As a practice we have long felt that having the opportunity to see the “patient’s eye view” of the practice is a useful thing. Consultation with the patients during the closure of the branch surgery in 2007 and a number of subsequent patient surveys have been very informative. The partners then decided to try to launch a patient involvement group in the autumn of 2010. The group has met 3 or 4 times a year since then. There is also regular email communication between times, in order to reduce the number of meetings which need to be attended face to face.
In the first instance, nominations were invited from the primary healthcare team – the aim being to invite a group from all sectors of the practice population, but willingness and enthusiasm being important. We took account of a number of factors – age and sex, social factors (parents, carers, those in employment and those retired) and also medical factors – aiming to involve patients who receive care from a range of practitioners. The practice is overwhelmingly white British in ethnicity. M embership has changed from time to time as some folks have had other priorities and needed to leave, and others have come on board. We have a mix of male and female, older and younger, and patients with a range of health concerns.
New members are always welcome - please ask to speak to the practice manager for more information if you are interested. Our practice newsletter (available in the waiting room) also tells you a bit about the group and its activities. One recent member joined after reading about the group there, and another out of interest in the topics covered in the survey.
A register of members is kept by the practice manager who co-ordinates communication with and between group members.
Activities during 2015-16
The group met to discuss the possibility of using Patient Partner - an interactive phone system for booking and cancelling appointments and for ordering repeat prescriptions. Some members came to view a demonstration and then fed back to the rest of the group. On balance, we decided that it was not sufficiently user-friendly to merit the expense. The group also looked at results of the "Friends and Family Test" questionnaires, and received feedback from the CQC visit and the resulting action plan.
Information was shared with the group about the upcoming PMS budget cuts and the impact they may have on the practice and how it functions. The group also took a "walkabout" in the reception area to hear plans for re-ordering the reception / records area to make it more private and more efficient. A new table has been provided for the self-service SurgeryPOD to help prevent obstruction of the disabled access counter.
The group put together a consultation document for use in the waiting room about options for ordering repeat prescriptions. Repeat prescribing is a significant use of reception time (and is therefore a significant expense). All options have been considered and were put out to patients for their views.
As a result of this consultation exercise the practice will look to put an answering service in place to record requests. This will be a useful "all hours" alternative to those who do not wish to use online ordering services.
The group has reviewed a summary of complaints received at the practice during the year and helped us reflect on the lessons to be learned.
Several group members also play a part in the CCG Patient Forum; these patients have been learning more about shared-decision making and plan to work in the coming months with the GPs on telling patients how this can help in consultations.
We are grateful to our patients for the constructive support they offer us unstintingly.
Activities during 2014-15
The group met in May to review progress from the previous year's action plan. They were also asked to comment on an application by Sister Esme Elliott for a Queens Nursing Bursary to review they way the practice delivers vascular care. This involved assessing the level of risk faced by each patient, and inviting those who were able to, to self-care using the surgery POD. The group approved unanimously of the proposal, and viewed the surgery POD (and gave it a trial!) while being asked to comment on the level of privacy and general layout of the area.
In September, the group convened to hear a presentation about the forthcoming Friends&Family test being introduced by the department of health. After this, the group were invited to consider what supplementary question(s) they may wish the patients to be asked as part of the survey, and how the questionnaire should look and be presented. The group met again in January to look at the first results. Action points suggested as a result of the first comments were a) for the pharmacist to write a protocol for staff to follow when medicines are requested early and b) for the practice to look at options for how to inform patients of waiting times when doctors and/or nurses are running late; these were added to the action plan. The group also heard from our representative from the CCG Patient Forum - they asked for a newsletter article to be written about this to inform the wider patient population. There was also a further review of action plan points and progress. In March the group was joined by a patient who serves as a public governor for North East Ambulance Service. We heard about opportunities for public involvement as volunteer drivers, first responders and trust members. We discussed how the practice could work with NEAS to promote this work. We also looked at a practice action plan to respond to the minor issues raised by the CQC inspectors during their recent visit. The group viewed the reception and waiting area and considered the dilemma posed by trying to balance good access (particularly for disabled patients) with safety and privacy. The consensus was that professional advice was needed but with patient input to any future action plan.
PRACTICE ACTION PLAN, 2013-14 updated And 2014-15
- Look at the website and see what we can do the refresh it and make it look interesting (again) to those who use it regularly
Action: Website was refreshed with a different format and is regularly updated; the practice was complimented on the website by the CQC
- Investigate the possibility of a Newsletter Stand to put near the check- in screen
Action stand purchased and in regular use
- Who’s Who – a photo board would be helpful so patients can identify the person they want to speak to or have an appointment with
Action: this was considered by the team and the task was allocated to a young apprentice; unfortunately the apprentice left before completing the task
- The space near the check-in screen is a good focal point – we should make that a regular communication point and update what we put there regularly so that people take note of it.
Action: we have sited the newsletter stand here; we also tried positioning the Friends&Family collection box here; we have also put posters up about the prescription ordering and collecting options (see below)
- We should use the PPG message board to do a feature on prescriptions, and include electronic prescriptions (see below)
- Reception staff could spot patients who might benefit from using a particular prescription ordering system and speak to them about it – perhaps having a focus for one month, which would pick up a lot of people
Action: it was clear that many patients were unaware of the options so we did a bit presentation on the “blue board” and then put posters by the check-in screen. Staff have been actively promoting electronic prescribing to those for whom it is suitable
- We should do a focus on the waiting room TV screen
Action: Liz has emailed the LifeChannel company but no answer has been received.
