patient survey report & action plan march 2015 · 2015. 3. 25. · the first meeting...

ST PETER’S SURGERY

PATIENT REFERENCE GROUP

PATIENT SURVEY REPORT & ACTION PLAN

March 2015

Patient Reference Group Report 2014-15 Version 1.0 of 27

ST PETER’S SURGERY - PATIENT REFERENCE GROUP

PATIENT SURVEY REPORT & ACTION PLAN

March 2015 INTRODUCTION AND BACKGROUND The practice‘s commitment to “Listening to Patients” has continued during the current year with the work of the Practice’s Patient Reference Group and further patient surveys as part of the new GMS contract’s Patient Participation Group, Direct Enhanced Service (DES). The following report outlines the strategy to maintain and develop a Patient Reference Group (PRG) that reflects the age, sex and ethnic profile of the practice and the process and methodology used by the practice in undertaking the patient survey and developing the action plan. It details

The Practices opening hours, including extended hours The profile of the current patient reference group and the steps being taken to provide a group that is representative of that profile The work programme of the PRG The survey process and methodology A summary of the analysis and the key issues identified from the PRG, Family and Friends Test (FFT) & the National Patient Experience Survey The action plan for 2014/15 agreed with the PRG

Appended to the report are the following: • Practice profiles & current PRG profile • PRG Agendas & Minutes • Review of the 2014/15 action plan and status • 2014/15 Survey results PRACTICE SERVICES AND OPENING TIMES The Practice offers all of the essential and additional services, with the exception of “Out of Hours” which are now provided by Badger via NHS 111. The services are accessible at the Practice throughout the core contract hours, face to face or via the telephones, see below.

Surgery Opening Hours

Inc. Telephone access Morning Afternoon Total Monday 8:00 AM 6:30 PM 10:30Tuesday 8:00 AM 6:30 PM 10:30Wednesday 8:00 AM 6:30 PM 10:30Thursday 8:00 AM 6:30 PM 10:30Friday 8:00 AM 6:30 PM 10:30Saturday 0:00Hours per week a receptionist is available via telephone or face to face 52:30Total number of hours practice is open 52:30


In addition to the core hours the Practice also provided, via the Directed Enhanced Service specification, extended opening hours for patient who may have difficulty attend the surgery during the core contract hours. The extended hours now provided by the Practice are shown below. The recent GP patient survey has also shown that the majority (only 11% expressing dissatisfaction) of patients are happy with the practices core working hours and the extended hours currently available, (See – GP patient survey).

Surgery Extended Opening Hours

NB - Concurrent GP hours count towards total extended hours Morning Afternoon Total Monday Doctors x 4 + Nurse 7:30 AM 8:00 AM 2:00Tuesday Doctors x 4 7:30 AM 8:00 AM 2:00Wednesday 0:00Thursday Doctors x 3 6:30 PM 7:00 PM 1:30Friday 0:00Saturday 0:00Hours per week a receptionist is available via telephone or face to face 52:30Total number of hours practice is open, inc extended hours 58:00

Note the core and extended opening hours of the practice have not changed from last year. Last year’s CCG local initiative to provide additional hours with weekend opening to relieve winter pressures on the Acute / A&E services has not been repeated. MAINTAINING & DEVELOPING THE PATIENT REFERENCE GROUP & PROFILE The practice has continued to deliver the requirements of the Patient Participation Directed Enhanced Service and has maintained a core group of patients within the current patient reference group. Whilst we have some very supportive and valued members, sadly, the profile of the group does not reflect the practice age, sex and ethnicity profile, (see appendix 1).

Our efforts to make the group more representative of the practice profile have continued during the last twelve months with posters, patient leaflets, messages on the “Jayex” board (patient communication message board) and information on the website.

We have continued to seek opportunities to target our ethnic populations with doctors and reception staff extending personal invitations to patients who have shown an interest in the work of the Practice. During the year we have recruited a further two patients, although only one of them has actually attended a meeting.

It is against this background that we have decided to make the development of the group a priority for the 2015/16 year, and we intend to target the younger patient age group and our black and minority ethnic groups, see the 2015/16 action plan

Details of the Practice profile and PRG membership profile are given in appendix 1


PATIENT REFERENCE GROUP WORK PROGRAMME The first meeting (10.6.2014) of the Practice’s Patient Reference Group the work programme for the 2014/15 year was as follows:

Minutes of the last meeting - Approval - Matters arising - Actions

Terms of Reference - Review & approve for use

Review Annual Report & Action Plan - Published Annual Report 2013-14

- Action plan - Progress

Changes to the GMS Contract and Commissioned Services - GMS Contract Changes (Over 75 Years) - Locally Commissioned Services - Directed Enhanced Services (Esp. PRG & Unplanned Admissions) - What are the issues?

Development of the PRG - Improving representation - What would you like to see happen to the PRG?

The second meeting (16.9.2014) programme was as follows:

Minutes of the last meeting

- Approval - Matters arising - Actions

Review Action Plan – Progress Update - Action plan

- Progress - Repeat Prescribing Patient leaflet

Review Internal Audit Reports - Infection Control (Inc. Minor Surgery)

- Complaints - Significant events - Patient Appointments & DNA - Service surveys

Changes to the GMS Contract and Commissioned Services - GMS Contract Changes - Friends and Family Test (FFT) - FFT Patient leaflet & Questions - What are the issues?

