Patient Participation Group (PPG) Report 2013/2014

Component 1- Profile of the PRG

       The Patient Reference Group (PRG) is made up of registered patients of Lambeth Walk Group Practice only. The most recent meeting was held on 24 th March 2014. Prior to that we met in Jan 2014 and March 2013. All the meetings have been held at the Practice.

The wider PRG is made up of 120 registered patients that have actively taken an interest in attending patient participation meetings at the practice. The PRG attendees were asked to register at the beginning of each meeting. The age range of members is from 5 - 85 years. This highlighted that we were attracting parents to the meeting who would bring along their children.

The PRG meetings consisted of a range of patients as follows:

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Those at retirement age (~65) constituted 34% of the PRG with the rest being either employed, students or unemployed with an average age of 58 years old. The ethnicity of the patients attending was 42% White, 36% Black, 6% Asian, 5% Chinese/Other, Mixed 3% & 8% unknown. This is a fair representation of our current demographic. The demographic breakdown is available on the

Practice website.

According to Data Net Dashboard the wider practice population consists of 46% White, 20% Black, 4% Asian, 4% Chinese/Other, Mixed 4% & 22.5% unknown. The top 4 non English main languages spoken among patients are Spanish, Portuguese, Arabic and French. It was noted that these groups were under represented in our PPG meetings and we are taking steps to attempt to include these groups.

Component 1- Profile of the PRG

 We took several steps to ensure we reached the Practice demographic as follows:

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Meetings held in the evenings so patients who work during the day or unsociable hours could attend meetings. 2.

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We attempted to target the patient population who speak Spanish by asking our Spanish speaking doctor to actively encourage her patients to come along to the group meetings.

We’ve translated surveys and invitations into Spanish.

We asked our Portuguese speaking Secretary to engage with patients and invite them along to meetings personally.

We’ve texted meeting details to all patients with a mobile number in their records.

PRG meeting dates are advertised in the surgery waiting areas.

PRG meeting dates and minutes are available on the Practice website. We’ve emailed patients and tried to encourage them to send their views via email if they are not able to attend meetings.

We will continue to take measures to make sure the group is representative of our practice population and have a new website due for release in April 2014 which has a translation facility in over 45 languages. This will allow for all the published PPG dates and meeting notes to be available to non English reading patients.

The surgery has full disabled access and we accommodated patients who attended with visual impairment and hearing impairments. We were aware from analysing our PRG group attendance that the group was representative across the board for some of our chronic diseases including diabetes and COPD.

Component 2 - How we agreed to and designed the Patient Participation Survey 2014

   The group met on 13 th met on 24 th January 2014. Prior to that we met in March 2013. We also March 2014.

Patients discussed their thoughts on things that needed improvement within the practice. We derived a list of important areas following the adoption of the minutes from the meeting in January in agreement with the PRG. Some of these issues were also taken from patients who had sent in complaints, national GP survey results for the Practice and from patients who had taken the time outside of the meeting to give us their feedback on issues arising. The main issues agreed upon for the survey with the PRG were as follows: 1.

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Continuity of access to the same GP Appointment convenience Repeat prescription process Appointment availability Emailing letters Overall Practice service

Component 3 Pt 1- How we carried out the Practice Survey

    We firstly designed the survey by creating a list of questions designed to engage patients in expressing their opinions according to the ideas and areas we had gathered from the PRG and other areas of feedback. With the aid of an online tool we were able to have an electronic, interactive version of the survey as well as paper copies for completion.

We used ‘Survey Monkey’ to design the layout and for final collation of the results.

Patients then had several options to complete the survey and we used several methods to advertise and communicate that the survey was running:

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Information regarding the survey was displayed on our website with a link to survey monkey or the option to download a paper copy and bring it in to reception. Paper copies were available at reception Clinicians had copies in the consulting rooms. The survey link was emailed out to patients with a covering email explaining the purpose of the survey, also with a option to opt out, as is required with all surveys.

Text messages containing the hyperlink for the survey were also sent out.

