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Patient Participation 3rd Year 2013-2014

Patient Participation 3rd Year 2013-2014.

Topic – Practice Communication

 

 

The practice has now been involved in the Department of Health Patient Participation service for 3 years. This is our year 3 report.

Previously our topics have been –

YEAR 1 -Patients who do not attend (DNA’s)

YEAR 2 – Prescription

This YEAR – Practice Communication

 

The key objective is to ensure that patients are involved in decisions about the range and quality of services provided by the practice. This is by the use of a Patient Reference Group and patient survey to bring about decisions that lead to changes in how services are delivered to patients.

 

Formation

The Patient Reference Group was formed after extensive publicity by the practice in the summer months of 2011. Membership of the Group is open to all patients all the time and we currently have a “virtual group” of 102 patients. This gives the advantage of offering the opportunity for expression of opinions without the constraints of attending meetings which inevitably will not be convenient for everyone. Additionally in a group of this size accommodating such numbers presents logistical problems.

 

Patient Reference Group - Demographics.

 

 

 

Patient Population % - based on ethnicity details we have for 5800 patients

Patient participation Group %

Age groups

 

 

Under 16

22%

-

17-24

10%

-

25-34

12%

4%

35-44

14%

10%

45-54

14%

31%

55-64

12%

17%

65-74

10%

17%

75-84

6%

18%

85 & over

2%

3%

Male/Female

49%   / 51%

42%   /   58%

White British

86%

96%

Irish

0.1%

 

Mixed – White & Black Caribbean

0.05%

 

White & Black African

0.3%

 

White & Asian

0.2%

 

Other Mixed Background

0.4%

 

Indian or British Indian

2%

 

Pakistani or British Pakistani

9%

2%

Bangladeshi or British Bangladeshi

0.1%

 

Caribbean

0.1%

 

African

0.4%

 

Chinese

0.03%

2%

Any other

1%

 

 

 

 

Process

A stepped approach was adopted to take the practice and the group through the process. This is:

 

  • Step 1 form a Patient Reference Group
  • Step 2 Practice agree with the Patient Reference Group some areas which could be covered in a patient survey
  • Step 3 collate patients views through the use of a survey
  • Step 4 provide Patient Reference Group with the opportunity to comment on the survey findings
  • Step 5 create an action plan with the Patient Reference Group to implement any changes
  • Step 6 publicise the actions taken and subsequent achievement

 

Seeking Opinion

In October 2011 the Patient Reference Group was asked to consider areas that they would like to be considered for development and be suitable for consideration by patients by way of a survey.

 

The results from the Group were as follows:

  • Patients not attending for appointments made – (colloquially known as DNA’s – Do not Attend)                                    24%
  • Prescriptions – over ordering                  18%
  • Prescriptions – ordering                         8%
  • Patient information                                 10%
  • Using reception                                      4%
  • Getting an appointment                          12%
  • Waiting room facilities                            1%    
  • Timekeeping                                          9%
  • Reception layout                                    4%
  • We also invited another suggestion (from each member) not covered in the above. We had 7 different suggestions but none of these came up more than once.

Year 1 Survey and Action Plan

In year 1 we took the subject “Patients who do not attend appointments” (DNA’s). We developed a patient survey and together with our Patient Reference Group, an action plan was created in an attempt to drive down numbers of DNA’s. Details of the survey, its results and Action Plan of year 1 are on our website.

 

Year 2 Survey and Action Plan

In year 2 it was decided to look at the next highest area of concern, Prescriptions – over ordering, prescription ordering and medication wastage.

Details of the survey, its results and Action Plan of year 2 are on our website.

 

Year 3 Survey and Action Plan

In year 3 group members commented on and entered into the current debate within the NHS. Group members were aware the NHS is make efforts to generate a culture of openness, transparency and candour. This in no small way has been driven by concerns of patients and the recent disasters seen in the NHS such as the Winterbourne View Hospital and Mid Staffs Hospital scandals. Whilst primary care can be said to be very different from the hospital environment, the lessons of lack of communication between the organisation and patients/carers/advocates was identified and needs to be taken forward throughout health care in England. With this in mind the proposed the topic chosen was “Improving communication with patients”.

