substance misuse prescribing policy · web view · 2015-03-11march 2013. contents....
TRANSCRIPT
Contents
1 Introduction...........................................................................32 Step 1: Form a group............................................................4
2.1 Steps taken to engage people.........................................................4
3 Step 2: Agree patient priorities............................................43.1 Process...........................................................................................4
3.2 Issues produced at meeting on Wed 4th July 2012..........................5
3.2.1 Duplicate surgery letters...........................................................5
3.2.2 Telephone access.....................................................................5
3.2.3 The waiting room experience....................................................5
3.3 Priority areas...................................................................................5
4 Step 3: Conduct a patient survey........................................54.1 Introduction......................................................................................5
4.2 Results............................................................................................6
5 Step 4 + 5: Review survey and Action Plan........................66 Step 6: Publicise actions......................................................7
Date: March 2013
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1 Introduction In the autumn of 2011 Central surgery reformed its Patient Reference Group (PRG). This group is representative of the practice population and its views, alongside findings from local practice surveys, suggest priority areas for practice change. The PRG produced an action plan which has been agreed with the practice and the PRG. During 2012 and early 2013 the group met twice with a core of 7 to 10 participants. We are open to taking new participants.
PRG ObjectivesStep 1: Develop a structure that gathers the views of patients and enables the practice to obtain feedback from the practice population, e.g. a PRG
Step 2: Agree areas of priority with the PRG
Step 3: Collate patient views through the use of a survey
Step 4: Provide the PRG with the opportunity to discuss the survey findings and reach agreement with the PRG on changes to services
Step 5: Agree an action plan with the PRG and seek PRG agreement to implementing any changes
Step 6: Publicise the actions taken and subsequent achievement
Expected OutcomesPatients have their say
Action is agreed with the practice
Actions and changes are publicised to patients’
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2 Step 1: Form a groupTable 1 shows why we selected groups of patients to belong to our PRG. Some members belonged to more than one group.
Table 1: Sample for the PRG
Type Reason NoNew patients 1,100 new registration in 2010 and 1,554 new
registrations in 20112
Unemployed 9.6% of South Shields population unemployed (2011)
1
Carers Important group 3
Long term chronic illness
Area that we want to develop where continuity of care and planned care is crucial
3
BEM Minority group 357 of 12,100 patients 1
Elderly >65 and over 75 – 1,092 65-74 and 1,157 over 75 – growing group
3
Learning or other disabilities
46 patients – 2 carers in group 2
Parents children
1,975 children under age 15yrs 2
2.1 Steps taken to engage peopleNew patient health checks personal invitation
Chronic conditions group
Substance misuse carer
Personal knowledge
Advertising practice website, screen, flyers, word of mouth
Two new members joined in 2012-13: the partner of one of the original members of the PRG and a patient member of South Tyneside Clinical Commissioning forum
3 Step 2: Agree patient priorities
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3.1 ProcessInformation and data was presented by practice on good and less good performance from the national patient survey, practice based commissioning improvements e.g. reducing ENT referrals and practice initiatives – nurse led same day service, and practice review of performance.
The group produced a list of issues which after discussion were loosely prioritised. The item of highest priority was receiving duplicate mail for abnormal investigations.
3.2 Issues produced at meeting on Wed 4th July 2012
3.2.1 Duplicate surgery letters Duplicate letters: “Sometimes you get two letters about the same
thing and you are not sure what is going on – is it serious or not…Why can’t they just pick up the phone and call – it must save a lot of time.”
3.2.2 Telephone access “This has improved dramatically since the last PRG…But can
you keep it going so that we don’t go back to where we were before?”
We like online appointment booking but make more available and for further in advance. “You should promote it more.”
3.2.3 The waiting room experience There is still a lack of communication about the wait or delays.
“Waiting time can be horrendous…I was waiting an hour.”
3.3 Priority areas Duplicate letters for appointments for test results or other
queries Sustaining telephone access and communication Improving the waiting room experience
4 Step 3: Conduct a patient survey
4.1 IntroductionThe patient survey was designed from patient priorities and questions found on the NAPP website.
120 patients were sampled as an ‘exit poll’ of patients – previous research has shown that mailing out questionnaires produces a very poor response
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rate. This was stratified so that patient questionnaires were given to patients on all day of the week (including Saturdays) and times of maximum use (normally mornings).
4.2 ResultsThe results were shared with the PRG on Monday 4th February 2013. It was missing our questions about “too many letters” but we will survey our patients with these questions in the next few weeks. The key areas that they commented on or were concerned about;
Good performance;It shows good quality of care by doctors and nurses, sustained telephone improvements compared to last year, improved communication for ‘waiters’, high levels of satisfaction about the service and support for a patient volunteer programme.
Less good performanceIt showed less good responses about ‘having to ring back for an appointment’ - that is counter to practice policy – but the group members agreed that this is the patient experience. The group reiterated their concerns about being sent “too many letters.”
5 Step 4 + 5: Review survey and Action Plan The following action plan was agreed with the group at a meeting where the survey was presented. This was then discussed and agreed with the practice who took action to improve services. Improvements to March 2013 are included.
Table 2: PRG Action Plan from 05/03/2013 and progress to date
What - ‘you said’ When – ‘we did’
Duplicate letters – “do something”
‘Action Clerk’ now routinely checks that there are not duplicate requests for same person before sending letters out
We now send letters for Chronic Disease Check up’s with prescriptions; it is a more efficient reminder and saves money
Educational meeting – we talked to all 11 GPs and 6 nurses about how to manage patient queries (e.g. medication changes noted in hospital letters). Other options include a personal phone call rather than an impersonal letter
A survey is underway to look at patient perceptions about this problem.
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Can you sustain telephone answering improvement?
Survey date showed mixed views – overall improvement.
Patients rated staff performance on the telephone as very good despite several new and inexperienced junior staff
A survey of telephone performance is done every 4 months
We are still being asked to ring back if there are not appointments
The data from the survey confirms this is other patients’ perceptions too. This is not our policy. It will be addressed by reception staff training.
Can you improve the waiting room experience – “long waits for some GPs”
Some GPs have already acted on data about their waiting time.
This will be addressed at a future educational meeting with data about GP and nurse surgery waiting times
Volunteering The Patient group liked this idea a lot. Morris and Alison will work up these ideas for the September meeting.
Commissioning – “we want to know more”
Dr Jon Tose or another GP from the commissioning group will come to the May meeting
“Unhappiness” with aspects of the service at Cleadon Park pharmacy
Cleadon Park pharmacist has agreed to come to May meeting
6 Step 6: Publicise actionsThe above action plan was placed on the practice website on 15 th March.
A leaflet explaining the plan and improvements was distributed to patients.
Text was placed on the waiting room screen.
Date: March 2013
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