The third meeting (13.1.2015) programme was as follows:



-


Review Action Plan – Progress Update - Action plan - Progress – inc.

Telephone system changes - feedback Repeat prescribing system changes - feedback

Friends and Family Test (FFT) - FFT Implementation - FFT Survey feedback - Priorities for development

Changes to the GMS Contract - Patient Information (on-line Access) - Choice of GP Practice

The forth meeting (3.3.2015) programme was as follows:



Review Action Plan – Progress Update - Action plan – Final Review - Produce Annual Report

Friends and Family Test (FFT) - FFT Survey feedback &summary report & GP Survey - Priorities for development (inc. Patient Reference Group)

Action Plan for 2015/2016 - NHS IT Letter - Agree actions for 2015/16

Changes to the GMS Contract 2015/16 - Overview

The full agendas and minutes of the meetings are given in Appendix 2. The final review / status of the 2014/15 action plan is shown in Appendix 3. The discussions round the action plan are detailed in the minutes of the meeting of the 13.1.2015 and 3.3.2015. The FFT survey results & analysis and GP Patient Survey result summary are detailed in Appendix 4.


DEVELOPING THE ACTION PLAN 2015/16 - INTERNAL AUDIT REVIEW, FRIENDS & FAMILY TEST (FFT) & GP PATIENT SURVEY SUMMARY OF PRIORITIES As part of the process for developing the 2015/16 patient reference group action plan, the group has considered a number of internal reviews and audits, as follows

- Infection Control (Inc. Minor Surgery) CCG inspection showed 89% compliance – no significant issues identified

- Complaints 22 anonymised complaints reviewed – no significant trend identified, however telephone and appointment access and waiting times were mentioned.

- Significant events 15 event head lines reviewed, again no significant trend identified - Patient Appointments & DNA Figures highlighted and explained - Service surveys Minor surgery – no infections

The internal reviews and audits were presented and considered by the PRG members. Detailed questioning help to provide focus on the issues considered important by both the Practice and the group members.

At the request of the PRG the implementation of services and contract changes have also been considered to ensure an appropriate balance between essential workload issues and service development / change, i.e. PRG members reviewed the GPs recommendation not to participate in the GP Choice enhanced service and agreed with the recommendation as it was felt that it would add additional workload and potentially distract from service provision to patients on the practice list.

Feedback from the GP Patient survey was considered and felt to be highly relevant, see summary details in appendix 4

The Friends and Family Test as implemented in accordance with the guidance and has been in operation since the 1st of December 2014 – results and comments have been shared with the PRG members in an anonymised form

Based on consideration of the above information the following priorities were agreed with the patient reference group on the 3.3.2015 (see minutes of meeting – appendix 2) KEY ISSUES Reception & Telephone Access - High Priority Appointment Access & Waiting times - High Priority Development of the Patient Reference Group - High Priority The above priorities were used to develop an action plan for the next 12 months (2015/16) and will form the basis of the work of the PRG


ACTION PLAN 2015/16

ST PETER’S SURGERY – Patient Reference Group Action Plan 2015/16

Reception & Telephone Access Action agreed Who When 1 Recruit an additional receptionist Practice Manager June 2015 2 Review telephone performance & set

telephone response targets – 90 in 90 Practice Manager, Reception staff & PRG

June 2015

3 Encourage patients to use the self-check screen and drop prescription requests off in the box provided to reduce reception workload

Practice Manager & Reception staff

Apr 2015 & Ongoing

4 Aggressively promote use of the internet for repeat prescribing appointments and medical record access to reduce call volume


Apr 2015 & Ongoing

5 Review and improve advice on how and when to contact the surgery by telephone

Practice Manager & Reception Staff

Apr 2015 & Ongoing

Appointment Access & Waiting times 6 Review and improve patient

information on Access rights, GP availability, appointment system, triage (its purpose and operation) and the effect of DNAs

Practice Manager June 2015

7 Review online appointments and consider increasing the number and type available, including nurse and HCA appointments.

Practice Manager June 2015

8 Investigate the use of text messages to improve patient communications and DNAs

Practice Manager Sept 2015

Development of the Patient Reference Group 9 Review membership and contract

requirements. Practice Manager and PRG

Jun 2015

10 Conduct a recruitment campaign Practice Manager and PRG

Sept 2015


APPENDIX 1

Patient Reference Group - Representative ethnic mix

Description Read Code No. Patients (1.3.2015)

