Annex D - submission of PP DES template March 2015

Patient Participation Enhanced Service 2014/15 Annex D: Standard Reporting Template
London Region North Central & East Area Team
Complete and return to: england.lon-ne-claims@nhs.net no later than 31 March 2015
Practice Name:
The Practice @ 188
Practice Code:
E83027
Signed on behalf of practice:
Signed on behalf of PPG:
1.
J.F.Hynes
P. Parnes
Date: 05.03.15
Date: 03.03.15
Prerequisite of Enhanced Service – Develop/Maintain a Patient Participation Group (PPG)
Does the Practice have a PPG? YES
Method(s) of engagement with PPG: Face to face, Email, Other (please specify)
Face to face, by telephone and by email
Number of members of PPG:
8
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Patient Participation Enhanced Service 2014/15 Annex D: Standard Reporting Template
Detail the gender mix of practice population and PPG:
%
Practice
PRG
Male
3769
2
Detail of age mix of practice population and PPG:
Female
3911
5
%
Practice
PRG
<16
18.3
%
0%
17-24
8.8%
25-34
22.8%
35-44
16.9%
45-54
10.4%
55-64
7.6%
65-74
5.7
> 75
9.5
0%
0%
11.1%
11.1%
55.6%
11.1%
11.1
%
Detail the ethnic background of your practice population and PRG:
Practice
PRG
British
Irish
17%
77.8%
1%
0%
Indian
Practice
PRG
Pakistani
4%
11.1%
White
Gypsy or Irish
traveller
0%
0%
1%
0%
Other
white
30%
0%
Asian/Asian British
Bangladeshi
1%
0%
White &black
Caribbean
1%
0%
Chinese
1%
0%
Mixed/ multiple ethnic groups
White &black
White
African
&Asian
1%
1%
0%
0%
Other
Asian
4%
0%
Other
mixed
1%
0%
Black/African/Caribbean/Black British
African
Caribbean
Other
Black
3%
1%
0%
0%
0%
0%
Arab
Other
Any
other
1%
11.1%
0%
Describe steps taken to ensure that the PPG is representative of the practice population in terms of gender, age and ethnic
background and other members of the practice population:
1. After discussion at a meeting the patient support group decided to advertise for patients to join who were younger than 50 and
from underrepresented group
2. Notices have been displayed in the waiting area, on the surgery website and in the newsletter asking patients in
underrepresented categories to join
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Interested in Joining
our new Surgery Patient Group DRAFT 15 4 13.doc
3. Partners and the Practice Manager have tried to recruit many patients from under-represented groups, both during
consultations and in the waiting area respectively. A number of Patients have shown an interest but at a later date been
unable to commit
4. The Patient Support Group members have dedicated hours of their time over a number of visits to talk to waiting patients
about the Group and to encourage people to join – without success so far – again people express an interest but say they do
not have the time.
5. The patient Support Group is very aware of the efforts put in by the surgery and certain PSG members to secure joiners from
under-represented groups – success has been frustratingly minimal
Are there any specific characteristics of your practice population which means that other groups should be included in the
PPG?
e.g. a large student population, significant number of jobseekers, large numbers of nursing homes, or a LGBT community?
YES
If you have answered yes, please outline measures taken to include those specific groups and whether those measures
were successful:
Specific groups the PSG and surgery has tried to recruit to the PSG in the last 12 months:
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Patient Participation Enhanced Service 2014/15 Annex D: Standard Reporting Template
Patients who are physically disabled or have a learning disability
Patients living in nursing homes
Patients living in retirement accommodation
Young Eastern European transient population
Young mothers
Orthodox Jewish patients – men + women of any age
Outcome of very pro-active continuous attempts to secure individuals for the PSG who fall into one of the above
categories:
Given that one of the criteria of the PP DES is to have only patients as PSG members, the opportunity to secure patients living in
retirement or nursing homes is severely limited as relatives and carers who could speak on behalf of these immobile patient/s, do not
qualify for membership. However the chair of the PSG is a voluntary advocate for Barnet and attends care homes weekly to speak
with residents. She represents their voice articulately at the meetings. Another member is a volunteer in independent living
accommodation and she is a vocal representative of this community of patients at the surgery.
