Component 1 of the DES (virtual group)
Please see below detail of the first PRG virtual meeting where there was an agreement between the PRG and the practice regards prioritising and local practice survey
The first meeting was held Thursday 15th Nov 2012 at Nursery Lane Surgery:
Team briefing from meeting:
The Attendees:
Dr Kumar - Partner
Dr Shetty - Partner
Dr Suku - Partner
Shana Begum - Practice Manager
PRG:
Apology:
Introduction:
The team met at our branch site Nursery Lane to discuss the new patient participation group for the 2nd year.
Nursery Lane has not been signed up to this DES and therefore a new group introduction was necessary to support and represent Nursery Lane.
PRG Establishment:
In 2012 an advertisement was put up in Lister Lane Surgery to recruit any volunteers to join the PRG. The response was immense, and the surgery went through a selection process in order to recruit patients from all minorities, age, gender, race and ability.
Following the merge in Sept 2012, it became necessary to re-advertise at Nursery Lane waiting room seeking new volunteers to represent the surgery.
Few candidates came forward and completed an application form to join as volunteers.
All applicants went through a scanning process to identify people who are genuinely interested in voicing their thoughts and suggesting innovation to the way their practice is operating. We made telephone contacts with individual applicants to invite them for a group meeting and discuss the plan for 2013. Every effort was made to ensure the PRG was represented as this was only way to get patient true opinion.
Practice involvement
Dr Kumar - principal partner
Dr Shetty - principal partner
Dr Suku - principal partner
Shana Begum - practice manager
PRG:
Apology:
The practice over both sites now consists of approx 5196 registered patients, see breakdown below:
Practice population profile |
PRG population profile |
PRG ethnicity profile |
PRG ethnicity |
Under 16 |
1234 |
|
|
|
17-24 |
598 |
|
|
|
25-34 |
976 |
3 |
1 |
Bangladeshi |
35-44 |
766 |
2 |
2 |
Pakistani |
45-54 |
581 |
1 |
4 |
White British |
55-64 |
449 |
1 |
1 |
Afro/Caribbean |
65-74 |
336 |
1 |
|
|
75-84 |
190 |
|
|
|
Over 84 |
66 |
|
|
|
We re-visited and discussed the 2011-12 action plans concerning the 3 areas around,
- Telephone access
The time scale was Aug 2012, following an extension build to the current premise, unfortunately the extension project was slightly delayed due to unavoidable circumstances and therefore the telephone upgrading system did not go ahead. However this item is now carried on to 2012-13 action plan as the extension project is due to go ahead in the coming months and the telephone upgrading will also be implemented.
- Appointment accessibility
New partnership with female GP (Dr Shetty) was taken place 2012, following patient population demand and patient needs. Salaried GP (Dr Sarwar) has ongoing contract with the practice to meet additional demands and improve appointments.
- High volume of DNA (did not attend)
This is a grey area the surgery tried various methods and has to tighten up the DNA policy by advertising in the waiting rooms and sending courtesy letters out reminding the importance of keeping their appointments. The surgery will continue to endeavour, as this is purely educational and we may find the right solution one day!
Agree priorities and local established surveys
The team discussed findings and action plan from 2012 survey and suggested a new survey around ‘appointments’ for 2012-13. The PRG members and the practice discussed the options for the new survey and the type of questions to ask.
The idea behind it was to ascertain whether the surgery is hitting the 48hr appointment policy and whether there was a choice and demand for a particular GP and if there is, are the patients getting their choices?
This was taken into consideration due to the surgery merge. Since Nursery Lane has now become a branch site, it was important to ascertain whether the choice was there!
The team is aware it is too early, as there will be lots of teething problems and the surgery is predominately seeking innovation to its services, systems and functionalities.
The PRG and the practice team agreed the priorities would be to establish whether the patients are getting same level of service prior to merge with appointments or whether the merge has affected the choice in appointments within their chosen site?
The RPG has suggested the surgery work around the types of questions they wish to generate around ‘appointments’ this should be in consistent to positive and negative findings. The surgery should also take into consideration any verbal complaints or written complaints the practices have received in regards to appointments, as this will help identify possibly new results!
Whatever said and done, the most important factor is not to let the patient get affected with any business functionality. This was the most important key factor.
Establishing a survey around ‘appointments’ would mean basic questionnaire surrounding choices and options for opinions to be expressed which can be taken as suggestive for innovation. The survey would be aimed at any service users over the age of 16yrs and should be able to complete following an appointment or as they wait to see a GP or a nurse.
