Surgery introduction:
Lister lane Surgery was established Aug 2008, previously known as ‘Lord Street Surgery’. The surgery is situated in Halifax town centre, close to local amenities with very good access to public transport services.
The surgery is a modern building with currently 2 doctors in the surgery, (1 male principal GP, and 1 female long term locum GP) 1 practice nurse, 1 practice manager and 2 admin staff.
Dr B Kumar is the principal Lead GP at Lister Lane Surgery. He is also a CCG (Calderdale Commissioning Group) board member.
The surgery is currently serving approximately 3,000 patients in the area and covers patients from different ethnicity as well as mixed race and gender.
Working with the local PCT
Dr Kumar is an elected board member of the steering group for Calderdale (the Cooperative of the Doctors' Practices within Calderdale and Kirklees).
Dr Kumar and his fellow colleagues actively support the formation and development of the future of Calderdale health. To maintain the momentum, the board members will be holding a network meeting once every month in order to enable the exchange of ideas, health services, and future Commissioning of patients health care in Calderdale.
Formulation of the PRG
The Patients Forum was established in January 2007, after a notice was put up in the surgery waiting room calling for volunteers.
We put up an advertisement on the surgery waiting room and all the consultation rooms requesting members of the practice population to join the PRG group. We also verbally requested patients at the reception desk. We made contacts with patients who were previous members of the PRG group requesting if they wish to proceed for further 12 months or opt out.
The communications were quite effective and we managed to recruit 14 members for this voluntary job.
We aimed for patients from different ethnic minority groups as our population is a multicultural population.
The surgery went the extra mile to get patients from a variety of ethnic minority group so that it was a fair share group and it would also be interesting to know that the different minority group think of the service the surgery is providing them, as every patient is different and every patient’s experience is different. We aim to ensure every patient receives an excellent service from our surgery and we continue providing a better service.
We aimed for male candidates as well as females candidates to join our PRG. This is to give a fair chance to our patient population. The surgery advertised for candidates over the age of 16yrs. This is so that patients are old enough and mature enough to help suggest and implement changes and improvements.
The volunteers had an application form to complete and submit to the practice manager. We received approximately 20 applications, out of which 14 candidates were nominated. Remaining patients failed to attend meetings, response to calls and letters or they were under the age of 16yrs. However the surgery will continue to contact these people who fit the criteria, in case they change their mind and wishes to participate in the PRG.
There is no closing number for the PRG members, so as many patients can join throughout the year.
Below is data showing current practice capitation breakdown.
Practice Patient population of age, race and gender.
Age Range |
Male |
Female |
Total |
GP Capitation Report Period Ending 21 Feb 2012 |
GP: |
Totals |
Health Authority: |
Kirklees and Calderdale |
|
|
Practice: |
Lister Lane Surgery |
0 - 16 |
375 |
371 |
746 |
17 - 24 |
154 |
173 |
327 |
25 - 34 |
371 |
309 |
680 |
35 - 44 |
274 |
171 |
445 |
45 - 54 |
156 |
130 |
286 |
55 - 64 |
105 |
90 |
195 |
65 - 74 |
88 |
72 |
160 |
75 - 84 |
59 |
59 |
118 |
85 - 110 |
15 |
20 |
35 |
111+ |
0 |
0 |
0 |
Total |
1597 |
1395 |
2992 |
|
|
Prepared on: |
21 Feb 2012 |
Patient Ethnicity Demographics
Ethnicity |
Patient Count |
Report Results: (Ethnicity) |
(XaJQv) British or mixed British - ethnic category 2001 census |
615 |
(XaJQw) Irish - ethnic category 2001 census |
9 |
(XaJQy) White and Black Caribbean - ethnic category 2001 census |
1 |
(XaJQz) White and Black African - ethnic category 2001 census |
1 |
(XaJR0) White and Asian - ethnic category 2001 census |
1 |
(XaJR2) Indian or British Indian - ethnic category 2001 census |
279 |
(XaJR3) Pakistani or British Pakistani - ethnic category 2001 census |
1260 |
(XaJR4) Bangladeshi or British Bangladeshi - ethn categ 2001 census |
140 |
(XaJR7) African - ethnic category 2001 census |
14 |
(XaJR9) Chinese - ethnic category 2001 census |
4 |
(XaJRA) Other - ethnic category 2001 census |
42 |
The surgery has 14 Patients who formulate the patient reference group (PRG). See table below for breakdown details of the PRG members.
