Winscombe and Banwell Family Practice

Patient Participation DES and Survey Report

2013-14

The Doctors and staff at the surgery would like to express their gratitude to all of the patients who took part in the Patient Survey and also to our Patient Participation Group (PPG), who gave their time and expertise to compile the survey, discuss the results and help us to formulate a workable action plan. We really do value the information and feedback gained from the survey; it has highlighted areas which need improvement and also shown areas where we are doing well.

This report summarises the further development and outcomes of Winscombe and Banwell Family Practice Patient Participation in 2013/14.

Validation that the Patient Participation Group (PPG) is representative

We have had an active face to face Patient Participation group since 2008. We currently have 20 members, 18 attend the meetings and 2 are virtual members. This is the same as last year although a couple of patients have left due to moving out of the area and a couple have joined. The PPG members, Practice Manager and Senior Partner have decided to meet on the second Thursday of every other month.

Profile of practice population and the PPG

Winscombe and Banwell Family Practice has a list size of 8818 patients. (April 2014)

Percentage comparison between the Practice Population and the PPG

Age Groups Practice Population

%Males Females

PPG Profile

%Males Females

Under 16 9.5 8.2 0 017-24 4.3 3.6 0 025-34 3.7 3.7 0 535-44 5.1 5.6 0 545-54 7.3 7.4 10 055-64 6.9 6.7 5 1065-74 6.6 7.5 5 1075-84 4.0 4.7 5 2585-90 1.0 1.6 5 1590+ 0.5 1.5 0 0Total patients % 49.2 50.9 30 70

Ethnicity

We have recorded ethnicity information for all of our patients registered in the practice during the last few years. Our patients are predominantly White British with our other main ethnic category being Asian due to Sidcot School boarding students which has a high prevalence of Asian students. Currently our PPG members are all white British.

Other characteristics of our PPG

One of our members is a carer; the majority of members are retired. We have not collated any further information such as disease, learning difficulties or any other minority groups regarding our PPG.

Process used to recruit Members

We are actively encouraging patients to join so ensure a more representative group of members by.

Producing information leaflets with a tear off application slip which can be returned to the surgery and which are available in the waiting rooms.

Displaying PPG information posters at both surgeries explaining the PPG and any of our patients are welcome to join either as a face to face or virtual member.

Having a page on our website dedicated to our PPG with information, contact details and a joining form.

We have also set up the virtual PPG in response to patients who wanted to be involved but could not attend the meetings.

We included an information leaflet and application form with all the PPG surveys we gave out which resulted in a very good response and we have had forms returned from 7 patients who have expressed an interest in joining the PPG.

Varying the times of the PPG meetings to enable working patients to attend.

Future plans for PPG Recruitment

One of the problems which impede us achieving a representative sample is the timings of the meetings which are usually held on a Thursday at 2.30pm. We will be holding at least one meeting in the evenings during the summer and it is hoped that this will encourage younger working patients to join. We have also set up a virtual PPG group although we have not had much interest in this.

We are also discussing the benefits of setting up a Face book page to encourage and enable younger members to have a say and to help inform them about the services we offer.

As a result of the PPG survey the group are going to write a quarterly newsletter which will be available in the surgery, one of the aims is to raise awareness of our group and encourage patients to join.

We will also be liaising with the local library to ask if they would display our information leaflet and application and the Parish Council to see if they would advertise our PPG in their magazine and on their website.

We continue to actively recruit both face to face and virtual members.

How the Patient Participation Group Survey was constructed and distributed.

Due to staff pressures we were unable to begin the PPG DES until 2014 as staff were being used elsewhere in the surgery to ensure that patient care and health continued to be our priority during times of staff absence. The construction and distribution of the survey were discussed in a meeting in February 2014. It was decided that we should follow on from last year’s survey and report; therefore this year’s survey would be comparable so we could see if there were any significant differences and whether our improvements had been effective. No particular problems or issues were highlighted during the last year as a topic, so a general survey was formulated again this year. The one concern was the number of questions so the questions were reduced to 21 this year. During the meetings we have had examples from NAPP and other healthcare surveys from Survey Monkey were researched for ideas and a focus for our survey.

Surveys were distributed by adding a link to survey monkey from the website, printing 200 surveys and handing them out to patients who were interested in completing them. We also made them available in the waiting area for patients to complete if they wished. A member of the PPG also handed them out to patients at our local village market. Some were taken up to our local boarding school for students to complete but we did not have any responses.