Due to the practice capitation of 5196 registered patients, the surgery will carry out 125 surveys (25, per 1,000) we have decided to distribute 60 surveys from Nursery Lane surgery and 65 surveys from Lister Lane surgery and aim to return 125 surveys. The surveys will be handed out randomly, and the there will be a sealed box provided at each site for the patients to post it in.
The survey will be conducted during the last week of November throughout both sites at the same time. Sealed boxes will be provided and the completed questionnaire will be collected, collated and analysed 2nd week of December 2012. This gives 2 weeks for completion.
Next meeting, date and time will be notified to team
Component 2 of the DES
Please see below detail of the first PRG virtual meeting where there was an agreement between the PRG and the practice regards prioritising and local practice survey
The first meeting was held Thursday 15th Nov 2012 at Nursery Lane Surgery:
Team briefing from meeting:
Component 1 of the DES (virtual group)
The Attendees:
Dr Kumar - Partner
Dr Shetty - Partner
Dr Suku - Partner
PRG:
Apology:
Introduction:
The team met at our branch site Nursery Lane to discuss the new patient participation group for the 2nd year.
Nursery Lane has not been signed up to this DES and therefore a new group introduction was necessary to support and represent Nursery Lane.
PRG Establishment:
In 2012 an advertisement was put up in Lister Lane Surgery to recruit any volunteers to join the PRG. The response was immense, and the surgery went through a selection process in order to recruit patients from all minorities, age, gender, race and ability.
Following the merge in Sept 2012, it became necessary to re-advertise at Nursery Lane waiting room seeking new volunteers to represent the surgery.
Few candidates came forward and completed an application form to join as volunteers.
All applicants went through a scanning process to identify people who are genuinely interested in voicing their thoughts and suggesting innovation to the way their practice is operating. We made telephone contacts with individual applicants to invite them for a group meeting and discuss the plan for 2013. Every effort was made to ensure the PRG was represented as this was only way to get patient true opinion.
Practice involvement
Dr Kumar - principal partner
Dr Shetty - principal partner
Dr Suku - principal partner
Shana Begum - practice manager
The practice over both sites now consists of approx 5196 registered patients, see breakdown below:
Practice population profile |
PRG population profile |
PRG ethnicity profile |
PRG ethnicity |
Under 16 |
1234 |
|
|
|
17-24 |
598 |
|
|
|
25-34 |
976 |
3 |
1 |
Bangladeshi |
35-44 |
766 |
2 |
2 |
Pakistani |
45-54 |
581 |
1 |
4 |
White British |
55-64 |
449 |
1 |
1 |
Afro/Caribbean |
65-74 |
336 |
1 |
|
|
75-84 |
190 |
|
|
|
Over 84 |
66 |
|
|
|
We re-visited and discussed the 2011-12 action plans concerning the 3 areas around,
- Telephone access
The time scale was Aug 2012, following an extension build to the current premise, unfortunately the extension project was slightly delayed due to unavoidable circumstances and therefore the telephone upgrading system did not go ahead. However this item is now carried on to 2012-13 action plan as the extension project is due to go ahead in the coming months and the telephone upgrading will also be implemented.
- Appointment accessibility
New partnership with female GP (Dr Shetty) was taken place 2012, following patient population demand and patient needs. Salaried GP (Dr Sarwar) has ongoing contract with the practice to meet additional demands and improve appointments.
- High volume of DNA (did not attend)
This is a grey area the surgery tried various methods and has to tighten up the DNA policy by advertising in the waiting rooms and sending courtesy letters out reminding the importance of keeping their appointments. The surgery will continue to endeavour, as this is purely educational and we may find the right solution one day!
Agree priorities and local established surveys
The team discussed findings and action plan from 2012 survey and suggested a new survey around ‘appointments’ for 2012-13. The PRG members and the practice discussed the options for the new survey and the type of questions to ask.
The idea behind it was to ascertain whether the surgery is hitting the 48hr appointment policy and whether there was a choice and demand for a particular GP and if there is, are the patients getting their choices?
This was taken into consideration due to the surgery merge. Since Nursery Lane has now become a branch site, it was important to ascertain whether the choice was there!
The team is aware it is too early, as there will be lots of teething problems and the surgery is predominately seeking innovation to its services, systems and functionalities.
The PRG and the practice team agreed the priorities would be to establish whether the patients are getting same level of service prior to merge with appointments or whether the merge has affected the choice in appointments within their chosen site?
The RPG has suggested the surgery work around the types of questions they wish to generate around ‘appointments’ this should be in consistent to positive and negative findings. The surgery should also take into consideration any verbal complaints or written complaints the practices have received in regards to appointments, as this will help identify possibly new results!