The young European transient population, although significant in number, tend to work and also to move out of area swiftly and
hence are difficult to secure. They have neither the time nor the incentive to improve the surgery as they will not be remaining long.
The young mothers (although having strong verbal opinions) say they are simply too busy.
One member of the PSG has an adult son who is a patient at the surgery and who is also severely disabled. She represents this
special community of patients when attending the PSG meetings.
One adult male from the disabled patient population is a new member and is yet to attend his first meeting.
One 19 year old male orthodox Jew was an active member of the group for much of the last 12 months. Unfortunately he has
recently resigned.
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One member of the PSG is a single parent and an orthodox Jew. He represents the male, the orthodox Jewish and the single parent
families when he attends the meetings.
Approaching individuals has been the most successful way to get patients interested. A member of the learning impaired community
has been secured in this manner.
Success has been most disappointing minimal compared to the time and effort expended to recruit underrepresented groups.
2.
Review of patient feedback
Outline the sources of feedback that were reviewed during the year:
•
Reviews on NHS Choices
•
Complaints to the surgery
•
Patient comments submitted via the waiting area and reception suggestion boxes
PSG Autumn
Newsletter 2014 September.docx
•
Annual patient survey
•
FFT feedback monthly summary from December 2014
•
PSG members findings after monitoring reception over the course of 3 weeks and listening to and observing both staff and patients experience and
concerns
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Patient Participation Enhanced Service 2014/15 Annex D: Standard Reporting Template
•
PSG members volunteered their time undertaking sessions talking to patients in the waiting area
•
Appointment demand audit findings
How frequently were these reviewed with the PRG?
Twice – at 2 consecutive meetings 2 months apart prior to devising the patient group led annual survey
3.
Action plan priority areas and implementation
Action Plan for The
Practice at 188 14 15 agreed with the PSG June 20th 2014.docx
Priority area 1
Description of priority area:
Improving patients experience at reception and with reception staff:
a) Physically and
b) Regarding staff interface with patients
c) Regarding patients complaining to reception about waiting times to see a clinician. As reception staff were not able to
proactively help in any practical manner, patients were getting annoyed with reception staff in order to offload their frustration
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What actions were taken to address the priority?
Patient group members voluntarily spent hours moniting reception over several weeks and identified priority areas requiring
change. Based on their summarised completed standard template forms feedback the changes below were instigated:
PSG Confidentiality
PSG SURVEY OF
agreement for when they
RECEPTION
sat in with
STAFF
reception
MAY 14.docx
May 2014.docx
1. The Front counter was lowered to enable more patients to more comfortably lean on and see over reception –
confidentiality and ease of communication were increased
2. The table and chair in the lobby were removed to allow more space in the limited area and a buggy to park more easily in a
cramped reception area
3. A new mat was bought for the front door entrance following a PSG request
4. A lock was put on reception door for security
5. Reception team were authorised by the partners to start a mid-morning drinks round for the staff to be made by a member
of the team for staff on duty – this was a request from the PSG as a result of the monitoring exercise
6. A confidentiality screen was bought and installed at the back reception desk to increase privacy of telephone conversations
and improve confidentiality for patients
7. The reception area was de-cluttered
8. The Head Receptionist attended a meeting with the PSG members to listen to their experience of and concerns about the
communication skills of the reception team – with lack of friendliness being the main issue addressed. As a result:
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9. Staff training took place to improve reception teams manner and communication skills with patients to make it more
customer friendly
10. Noticeable Improvements by reception staff have been acknowledged and fed back to the team
11. The times of the running of clinics were amended to stagger them throughout the day and the week. This has helped
reduce the quantity of patients in the surgery at any one time. This change was agreed after it became a request by the
PSG who experienced the over cramped premises when undertaking the PSG monitoring exercise. Additionally the Annual
survey feedback highlighted the over cramped nature of the reception area. Staggering clinics was introduced.