Number of PRG members from the practice Ethnicity population group.
Ethnicity |
No of pt population |
No of PRG members |
White British |
615 |
2 |
Irish |
|
0 |
White and black Caribbean |
|
0 |
White and black African |
|
0 |
White and Asian |
|
0 |
Indian |
279 |
2 |
Pakistani |
1260 |
4 |
Bangladeshi |
140 |
2 |
Caribbean |
1 |
1 |
African |
14 |
1 |
Chinese |
|
0 |
Philippines |
40 |
1 |
Any other –Czech/Polish |
70 |
1 |
The reason for choosing 4 members from the Pakistani ethnicity patient population is:
- Highest practice patient population
- Highest applications from the ethnic minority group
Number of PRG members from the practice gender population group.
Male |
9 |
Female |
5 |
Underdetermine |
0 |
Number of PRG members from the practice age population group.
Under 16 |
0 |
17-24 |
1 |
25-34 |
5 |
35-44 |
4 |
45-54 |
2 |
55-64 |
2 |
65-74 |
0 |
75-84 |
0 |
Over 84 |
0 |
Importance of the PRG members:
It is important to have a PRG so that the positivity and negativity can be addressed and actioned appropriately. It is also very important to take the patient view in consideration to improve the service; after all they are the people the service is there for.
We can take all patients and any patient view or opinion into consideration, but having a PRG means it’s broken down into a smaller team where the discussion is much more effective and positive results can lead to and even better service.
Role of the PRG
The PRG will collate views and opinions from the patient population, personal experience and also take in consideration experience of other PRG members. This will help analyse concerns and how best to action it.
The practice also offers the opportunity for patients to write in to practice manager or the senior GP, who is Dr Kumar, raising any issues regarding the service. This could be improvement suggestions to concerning areas.
The practice also has a ‘Suggestion box’ so the patients and visitors can leave comments and messages. This is read in conjunction with the surgery complaints and other service reviews, which is discussed often in the practice meeting with the team. Sometimes the response to patient is sent within 28 days of receipt and the reviews are discussed in the practice meeting at a later date.
Making positive changes
The PRG has helped introduce a number of positive changes, including an easy to operate self check-in system and a new appointments system that has led to fewer cancellations. The practice was one of the first to offer extended opening hours and ‘early bird’ appointment slots. The surgery has also built its own website, where the patient can gain access for numerous purposes. The website provides information about the practice, including the services available and the work of the PPG, updates on national issues such as swine flu and advice and guidance on a range of health and travel issues. It also includes a facility to allow patients to request repeat prescriptions online cancel appointments and update the practice on changes to their personal details. (This is only allowed, providing you have your unique login details for system online)
The way forward
The surgery has a number of improvements in the pipeline that are all designed to make contacting or visiting the surgery a better experience. Ideas include:
- Free parking space,
- New surgery extension for more services and facilities,
- Additional GP partner on board which provides more appointments and less waiting time,
- Family planning services including IUD fittings etc
- Advantage of a female GP
Improvement areas highlighted by the practice:
- Appointment Accessibility
- Telephone Access
- High level of DNA (did not attend)
Local practice survey
In view of surgery population of 2890 Aug 2011, the surgery needs to conduct at least 75 individual returned surveys which works out 25 per 1,000 patients.
Development of the survey:
The practice looked into various areas of concerns, such as:
- Previous survey results,
- Regular verbal concerns raised by patients
- National GP patient survey issues
- Planned practice changes
- Practice priority and issues including themes and complaints
We have used few tips from each above area and put together a survey which should bring out positive answers to few grey areas for suggestions and changes.
Conducting the survey:
We have generated 75 printed and returned surveys (paper based) which works out 25 survey per 1,000 patients, and with a practice population of approximately 3, 000 patients we needed to complete 75 returned survey. We split them up between reception office, consultation rooms, waiting room and treatment room.
Following our 1st PRG meeting on 17th Aug 2011, we conducted the survey during the end of Aug and aimed for completion of 75 surveys by end of the week, so that data can be checked and analysed ready for next PRG meeting on 12th Jan 2012.
The survey was based on highlights from the PRG meeting on the 17th Aug 2011. The questions reflected on areas of concerns and issues for potential improvement. The suggestions for the questions were agreed by the PRG and the surgery staff.