Whatever said and done, the most important factor is not to let the patient get affected with any business functionality. This was the most important key factor.
Establishing a survey around ‘appointments’ would mean basic questionnaire surrounding choices and options for opinions to be expressed which can be taken as suggestive for innovation. The survey would be aimed at any service users over the age of 16yrs and should be able to complete following an appointment or as they wait to see a GP or a nurse.
Due to the practice capitation of 5196 registered patients, the surgery will carry out 125 surveys (25, per 1,000) we have decided to distribute 60 surveys from Nursery Lane surgery and 65 surveys from Lister Lane surgery and aim to return 125 surveys. The surveys will be handed out randomly, and the there will be a sealed box provided at each site for the patients to post it in.
The survey will be conducted during the last week of November throughout both sites at the same time. Sealed boxes will be provided and the completed questionnaire will be collected, collated and analysed 2nd week of December 2012. This gives 2 weeks for completion.
Next meeting, date and time will be notified to team
Component 3
Collate and inform findings of survey
The survey was paper based generated and printed in the premise.
The surgery distributed 125 surveys and ensured they collected 125 back. Sometimes the odd one or two were not returned and therefore it was necessary to print those again to balance the 125 surveys.
The survey was in place ready for distribution week commencing 26th Nov and was completed by the 7th Dec 2012.
Staffs have been encouraging users to complete a survey following appointment attendances for the GP’s and nurses.
Some patients choose to take the survey away and bring it back. The choice was there should their wish to disclose personal details such as name and contact number for feedback purpose. Otherwise the survey was completely anonymous. The aim was to obtain opinion and factual information based on personal experience with the surgery.
(See sample survey attached)
The information was collated into a bar chart and tally chart format using excels to help formulate an action plan following the findings. This will be established during the next PRG meeting. (See data analysed attached)
PRG meeting:
Thursday 14th Feb 2013, 1.00pm at Lister Lane Surgery. (See minutes attached)
Component 4
Discuss findings from survey
See minutes below
Lister Lane Surgery
PRG Meeting Thursday 21st Feb 2013: 12.30pm (postponed from 14th Feb 2013)
The Attendees:
Dr Kuma - Partner
Dr Shetty - Partner
Dr Suku - Partner
Shana Begum - Practice Manager at LL
The team met once again and discussed the findings of the survey conducted Nov-Dec 2012 as agreed on the last meeting on 15th Nov 2012.
The survey returns are giving polite responses only. This survey was designed to an extent where patients were given up to 3 options for suggestion for each question asked. Unfortunately patients have not taken that opportunity to express their concerns or choices.
We have had little feedback from patients via survey and they are listed below.
Feedback from NL |
Solutions/options |
Nurse is more available than GP changes |
in progress |
Appointments mostly good |
|
Appointments available same day |
|
More appointments with the GP |
changes made |
More appointments with the Nurse |
will look into |
Feedback from patients of Lister Lane
Feedback from LL |
Solutions/options |
ease off access to appointment bookings |
variety of choices available |
notice to alert nurse on leave |
patients are advised of this |
Open longer hours? |
10.5hrs a day (54hrs access wk) |
Employ more GP’s and Nurses |
4 GP’s and 2 nurses available |
Open Saturdays? |
Meeting more than core hrs |
Cut waiting time to see a GP |
changes in progress |
More nursing hours |
will look into |
More phone lines |
in process |
More call handlers |
in process |
More Dr Kumar sessions |
already doing 9 sessions |
Online booking complex, ease of access |
TPP set up, |
More late evenings access |
surgery complying with DES |
Looking at the feedback results it shows there is more negativity from LL service users than NL service user. Lister Lane surgery is situated in the middle of Town centre, covers approx 3,300 pts of its own prior to merge, and also with the easy access and modern built premise with access to 2.1 GP, the demand and patient expectations have grown immense. The surgery is predominantly seeking innovative ideas, solutions and methods to tackle the highlights above. There has already been measure put in place to answer a lot of the queries patients have flagged up. The surgery takes its patients suggestion for improvement very seriously and aims to implement changes accordingly.
Please refer to evidence for component 5 of the DES to see action plan put together following this meeting.
Component 5
Action plan and priorities from survey findings 2012-13 as agreed by PRG and the practice team
Suggestions from survey findings |
Results |
Action to be taken |
Time scale |
Ease off Appointment booking |
Majority of the patients are satisfied with the current booking system, however the online booking system is not as popular with the branch site.
|
Practices to promote online appointment bookings by advertising more adequately to draw patient attention preferably at Nursery Lane as this is something new for that site.