We included both multiple choice and open-ended questions to enable patients to comment freely, the survey was discussed at a practice meeting with the Doctors and the distribution methods agreed.

Due to time/staff pressures it was not possible to send out the survey to a random sample of patients as we did last year. We have a high number of Nursing and Dementia residential homes in our area; it was felt that it was inappropriate to ask those residents to complete a survey which was agreed during the PPG and Doctors meeting.

In February 2014 we distributed 200 surveys to both surgery premises and asked both Receptionists and Clinical staff to remind patients about the survey and encourage them to fill one in if they wanted to. We also posted the survey on our website and advertised it for patients to fill in online. As the response from younger members of the practice population are under-represented; the Receptionists were asked to target younger patients if at all possible to help us with a more representative sample.

This year the response from patients was significantly less than last year. A total of 66 out of a total of 200 surveys were completed and returned which equates to a 33% return rate, this is 10% less than last year. Only 2 were filled in online as opposed to 31 last year.

This reason for this could be that last year the survey was available to complete for a longer period and in future we will make sure that we give enough time to get a fully representative sample. Also last year the survey was a part of our website, patients weren’t redirected to a different website to complete it. This may have put patients off completing the survey as there is less trust and familiarity with outside sites. More effective advertising of the survey online and in the surgery may also have improved uptake. In the future, we will be more conscious of how we distribute and advertise surveys. Patients may also be tired of completing surveys, as we seem to be asked to complete surveys regularly everywhere we go. This year we have also been asking our patients to complete surveys for GP revalidation, in addition to other surveys requested of the patients. If patients have no particular comment to make, are generally happy or are indifferent with respect to our service they are less inclined to complete a survey.

Outcome of the Survey results.

Please the Analysis of the Survey Results in Appendix 1 and a copy of the survey in Appendix 2

The results of the survey were overall very encouraging and the majority of patients were very happy with the service, resources and clinics we provide. The PPG also suggested putting a question in the survey regarding patient access and disabled parking. As our population especially in Winscombe is generally older this is a concern. Unfortunately Disabled parking at Winscombe was brought up as an issue within the survey as it was last year; we are restricted by the amount of land we have. There were also complaints regarding the pharmacy provision in Winscombe which need to be addressed again.

Update on progress for Actions from last year and considerations for improvements for this year

The actions decided from last years survey included

1. More effective use of the website by informing the patients of our website and the information it provides.

This year we have made a conscious effort to inform patients of our services and what we have to offer as a Surgery. This has been significantly helped by having online access for appointments and prescriptions as this has meant that patients are viewing the website more frequently; we can add new information immediately and easily which helps to reach a far greater audience. Information regarding the surgery and other health issues is not limited to mail outs or patients visiting the surgery as it was previously.

2. Clinics and Services

We regularly update the website to list any new clinics/services we provide. This year we hope to write more about the specific clinics to help patients have a better understanding. We will also list whether they are self referral or GP referral clinics. We will also ensure that the notice boards are relevant and not to cluttered so it is easier to read and understand the posters we have.

3. Local Chemist at Winscombe

Many patients were still unhappy with the level of service provided by the local boots chemist in Winscombe. Although we have tried to arrange a meeting they have also had staffing issues this year and now have a new manager and pharmacist. We are looking to arrange a meeting with them in the near future to look at the issues that have been raised by patients and also by the surgery. We hope to improve the service by working together as much as possible. We aim to get scripts to Boots chemist in Winscombe on the same afternoon if the repeat prescription is handed to us before midday; they come to collect the prescriptions at 2pm each day. If the repeat prescription is handed in after midday we cannot guarantee it will go down to the chemist the same day but we always try to do our best. If repeat prescriptions are handed in after 2pm then they go down to the chemist the next day. They have then stipulated their own time for collecting the filled prescriptions and unfortunately due to the amount of scripts, space and staffing this can sometimes take longer. Boots Pharmacy now offer a repeat ordering service which we hoped would ease the pressure somewhat as it helps them to predict the amount of work. We will continue to work with them to improve the service for our patients.

Again there was high praise for the other pharmacies we deal with, especially Banwell Pharmacy and Axbridge Chemist.

4. Parking at Winscombe

This is difficult to address as there is no more land to increase the parking, however the issue has been discussed in Practice Meetings and will be raised with the Patient Participation Group to see if any solutions can be found. Staff are encouraged to park in the free car park in the village to free up spaces for patients.