 

Develop a Patient Survey

A draft survey was created by the practice in August 2013 and the group was asked to consider the style, wording and give general feedback as to its suitability. Once again specialist help from our local CCG also formed part of the input in the survey’s construction.

 

The Reference Group generated many interesting and thoughtful responses and there were a number of e-mail exchanges including many specific survey questions. After this consultation and some fine tuning to the Final survey on communication was rolled out from late September through October 2013. Patients were invited to complete paper versions in the two medical centres, Reference Group members were invited to complete the survey by e-mail and 3500 randomly selected patients were contacted by post and invited to complete the survey. Regretfully touch screen machines used in previous years and supplied by our local PCT were unavailable to us because of service cuts. The survey closed on 30 October 2013.

 

Results of the Patient Survey

Many patients were happy to take part in the survey and give us their views. These are the numbers of completed surveys:-

 

  • e-mail - 16 surveys,
  • postal - 517 surveys
  • in-surgery - 61 surveys. 
  • Total of all responses 594 surveys

 

The survey, questions and results are given below. In addition there were 207 individual comments left by patients. The Patient Reference Group has seen all these comments, however we have not produced them here as the space needed would be prohibitive. If you would like to receive a paper copy of the 207 comments, then please contact the practice and we will easily arrange this.

 

 

Results of All Surveys Completed - Numbers

 

Communicating with reception – when you speak with our reception is what is said clearly understandable

Confusing

Quite confusing

No opinion

Quite understandable

Very easy to understand

1

3

16

191

385

 

Communicating with reception – The information provided by the reception staff

Not had any information

Difficult to understand

No opinion

Quite easy

Very easy to understand

15

6

23

179

346

 

Information – Thinking about information provided by the practice. Are poster displays in the practice useful?

Not noticed

Needs improving

Slightly useful

Useful

Very useful

38

10

54

355

110

 

Information – Is the practice information leaflet useful?

Not seen it

Needs improving

Slightly useful

Useful

Very useful

92

20

33

329

106

 

Information – Is our waiting room patient calling system clear?

Not noticed

Needs improving

Slightly useful

Useful

Very useful

11

127

29

210

182

 

Information – Is our waiting room Patient Newsletter useful?

Not noticed

Needs improving

Slightly useful

Useful

Very useful

104

6

50

283

131

 

Information – Is the practice website useful www.drpatelandpartners.co.uk

Not seen it

Needs improving

Slightly useful

Useful

Very useful

256

6

12

79

71

 

Information – Do you know what to do next if you had a concern, query or complaint?

 

No

Some idea

Yes

 

 

66

170

272

 

 

Thinking about your most recent consultation with the doctor, can you indicate your experience – Explaining tests and treatments:

Poor

Fair

Good

Very Good

Excellent

3

15

117

214

222

 

Thinking about your most recent consultation with the doctor, can you indicate your experience – Involving you in decisions about your care

Poor

Fair

Good

Very Good

Excellent

4

18

116

214

204

 

Thinking about your most recent consultation with the doctor, can you indicate your experience – Giving you enough time:

Poor

Fair

Good

Very Good

Excellent

14

28

134

209

177

 

Thinking about your most recent consultation with the doctor, can you indicate your experience – Listening to you:

Poor

Fair

Good

Very Good

Excellent

7

23

106

193

230

 

Thinking about your most recent consultation with the doctor, can you indicate your experience – Treating you with care and concern:

Poor

Fair

Good

Very Good

Excellent

4

21

96

179

245

 

Results of All Surveys Completed - Percentages

 

Communicating with reception – when you speak with our reception is what is said clearly understandable

Confusing

Quite confusing

No opinion

Quite understandable

Very easy to understand

0%

1%

3%

32%

64%

 

Communicating with reception – The information provided by the reception staff

Not had any information

Difficult to understand

No opinion

Quite easy

Very easy to understand

3%

1%

4%

31%

61%

 

Information – Thinking about information provided by the practice. Are poster displays in the practice useful?

