Patient Participation
Introduction and Objectives
Station Drive has enjoyed an active Patient Participation Group. The role patients play in helping to
determine care and how it is delivered should not be underestimated.
The Station Drive Patients Participation Group has been particularly active and is represented on the
Locality Board and the main CCG Board. Members also sit on Mental Health and other committees
and have had an active voice in the debate around the proposed Ludlow Health Facility.
The key objective of the DoH has been to ensure that patients are as involved as practical in
decisions about the range and quality of services provided.
The Station Drive Patients Group have been involved in survey and direct questioning of the patients
of the surgery using flu days and other opportunities to promote dialogue and debate.
This year (2013/4) The group has had active meetings with the Dementia lead for the CCG, engaged
in a Care Coordination project and also recruited patients to Compassionate Communities. As the
Chairs reports and meeting minutes also reflect the group continues to actively ensure that views of
the population of South Shropshire are heard at a range of Patient Participation CCG and Ludlow
Healthcare planning events.
Components of Patient Participation
Develop a PRG
The Patient Group has been running for 3 years and was constituted by open invitation to all
patients. A large notice board is available in the Waiting Room regularly updated by the group along
with a suggestions box. The aim has always been to encourage participation from the widest
demographic possible and the practice reception team encourage new patients to become involved
and also suggest attendance at meetings to all who wish to influence the way the surgery is run.
To highlight the group Patient Participation Group representatives attend the flu day (where over
1000 of our 8300 patients attend) this provides an opportunity for survey of the patient group and
discussion of any hot topics.
Carers are especially encouraged as this sub population has direct and often very pertinent
knowledge of the needs of the vulnerable and direct comment on how health care is developed. The
group in its January meeting encouraged a wide audience by promoting a discussion led by the CCG
lead for dementia.
The Practice encourages engagement through:
Proactive invitation to all new patients to join the group
Web page and dedicated web space for all minutes and notices
Notice Board and Suggestions Box
Direct engagement and representation at all meetings with the presence of at least one doctor and
often other staff members (such as the Care Coordinator)
The Station Drive Surgery Patient’s Group comprises 18 – 20 patients including an elected Chair and
Secretary.
The group interface with up to 1000 members of the practice population at the flu day (a weighted
sample but because they comprise the elderly and those with chronic disease arguably a cross
section of the main users of services)
The PRG is based on this wider population for survey results and also a specific PRG Calculation has
been performed on the survey sample from February 2014
The sample size for this survey was 344 Patients all of whom accessed the services in the week
Male
Female
70
60
50
40
30
20
10
0
under 15
15-20
21-40
40-60
60 or over
The profile of this user sample is close to the profile of the PRG which comprises 15-20 members
with a predominant elderly bias but fairly equal male female split. Racial minorities are represented
in proportion to the underlying demographic.
Components of Patient Participation
Agree Areas of Priority
The patient priorities are represented through discussion (as minutes) at the Patient Group, through
on-going work on the Action Plan formulated in 2012/3 and also through survey at the flu day.
At the 2013 Flu Day the Chair Secretary and Care Coordinator again attended (as in 2012) to gather
ideas and feedback, encourage participation in the Patient Participation Group and also to evaluate
response to the Action Plan and gather ideas and suggestions for any other issues to be included.
The Action Plan is debated and considered at each Patient Group meeting (as Minutes) and again
progress or otherwise made by the Practice is noted.
At the Flu day in 2013 the key themes again were:
1. Opening times
2. Appointments availability
3. Telephoning the Practice
4. Manpower (locums and availability of doctors)
5. Ambulance and concerns over the Hospital (Planned redevelopment failing)
6. CCG Level decisions re priorities of care
It was noted that the practice had started a telephone triage system such that all urgent demand
was met by telephone response on the day, more on line appointments were offered, on line
prescriptions available and that despite a national and deepening recruitment crisis and 2 years of
trying to recruit with national advertisements the practice had secured more permanent workforce
(Dr Moore and latterly Dr Wood)
The question format therefore for the February Survey was chosen to reflect these themes. The
practice also (as in 2011) requested that individual clinician level data could also be collected.
Components of Patient Participation
Collate Patient Views through use of a survey
Face To Face Survey
The Patient Group chose to conduct the survey by face to face discussion with patients visiting the
Practice for a ‘flu vaccination at the Saturday morning special clinic on 28th September 2013.
Replicating the Survey of 2012 Three members of the group again spent 4.5 hours each talking to
patients and recording their issues.
The PRG reported back to the Patient Group and as in the previous year a full range of comments
and discussion was considered. This was presented at an open meeting and it was determined that
the PRG would both update the Action Plan and also the Practice chose to repeat the 2011 Survey to
see what progress (or other) had been made around the key areas of the action Plan.
Survey credibility
Whilst the survey did not address a randomized group of patients the very large numbers and the
direct and open discussions facilitated by the PRG were felt to provide a very credible and
representative formative output and survey.
Direct Survey
As in 2011 and using exactly the same methodology a wide scale Patient Survey was undertaken
during the week commencing 24th February 2014
The Direct Survey was designed to follow up on 2011 and look for change in terms of the Action Plan
Agreements and proposals.
The direct survey as in 2011 also used GPAQ (General Practice Assessment Questionnaire) questions
to allow clinician feedback. A simple GP Tools form was used to allow this.
Components of Patient Participation
Opportunity to Discuss Survey Findings/Agree actions
The feedback from the Flu day survey was discussed at the Thursday 3rd October 2013 meeting as
minutes (on website)
No new issues other than the relative low awareness of the Practice Website were recorded. Patient
Group Members also asked that clearer information about opening times is posted (again the
knowledge around existing extended hours and the early morning phlebotomy service for fasting
bloods was not well publicised.