5. Opening hours

We have been asked again this year for weekend surgeries but unfortunately we do not have the staffing capacity for this at present. We will continue to review the situation regularly.

PPG Survey Results and Action Plan

Unfortunately we did not manage to have a meeting to discuss the action plan. However, the results were emailed to the majority of members asking for their comments. Only two members replied and expressed that the results of the survey looked encouraging and that generally patients were happy with our care and service. We have struggled this year to have regular meetings as the Practice Manager has had long term absence and there has not been the opportunity to re-elect a chairperson. Hopefully this year we can return to regular meetings.

Overall view from the patients’ responses and Actions.

Many comments were made about the helpfulness, friendliness and efficient service. Our patients liked our personal and approachable staff and that nothing seemed too much trouble for any of the staff. However, we had a couple of negative comments where patients thought that their symptoms weren’t taken seriously and there was a reluctance to refer to a specialist. Another clinical issue that was remarked upon was that the new computerised INR system left longer between checks and the patients felt more confident when the clinician decided the dose and not the computer. These comments will be fed back to the GP’s during a meeting and although the respondents were anonymous they are worth highlighting.

The following priorities and actions will continue to be reviewed and improved.

You said We willWebsiteContinue to promote the website to inform patients about our services and surgery information.

Publicise the website on our check in screens

Encourage the receptionists and clinicians to inform patients when appropriate.

GeneralMore information about the Doctors and their specialities

The patients would like information regarding the times which Doctor was practicing.

Ask the Doctors to write a small piece for the website listing their specialities but also stress that they have a wide overall knowledge and experience in general practice.

List the Doctors normal rotas although they are subject to change regularly due to meetings, annual leave and other commitments.

Newsletter

There should be more information regarding the PPG and also what is happening within the surgery

The PPG will produce a quarterly newsletter which would be accessible on the website and also in the surgery.

Ask Winscombe library if they are happy to stock a copy

Clinics and ServicesMany Patients were not aware of the services and clinics we provide at the surgery. Although it was agreed that if you did not need the particular service you may not need to know about it.

Clinicians and Receptionists to continue to inform patients if appropriate.

Write more information about the clinics on the website and the best way for patients to access them if necessary.

Local Pharmacy in Winscombe

The problems are continuing from last year; patients having to wait 4 days for a prescription, mistakes made and stock was often not kept on the premises and patients had to wait.

We will arrange a meeting with the pharmacy manager and/or pharmacist to discuss the issues brought up by our patients and see if we can work together to improve the service.

Opening Hours

Patients would like us to have a Saturday morning Surgery as our extended hours.

Currently our extended hours are early morning clinics which are very popular and are pre-booked. We will continue to review our opening times regularly.

Confirmation of Opening times

Winscombe Surgery

Monday Tuesday Wednesday Thursday Friday Saturday and Sunday

Core Hours 8am-6.30pm 8am-6.30pm 8am-6.30pm 8am-6.30pm 8am-6.30pm ClosedExtended Hours 7am-8am 7am-8am 7am-8am

Banwell Surgery Monday Tuesday Wednesday Thursday Friday Saturday and Sunday

Core Hours 8.30am-1pm 3.30-5.30pm

8.30am-1pm 3.30-5.30pm

8.30am-1pm 3.30-5.30pm

8.30am-1pm 8.30am-1pm 3.30-5.30pm

Closed

Extended Hours All held at Winscombe Surgery

Access is via pre-bookable appointments and book on the day appointments for urgent problems. Appointments can be booked either by phone, in person or requested via our website. We have very experienced and knowledgeable Receptionists who are happy to help and advise patients of our services and clinics.

We provide Early Morning surgeries from 7am-8am three days per week. All of our 5 Partners work one session per week. All our extended hours appointments are pre-bookable in advance and mainly reserved for patients who work as we are a commuter village.

To view a copy of this report and the action plan from the survey please see our website:

http://www.winscombebanwellsurgery.nhs.uk

Click on the link to the Survey Report on the right hand side.

The report will be available from the surgery and advertised in the upcoming PPG newsletter. We will also put a poster in the waiting rooms advising patients how to view the report and also the outcomes from the action plan. We will put up a “you said, we did” poster.

