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PPG 2012

GP lead

Dr Elaine Davenport

Practice lead

Nikki Long (practice manager)
Alison Wakeling (PA to practice manager)

Lead patient contact

Christopher Sell

 1. Orchid House Surgery is situated in the town of Ferndown. The practice covers a wide residential area, there is a range of housing from owner-occupied, rented accommodation and social housing.

Our average practice population is 8365 of which 4052 are under 55 and 4313 are over the age of 55 of those, 3062 are over 65, many with chronic long-term disease management issues. We have a very minimal annual turnover of patients.

The age distribution is as follows:

REGULAR PATIENTS IN MAR 2012. BASE IS NATIONAL POPULATION UK 1988

Age Groups

10-4

5-16

17-24

25-34

35-44

45-54

55-64

65-74

75-84

85-89

90+

Males

127

416

278

310

381

503

580

613

506

138

61

Base

280

575

618

619

582

461

426

323

166

18

7

Percent

45%

72%

45%

50%

65%

109%

136%

190%

304%

754%

833%

Females

129

392

274

302

394

548

673

696

653

246

145

Base

266

543

592

611

581

459

448

413

288

52

37

Percent

48%

72%

46%

49%

68%

119%

150%

169%

227%

477%

393%

 

Total Males:

3913

Base:

4076

%:

96%

Total Females:

4452

Base:

4289

%:

104%

Total both sexes:

8365

Base:

8365

%:

100%

 The ethnic distribution of our general practice population is as follows:

No of patients in each ethnic group

No of Patients

%

White British

8107

97%

Mixed British

0

0%

Irish

20

0.24%

Other White Background

85

1.02%

White and Black Caribbean

5

0.06%

White and Black African

5

0.06%

White and Asian

0

0%

Other Mixed Background

5

0.06%

Indian or British Indian

7

0.08%

Pakistani or British Pakistani

3

0.04%

Bangladeshi or British Bangladeshi

10

0.12%

Other Asian

38

0.46%

Caribbean

1

0.01%

African

7

0.08%

Other Black Background

13

0.16%

Chinese

6

0.07%

Other

53

0.64%

Total

8365

 

2. We approached all of the following:

• The elderly
• Retired people
• People who work
• Carers
• Terminal patients
• Vulnerable Group
• Patients with learning disabilities
• Nursing/Care home residents
• Ethnic minorities

The VPPG membership has representation from the following groups:

• The elderly
• Retired people
• People who work
• Carers
• Terminal patients
• Rest home residents

It was not possible to get representation from the following:

• Drug users (non representative of Practice population)
• University students (as not applicable to Ferndown)

The practice population does not include any marginalised group nor is there a high incidence of drug users in the population.

Marginalised group:
Homeless
Refugee or asylum seekers
Black minority ethnic communities
Gypsy /Traveller
Ex-Offenders

3. As all of our patients are considered members of our VPPG new patients are also recruited via the new patient questionnaire which now includes an area for email addresses and contact consent.

We provide separate sign up sheets along with our patient survey in our waiting room on our information table for most of the year.

We have an ongoing poster campaign in our waiting room encouraging our patients to join our VPPG.

We had a VPPG sign up campaign at our recent flu clinics.

We also have information on our website explaining about our VPPG and advising our patients how to join up if they wish to.

We have added a sign up form to our website so the patients can sign up straight away.

We have also added to our repeat prescription section on our website a ‘VPPG advert’ to target patients that don’t frequently attend the surgery and use our website to request prescriptions.

We also sent letters out to patients identified as infrequent attenders.

4. We feel that we have offered as many of our patients as possible the opportunity to sign up to the PPG by the various advertised means as above.

Although the age / gender distribution may not accurately reflect the registered population of 50:50, it was felt that it is reflective of the population of regular users of the surgery and those who voluntarily wish to get involved with our PPG.

Infrequent attenders were sent mail shots (see above link) to invite them to join our PPG they also have easy access to our up-to-date website and if requested we will happily post any of our patients our newsletter.

Our newly appointed Tracker Nurse has targeted the more vulnerable patients that we have on our list and invited them to engage with our PPG group.

5. The PPG members were polled in the following way:

Upon signing up to join our PPG, members were directed, via Email, to our website to complete an online survey about visiting our surgery and the service we offer.