Promotional materials to be supplied over branch sites
|
No time scale, although the practice is expecting to meet as many patients as possible with this request. All patients will routinely be given the choice to register for online access.
Audit review in 6/12
|
Appointment with the chosen health professional |
Majority of the survey users from Lister Lane Surgery have said it’s not quite easy to get an appointment with their chosen Health Professionals (73% between both practice) |
There is an increasing demand for the appointments with chosen GP and with the increasing population list; the practice is trying to accommodate the patients with their 1st choice.
Dr Shetty is also growing her popularity and will soon become a full time GP which should help resolve a lot of issues around ‘choices’.
Dr Sarwar has returned from her maternity leave and is currently serving 1 day a week.
|
Dr Sarwar’s return to work is to help reduce appointment waiting time for Dr Kumar and Dr Shetty.
Dr Sarwar’s template will only serve on the day demands. As this is a pilot scheme,
Dr Sarwar’s session will increase as the pilot runs successfully and improves the waiting time for patients chosen GP.
Review in 6/12
|
Appointment booking Procedure |
64% of LL patients are using the phone lines to book their appointments.
75% of NL patients are using the phone lines to book their appointments.
|
We are seeking telephone innovation to provide better, quicker and an efficient level of telephone access so that the high volume users are not affected in the queue and get a quick access to the surgery and to the right extension. |
By Spring 2013 |
Alternative option to appointment |
Our survey shows that if a patient is unable to obtain an appointment sooner than they are offered they are using telephone consultation as an alternative. |
The telephone consultation is currently a hit method to prevent high unnecessary attendances to A+E.
TC is offered to every patient who requests an appointment and unable to get one on the same day.
However if the nature is classed ‘urgent’ then this patient is offered an ‘urgent’ appointment with a GP on the same day.
|
Currently method working super, TC will be introduced to all branch sites as uniformity; this will give an equivalent result on Audit on A+E attendances and walk in centre users, geographically. |
Survey users by age, gender, ethnicity |
Survey indicates high volume of participants are Caucasian, female senior citizens from Nursery Lane,
High volume of Caucasian, female ranking age from late 20’ to middle aged for Lister Lane.
|
The participants were selected randomly, however this reflects on patient population type from each site.
We would like to hear from variety of age group on their views next time.
|
12/12 surgery will generate internal survey amongst all sites and target fraction of patient population from different
Age, gender, locality
|
Optional feedback information from survey 2012-13
The following feedback was given by patients via survey and they will also be taken into consideration for improvement within the next 6months.
Feedback from patients at Nursery Lane
Feedback from NL |
Solutions/options |
Nurse is more available than GP |
in progress |
Appointments mostly good |
|
Appointments available same day |
|
More appointments with the GP |
changes made |
More appointments with the Nurse |
will look into |
Feedback from patients at Lister Lane
Feedback from LL |
Solutions/options |
ease off access to appointment bookings |
variety of choices available |
notice to alert nurse on leave |
patients are advised of this |
Open longer hours? |
10.5hrs a day (54hrs access wk) |
Employ more GP’s and Nurses |
4 GP’s and 2 nurses available |
Open Saturdays? |
Meeting more than core hrs |
Cut waiting time to see a GP |
changes in progress |
More nursing hours |
will look into |
More phone lines |
in process |
More call handlers |
in process |
More Dr Kumar sessions |
already doing 9 sessions |
Online booking complex, ease of access |
TPP set up, |
More late evenings access |
surgery complying with DES |
2011-12 action plan carried forward
- Telephone access
The time scale was Aug 2012, following an extension build to the current premise, unfortunately the extension project was slightly delayed due to unavoidable circumstances and therefore the telephone upgrading system did not go ahead. However this item is now carried on to 2012-13 action plan as the extension project is due to go ahead in the coming months and the telephone upgrading will also be implemented. The surgery has innovative plans to upgrade the telephone system to do the following:
- Digital upgrade with options for extensions
- Call recording facilities (all practices)
- More call takers
Completion by Spring 2013
PRG and practice agreement
The PRG and the practice staff came to an agreement and put the above action plan together. The PRG members are pleased with the way the surgery’s current set-up with telephone consultation and how it’s cutting down on A+ E attendances. They have also suggested that the practice create uniformity with this to help educate patients and to encourage patients to utilise services offered by their GP surgery.
Component 6
Confirmation of the business opening times for Lister Lane Surgery and Nursery Lane Surgery
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)
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 Summer 2013 as there will be a 3rd branch site (Boothtown Surgery) this will be discussed with the PRG at a later date.
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.