% of known list PRG of 20 Representation

CURRENT PROFILE

British 9i0.. 4756 59% 13

Irish 9i1.. 38 0% 0

Any other white 9i2.. 592 7% 1

68% 14 29

Mixed

White & Black Caribbean 9i3.. 241 3% 1

White & Black African 9i4.. 98 1% 0

White & Asian 9i5.. 88 1% 0

Any other Mixed 9i6.. 67 1% 0

6% 1 1111

Asian or Asian British

Indian 9i7.. 175 2% 0

Pakistani 9i8.. 1137 14% 3

Bangladeshi 9i9.. 85 1% 0

Any other Asian 9iA.. 73 1% 0

18% 4 2223

Black or Black British

Caribbean 9iB.. 253 3% 1

African 9iC.. 257 3% 0

Any other Black 9iD.. 48 0% 0

Chinese or other ethnicity 7% 1

Chinese 9iE.. 46 0% 0

Any other ethnicity 9iF.. 39 0% 0

Not stated 1% 0 Leave blank 9iG.. 31 0% 0 0

TOTALS 8027 20 20 32

Patient Reference Group - Age/Sex mix

Age Band Male / Female No. Patients % Of list PPG of 20 Representation

0 - 18 F 1282 PRG to be selected from voting population

M 1285

19 - 30 F 819 12.6% 3

M 784 12.1% 2 5 5

31 - 45 F 878 13.5% 3

M 935 14.4% 3 6 6

46 - 60 F 814 12.5% 2.5

M 811 12.5% 2.5 5 7

60 - 100 F 764 11.8% 2

M 694 10.7% 2 4 14

TOTALS 6499 20 19 32


APPENDIX 2

St. Peter’s Surgery - Patient Reference Group Meeting

10th June 2014, 7:00 to 8:00pm

AGENDA

ITEM

1

Welcome and Introductions - Registration

All

2

Apologies

3


Approval Matters arising Actions

All

4

Terms of Reference

Review & approve for use

Chair

5

Review Annual Report & Action Plan - Published Annual Report 2013-14

Action plan Progress

All

6

Changes to the GMS Contract and Commissioned Services

GMS Contract Changes (Over 75 Years) Locally Commissioned Services Directed Enhanced Services (Esp. PRG & Unplanned

Admissions) What are the issues?

All

7

Development of the PRG - Improving representation - What would you like to see happen to the PRG?.

All

8

Any Other Business

All

9

Agenda for next meeting

Action Plan – Progress Report Review Practice Internal Audits (i.e. Complaints) GMS Contract Changes GP Patient Survey

All

10

Date and time of next meeting - Tuesday 16th Sept 2014, - 7:00 to 8:00pm – St. Peter’s Surgery

Chair


ST. PETER’S SURGERY - PATIENT REFERENCE GROUP (PRG)

MINUTES OF THE MEETING HELD ON TUESDAY 10TH JUNE 2014 1. ATTENDANCE

PRESENT APOLOGIES Mr J Emery (Chair) Mrs A Pritchard (Minutes)

Mr W Ellens Mrs Mary Frankham

Mrs M Bradburn Mr J Dwyer Mrs P Etchells

Mr R Etchells Mr K Slater

2. WELCOME & REGISTRATION All members were welcomed to the meeting and signed the attendance sheet on arrival. Mr JAE offered the apologies for those that could not attend.

3. MINUTES OF THE LAST MEETING The minutes of the 11.03.2014 were checked and approved as a true and accurate record. All previous minutes are available for viewing on the Practice Website: www.stpeterssurgery.com 3.1 MATTERS ARISING MB commented that the leaflet for the Attached Staff Services should be

printed in a lighter shade of blue or alternate colour as the dark blue made it difficult to read. This was agreed by all.

3.2 ACTIONS WE still trying to arrange for a speaker for September’s meeting

There were no other outstanding actions

4. TERMS OF REFERENCE JAE informed the group that 2 points had been added due to changes in the

service specification for PPG’s under activities of the group, section 4 - 4.1 “Review external and internal performance information” and 4.7 “Develop action plan to improve services and monitor progress”

It was noted that both of the above additions were a reflection of the PRG’s past and current activities. The terms of reference were reviewed and approved.

5. ANNUAL REPORT 2013/14 & REVIEW OF ACTION PLAN 2014/15 Copies of the annual report for 2013/14 were handed out and the group informed

that a copy was also available on the website.


The action plan for 2014/15 was reviewed as follows -

Reception and Telephone Access Staffing Plan

The Surgery has identified a need to recruit a new afternoon receptionist. It is anticipated that this will be complete by Oct 2014. Lunch breaks for receptionists are being reviewed to ensure the provision of consistent cover over the lunch period. JAE confirmed that the practice had recruited a new Health Care Assistant and an admin / secretary. The new staff will be starting on the 2nd July 2014 and the 16th June 2014 respectively. Both of these appointments were to replace existing capacity and provided some additional capacity and improvement in admin cover during the working day.

Telephone System Auto Attendant It has been agreed by the Partners that the option to use the ‘auto-attendant’ as the first line of answering would be the most suitable option for two reasons, 1 – consistent patient information, 2 – effective call queueing, and will therefore be changing to this method of telephone answering. In addition, having undertaken a risk assessment of the current system it would ensure all patients are advised that calls are recorded every time they call the practice.

Telephone Requests for Prescriptions Some of the clinical risks identified were language difficulties, prescription errors – some patients do not know what medication they are on and just request ‘all’, compliance issues, hence the reason for stopping all telephone requests. Patients will be given a 3 month warning period - hopefully to start July with a view to stopping all requests in September (under review). The exception to this will be known housebound patients, who will still be allowed to request prescriptions over the telephone.

Online Access and Other Identified Actions The number of patients using the Online Services is slowly increasing. However this and other actions will be addressed in the coming months

EMIS Appointments System and Access “Apps” JAE confirmed the Practice had reviewed the EMIS appointment system. The software was poor in comparison with the existing appointment system and the doctors agreed it was not appropriate to move to the EMIS system at this stage. This will be reviewed again next year.