Not noticed

Needs improving

Slightly useful

Useful

Very useful

7%

2%

9%

63%

19%

 

Information – Is the practice information leaflet useful?

Not seen it

Needs improving

Slightly useful

Useful

Very useful

16%

3%

6%

57%

18%

 

Information – Is our waiting room patient calling system clear?

Not noticed

Needs improving

Slightly useful

Useful

Very useful

2%

23%

5%

37%

33%

 

Information – Is our waiting room Patient Newsletter useful?

Not noticed

Needs improving

Slightly useful

Useful

Very useful

18%

1%

9%

49%

23%

 

Information – Is the practice website useful www.drpatelandpartners.co.uk

Not seen it

Needs improving

Slightly useful

Useful

Very useful

60%

1%

3%

19%

17%

 

Information – Do you know what to do next if you had a concern, query or complaint?

 

No

Some idea

Yes

 

 

13%

33%

54%

 

 

Thinking about your most recent consultation with the doctor, can you indicate your experience – Explaining tests and treatments:

Poor

Fair

Good

Very Good

Excellent

½ %

3%

20%

37%

39%

 

Thinking about your most recent consultation with the doctor, can you indicate your experience – Involving you in decisions about your care

Poor

Fair

Good

Very Good

Excellent

½ %

3%

21%

38%

37%

 

Thinking about your most recent consultation with the doctor, can you indicate your experience – Giving you enough time:

Poor

Fair

Good

Very Good

Excellent

3%

5%

24%

37%

31%

 

Thinking about your most recent consultation with the doctor, can you indicate your experience – Listening to you:

Poor

Fair

Good

Very Good

Excellent

1%

4%

19%

35%

41%

 

Thinking about your most recent consultation with the doctor, can you indicate your experience – Treating you with care and concern:

Poor

Fair

Good

Very Good

Excellent

1%

4%

17%

33%

45%

 

 

 

These results were presented to the Reference Group and from the end of October until mid December 2013 feedback and comments came in from the Group.

 

Action Plan

From the feedback the surgery drew together the collective thoughts and devised an action plan (below).

 

The aim of the plan is to reflect the collective view of all those patients who completed the survey and also the Patient Reference Group.

 

The plan approaches the problem in different ways.

  • To influence patients,
  • To take general action,
  • To take specific action.

 

All this is underpinned by the support of ordinary patients’ views and the Patient Reference Group views. To assess the impact of the plan we will carry out some further questionnaires.

 

INFLUENCE

 

Action

Method of Implementation

When to implement

Resource Implications

Method of review

Raise awareness of practice leaflet

 

Poster

Waiting room poster advising patients to ask for a copy

 

May 2014 Leaflets & posters on permanent display 05/2014

Simply designed poster can be easily produced

See “Assessment” below

Patients unaware of practice website

 

 

Poster

 

 

 

 

Newsletter

Waiting room poster advising patients of address

 

Short article in newsletter reminding patients

May 2014

On display 05/2014

 

 Spring/Summer newsletter 2014 Done & repeated on all subsequent

Simply designed poster can be easily produced

 

None

See “Assessment” below

Raising awareness of the complaints and feedback procedures

Poster

 

 

 

Newsletter

Waiting room poster advising patients of it and its functions

 

Short article in newsletter reminding patients

May 2014 Permanent poster on display 06/2014

 

Summer 2014 newsletter  Article in Autumn 2014 newsletter

Simply designed poster can be easily produced

 

None

See “Assessment” below

ACTION - GENERAL

 

Action

Method of Implementation

When to implement

Resource Implications

Method of review

Awareness of practice website

Advise in our correspondence

 

 

 

 

 

NHS Choices

 

 

 

 

 

Prescription message

 

 

Redesign our standard letter template to include website detail

 

 

Include a link in the national NHS Choices website to our own.