Every staff played a key part in handing the surveys to the patient randomly picked before, during or after consultations or visits. We tried to aim at patients from different ethical minority group so that efforts was made to obtain opinion and suggestions from variety of patients regardless of age (specific to survey agreement) gender and race.
Few patients choose to take it away and bring it back at a later date. Few managed to complete the survey during their visit. Some patients chose to put their names on the forms as others did not, although patients were advised it is completely anonymous.
Analysing the survey findings into facts and figures, graphical presentation:
The survey was conducted on the last week of Aug 2011 following the PRG meeting. The results were put together on and excel spreadsheet and then it was presented using graphical tool to display findings. The results were later presented discussed at the PRG meeting on the 12th Jan 2012. (See minutes attached dated 12th Jan 2012)
Following the survey results, we put together an ‘action plan’ which shows below what the current set up is and what method of action to be taken. – refer to minutes of PRG meeting on the 12th Jan 2012, where the discussions of survey findings were made and agreement on action plan.
Action Plan: following discussion with the PRG members after analysing the findings from the 75 returned survey
Details of actions taken
Suggestion
Based on survey data
|
Results
Based on survey findings
|
Action to be taken by/whom
To be implemented or completion duration
|
Upgrade on telephone system
|
Telephone: the current system in place has 3 call queuing facility with music played in background. We will look into potentially diverting calls to dedicated personal to better call handling management
|
The Surgery is looking to implement new changes after the completion the new extension by Aug 2012. The new telephone service access should give caller a choice to whom or which department they wish to speak with. This will cut calls, waiting time, frustration and verbal complaints patients have been pointing out.
|
More appointment availability
|
Appointment accessibility:
The surgery is progressively growing by numbers and therefore a 2nd GP has become necessity. Providing a female GP will not only benefit the female patients but also provide additional appointments to improve service.
|
The Partnership with the female GP, Dr Shetty will not only benefit the patients with additional appointments, but will increase and improve services by providing female family planning, contraception and IUD fittings. Most female patients feel comfortable speaking and consulting their own GP for such service as all this comes in confidence. This has been a worrying factor in the ethnic minority group who are very reserved and reluctant to open up for choices and opportunities available. Having a female Asian speaking GP will resolve any of these problems. The partnership will be in place by April 2012 and Dr Shetty should increase from 4 sessions to 6 sessions a week.
|
DNA appointment rates
|
High level of DNA:
The surgery has been experiencing a major difficulty with the level of DNA over the past few years. The patients understanding of cancelling an appointment does not appear as a significant issue.
|
The one area which most surgeries are trying to tackle despite all the literature, education, and reminder used to educate their patients. We can only continue to keep improving our educational standards on the issue around ‘appointments’ We will keep reminding the patients the importance of cancelling. We have implemented online booking access via System online where patients can manage their own appointments and prescription via online. All and every facility is being implemented to make access and contact to surgery easier by day. We have also implemented SMS service to consented patients who have a mobile number on their record. An SMS appointment confirmation is automatically sent to the patient as soon as an appointment is booked. A further SMS reminder is sent on the actual day of the appointment to remind the patient once again. We have also decided to try call the patient who has missed their appointment during that session, and offer them to still come and they will be seen at the end of session. This is a slow progress but is looking quite positive.
|
Progress made with the ACTION PLAN:
The ‘action to be taken by/whom’ is the progress the surgery has taken or wishes to take in the near future. Certain changes are being implemented in the new financial year. Other changes will be implemented following completion of the new extension.
The surgery will or should complete all agreed changes with the PRG by Aug 2012.
Details of actions to be taken
Suggestions
Based on survey data
|
Results
Based on survey findings
|
Action to be taken by/whom
To be implemented or completion duration
|
Upgrade on telephone system
|
Telephone: the current system in place has 3 call queuing facility with music played in background. We will look into potentially diverting calls to dedicated personal to better call handling management
|
The Surgery is looking to implement new changes after the completion the new extension by Aug 2012. The new telephone service access should give caller a choice to whom or which department they wish to speak with. This will cut calls, waiting time, frustration and verbal complaints patients have been pointing out.
|
More appointment availability
|
Appointment accessibility:
The surgery is progressively growing by numbers and therefore a 2nd GP has become necessity. Providing a female GP will not only benefit the female patients but also provide additional appointments to improve service.