Access (Inc. Opening Hours) & Waiting times DNA Audit

To be reviewed at next meeting. Weekend Access to Surgery

As the funding has been withdrawn, this option is not currently viable.

6. GMS CONTRACT & COMMISSIONED SERVICE CHANGES JAE gave an overview of the GMS contract and commissioned service changes. The Quality & Outcomes Framework (QOF) has been curtailed which had reduced practice income by approx. 40%. This funding has effectively has been re-targeted to support the introduction of a new enhanced service, “Avoiding Unplanned Admissions”. This enhanced service (ES) is designed to help reduce avoidable, unplanned admission to hospital by ensuring that patients at high risk patients of being


admitted to hospital in emergency situations are reviewed by the Practice to provide a care plan specifically tailored to meet the needs of individual patients to minimise the risk of emergencies. JAE highlighted the named GP for patients aged 75 years or over and confirmed that the practice is currently allocating named GP’s based on known GP-patient relationships / proportionate GP workloads. This will be achieved by the end of June 2014. Other changes to the GMS contract will be explained as more information becomes available; i.e. friends and family test, GP Practice choice and online access. The PPG/PRG specification has also changed and there is no longer a requirement to undertake a patient survey. However, there is now a requirement to consider service / audit information i.e. complaints, DNA audits etc., to draw up appropriate action plans. It was noted that St. Peter’s PRG has already been doing this prior to the new scheme. JAE confirmed that locally commissioned services were as follows; ECG, Spirometry, Diabetes, Near patient testing, Prescribing, Palliative care, Shared care, Sexual health, Treatment room, Participation/Engagement, Phlebotomy, Alcohol & Health Checks JAE confirmed that other nationally commissioned services were as follows; Minor Surgery, Vaccination programmes, Dementia services, Learning disabilities and Alcohol.

7. DEVELOPMENT OF THE “PRG” Unfortunately due to time constraints this item was deferred to the next meeting.

8. AOB A question was raised from a group member with regards to having Flu Clinics on a Saturday. JAE informed the group that this had been arranged last year but did not get sufficient take up to make the service financially viable. However, the option will be offered again this coming season.

9. DATE OF NEXT MEETING Tuesday 16th September 2014, from 7.00pm until 8.00pm



16th September 2014, 7:00 to 8:00pm

AGENDA

ITEM

1


All

2

Apologies

3



All

4


- Progress - Repeat Prescribing Patient leaflet

All

5

Review Internal Audit Reports - Infection Control (Inc. Minor Surgery)

- Complaints - Significant events - Patient Appointments & DNA - Service surveys

All

6

Changes to the GMS Contract and Commissioned Services

- GMS Contract Changes - Friends and Family Test (FFT) - FFT Patient leaflet & Questions - What are the issues?

All

7

Any Other Business

All

8


- Action Plan – Progress Report - FFT Survey Response - Priorities for Development (inc. Patient Reference Group) - GMS Contract Changes (GP Practice choice and online

access)

Chair

9

Date and time of next meeting - Tuesday 14th January 2015, - 7:00 to 8:00pm – St. Peter’s Surgery

Chair



MINUTES OF THE MEETING HELD ON TUESDAY 16TH SEPTEMBER 2014 1. ATTENDANCE


Mr K Slater

Miss L Akins Mr J Dwyer (delayed arrival)

Mrs P Etchells (delayed arrival) Mr R Etchells (delayed arrival) Mr W Ellens Mrs J Murphy

2. WELCOME & REGISTRATION All members were welcomed to the meeting, in particular our new member Mrs Janet Murphy. The attendance sheet was signed on arrival and Mr JAE offered the apologies received for those that could not attend.

3. MINUTES OF THE LAST MEETING The minutes of the 10.06.2014 could not be approved due to the late arrival of those present at the last meeting. Approval will be deferred until the next meeting. All previous minutes are available for viewing on the Practice Website: www.stpeterssurgery.com 3.1 MATTERS ARISING Not applicable

3.2 ACTIONS Not applicable

4. REVIEW OF ACTION PLAN 2014/15



The Surgery had identified a need to recruit a new afternoon receptionist. We are currently conducting a review of existing staffing hours. Recruitment is expected to start in October with the team fully operational by January 2015. The recruitment has been delayed to assess the impact of the changes to the telephone system and monitoring software. We will continue to encourage patients to use the self, check-in facility and the repeat prescription ordering box.

Telephone System Auto Attendant The telephone system software has been upgraded and we are now using an automatic call distribution system. The ‘auto-attendant’ is now in first line


operation and will answer all incoming patient calls. In addition, the initial message has been simplified and shortened. Patients’ will now only hear 1 message and no options – all others have been removed. The message advises patients that all calls are recorded every time they call the practice and that they are in a queue. Call queues are now being answered more effectively. In 3 days of operation, abandoned calls have been cut by 50%. The stopping of telephone requests for repeat medication is also expected to make a big impact. Historically our telephone answering service looks poor compared to surgeries who do not take prescription requests over the telephone. It is vitally important that we improve telephone access for patient wishing to access the GP. Requests for repeat medication can be made routinely.

