patient participation in gps report july 2014

8/12/2019 Patient Participation in GPs Report July 2014

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Patients and Information Open House: Report on thePatient participation in general practice workshop

Tuesday 17 June 2014, Ark Centre, Basingstoke

1. Introduction

The workshop was introduced by Emily Carter, Regional Head of Patient and PublicVoice, and Martin Smethers, Chair of the Fordingbridge Surgery Patient ParticipationGroup. Information was provided about existing mechanisms to involve patients ingeneral practice and new NHS England initiatives; such as the introduction of theFriends and Family Test to general practice from 1 December 2014 and the 2014/14GP contract with incentives for participation and working in partnership with patientparticipation groups. Participants were tasked with discussing what needed tohappen to improve patient participation in general practice.

2. Summary of feedback from workshops discussions

Notes from the workshop discussions are provided in Appendix 1, grouped bytheme. A brief summary of the feedback provided is below:

Patient participation groups (PPG)

Lots of suggestions on what makes a successful PPG from experience ofpeople in the room for example constructive working relationships with theGP practice and having a clear purpose

Importance of links between PPGs and Clinical Commissioning Groups

(CCGs) and local Healthwatch organisations Ideas for what would help PPGs prosper:

o Sharing of best practiceo Networks of PPGs, potentially linked to CCGso Clarity on the role of PPGs from NHS Englando Role for Care Quality Commission (CQC) inspections to promote

importance of PPGs and patient involvement


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Changes to participation element of GP contract

Concern that as an optional part of the contract and with less money perregistered patient attached compared to previous years that GP practices willnot choose to participate

Suggestions made that in future years this be part of the core contract and notan optional part, or that money per patient be removed if not complied with asopposed to given if complied with.

Many people not aware that this change has happened

Friends and Family Test (FFT)

Very low awareness that this is coming to general practice Benefits of introduction of FFT recognised by participants, providing:

o a consistent approach to administering and analysing the survey istaken allowing comparisons to be made with other local practices

o response rates are sufficiently high enough and provide arepresentative sample of the practice population

o balance of positive and negative feedback is reviewed and acted upon

Suggestions of other ways for patients and the public to engage in general practice

Need to involve children and young people go to youth clubs; using socialmedia (such as twitter and facebook);

Outreach into community speak with people who dont take part in existingactivities e.g. often ethnic minority communities; young people

Discussion of barriers to people getting involved

3. Actions in response

The feedback received was really helpful and this is how the NHS England Southteam will be responding:

a. Communications with PPGs, GP practice managers, CCG lay members, CCGpatient engagement leads and local Healthwatch organisations on resourcesavailable to support PPG development. This includes: National Association ofPatient Participation framework for healthy PPGs .

b. Communications with PPGs, GP practice managers, CCG lay members andCCG patient engagement leads on changes to GP contract element onpatient participation and promoting the outcomes of the pilot in Swindontesting out ways of working between PPG and GP practices to review patientfeedback
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c. Learning session(s) for PPG members and GP practices on ways of workingtogether to review patient feedback delivered before the end of February2015

d. Support available to practices on how to implement the Friends and Family

Test in general practice accessed via the NHS England Area Teamse. Communications to CCG patient engagement leads and practice managerswith national guidance on friends and family test implementation andsuggestion for practices to work collectively across a geography to provideconsistency

f. Sharing feedback and suggestions received with national leads on areascovered in discussions, specifically: NAPP for suggestions on best practice for PPGs to be included in

framework mentioned above Care Quality Commission regarding promoting PPGs and patient

engagement as part of GP inspections NHS England national teams feedback on friends and family test and GP

contract


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Appendix 1: Notes from workshop discussions

Patient participation groups

Suggestions for successful PPGs.

GPs to join in PPGs and to value the role of the group Needs constitution Funding needs to be identified Healthwatch to be linked to PPGs Clear route for resolving issues and ownership of actions Clarity on purpose and what can be achieved Need to see progression from issues raised PPGs need to be independent of practice co-operative and not

confrontational Sustain interest must feel worthwhile Ownership with deliverables PPGs need to have independence from practice providing constructive

criticism and ideas and work collaboratively with the practice People need to see benefits Feedback needs to be acted upon otherwise public lose confidence in PPGs PPGs to be set up as newly established need to be independently minded. Need a marriage co-operation work together include a strong

chairman Ensure minutes of meetings are taken Make PPGs democratic and representative PM only one with authority to

appoint members PPG meetings are not for complaints PPG to have an annual meeting PPGs can help Healthwatch and support those functions

What support would be useful for PPGs?