See below for Appendices

Appendix 1 - Analysis of the Results of the PPG Survey

Winscombe and Banwell Family Practice

Patient Survey 2014Number of Responses: 66Gender

Male   21%Female   78%

Comparing the gender of patients completing the survey this year more females completed the survey than last year. Older patients (65-74 years) were more likely to complete the survey, 34% compared with 13% last year.

Age GroupUnder 17  0518-24   1%25-34   3%35-44   4%45-54   6%55-64   25%65-74   34%75 or Older   38%Over 85  6%Prefer not to say 0%

Which surgery do you usually attend?Winscombe 71%Banwell 28%

The difference between Winscombe and Banwell patients completing the survey was also different to last year, 71% of respondents were from Winscombe compared to 46% last year and only 28% of patients in Banwell compared to 51% last year. This could be for a multitude of reasons but most likely due to time pressures as Winscombes’ population are more likely to be retired and therefore more time to complete the survey in a small window of time.

Are you happy with access for disabled patients?Yes   72%No   1%Other (Please specify)   0%No response   27%

The access for disabled patients is perceived as good at both sites. We did have a comment regarding disabled parking at Winscombe, we have difficulty with space and have looked into options for increasing parking to improve the situation but unfortunately we cannot expand any further. Once in the surgeries we have made every effort to assist disabled patients to easily move around the surgery within the inevitable limits of the buildings and it seems that this is adequate for the patients. We did not know, however, how many of the respondents were disabled or care for a patient who is, so cannot comment further.

Do you look after someone who could not manage without you? Relative, Spouse, Friend or Neighbour.

Yes   16%No   81%

No response   3%

Are you aware we can signpost you to local groups such as Crossroads Care for support?Yes   50%No   40%No response  10%

We were pleased with the response to this, although it can be improved upon. We have patient leaflets and information on our website with support groups and societies who can assist our patients. We also have close links to Crossroads Care and have in the past had representatives at the surgery highlighting the work they do for carers.

How often do you typically come to the Practice?Regularly (every few weeks or more)   31%Occasionally (a few times a year)   60%Rarely (no more than once a year) 7%

This is very similar to last year’s results and the slight increase this year could be due to a higher percentage of our older population completing the survey.

Are you aware that you can request a private area to speak to the Receptionists?Yes   69%No   28%No response   3%

Last year only 31% of the patients knew that they could request a private area to speak to a Receptionist however, this year 69% were aware of this. Our increased advertising of our services to the patients has meant that patients are more informed.

How satisfied are you with the opening hours of the Surgery?Very Satisfied   50%Fairly Satisfied   34%Neither Satisfied or Dissatisfied   10%Quite Dissatisfied   0%

Very Dissatisfied   0%Don't know the opening hours   4%

The results this year are very similar to last years. Very satisfied decreased by 5% and fairly satisfied increased by 4%. The patients who were neither satisfied nor dissatisfied also increased by 5%. Patients who didn’t know our opening hours decreased by 1%.

Are you aware that the Surgery offers early morning clinics from 7am onwards?Yes   90%No   9%

Last year 82% of patients knew that we had early surgeries and we have tried to promote them for our working patients over the last year.

Are you aware that you can request the following?An appointment at either Winscombe or Banwell?  98%A telephone consultation with the doctor?   78%

We have looked at ways for our patients to have access to our clinicians and even though we have always offered the choices above we have tried to promote them this year. This seems to have been effective as 98% patients were aware that they could book an appointment at either site as opposed to 88% last year. 78% knew they could request a telephone consultation when only 41% knew last year. This is encouraging as it means that our attempts to inform patients have been working. In the past 6 months, if you need an urgent appointment, were you able to see a Doctor on the same day?

Yes   78%No   4%Can't Remember  4%

No response   14%

We never turn a patient away if they believe their symptoms are urgent. Therefore we presume that patients are thinking about non-urgent appointments or have managed to speak to a Doctor and then not needed an appointment.