Telephone Requests for Prescriptions A message has been put on all repeat prescriptions stating that the telephone request service for repeat prescriptions will stop with effect from 5th January 2015. The implementation of this action was delayed to get the PRG approval of the patient leaflet explaining the decision. A copy of the draft patient information leaflet was circulated to all members to provide an opportunity to read and comment on the content. Concerns were expressed about housebound patients but JAE stated that it was the intention to allow known housebound patients without access to the internet to make telephone requests, these patients will be notified individually. In addition, the Practice is moving to the use of electronic prescribing (EPS2) with effect from the 1.10.2014. This will take time to establish and is not expected to make any immediate impact but should in the longer term reduce the need for patients to request repeat medication. The issue of Pharmacies ordering patient prescriptions was discussed. JAE confirmed that discussions were taking place with the CCG to see if this process can be stopped, ultimately, EPS2 will have this effect.

Online Access and Other Identified Actions Whilst the recent internet access survey indicated that 85% of patients have internet access, the number of patients registered to use the Online Services is only just in excess of 42%. The Practice is continuing to encourage patients to use this facility. Mrs JM asked if it was easy to use the online services. JAE suggested that the practice send a username and password and online service leaflet to Mrs JM. Mrs JM agreed to feedback her experience at the next PRG Meeting.

ACTION: JAE to send Online Service registration details and Mrs JM to provide user experience feedback at the next meeting.

Access (Inc. Opening Hours) & Waiting times DNA Audit and Feedback

The DNA audit is on the agenda, along with a number of other internal performance audits. These actions will effectively be complete following this meeting.

The status of all other actions in the plan is either complete or suspended.

5. INTERNAL AUDITS REVIEW JAE gave a presentation on a number of internal performance audits undertaken by the practice during the last 12 months. Each of the following reports was discussed


Infection Control Complaints Significant Events Patient Appointments & DNA Service Surveys

Mr WE asked how many patients were removed due to non-attendance of appointments. JAE confirmed the practice had identified in the region of 23 patients for possible removal.

Mrs PE asked if the Practice could use a ‘Text Service’ notifying patients in advance of their appointments. JAE confirmed that this was a possibility for the future. However, given some uncertainties with the implementation new General Practice Systems of Choice contract (GPSoC) and the impending charge for the text message service the practice was reluctant to commit to any new contract in the short term.

6. GMS CONTRACT & COMMISSIONED SERVICE CHANGES

Friends and Family Test (FFT) JAE confirmed the FFT is replacing the previous patient survey. It is a contractural requirement for all GP Practices. JAE gave a presentation outlining the primary aims, the principles and what practices must do to comply with contract requirements. It is mandatory that the FFT contains at least two questions. The first question must be used in the specified standard format. Only the answer to the first question will be published by the NHS, The Practice will also publish the results on the website and in the waiting room. The wording of the second question is at the discretion of the Practice but should be an open question requiring a free text answer. A draft patient leaflet explaining the FFT and containing the first question in the agreed format was circulated to the group members present for their feedback. JAE presented a number of options for the second question to start the discussion but stressed that the PRG did not have to choose one of them. The wording of the second question was discussed at length. It was agreed that the question; should be related to the first question and should seek to encourage negative or positive comment.

The question finally agreed was as follows:

Please tell us about the main reason for your response to the first question?

Analysis of both questions will become a standing item on the agenda of future PRG meetings.

7. AOB Mr WE agreed to try and arrange a speaker for the next meeting – Subject: “Expert Patients”.

8. DATE OF NEXT MEETING

Tuesday 13th January 2015, from 7.00pm until 8.00pm



13th January 2015, 7:00 to 8:00pm

AGENDA

ITEM

1


All

2

Expert Patients Programme - Speaker – Ms Joanne Hannigan

Speaker

3

Apologies

Speaker

4



All

5


- Progress – inc. Telephone system changes - feedback Repeat prescribing system changes - feedback

All

6

Friends and Family Test (FFT) - FFT Implementation

- FFT Survey feedback - Priorities for development

All

7

Changes to the GMS Contract

- Patient Information (on-line Access) - Choice of GP Practice

All

8

Any Other Business

All

9


- Review Action Plan - FFT Survey Response - Priorities for Development (inc. Patient Reference Group) - Agree Action Plan for 2015/2016 - GMS Contract Changes 2015/2016

Chair

10

Date and time of next meeting - Tuesday 3rd March 2015, - 7:00 to 8:00pm – St. Peter’s Surgery

Chair



MINUTES OF THE MEETING HELD ON TUESDAY 13TH JANUARY 2015 1. ATTENDANCE


Mrs J Murphy Ms Joanne Hannigan (speaker)

Miss L Akins Mr W Ellens Mr K Slater

Mrs P Etchells Mr R Etchells

2. WELCOME & REGISTRATION All members were welcomed to the meeting, and wished a Happy New Year! The attendance sheet was signed on arrival and Mr JAE offered the apologies received for those that could not attend.

3. EXPERT PATIENTS PROGRAMME Mr JAE also offered the apologies for our Guest Speaker Ms J Hannigan who unfortunately was unable to attend. Mr JAE thanked Mr WE for arranging the speaker – perhaps it could be rescheduled? Action: Mr WE agreed to try and re-arrange the speaker for the June PRG meeting – Subject: “Expert Patients”.