- Liz to consult with the nursing team to see if anyone would be willing to do an early or late clinic
Action: nursing staff have been asked about this; one nurse was willing to consider it but is not currently available on Thursday night (which is our late evening). For safety we need the clinical staff to do the same late night to avoid lone working
- Liz to make the clinicians aware of the frustration of late running clinics and highlight the need for reception staff to update patients on late running clinics when they can
Action: this has been discussed at partnership meetings. A subsequent friends& family test feedback sheet raised this issue again. Liz has contacted the company who supply our medical software and check-in screen to see what the options are for a screen which displays waiting times (possibly in conjunction with a call-board). As yet such a joined-up system is not available.
- GPs and Nurses need reception staff to ask appropriate questions in order for appointments to be made with the right person at the right time for the right duration; we need to publicise the fact that this is their role.
Action: we know this can be resented by patients but a poster by each consulting room door emphasises why this is a practical help and reduces late running
- Discuss options of a message pad on desk for sensitive enquiries / appointment types
Action: the PPG agreed on wording for an information notice which is now in use at front desk
- It is frustrating for patients when the feel told off for requesting medicines early; the perception is that rules are unclear and are not consistently used.
Action: Liz asked practice pharmacist to write a protocol for the staff which is now in operation
- Patients need to be informed about wider issues – the work of the Patient Forum, the PPG and the roles of different members of staff and how they can support the patients
Action: regular newsletters every 2-3 months highlighting all of these things
- Review of waiting and records area to protect privacy, enable secure disabled access around the SurgeryPOD
Action: PPG looked at the area March 2015 and recommend a professional reivew but with patient input. Ongoing
Activities during 2013-14
The group met in June to review activities and to think about Self Care topics. The doctors had agreed to buy a noticeboard for the Patient Group to use to publicise topics of interest or concern. This can often be found around the building with useful displays of information! Minutes_05_06_2013.rtf In October the group met again to discuss a range of topics, including an update of activites since the 2012 survey and also ideas for the 2013 survey. The group also talked about the flu campaign, a report from those who attend the CCG wide Patient Forum and other matters Minutes_21_October_2013.rtf. Some members of the group also met to review materials to be used in the Keep Calm winter campaign, and gave their feedback to the Communications Team which helped to improve the finished articles!
The group were keen to have a fairly open survey which focuses on what patients perceive to be the strengths of the practice, and areas to work on. This left a lot of scope for comment. The survey was available on the website and in the practice during November and December. The results were analysed and discussed at a meeting of the Patient Group in January. At this meeting an action plan was drawn up, and was then emailed to other group members who were not able to attend the meeting. MINUTES_23_1_14.doc It was also discussed at the doctors' business meeting.
The action plan can be found here: 2013_Patient_survey_-_ACTION_Plan.doc
The action plan includes mention of a wish (raised by approximately 10% of respondents) for more late evening appointments - particularly nurses. The group discussed the practical problem that many nursing appointments involve taking blood (or other specimens) and that the Hospital Courier collects samples at just after 4.30pm. The group were sympathetic to the practical problems which that raises - but the plan was to discuss the matter with the nursing team and see what could be resolved. The practice currently offers early appointments from 7am on Fridays, and late evening appointments finshing at 8.30pm on Thursdays. Otherwise, appointments are routinely available from 8.30am to 6.30pm on other days. It was noted that since the survey designed to raise awareness of the "online profile" of the practice, use of the website has greatly increased. Web users are booking and requesting appointments online and also using the website for repeat prescriptions.
Activities from previous years.
The patient survey 2012-13
During this year our patient participation group met in August to discuss its priorities for this year and decide what to consult the wider patient population about via a survey. Minutes_1_8_2012.rtf The group felt the emphasis should be on the move to Clinical Commissioning Groups, and finding our what our patients thought about it. There was a long conversation in the group about their interests, concerns and areas where we felt we needed to know more. As a result of this, a survey was drafted and approved by all group members. The group was keen to ask some questions which would also link in to the previous survey on patient information and the quality of our communication with patients. Patient_survey_autumn_2012.rtf
The survey was carried out in October 2013 and was available on paper copy in the surgery and via the website. You can find a full analysis of this in this document: Analysis_-_SURVEY_RESULTS_2012.rtf . This was the reviewed by the group at their November meeting in 2012. Minutes_21_November_2012.rtf The Action Plan at the top of this page is the result of that discussion and was fully endorsed by the doctors. The group met again in February 2013 to find what had happened so far with their Action Plan, and to look again at last year's survey Action Plan results. Minutes_27_02_2013.rtf
Patient Survey 2011-12
You can see the 2011-12 Action Plan here: The_Patient_Survey_2011Action_Plan.rtf
When this was re-visited in February 2012 the group was pleased to find that all bar 2 points were complete - neither of which were within the practice's control (these were the publication of practice details at the Killingworth Shopping Centre and the alteration of the wording on the Morrisons sign board outside the practice). All other action points are complete - regular visitors to the surgery will have seen the useful new displays of patient information near the consulting rooms.
How can you contribute?
In response to the current year's action plan, we are actively investigating the possibility of putting on some health education events during the spring and summer. Please let us know if there is any topic which you think would be particularly useful. For more information on any of this please email firstname.lastname@example.org or ring her on 216 4920.