 

One month per half year, create special prescription message

May 2014

Now on footer 12/2014

 

 

 

 

April 2014

Done 04/2014

 June and December each year

Done June 14 & Jan 15

Full review of our letter templates will be needed. Needs some staff time and resources

 

Need to investigate method to follow.

 

Easily done, diarise action dates

To be a permanent change

 

 

 

 

 

To be a permanent change

 

 

Monitor patient feedback

Assistance with complaints

Leaflet

Create a leaflet available for handing out at reception

April 2014

Completed 04/14

Ensure this includes guidance on other organisations/ agencies who can help

To be a permanent change

ACTION - SPECIFIC

Patient calling system

 

Patients experiencing difficulty hearing their call

Critically appraise present systems, strengths and weaknesses. Practice to investigate products available

-         Visual

-         Audible

 

Practice to investigate feasibility of doctors working differently

Consider and contrast alternatives balancing costs Vs benefits

 

 

 

 

 

Consider ways other than technology for calling the patient

A working group to research and report back within first quarter (Apr-Jun 2014)

 

 

 

A working group to research and report back within first quarter (Apr-Jun 2014)

Some work late summer 2014.

Inconclusive

Scheduled for Mar 15

Perception that many of these products are expensive

 

 

 

 

 

 

Might impact on patient consultation time. May be more difficult and time consuming, reducing the patient time

 

 

 

 

 

 

 

See “Assessment” below

Appointments structure

Although not part of the “communication survey”, some patient comments indicate concern over availability mix

 

 

 

 

 

 

Expanding methods of appointment booking

Data collection exercise, assessment, review and implementation to be drawn up

 

 

 

 

 

 

Move ahead with some on line appointment booking

Data collection to begin April 14, assessment May, implement June 14 onwards

Changes to “mix of appts made Oct 14

 

 

 

July 2014

Begun Mar 2015

Considerable. Data collection will involve paper and computer collection. Assessment by team drawn from across the practice

 

 

Ability to do this rests with clinical software suppliers.

Review comments and feedback from patients, reception, doctors 2 months after implementation Likely -revisions and a follow-up plan.

 

This significant change will mean only limited number of appointments to be available initially

See “Assessment “ below

 

Patients unaware of practice leaflet

Ensure a leaflet provided to all newly registered patients

Issued by receptionist with registration form

From April 2014

Standard procedure from May 14

None

None needed

Raising awareness of website

Leaflet

Complaints procedure

By publicity paper

Create a short paper drawing patients attention to these. To include in our regular patient recall letters

Recall letter system under review and revision. Carried forward to 05/15. Large amount of work needed to build into a new system.

Opportune time to introduce this with manageable impact

Expect to receive patient feedback

 

See “Assessment” below

ASSESSMENT

Practice leaflet, website, complaints procedure

Benchmark patient awareness

Assess impact of our actions

Short survey of patients

 

6 months after implementation (Sept 14)

Completed Oct 14 & Jan 15 - Evidence of raised awareness

Patient calling system

Benchmark patient satisfaction

Assess impact of our actions

Short survey of patients

 

6 months after a solution has been implemented

Dec 14 No equipment purchased yet.  Funding issue defer to summer 2015 when cost reconsidered

Appointments Structure

Benchmark patient satisfaction

Assess impact of our actions

Short survey of patients

 

3 months after a solution has been implemented and should be repeated 3 months later

Survey Dec 14 - inconclusive.  Further survey set for Easter 2015.

 

 

 

     Reviewing the Plan

 

On 19 December 2013 the Patient Reference Group were presented with the plan for their consideration. Feedback from this was very positive and the plan was approved by the Group.

 

The Practice would again like to thank the Patient Reference Group for all their efforts, thoughts, feedback and suggestions. This really has been a good exercise in helping our patients to have a voice in influencing how things are done at the surgery.

 

We would also like to express our thanks to all the patients who completed the survey.

                                                                                               



 
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