4. MINUTES OF THE LAST MEETING The minutes of the 10.6.2014 & 16.9.2014 were approved. All previous minutes are available for viewing on the Practice Website: www.stpeterssurgery.com 4.1 MATTERS ARISING Not applicable

4.2 ACTIONS Not applicable.




The recruitment of a Receptionist has unfortunately been delayed due to the resignation of a Practice nurse and the need to recruit a Practice Nurse and an additional health Care Assistant, (HCA). Members were advised that the new HCA would be joining the Practice on 19th January. Nurse recruitment was ongoing.

Mr WE asked whether HCA’s would be able to provide flu vaccinations. Mr JAE explained the different arrangements for administering vaccinations. Practice Nurses have to sign a PGD (Patient Group Directive) which allows


the nurses to make the decision, by following the guidance and criteria in the PGD, as to when to administer a vaccine directly to a patient. For a HCA to administer vaccinations they must follow a Patient Specific Direction which means the GP has to review all patients expecting to receive a specific vaccination. However, this may be a possibility for the future but would require the HCAs to undertake further training. The practice hopes to start the recruitment programme for a new Receptionist and Cleaner in February / March. We will continue to encourage patients to use the self, check-in facility which is averaging around 75% usage at present.

Telephone System Auto Attendant Mr JAE presented to the group the results of an audit carried out since the Practice began using the auto attendant to answer all calls and automatic call distribution system against the previous method of answering calls. The audit figures showed a significant improvement with the new system – more calls are being answered within a reduced time frame. However, the Practice recognises that further improvements are still needed and expects to achieve further improvements by: Recruitment of the additional receptionist Improving the receptionist working arrangements especially during the

transition from morning to afternoon staff Gradual reduction of calls for repeat medication The extra Receptionist will also help with call answering. Mr JAE stressed that the Practice was not complacent regarding the telephone answering and really was seeking to improve the service.

Text messaging had been put on hold as there was a lack of clarity on how this would be funded. This will now be reviewed in the light of the latest pronouncements about the commissioning of a SMS service for the NHS.

Mr WE asked if we were getting more same days requests for appointments. Mr JAE stated that a Triage Audit was currently underway to review this.

Telephone Requests for Prescriptions Mr JAE confirmed the Practice had now stopped taking requests for repeat medication over the telephone, with effect from the 5.1.2015. We were expecting to have a number of complaints about this change in service. However, the campaign to inform patients with an advanced warning of up to 6 months appears to have worked well. More patients are now taking up online prescribing. Unfortunately a website app is not currently available for our online system.

Online Access and Other Identified Actions The Practice is continuing to encourage patients to use this facility and has further developments planned, see item 7 below. The access leaflet is the only item remaining for completion.

Access (Inc. Opening Hours) & Waiting times

The status of all other actions in the plan is either complete or suspended. 6. FRIENDS AND FAMILY TEST (FFT)

It had already been confirmed, at the last PRG meeting, that the FFT is replacing the need for a further patient survey. Following the discussions at the last meeting,


the Friends and Family Test is now being promoted on the Jayex board, website, waiting room posters etc. and patients are being encouraged to complete feedback both at the practice and on home visits, via the practice website. Although we do not have to publish the results until the January figures are collated the Practice has published the December results on the Practice website, excluding comments. Mr JAE shared the results and the comments received in an anonymous format with the PRG (all PRG members have signed a confidentiality agreement). Summary: A total of 24 results have been received to date, 4 were received via the Practice website. The results have been reported in line with NHS guidance.

RESULTS Extremely

likely Likely

Neither likely or

unlikely Unlikely

Extremely

unlikely Don't know

Dec 14 16 4 3 1 0 0

Of the 24 responses, 4 patients did not comment on their first answer. The majority of comments were very supportive and positive, 1 comment suggested improvements and 3 comments were inappropriate and related to immigration issues. Mr JAE stated that all patients entitled to receive NHS treatment will be treated in accordance with the Practice’s equality and diversity policy.

7. CHANGES TO THE GMS CONTRACT 2014/15 The Practice’s Patient Information (online) Service Access Statement was

published on the Practice website back in September 2014. It is a contractual requirement that by the 31st March 2015 patients will be able to access online, elements of their own medical records held by the Practice. The practice is currently making arrangements to ensure that this will be provided for those patients signed up for online services. Establishing and improving patient online access to GP services is intended to benefit not only patients but also GP practices.

GP Practice of Choice - With effect from the 1.1.2015 Practices have the right to register patients living outside the Practice area without the commitment to provide home visits for those patients. In addition, Practices were offered an enhanced service to provide home visits to those patients living within the Practice area but register to another Practice. After careful consideration the Practice decided not to extend their service to register patients living outside the area and not to take on the home visit enhanced service for patients not registered with the Practice. This decision was taken in the best interest of our current patients, to avoid additional workload that would reduce capacity and provide a distraction from our focus on existing patients

8. AOB

In response to a question from Mr WE, Mr JAE confirmed he would discuss the CQC visit and how the PRG could support the Practice at the next meeting. PRG members will be advised of the inspection date when known. Mr JAE confirmed that it will be a contractural requirement for practices to have a PRG with effect from the 1.4.2015, more details to follow when available.