Another email was sent to all 161 members of the group in order to gain feedback on any areas the patients felt we needed to improve on and to help us target areas for the patient survey.

Of the 161 emails we sent, we had 63 replies. The following issues were consistently raised by the PPG as areas that need improvement:

• Patients ringing in at 8:30am
• Lines constantly engaged
• The patients do not understand what ‘triage’ means – despite the handouts and staff advice
• Patients want to be able to phone up once and either book an appointment on the day or further in advance.

So based on the above results the most important issues for the patients were telephone access and ease of pre-booking an appointment.

6. Our patient survey was drawn up including the above findings. We polled a cross section of the practice population on telephone access, GP access, our “on-call” Doctor system, regarding extra on-site services we could offer and we asked them for comments and suggestions on how we might improve our service.

The survey was carried out both in house, via a waiting room campaign, and by direct mailing to a random sample of infrequent attenders, in order to get all views, over a 4 week period. The patients were asked to put the anonymously completed forms into a box in reception or return to the practice.

7. The practice decided to conduct its own survey using word. The results were collated by a proficient member of the admin team through an excel spreadsheet. The results were presented within the survey on a word document and published on our website.

The results of the survey with our follow up comments were forwarded to all members of the PPG for their input.

8. The group were invited to discuss the findings via email and encouraged to come up with their own suggestions for ways of improving our services.

These suggestions, together with the patient comments from the survey, were brought to a meeting to be discussed with the GPs in order to form the basis of the action plan.

9.

Survey finding/proposal

Recommendation

Ringing in at 8:30

Opening phone lines earlier (e.g. 8:00)

Workers can't phone during working hours

To offer an online appt booking system

Unable to get an appt

Offering more pre-bookable appt and less on-the-day particularly for the following day

10. Number of patients surveyed for our 2012 patient survey: 500

Percentage of surveys returned: 31%

The statistics showed that 28% of patients polled were not happy with our telephone system and that 24% were not happy with our ease of access to a Doctor on the day.

We felt these statistics were reasonable in comparison to previous surveys, so we focused on the recurrent comments from the PPG and the patient survey which consistently noted patient difficulty in getting through on the phones at 8.30am (“bottleneck”/”phone lottery”).

11. Following a meeting with the GPs due consideration was given to opening the phones for general appointment use at 08:00, however upon discussion it was realised that this would still result in a “bottleneck” problem only 30 minutes earlier than we have now.

Patient booking via the phone system was looked into and a representative came to give us a demonstration. Whilst this system did look to be useful there was no additional funding available. We have now looked to our current system supplier to demonstrate their version of online booking. A demonstration has been booked for May 2012 to see how this could improve our service.

We have, in the past, increased the period of time that pre-book able appointments become available in & all the GPs have had extra appointments added onto all their surgeries. The ratio of pre-book ables to book on day appointments was discussed.

The agreed action plan was then focused to achieve the following aims:

Recommendation/Proposal

Action to be taken

Opening the phone lines earlier i.e. 8am

After discussion it was agreed that all we would be doing is having the “bottleneck” at 08:00 rather 08:30. We also had to consider the extra staffing costs this would involve alongside extended hours and after further consideration we will not be implementing this at this time.

Offering an online appointment booking system

We consider this as a workable addition to our current system, which could bring significant benefits to the patients and may address some of the “bottleneck” problem we experience in the mornings. Demonstration arranged with our system provider for May 2012.

Consider revising the appointment system to offer more pre-bookable appointments (particularly for the following day) and less on the day appointments to try and alleviate the need for the patients to ring back the following day.

We offer an all day every day telephone triage system which is based on patients having on the day access to a GP.
We are changing the release times of the pre book able appointments so that they are all released at 8:30 rather than staggering them at 8:30 and 11:00 in the hope that this may address some of the telephone issues.

 

12. We do not have any proposed contractual changes that would require discussion with the PCT.

13. Our surgery is open from 08:00 until 18:30 Mon-Fri, our general phone lines do close between 13:00 and 14:00 to allow for staff lunches but during this time the emergency surgery phone is manned by one member of staff.

Our doors remain open and the reception desk staffed all day.