12. GPs and the nurse have inserted ‘catch up’ slots into their clinics to reduce patient waiting times as it is to help them avoid
running too late. This was introduced in part to help reception staff as patients were complaining to reception. The
consequence was that other patients were not being looked after and the reception area was becoming over-cramped with
both complaining patients and patients attending for clinic or requiring staff assistance with other matters.
13. Since March 2014 there have been 15 minute appointments available. This has helped reduce delays in appointments as
doctors have longer to consult with their patient.
14. On a daily basis patients struggling with the Jayex automated arrival screen have been trained in how to use it over the
course of the year. The result has been fewer patients waiting in the reception queue getting frustrated and fewer patients
waiting in this cramped small area.
Result of actions and impact on patients and carers (including how publicised):
1. A reduction in verbal complaints regarding the cramped waiting area.
2. A reduction in patients complaining about staff rudeness as staff are not being challenged so often by frustrated patients
who have waited over an hour for their appointment.
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3. More patients can more easily make use of the lowered front counter. There have been fewer complaints about lack of
access at reception due to the high counter that many patient struggle to reach.
4. Carers and the disabled and young mothers have found it less overly difficult to get buggies and wheel chairs through the
reception area as there is more space as the table and chair has been removed, clinics are more staggered and less
patients are in the reception area complaining about waiting times.
5. Confidentiality has improved with the lowering of the front counter and the installation of a confidentiality desk screen at rear
desk.
6. Staff are happier as fewer complaints, patients friendlier and they are working in less cramped and more secure working
conditions – as a result of a reception door lock being installed; de-cluttering of reception; staggering of clinics; catch-up
blocks being inserted into clinicians surgeries.
7. There are now appointments offered at times where they were not previously i.e. Wednesday afternoon and over the lunch
time period
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Priority area 2
Description of priority area:
Appointments - both:
a)To Improve patients ability to secure a speedy appointment reducing the current up to 2 weeks wait time
and
b) To reduce the waiting time to see the clinician as patients are often delayed more than 30 minutes resulting in formal
complaints and patients suffering parking penalties
What actions were taken to address the priority?
a) For a temporary period during the winter, from January 6th 2015 there have been an additional number of GP appointments
available every day of the week both pre-bookable and urgent on the day – the impact on reduced complaints and patient
numbers will be reviewed at the end of the period.
b) The GPs who regularly run late changed their clinics to include catch up slots to reduce waiting times for patients
c) A number of 15 minute appointments are now available. This helps clinicians run to time as they have a longer than
traditional consulting length. It also results in patients issues being dealt with and patients not needing to book another
appointment to deal with another issue that there was not the time to address in a 10 minute consultation.
d) The nurse has been provided with ‘catch up time’ slots in every clinic to help reduce the long waiting time/delay when
patients have appointments with her
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Priority area 3
Description of priority area:
Reduce the number of patients onsite at any one time due to the cramped conditions inside the surgery and the resulting
patient frustrations with not being able to move/sit down
What actions were taken to address the priority?
1. Clinics were moved to reduce the number of clinics running simultaneously – there are now two clinics running on a
Wednesday afternoon - prior there were none on a Wednesday afternoon. HCA clinics have also been moved to
lunchtime/early afternoon when surgery less busy with people.
2. Clinicians having blocks in their clinics to cat up and some 15 minute appointments – has resulted in reduced numbers of
patients waiting for delayed appointments as the through flow of patients is smoother. Fewer patients waiting for
appointments in cramped waiting areas.
3. Patients have been taught how to announce their attendance at the surgery using the Jayex automatic arrivals system to
reduce the number waiting in the small and cramped reception area and in the reception queue.
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4. Promote further alternative methods of securing appointments and repeat prescriptions to avoid surgery attendance – e.g.
online booking and requesting of repeat medication
5. Increased staffing levels to reduce patient waiting time at reception – this has reduced patients waiting time to be assisted
at reception and to have the phone answered.
Result of actions and impact on patients and carers (including how publicised):
1. Fewer complaints
2. Less stressed/more content staff and patients
3. More positive formal reviews on NHS choices website and via FFT survey comments
4. Shorter queuing time at reception
5. Fewer people waiting in the cramped waiting areas
6. Patients verbally expressing gratitude that clinics are now held Wednesday afternoon
7. PSG agreement that there are noticeable improvements
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Is this the first year your practice has participated in this scheme?