We remembered from previous years that our Spanish patients would not be able to fill out copies of the survey in English so we used ‘Google Translate’ to create a version in Spanish and ensured copies of it were available in reception and the consulting rooms.

The survey ran for 14 days.

The Statistics

     In total we gave out 40 copies of the paper survey and had responses from 28 patients. We sent out the survey monkey link to 784 patients by email and had responses from 56 patients.

We text the link to the survey to 5,800 patients as well as putting the link on the practice website. We had responses from 294 patients. In total we had 378 responses to our survey.

Some of our online survey takers were able to skip questions which also proved to be valuable data as it confirms the null hypothesis; if they skipped the question it is because the question did not apply to them from which we could derive a solid conclusion.

Component 3 Pt 2 Summary of Evidence

Q1. D o yo u e ve r sta te a p re fe re nce o f d o cto r whe n b o o king yo ur a p p o intme nt?

Answe r Op tio ns R e sp o nse Pe rce nt R e sp o nse Co unt YES NO 55.3% 44.7% a nswe re d q ue stio n skip p e d q ue stio n 209 169 378 0 Q2. H o w o fte n ha ve yo u se e n the GP o f yo ur cho ice ?

Answe r Op tio ns Once a year or less 2-3 times a year 4-5 times a year 6-7 times a year More than 7 times a year R e sp o nse Pe rce nt 37.8% 34.1% 12.4% 5.8% 9.8% a nswe re d q ue stio n skip p e d q ue stio n R e sp o nse Co unt 143 129 47 22 37 378 0 Q3. In yo ur o p inio n, a re the y usua lly a va ila b le whe n a sk to se e the m?

Answe r Op tio ns YES NO R e sp o nse Pe rce nt 61.9% 38.1% a nswe re d q ue stio n skip p e d q ue stio n R e sp o nse Co unt 234 144 378 0

Summary of Evidence

Q4. If yo ur d o cto r is no t a va ila b le , wha t d o yo u d o ?

Answe r Op tio ns Opt to see another doctor Wait till chosen doctor is available R e sp o nse Pe rce nt 82.8% 17.2% a nswe re d q ue stio n skip p e d q ue stio n R e sp o nse Co unt 313 65 378 0 Q5. Ple a se ind ica te if yo u ha ve use d a ny o f the La mb e th W a lk clinics b e lo w.

Answe r Op tio ns Walk In Clinic Telephone Triage Booked Appointments R e sp o nse Pe rce nt 86.1% 25.8% 63.3% a nswe re d q ue stio n skip p e d q ue stio n R e sp o nse Co unt 310 93 228 360 18 Q6. H a s the re e ve r b e e n a n o cca sio n whe re yo u we re no t a b le to a cce ss a ny o f the clinics me ntio ne d b e lo w.

Answe r Op tio ns R e sp o nse Pe rce nt R e sp o nse Co unt Walk In Clinic Telephone Triage Booked Appointments 20.9% 17.3% 69.8% a nswe re d q ue stio n skip p e d q ue stio n 29 24 97 139 239

Summary of Evidence

Q7. D o yo u ha ve re p e a t p re scrip tio ns?

Answe r Op tio ns YES NO R e sp o nse Pe rce nt 54.1% 45.9% a nswe re d q ue stio n skip p e d q ue stio n R e sp o nse Co unt 203 172 375 3 Q8. H a ve yo u e ve r e xp e rie nce d a n issue o r d e la y whe n co lle cting a re p e a t p re scrip tio n?

Answe r Op tio ns R e sp o nse Pe rce nt R e sp o nse Co unt YES NO 18.8% 81.3% a nswe re d q ue stio n skip p e d q ue stio n 63 273 336 42 Q9. H a ve yo u e ve r e xp e rie nce d a ny o f the fo llo wing p ro b le ms with yo ur re p e a t p re scrip tio n?

Answe r Op tio ns Incorrect Prescription received Not done in 48 hours Medication not listed as a repeat item Signed prescription lost Prescription requested lost R e sp o nse Pe rce nt 23.1% 41.8% 31.9% 7.7% 17.6% a nswe re d q ue stio n skip p e d q ue stio n R e sp o nse Co unt 21 38 29 7 16 91 287

Summary of Evidence

Q10. W o uld yo u find it use ful to ha ve le tte rs fro m the surg e ry se nt to yo u b y e ma il inste a d o f p o st?

