile goes a long way. Calling in the morning and having to call back the next day to make an appointment, also closed at lunchtimes and Saturdays. If possible it would help if treatment explanations could be given in more detail. It is accepted that GPs are under severe time constraints though. I am not a fan of the seating arrangements. They face the door which can be intimidating when you first walk in with people looking straight at you. 4
Just that we should be seen on the appointment time and not have to wait. My doctor has always been fantastic and the receptionist staff have always been extremely friendly. I have been at this practice for over 50 years and always found them to be very satisfactory I have been registered with this practice for 12 years. Have always managed to get an appointment and usually with the doctor I ask for. The staff are helpful and knowledgeable and always have a smile for you. They all deserve to be working in better conditions than they do at the moment. Thank you for many years of tender loving care This is the most caring practice I have ever belonged to. The staff are always helpful and the GPs & nurses give an excellent service given the constraints of their surroundings. Practice Leaflet The A5 Practice leaflet was provided along with the briefing paper prior to this visit. This was produced in May 2009. Under Schedule 3 Information To be Included In Practice Leaflets, five items were identified as not meeting the standards. However, during our meeting with the Practice Manager, a revised up to date leaflet was provided, which had been produced in December 2011. Three of the missing items had been corrected, and the Practice Manager made note of the other two needing attention. Interaction with the Wider NHS Services are utilised at Barry Hospital and Llandough. Patient records transfering within South GlamorganCardiff and the Vale of Glamorgan are normally quickly obtained. Further afield, for example London, sometimes takes a couple of months. Reccommendations to Council 1) When further decisions are made, Council will need to monitor the location of any new building for accessibilty of patients and further monitoring of services available to patients, should the two Practices merge at a later date. 2) Plug sockets should be made child safe 3) The plastic toys within the waiting room need thorough cleaning so that they are respectable and hopefully sanitised satisfactorily. The visiting team would like to thank Mrs Anne Griffiths and patients for giving of their time and assistance during the visit. John Viney Jennifer Robbins Community Health Council Members Please note that due to mathematical rounding rules, the graphs included in this report may contain a variance of +/- 0.1%. Also, the italic comments contained within this report are only a small sample of both positive and negative comments received by the CHC. To view all of the results of the patient survey, please visit the CHC website using the following address: www.communityhealthcouncils.org.uk/cardiffandvale 5