NO
If you have participated in this scheme for more than one year, outline progress made on issues raised in the previous
year(s):
Action points achieved 13/14 reviewed:
1. The Surgery website set up as part of the 13/14 action plan has been used fruitfully and appropriately during 14/15. More
patients have been made aware of its existence and its value during the course of this financial year. Its practical use is
extensive. For instance, it provides up to date information about the surgery such as opening hours (including extended
opening hours times); patients can register via the website; patients can book appointments and request repeat
prescriptions electronically via the surgery website; patients can submit the Friends and Family Test survey response
electronically via the surgery website; patients can download the surgery formal Complaint form, the request form to opt
out of the Summary Care Record national campaign and they can complete the Joiner request form via the surgery
website.
2. The number of patients requesting a pin number to use the Online option for booking appointments and requesting repeat
medication has increased dramatically and this facility has now been taken up by over 1200 patients.
This facility has been extended. Patients with online access can now also view parts of their Summary Care Record when
they access EMIS online using their pin number.
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3. Patients are making good use of the surgery’s increased opening hours which became 52.5 per week from March 3rd 2014
to:
Monday
Tuesday
Wednesday
Thursday
Friday
8am – 8pm
8am – 6.30pm
8am – 4.30pm
8am – 6.30pm
8am – 7pm
Clinics are now staggered to help reduce the number of patients in the cramped building at any one time. There are now 2
busy clinics running Wednesday afternoon.
4. A large number of 15 minute appointments, introduced in 13/14, remain available to comply with Key Performance Indicator
22. There has been a positive impact on the patient experience in that waiting time to see the GP has reduced. Fewer
patients are complaining about excessive (over 30 minutes) delays for their consultation. In addition longer appointments
often enable the GP to deal with more than 1 issue in each consultation where necessary, avoiding patients returning and
also avoiding patient frustration.
Key Perrformance
Indicators March 2014 to be advertised in the surgery and on the website.docx
5. It was agreed in 2013/14 to undertake an extensive survey September 2014 – this was actioned.
Questionnaire for
the Surgery August 2014.docx
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6. PSG members – as agreed in 2013/14 action plan – have monitored reception over a period of 3 weeks to observe the
patient and staff experience. As a result of this activity recommendations have been actioned by the Partners
PSG SURVEY OF
PSG Confidentiality
RECEPTION STAFF MAY
agreement
14.docx for when they sat in with reception May 2014.docx
7. As agreed with the PSG – suggestion boxes continue to be provided at reception and in the waiting area to secure patient
feedback. This feedback has been used by the PSG to help them decide the 3 action points they proposed to the Partners
during 2014/15 PSG DES process.
PPG Sign Off
Report signed off by PPG: P. Parnes (Chair Person)
YES
Date of sign off: 03.03.15
How has the practice engaged with the PPG:
-
-
Meetings with the PSG during the year led by the Practice Manager representing the Partners
Meetings between the PSG and the Partners during the year
PSG meeting with Action Plan for The
Partners 5th March 2014
Practice
to review
at 188progress
14 15 agreed
with points
with the
detailed
PSG June
in agreed
20th action
2014.docx
plan of October 2013 (2).docx
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Patient Participation Enhanced Service 2014/15 Annex D: Standard Reporting Template
How has the practice made efforts to engage with seldom heard groups in the practice population?
a) Individuals have been approached during the course of the year by PSG members, The Practice Manager and Partners to
try to cop-opt the young; the young mothers; those with special needs; those in residential care homes – into joining the
PSG. Partial success has been achieved with securing temporarily a 19 year old from an underrepresented group and a
patient from the special needs community has agreed to join, although he is not able to attend the coming meeting of the
PSG – he has stated he would like to attend the following meeting.
b) 2 members of the PSG have close connections with patients in Independent Living accommodation and Care Home
Accommodation. They have voiced concerns and suggestions on behalf of those underrepresented groups with whom they
undertake regular voluntary work.
c) Notices have been on display in the waiting areas for the last 12 months advertising for joiners from underrepresented
groups.