To see examples that they can drive positive change Link with Healthwatch and CCG corporate processes (engagement,

educative) but capacity is an issue Sharing best practice (calls on busy peoples time)

o Awards of some sort?o Continuous improvement

Good PPGs could share best practice Need someone i.e. CCGs to pick up issues \ actions \ outcomes and then

share these more broadly

Umbrella meeting monthly of PPGs; getting patients interested and involved. Good links with Healthwatch


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Aims in terms of deliverables by NHS England, CCG, GPs, PPG Need national independent anonymous surgery PPGs. Obtain proper

statistics from significant surgeries with a good representative sample. A national Association of PPGs could co-ordinate.

Development of forums to ensure better link- up between PPGs and also withHealthwatch

PPGs joining together for area forum with CCG involvement How to recruit new members If several PPGs in the same town, have combined meetings Primary care hubs

Ideas for promoting PPGs with GP practices

Now that CQC inspecting GPs, could enquire why particular GP Practices do

not have PPGs. GPs need to meet certain standards Find out how many practices are having problems setting up a PPG See PPGs as an ally, not a threat PPGs should be an ally rather than a threat Has to be business value/opportunity cost rather than ad hoc

Suggestions for PPGs to communicate with wider community.

PPG information could be included with the patient prescriptions Fetes, meetings, PPGs need a budget Local websites, town Facebook, email. Prefer to face-to-face PPG could have a separate website independent of the GP practice but linked PPG patient group surveys 6 month of replies could be provided on a website

to include CCG notices and surgery replies. Patients could put up a question foranswer

Changes to participation element of GP contract:

Until it is mandated it is not going to happen and will not be meaningful This is being seen as a tick box exercise for many practices. However, there

is real potential for this to be carried out meaningfully Could be that money taken away if not carried out, rather than give money if

they do? PPGs needed to be organised such that issues could be discussed and

actions taken to resolve so that there are positive outcomes Could enhanced service specification become part of the core contract? Patient feedback indicate 2 very different results from survey by GP practice

and survey from local residents also independent of GP practice Issues duplicated between PPG and GP practice which needs to be resolved Patient survey and PPG; issues responded to ie matters of privacy. Evidence

based.


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Ensure patient views are heard and responded to

Friends and Family Test

Raising awareness

This is mandated how is it advertised? Need for communication to community to practice and to PPG Health workers unaware of friends and family questionnaire Patients may not bother if they think the survey is for a foregone conclusion

Consistent approach

What outcomes are we expecting? Needs to be consistent with independence in how it is administered and

analysed Needs a uniform approach across CCGs to get involved with your practice

on how it is administered and analysed Comparisons could be made reference against, compare and contract

against other GP practices Positive feedback as well as negative Transparency or feedback. Maybe tablets .. forms that can privately give

feedback; collated and made public There may be a much lower response and therefore not representative.

Sharing the results..

Friends and Family needs to be reported back independently Patients dont want to complain, or be negative in the surgery, so who will

view/receive the FFT Test outcomes? Will it be available at local PPG level? Should FFT Test / PPG feedback and action plan be publicised and audited? Will it influence patient opinion? We need to give good/positive feedback to GPs so that there is balance

patients receive feedback / follow up to know complaints are acted upon and

making improvements.Other ways to engage in general practice

Social events to bring in patients Meetings could be carried out in a neutral place library. It was queried whether PPGs were the only method? Could NAPP (National

Association for Patient Participation) carry out health education sessions patient to patient level?

Concept is of good citizen involvement in the NHS

Healthwatch right to enter and view. A communication tool.


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Need to connect with youth potentially to go to youth clubs etc and workwith them to discuss issues via social media. Also visit groups of older people

GP practices open up via Facebook and twitter for young to comment, olderpeople could use feedback forms

Those running groups can get feedback from their members. Patientrepresentatives can get informed feedback from those people who may notwant to be on the PPG e.g. young people. Young people may use twitter andother social media

People do not want to work with intermediaries they want to speak directlyand hear what is going to happen as a result need transparency. Exampleof www.evolve.com

NHS England questionnaire for whole country from a non-biased opinion Accessibility needs to be considered

Important to better target hard to reach groups, which includes non-UKcitizens and young people, to get their views Multiple ways of communicating Elderly social exclusion social media Need a timescale for response to comments for example 7 days. Engage with Healthwatch and local CCGs to put pressure on surgeries Get the Practice Manager to give a talk to a group of patients How can I be

a bette r patient positive feedback rather than negative What is the national and regional role?

Working as partners working together Patients understanding context of surgery as well as GPs understandingperspective of patients.

Perceived barriers to participation in general practice :

Patients worry about giving personal time Patients worry about being struck off if complaints made one person

advised having experience of this Some PPGs viewed as small hand-picked group by invitation only from the

GP GPs may not have time to carry out analysis of information provided from theirpatients

PPG members usually older say over 60 so not fully representative of thepractice

Apathy - people think they will not be listened to; dont know what is going on;dont know where to go

Difficult to get patients to engage with PPG Some GP s dont encourage patient engagement and dont have a PPG

Less than 50% feedback is not a true picture

patient participation in gps report july 2014

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