Answe r Op tio ns YES NO R e sp o nse Pe rce nt 69.0% 31.0% a nswe re d q ue stio n skip p e d q ue stio n R e sp o nse Co unt 254 114 368 10 Q11. On a sca le o f 1-10, ho w like ly a re yo u to re co mme nd T he La mb e th W a lk Gro up Pra ctice to frie nd s a nd fa mily if the y ne e d e d simila r ca re o r tre a tme nt? 1 = Extre me ly unlike ly 10 = Extre me ly like ly Answe r Op tio ns 1 2 3 4 5 6 7 8 9 10 R e sp o nse Pe rce nt 2.2% 2.5% 1.9% 2.7% 6.8% 6.3% 11.4% 20.7% 11.7% 33.8% a nswe re d q ue stio n skip p e d q ue stio n R e sp o nse Co unt 8 9 7 10 25 23 42 76 43 124 367 11 Q12. W o uld yo u re co mme nd this surg e ry to frie nd s a nd fa mily?

Answe r Op tio ns YES NO R e sp o nse Pe rce nt 89.9% 10.4% a nswe re d q ue stio n skip p e d q ue stio n R e sp o nse Co unt 330 38 367 11

Summary of Evidence & Results

o o o o o o 378 people took the survey. Some questions could be skipped.

Q1 – 40% patients gave no preference to which GP they wanted to see – we could put posters at reception to let patients know they have a choice to request a GP at the walk in clinic.

Q2 – In retrospect we realised that this question was difficult to interpret and it therefore did not give us as much information as we would have liked. We did not set enough parameters when asking the question. We therefore decided not to use this information when analysing the results.

Q3 – 38% answered No – GP could be busy, patient may not want to wait, particular GP may not be in that day.

Q4 – 83% would not wait to see chosen GP at another time, we assumed that the 17% that chose to wait had a problem that did not require immediate attention. Q5 – The majority of responders had used the walk in clinic (WIC), with far less at 25% using telephone triage (TT) and 63% accessing booked appointments (BA). The TT result was surprising and we concluded from the PRG feedback that not everybody is aware of the meaning of telephone triage system.

Summary of Evidence & Results

o o o o Q6 – 2/3 of patients did not answer this question. 135 patients did. We presume 233 have always had access. Most dissatisfaction with BA – increase access/rota. Opening times – extended hours. 20% not attending WIC. Q7 – 55% (203 people) of patients who took the survey have a repeat script. Q8 – 81% of these patients have not experienced a problems with their repeat scripts.

Q9 – 62 (of 203) patients said they had experienced a problem with their script but there were 91 responses to this which highlights that patients were experiencing more than one problem with repeat scripts as patients could tick more than one of the options.

Summary of Evidence & Results

o o o Q10 – Emailing letters from the surgery – generally positive response, 70% of patients happy to be emailed. We noted that we would need to ensure we had express permission from patients and collection/constant updating of email addresses in order to ensure confidentiality – a specific process would be required to maintain safe information governance.

Q11 – Recommending the Practice - Qualitative interpretation.

Q12 – 90% would recommend to family and friends. 357 people answered. Similar percentages between Q11 & 12.

Component 4 - Steps taken to get the PRG to discuss the survey and action plan

        The results of the survey were discussed with the PRG at the meeting on 24 th March 2014.

Each point was discussed in detail.

A plan of action was then formulated based on the opinions and feedback of patients regarding steps to be taken to mitigate and solve some of the problems patients expressed they have been experiencing at the practice.

We were also able to look at common suggestions derived as a result of group thinking regarding the survey results.

The findings of this survey will be implemented with a specific timeline and followed up at the next meeting in July 2014. Some of the findings were actually already being tackled by the surgery as a result of previous PRG meetings and email communications/letters of suggestion at the time of the survey results being released. We found that upon speaking to patients about the findings of the survey, a general trend of thought evolved.