9. DATE OF NEXT MEETING

Tuesday 3rd March 2015, from 7.00pm until 8.00pm



3rd March 2015, 7:00 to 8:00pm

AGENDA

ITEM

1


All

3

Apologies

Speaker

4



All

5


- Produce Annual Report

All

6

Friends and Family Test (FFT)

- FFT Survey feedback &summary report & GP Survey - Priorities for development (inc. Patient Reference Group)

All

7

Action Plan for 2015/2016 - NHS IT Letter - Agree actions for 2015/16

All

8

Changes to the GMS Contract 2015/16

- Overview

All

9

Any Other Business - Funding Applications for Premises Improvement Grants

All

10


- Speaker – Expert Patient Programme - Terms of Reference & Confidentiality Statement - Review Action Plan - FFT Survey Response - GMS Contract Changes 2015/2016 (Details)

Chair

11

Date and time of next meeting - Tuesday 3rd June 2015, - 7:00 to 8:00pm – St. Peter’s Surgery

Chair



MINUTES OF THE MEETING HELD ON TUESDAY 3RD MARCH 2015 1. ATTENDANCE


Mr J Dwyer

Miss L Akins Mr W Ellens Mr K Slater

Mrs P Etchells Mr R Etchells

Mr D Tranter

2. WELCOME & REGISTRATION All members were welcomed to the meeting. The attendance sheet was signed on arrival and Mr JAE offered the apologies received for those that could not attend.

3. MINUTES OF THE LAST MEETING The minutes of the 13.1.15 were approved. All previous minutes are available for viewing on the Practice Website: www.stpeterssurgery.com 3.1 MATTERS ARISING There were no matters arising

3.2 ACTIONS There were no outstanding actions


The action plan for 2014/15 was reviewed for the final time as follows -

Reception and Telephone Access All actions complete with the following exception Staffing Plan

The recruitment of an additional receptionist is expected to be completed by the end of April, but will be carried forward to next year’s action plan. JAE also confirmed that nurse recruitment is ongoing.

Access (Inc. Opening Hours) & Waiting times All actions complete with the following exceptions

Online Access and Other Identified Actions JAE confirmed that changes to extended hours provision, named patient and GP/nurse availability meant that the leaflet need changes befor release. Therefore, the access leaflet would be carried forward to next year’s plan.

Text messaging is now a possibility and will be reviewed in the light of the latest pronouncements about the commissioning of a SMS service for the NHS.


5. FRIENDS AND FAMILY TEST (FFT) & GP Patient Survey The Group were shown the results of the FFT survey and summary report, from December 2014 to February 2015 and the results of the GP patient survey to identify areas for development.

FFT Results

RESULTS Extremely

likely Likely

Neither likely or unlikely

Unlikely Extremely unlikely

Don't know

Dec 14 16 4 3 1 0 0

Jan 15 16 3 2 0 0 0

Feb 15 23 7 0 0 1 1

58 Positive comments, 7 Negative comments (see below), 13 patients did not make a comment). Discussion took place surrounding patient comments and areas of concern. Key issues noted were: appointment access, length and waiting times, telephone answering, list size, languages and use of technology

Mr JAE pointed out that there were some discriminatory comments that the Practice would not be responding to. In addition, it would be difficult to address the length of appointment times and the list size as these figures were broadly comparable with other local and national Practice figures. However, telephone answering waiting times the use of technology to improve access were all issues that could be addressed.

Furthermore the GP Patient Survey also highlighted the areas for improvement around getting appointments, telephone answering and waiting times

It was agreed that whilst the Practice had made significant improvements one of the key issues for further development, as identified above, was the surgery’s telephone answering service, appointment access and waiting times.

In addition, following discussion on the development of the PRG it was agreed that we should seek to engage representation from the younger element of the practice list.

6. ACTION PLAN FOR 2015/16

NHS IT letter In setting the objectives for the 2015/16 action plan JAE provided the group with a copy of an NHS England document outlining the practice’s contractual responsibility to “offer and promote to patients: online booking of appointments, online ordering of repeat medications and online access to summary information within patient records (allergies, medications, adverse reactions)”. JAE felt it was important to make the group aware of the drive by NHS England to extend the use of technology to improve accessibility of NHS services. The Practice’s own Patient Information (online) Service Access Statement was published on the Practice website back in September 2014.

JAE pointed out that it is a contractual requirement that by the 31st March 2015 patients will be able to access online, elements of their own medical records held by the Practice. The practice is currently making arrangements to ensure that this will be provided for those patients signed up for online services. Establishing and improving patient online access to GP services is mandatory and intended to benefit not only patients but also GP practices.


Agree Actions for 2015/2016 Following the general acceptance of the key issues identified by patient feedback

Mr JAE asked the PRG members for their thoughts on setting realistic targets to be achieved by the Practice Receptionists, with regard to telephone answering. A number of objectives were agreed to form the action plan for 2015-16 – See the PRG action plan 2015/16. Specifically in the following areas:

Telephone answering targets Performance reviews are currently being conducted on a regular basis. As previously discussed, since the Practice had begun using the auto attendant to answer and distribute calls, the figures have shown a significant improvement, with 90% of calls being answered within 2:45 minutes compared to previous figures of 4:50 minutes. The Practice, however, recognises that further improvements are still needed. In reply to a member’s question, JAE confirmed there are no NHS targets to comply with, in terms of telephone answering times, any targets set would be the Practice’s personal targets. Following discussion it was felt that a target of 90 in 90 (i.e.90% of calls answered in 90 seconds) should be set.