|
The Partnership with the female GP, Dr Shetty will not only benefit the patients with additional appointments, but will increase and improve services by providing female family planning, contraception and IUD fittings. Most female patients feel comfortable speaking and consulting their own GP for such service as all this comes in confidence. This has been a worrying factor in the ethnic minority group who are very reserved and reluctant to open up for choices and opportunities available. Having a female Asian speaking GP will resolve any of these problems. The partnership will be in place by April 2012 and Dr Shetty should increase from 4 sessions to 6 sessions a week.
|
DNA appointment rates
|
High level of DNA:
The surgery has been experiencing a major difficulty with the level of DNA over the past few years. The patients understanding of cancelling an appointment does not appear as a significant issue.
|
The one area which most surgeries are trying to tackle despite all the literature, education, and reminder used to educate their patients. We can only continue to keep improving our educational standards on the issue around ‘appointments’ We will keep reminding the patients the importance of cancelling. We have implemented online booking access via System online where patients can manage their own appointments and prescription via online. All and every facility is being implemented to make access and contact to surgery easier by day. We have also implemented SMS service to consented patients who have a mobile number on their record. An SMS appointment confirmation is automatically sent to the patient as soon as an appointment is booked. A further SMS reminder is sent on the actual day of the appointment to remind the patient once again. We have also decided to try call the patient who has missed their appointment during that session, and offer them to still come and they will be seen at the end of session. This is a slow progress but is looking quite positive.
|
Availability of information
Once the changes are in place the wider practice population patients will have a clear understanding of what is expected from their GP surgery as of services, facilities, staff and access.
The information will be divulged via PRG, who will be the first form of contact by the surgery following changes. Other ways of addressing changes to the surgery are:
- Notice boards,
- Surgery website,
- Face to face consultations
- Telephone service
- Practice Leaflet
- PRG open team meeting with wider patient population
Patients can log onto our following surgery website:
www.listerlanesurgery.co.uk
Email: reception@listerlanesurgery.co.uk
Patients will be able view all the information they require. This includes some the following:
- Service provision
- Details of GP, staff and other alliances
- Patient satisfaction survey results
- Details of Lister Lane PRG
- Ways of contacting various people including PRG
- Links to services including disease management
- Links to system online
- Links to patient registrations
- Links to surgery progression, achievement in the national table and other QOF related issues
- Links to practice leaflet
- Links to practice complaint procedure
- Links to practice suggestion box
There are unlimited choices on the website.
The website is also due for an upgrade by March 2012.
All the above plus more will be made available.
The website is or will be further developed so that not only the surgery patient population can access and get benefit but is or will welcome wider patient group so that practice population remains to develop.
Confirmation of the opening times:
The survey does not seek patient opinion on the following:
- Opening hours
- Core hours
- Extended access DES
- Individual healthcare professional accessibility
This is because maximum level of access is provided and the patient population are satisfied with this. Satisfactory results have been highlighted in the practice survey in the previous years.
Opening hours:
Surgery is open from 8am to 6pm (10hrs a day)
Core access:
Patients are able to access the surgery from 8am to 6.30pm (10.5hrs per day)
Extended Access DES:
The surgery has been signed up with the ‘extended accesses’ since 2007. This is potentially aimed at patients who are working and unable to come and see their doctor during the core hours and also for school children and students of higher education who also have similar issues with the timings.
However the appointments are available for anybody to book, it is available for online booking, advance booking or even on the day providing that there is an appointment available to offer.
The DES has been extremely successful and is run on a Wednesday evening 6.30pm to 8pm; six appointments are available at 15minutes interval with Dr Kumar.
There is a contingency of this service so that patients can be assured that an ‘extended access’ is always available on a Wednesday evening. Should Dr Kumar not be available due to annual leave or other commitments Dr Shetty will be covering the session.
Individual healthcare professional accessibility
The principal GP of the surgery (Dr B Kumar) is available for face to face consultation and telephone consultations and other method of access, all day from 8am to 6.30pm and 8am to 8pm on a Wednesday five days a week.
Dr Shetty is currently available Mondays and Thursdays 8am to 6.30pm. Increase access will be available following changes (refer to action plan, component 4)
A copy of this report, including the survey and the data analysis has been submitted to the Calderdale primary Care Trust as part of the PPG DES.
This report has been put together by:
Shana Begum
Practice Manager
Lister Lane Surgery
30 Lister Lane
HX1 5AX
Tel: 01422 353956
Website: www.listerlanesurgery.co.uk
Email: rececption@listerlanesurgery.co.uk