Patients are able to contact the surgery via telephone between 08:00 – 13:00 and 14:00 – 18:30.

Patients can contact us via Email at any time of the day, although will only receive a reply during normal surgery opening times.

Our reception desk is manned from 08.00 to 18.30 and patients can come to the surgery to discuss problems face-to-face if they wish.

14. We offer 4.5 extended hours per week on a pre-book able basis via the triage GP. Patients can see a GP during extended hours between
07:30 – 08:00 Mon, Tues, Wed and Thurs
18:35 – 19:05 Mon, Tues, Wed, Thurs and Fri.
The GPs work these extended hours on a rota’d basis depending on their on call, so the GP the patient can see varies.

From a previous survey we carried out last year we found that although we offer extended hours and publicise it directly from the GP’s to the patients, via handouts, word of mouth, posters, practice booklet and via our website our patients do not seem keen to use it as they use our telephone triage system and then get an appointment to suit them via the GP.

15. Our findings from the patient participation group suggestions, surveys and discussions are displayed on our practice website, which is updated as required.

We are also publishing this report on our website and will continue with our poster campaign and sending out postal invites to patients asking if they would like to join our PPG in order to continue to make sure that our group is representative of our practice population.

We have found that having so many members of our PPG, and with the numbers anticipated to grow, that feed back would be easier to gain by having a smaller representative group. This will be elected by our PPG members during the following year.

Thank you to all the patients who anonymously participated in the surgery surveys both in house, postal and virtual.

Special thanks to all the members of our virtual PPG, for your help, support and constructive comments and ideas.

Comments from the PPG group

Very interesting results. I see that this trying to get an appointment on the day is a problem and agree that whatever you do, will not really make much difference. There are obviously x amount of spaces for a duty doctor to see patients - and that's really the sum of the situation.

I must congratulate you and the doctors for taking the time and effort to put this survey together. I think that it shows a real commitment to your patients and shows that you all really do have the patients best interests at heart.

Thank you for sending survey results, it is interesting to see what the major problems are and how you are tackling them. 

We moved from London and our previous doctors were not concerned with the patients opinions so I was very surprised to see the lengths you go to in order to listen to your patients. Good Luck with trying to please everyone. We have found everyone really welcoming at the surgery and the doctors are really caring.

I had not given much thought as to why the phones were always busy, only that it was frustrating to not be able to get through when you feel you need to speak to someone or get an appointment. I have a better understanding of the on call system now so thank you, although I am concerned as to how you can ensure that everyone is made aware unless they sign up to the group.

Thank you for giving me the opportunity to get involved with the practice, my understanding of the over worked nature of practices in general has changed remarkably since being able to have this insight.

I hope some of my suggestions may help, we are really happy to be patients here.

I didn’t really understand how the practice worked and to be honest I wasn’t really interested but I can now see the problems you have and I am reassured that you are doing all you can to address the issues raised.

To be honest every doctors surgery I have been a patient at seems to have problems with patients getting through on the phone, maybe its simply a question or demand being higher than the available appointments so maybe you should not have as many patients on your books.

Thank you for involving us in this process, it has been a very interesting experience.

I still think that you need to do something about the waiting room. Don't know if a coat of really bright paint will be the answer, but it is a really dark place. I know that you can't use living plants because of people's allergies etc., but it needs something.
Surgery comment - Actually we were a bit confused by this as our waiting room is painted cream but we do have artificial plants in the centre so the patient must have been referring to our waiting room.

Your Neighbourhood Professionals. Just a Click Away! Need advice on your pension? Want to avoid unwanted tax implications? Contact a local financial adviser today Penn Lawnmowers Parley Cross Pharmacy Gorselands Nursing Home Brook View Nursing Home Digitone hearing Co Alchemy Health Clinic
Ferndown Medical Centre, St Mary’s Road Dorset, Ferndown, Dorset, BH22 9HF
Website supplied by Oldroyd Publishing Group
Your Neighbourhood Professionals. Just a Click Away! Need advice on your pension? Want to avoid unwanted tax implications? Contact a local financial adviser today Penn Lawnmowers Parley Cross Pharmacy Gorselands Nursing Home Brook View Nursing Home Digitone hearing Co Alchemy Health Clinic
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