Appointment access - Online Nurse appointments Mr BE suggested the possibility of making general nurse appointments available online. Mr JAE agreed to look into this.

7. GMS Contract Changes 2015/2016 Mr JAE discussed the forthcoming changes to the current contract and provided a list of the contractual additions. JAE confirmed OOH services were not provided directly by St. Peter’s Surgery. The changes and impact would be explained in more detail over the next 12 months as the details were made available.

8. AOB CQC Visit

As previously discussed, JAE confirmed CQC Inspectors would be keen to talk to both staff and patients of the practice. Therefore, JAE extended an invite to all members of the PRG to participate in discussions during the CQC visit. PRG members will be advised of the inspection date when known. Several members expressed a desire to participate in the inspection process.

Premises Development Funding Bid

JAE confirmed the Practice had submitted a funding bid for upgrading four of the Practice’s existing consulting rooms. The group expressed their support for this bid.

9. DATE OF NEXT MEETING Tuesday 2nd June 2015, from 7.00pm until 8.00pm


APPENDIX 3

ST PETER’S SURGERY – Patient Reference Group Action Plan 2014/15 – Final Status Statement

Reception & Telephone Access Action agreed Who When 1 Review reception staffing plan Practice

Manager & Reception Staff

Apr / May 2014 - Currently under review. Doctors agreed to an additional receptionist (PM). Delays due to recruitment of nursing staff. Recruitment to start in February 2015 - C/fwd

2 Encourage patients to use the self-check screen and drop prescription requests off in the box provided to reduce reception workload


Apr 2014 - COMPLETE & Ongoing

3 Have all calls answered by the auto attendant to queue calls more effectively and re-route from reception. (C/fwd)


Sept 2014 – COMPLETE Telephone system investigated – changes planned. New system now operating.

4 Stop telephone requests for repeat prescriptions to reduce calls – Stage 1 issue warning of change Subject to PRG waiting room survey and further discussion

Practice Manager Practice Manager & PRG

Jan 2015 – COMPLETE Sept 2014 to Mar 2015 Doctors recommending a stop to telephone requests for repeat prescriptions (for reasons of patient safety and compliance) In line with MPS advice. Patient leaflet agreed Will be supported by actions 2,5 & 6

5 Aggressively promote use of the internet for repeat prescribing and appointments to reduce call volume


July 2014 – COMPLETE & Ongoing

6 Review and improve advice on how and when to contact the surgery by telephone

Practice Manager & Reception Staff

Dec 2014 – COMPLETE & Ongoing Website being updated as required

7 Investigate telephone website access via “Apps”

Practice Manager

July 2014 - COMPLETE Investigated – Appointments and website access for EMIS Web. Not viable for St. Peter’ at this stage

Access (Inc. Opening Hours) & Waiting times 8 Audit Non-attendance - Patients not

attending appointments should be warned and persistent DNA offenders removed from the practice list. To prevent wasted appointments

Practice Manager

Sept 2014 - COMPLETE

9 Provide feedback to the Patient Reference Group (PRG) on the DNA audit

Practice Manager

Sept 2014 - COMPLETE

10 Review and improve patient information on Access rights, GP availability, appointment system, triage (its purpose and operation) and the effect of DNAs

Practice Manager

June 2014 – In Progress can now include new telephone access Draft leaflet with GP’s for comment To carry forward 2015/16

11 Investigate the use of text messages to improve patient communications and DNAs

Practice Manger

Awaiting review of SMS costs New scheme now agreed for one year Subject to GPSoC approval of BMJ software To carry forward 2015/16

12 GPs to consider weekend access GPs & Practice Manager

June 2014 – COMPLETE Doctors reviewed the Saturday morning access data Jan to Feb 2014. CCG have now with drawn funding – Not financially viable


APPENDIX 4

St. Peter’s Surgery – Family and Friends Test Results

RESULTS Extremely likely

Likely Neither likely or unlikely

Unlikely Extremely unlikely

Don't know

Totals

Dec-14 16 4 3 1 0 0 24

Jan-15 16 3 2 0 0 0 21

Feb-15 23 7 0 0 1 1 32

TOTALS 55 14 5 1 1 1 77

71.43% 18.18% 6.49% 1.30% 1.30% 1.30% 100.00%

FFT Results ‐ Comments Summary

58 Positive comments,

7 Negative comments (see summary of key issues below)

13 patients did not make a comment)

Patient Generic Comments – Areas of Concern Take too long for routine appointments. Take too long to answer the phone. Waiting times once you have an appointment are too long.


St. Peter’s Surgery – GP Patient Survey Results 2014

What this practice does best

96% of respondents say the last nurse they saw or spoke to was good at treating them with care and concern

Local (CCG) average: 91% 96% of respondents say the last nurse they saw or spoke to was good at giving

them enough time Local (CCG) average: 92%

94% of respondents say the last nurse they saw or spoke to was good at explaining tests and treatments Local (CCG) average: 91%

What this practice could improve

34% of respondents find it easy to get through to this surgery by phone Local (CCG) average: 76%

51% of respondents usually wait 15 minutes or less after their appointment time to be seen Local (CCG) average: 71%

60% of respondents describe their experience of making an appointment as good Local (CCG) average: 74%

patient survey report & action plan march 2015 · 2015. 3. 25. · the first meeting...

Documents