We will consult the PRG as we go along informing the group of the progress intermittently by email, the practice website, practice newsletter and text messages if appropriate.

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Component 5 – Action Plan following discussion of the Patient Participation Survey 2014

The PRG met on 24th March 2014. The main action points that the PRG members discussed and agreed upon following the review of the survey are as follows:

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Ensure text messages are not being delivered by patients at unsociable hours. April 2014 – Practice Manager to review process and prevent this.

Possibly change the name of ‘Telephone Triage’ to ’Telephone Consultations’ but more importantly increase patients awareness of this service. Review at June 2014 PRG meeting - All.

Increase advertising and understanding of Nurse Practitioner/Practice Nurse team service to increase uptake. – April 2014 – via new information screen in reception and on website – Practice team. Increase awareness that the walk in clinic is a general clinic, not just for urgent or emergency purposes only. April 2014 – via new information screen in reception and on website – Practice team. Continue to review our extended hours provision so that it can reach the needs of more people. Review at staff quarterly meeting in May 2014 and feedback to the PRG in June 2014 Contacting of patients with results – general query around current process which was explained and patients accepted. No further action.

The practice to review the Prescription process and ensure we are issuing scripts effectively. Review in June 2014 at PRG meeting .

Component 5 – Action Plan following discussion of the Patient Participation Survey 2014

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9. Large print letter – to identify patients who require this and ensure correspondence in writing from the Practice is sent to them in this format. June 2014 – Practice team Relay Health – A patient suggested the Practice take a look at this site which is often used by American General Practitioners as a way to look alternative means of communication. The patient felt that the site was full of so much information that he did not always need to see his GP. June 2014 – All.

10. Care.data – patient would like more information relating to this subject (the go live date has been postponed for 6 months). June 2014 – Practice team 12. Reception – too much information in the reception at present. To consider new ways of arranging information and communicating with the patients. Patient suggested that we could take away the majority of the leaflets and instead use the reception area to display information about the practice in a very clear way. This would minimise patient’s confusion and would give more clear and direct information. To be reviewed and updated in April – progress published on the website by April 30 th Practice team 13 . DNA – to consider ways to reduce this making patients aware of the consequences and impact on other patients when they DNA. Review June 14.

2014 PRG meeting Choose and Book – consider a review of this as it seems to be problematic making appointments in this manner – consider patient poll and ask for feedback - Action May 2014 – Practice team

Details of the action plan

 We needed to look at the continuity of care for all patients as over 60% of patients who responded to the survey see the GP 2 or more times per year.

The PRG decided that we should:

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Ask the surgery to launch a campaign that educates patients about the importance of seeing the same GP when they attend the surgery. – April 2014 – Practice team The campaign could consist of adding information to the practice website April 2014 – Practice team Doctors could be better at asking patients to come back and see them – discuss at May 2014 quarterly Practice team meeting.

Receptionists helping patients to remember who they last had an appointment with by looking back in the clinical records when booking appointments or registering patients in the walk in clinic – on-going.

Practice Opening Hours

     We are open from 8.00am – 6.30pm Monday to Friday. We do not close at any point during the day. There is always a doctor on site during this time.

The Practice closes on designated afternoons for protected learning time as agreed with the CCG for staff training and education (this is not more than 3-4 times per year).

During times when the Practice is closed for protected learning we get cover from SELDOC. We always ensure we give patients notice of this via the website, notices in reception and posters placed outside the building. We change the telephone messages to reflect the closure and calls go straight through to the SELDOC team .

There are various methods of obtaining an appointment during the opening hours mentioned above. We have: 1.

The walk in clinic – open to all registered patients. This runs on a first come first served basis from 8.30am – 10.30am.

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We also offer booked appointments in the afternoon which run between 1.30pm – 6.30pm with a variety of doctors & nurses. We have some booked morning appointments. We also offer Early morning appointments 2 days a week.

We also have booked telephone appointment consultations on a daily basis.

Extended Hours

  Lambeth Walk currently has an extended hours access programme. We offer early morning appointments Monday and Wednesday mornings from 7am 8am.

These appointments are available to all registered patients .