Interested in Joining
our new Surgery Patient Group DRAFT 15 4 13.doc
Has the practice received patient and carer feedback from a variety of sources?
Yes
a) Analysis has been undertaken of the completed extensive annual survey results
Patient survey
Results The Practice at 188 14 15 Survey for printing for waiting room.xlsx
b) Analysis of FFT monthly results and patients written comments on question 2 of the survey
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Patient Participation Enhanced Service 2014/15 Annex D: Standard Reporting Template
Friends and Family
February 2015
Test summary of feedback
Friends
by month
and Family
from January
Test summary
2015.xlsx
of feedback by month f.xlsx
c) NHS Choices reviews were discussed
d) Review of Formal Complaints has taken place
e) Review of comments submitted to the surgery in the PSG instigated Suggestion boxes located at reception and in the
waiting area has taken place
f) Written compliments submitted by patients have been reviewed
g) PSG members have spent many hours over a period of weeks monitoring patient experience at reception and talking with
patients waiting for an appointment. Standard forms were completed by the PSG members who undertook these sessions
in order for the data they wrote to be summarised in preparation for the two meetings during which the above patient
feedback from a wide variety of sources – was discussed and reviewed.
The PSG members discussed the above feedback with the Head receptionist and the Practice Manager at 2 consecutive PSG
meetings. The information was also used to decide the action points the PSG members were to put to the Partners for actioning
2014/15.
Was the PPG involved in the agreement of priority areas and the resulting action plan?
Yes.
The PSG was proactively involved. Indeed the PSG representatives led the discussion with their suggestions/requests at the
meeting with the partners June 20th 2014.
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PSG meeting Minutes
with Partners Friday June 20th .docx
How has the service offered to patients and carers improved as a result of the implementation of the action plan?
Improved patient experience at ground floor reception
Staff are noticeably more ‘customer first focused’ with both patients and staff responding positively to the improved communication
which is now more friendly and helpful.
Increased staffing levels at reception has helped improve the patient experience as response time is faster for staff to provide
assistance
Less queuing as many patients have been proactively taught to use the Jayex touch arrival screen
Greater confidentiality at reception due to the lowered front counter and the desk screen at back desk to avoid patients
overhearing conversations so clearly
Less congestion in the waiting area as the table and chair has been moved
Less congestion in waiting areas and more satisfied patients because:
a) Clinicians have inserted ‘catch up’ blocks into their clinics to reduce patient frustration and waiting times to see the GP and
nurse
b) Clinics are staggered more – with use being made of the increased opening hours – clinics running through lunch and on a
Wednesday afternoon which were not available a year ago.
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c) Fewer patients complaining of parking fines due to delayed clinical appointments
More appointments have been made available recently and this period is being considered a trial 3 months to be reviewed April
2015 – result is fewer complaints; improved patients feedback via FFT surgery; less pressured reception staff.
Do you have any other comments about the PPG or practice in relation to this area of work?
The PSG is a powerful voice at this surgery and very proactively involved with surgery decision making in the areas of action
points required for the PP DES and KPI choices.
The members are committed to improving the patient experience at the surgery
Overwhelmingly the biggest feedback from patients over the last 2 years and from the PSG is that their experience will be
improved mainly when fit for purpose premises are secured as there is a very limited amount that can be achieved whilst in the
current premises.
The PSG have made further suggestions on ways to improve conditions for patients whilst waiting for appointments such as
converting an office into a waiting room on the 1st floor. Unfortunately further funding has not been made available from any
source (internal or external to the surgery). The PSG will continue to pursue their endeavours for further improvements to the very
unsatisfactory and unfit premises.
Key Perrformance
Patient Support
Indicators March 2014Group
to be End
advertised
of Year in
Report
the surgery
2014 2015
and on
published
the website.docx
March 2015.doc
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Patient Participation Enhanced Service 2014/15 Annex D: Standard Reporting Template
Complete and return to: england.lon-ne-claims@nhs.net no later than 31 March 2015
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