Complaints and significant events are discussed within the practice and the group routinely reviews
comments or suggestions received. Full and detailed minutes of the group are maintained and are
posted on the Patient Group section of the practice website.
The flu day survey provided an opportunity to review progress against the action plan and a new
theme re awareness of online booking website and opening times was added.
The survey in February 2014 was designed to monitor progress (using the standard questions set in
2011.
The findings of the 2014 Survey are appended
In short the following were noted
An increase even in a year of the frequency of consultation No change in the rating for
reception
No change in the need for privacy at reception (still seen as a need by nearly 20%)
No statistical change in rating for availability but perhaps a shift toward more satisfaction
No change in awareness of early morning and late evening working (we were surprised
that 30% were still unaware)
An improvement in access with 74% seen immediately or on the same day
A slight improvement in waiting time for doctors and nurses
A large improvement in telephone access63% saying easy compared to 50 in 2011
An ongoing demand for on line text and other messaging services and prescription
requests.
The actions are reviewed quarterly at meetings of the Patient Group. There is a dynamic and ongoing discussion as recorded in the minutes of actions arising and progress or lack of.
Components of Patient Participation
Opportunity to Discuss Survey Findings
Telephone system
– problem of
getting through
especially in the
mornings
Progress Feb 14
Telephones –
difficulty in using
the new system
Progress Feb 14
Access to named
Doctor and
problem of
turnover of GPs
Progress Feb 14
ACTION
WHEN
BY WHOM
To audit call back wait times
March/May Reception
To trial dedicated telephone
answering responsibilities for
Receptionists
Immediate
Reception
To consider message (esp in light
March
of 111)
To look at reducing telephone
May
Reception and Clinical
demand by adjustment to results
Team
protocols
Call Back times were audited and a re-audit is due
Clinicians continue to adjust results reporting to provide more patient
information and are actively considering on line access to pathology and
other results. More patient friendly descriptors of results (eg cholesterol x no
action required other than low cholesterol diet) have been introduced.
Continues to be an “active issue” re audit Feb 14 survey
Reception team to review message May
Reception
and to arrange meeting with
Patient Group
Patient Group representation to
modify/amend message.
Message was reviewed and options streamlined
Recruitment of new GP Partner
Advertising
Partners
February
Ongoing advertising has occurred with both national (BMJ /Pulse) and local
advertisements. The practice also contracted a head hunter to look for
suitable applicants.
Dr Sally Wood has been recruited and Dr Wieland Moore continues working
at the practice. Locums wherever possible are chosen from a restricted pool.
It was noted that despite best efforts recruitment remains a huge issue for
the practice (and many others in the Marches) The current GPs are all
working very long working weeks to provide continuity of care.
This issue has been flagged with the CCG and LAT and has registered on the
National agenda with efforts to increase GP training.
The practice has confirmed status as a Training Practice and has welcomed Dr
Ade Buluro and latterly Dr Samara Afzal. These fully qualified training GPs
continue to help providing additional resource
Confidentiality at
the Reception
desk
Progress Feb 14
Ventilation in
waiting room
Progress Feb 14
Advertise
volunteer car
service
Progress Feb 14
Magazines in
waiting room
Progress Feb 14
online
appointment
booking for Nurse
appointments
Progress Feb 14
prescriptions
Progress Feb 14
test results system
Progress Feb 14
To remind all Receptionists of this
February
Practice Administrator
issue, and to close the hatch when
not dealing with a patient
Has been completed.
With the news that the new Ludlow Healthcare facility is not being built we
need to consider the mechanics of the practice. A confidential area for BP
Height and weight measures and display of patient leaflets which require
more confidentiality (youth sex health/ contraception/HIV etc is being
arranged. Re audit
Make one duty Receptionist
February
Receptionists
responsible for checking
2013
temperature of waiting room and
taking action.
Done
Practice to ask Care Co-ordinator
May
Patient Care coto liaise with Patient Group
ordinator
Care Coordinator has changed this discussion now rests with Co Co
(Compassionate Communities and has been forwarded) New Care
Coordinator should be in post by March but longer term post in FY 14/5 not
assured yet)
Patient group to review and
April
Patient Group
discuss how this can be improved.
Done Old mags removed
Implement this
May
Reception team
Nurse appointments are variable length depending on procedure we will
implement this in due course but resolution of appt length etc required and
Patient Info to be available
Discuss frequency of prescriptions June/July
Partners,
with CCG and then strategic review
CCG confirm normally prescriptions should be 1 month, locally for certain
long term drugs eg statin or blood pressure we extend this. Strategic review
planned with CCG Pharmacist but not yet tsarted.
Process review of this system
March
Partners, and Practice
admin team rep.
In progress especially as on line anticipated.
Components of Patient Participation
Action Plan agreed ongoing
Telephone system
Access to named
Doctor and
problem of
turnover of GPs
Confidentiality at
the Reception
desk
online
appointment
booking for Nurse
appointments
test results system
New Actions 2014
Publicise
website/on line
services
Advertise
extended hours
ACTION
To audit call back wait times
To look at reducing telephone
demand by adjustment to results
protocols
Recruitment of new GP
The practice needs to continue to
monitor workforce and proactively
secure more doctors as needed
To remind all Receptionists of this
issue, and to close the hatch when
not dealing with a patient
Consider remodelling
Implement this
WHEN
Ongoing
audit
BY WHOM
Reception and Clinical
Team
Ongoing
Partners
Sept 2014
Practice Administrator
May 14
Reception team
Implement On line access
June 14
Partners, Admin Team
ON line access to prescriptions
now printed on all prescription
counterfoils
Continue to promote extended
hours extended phlebotomy etc
and advise patients of changes
regularly revise website
Feb 14
onward
Ongoing
Admin team