If you were unable to see a Doctor on the same day, why was that?No Appointments   12%The times offered didn't suit me   1%The Appointment was with a Doctor I didn't want to see 6%Was offered an appointment at a different location  7%Can't remember   1%Another Reason (Please specify) 0%

How often do you see the Doctor you prefer?No preference   15%Always or most of the time   72%some of the time   9%Never or almost never   0%Not tried at this Surgery   3%

Access to Doctors that patients have requested has also improved since last year as it has increased from 63%. This ensures that patients have good continuity of care if they wish.How easy is it for you to get an appointment with a Practice Nurse at the SurgeryHaven't tried   13%Very easy   57%Fairly easy   28%Not very easy   0%Not at all easy   0%

Are you aware of the following clinics, self-testing facilities and services available?24 hour Blood pressure testing

37%

Self-test Blood Pressure  59%Ante-natal Clinic  63%Asthma Clinic  45%Baby Clinic 63%Blood tests (Phlebotomy) 77%Chiropody and Podiatry 46%COPD Clinic 18%Counselling 21%Cryotherapy clinic 15%Diabetes Clinic 43%Ear Microsuction 28%Hearing Tests 43%Heart Disease Clinic 27%Joint Injections 43%Minor Surgery 56%Palpitation Diagnosis 22%Physiotherapy 43%Stop Smoking Support 53%Urinary Incontinence 27%Warfarin Clinic 43%

Overall patients are more aware of the services we have on offer. We attribute this to increased use of the website by patients and also by the surgery by promoting our services. We have also tried to organise Reception so that notices are more organised into health and age groups. Therefore patients can easily identify notices that are applicable to them.What other Clinics would you like to see offered?This year the most popular requested clinic was a skin cancer/mole check clinic. Currently patients have to book an appointment with a GP to have their moles checked. This is something that we will look into providing if it is practicable. Well women and Well man checks (MOT’s) have also been requested and although we do provide this service with our nurses and also by the introduction of the NHS Healthcheck it is something we could look at promoting further. Other requests we more specialised and we don’t have the resources for such specialised clinics such as Facial Palsy, Hearing aid maintenance and repair.How do you order your prescription?In person   68%By post with repeat counterfoil   7%Online through the surgery website   12%Through the Pharmacy   24%

Are you happy with the Pharmacy provision?Yes 87%

No  7%No Response 6%

Overall, how happy would you say you are with the level of the services you currently receive?Very happy   63%Quite happy   27%Neither happy nor unhappy   6%Slightly unhappy   0%Very unhappy   0%No response   4%

How likely are you to recommend the surgery to family and friends?Very likely   75%Quite likely   13%Not sure   4%Not very likely   0%Not at all   0%

What aspects do you like in particular, and at any cost would you want to keep? Are there any changes you would like to see introduced?What aspects do you like in particular and at any cost would you want to keep?(If you wish to see a full list of comments please ask at the surgery)

The comments made regarding aspects that respondents would like to keep at any cost included: The ability to see/talk to a doctor on the same day if necessary The accessibility of preferred doctors The ‘in surgery’ pharmacy at Banwell Early morning appointments and flexible appointment hours Friendly, helpful and approachable service from all the staff Keeping all the clinics and services we provide currently.

What changes would you like to see introduced?(If you wish to see a full list of comments please ask at the surgery)The comments regarding changes that respondents would like included:

Change the awkward parking layout at Winscombe for disabled patients Provide well women/men check-up, obesity and skin blemish clinics. Have extended hours opening at Banwell as well as Winscombe for workers. Opening at the weekends especially Saturday mornings

Website to detail every doctor in the practice and their specialities

This survey has been organised by the Patient Participation Group, which is made up of patients, and practice representatives. We are very grateful for their time, and for the time and care you have taken in completing this questionnaire. If you are interested in joining the Patient Participation Group, please see our Reception staff who will be happy to help.Are you aware we have a Patient Participation Group?Yes 43%No 50%No response 7%

 

Appendix 2 – A copy of the PPG Survey

Winscombe and Banwell Family PracticeAll information will be held in accordance with the Data Protection Act 1998.

The following information is needed to help us make sure that a representative sample of our patients are included.

PLEASE TICK THE RELEVANT BOX.

Gender:

Male

Female

Other

Prefer not to say

Age Group:

Under 17

18 – 24

25 – 34

35 – 44

45 – 54

55 – 64

65 – 74

75 – 84

Over 85

Prefer not to say

Which surgery do you usually attend?

Winscombe

Banwell

Are you happy with access for disabled patients?

Yes

No

Do you look after someone who could not manage without you? Relative, Spouse, Friend or Neighbour.

Yes

No

Are you aware we can signpost you to local groups such as Crossroads Care for support?

Yes

No

How often do you usually come to the Practice?

Regularly (every few weeks or more)

Occasionally (a few times a year)

Rarely (no more than once a year)

Are you aware that you can request a private area to speak to the receptionist?

Yes

No

How satisfied are you with the opening hours of the surgery?

Very satisfied

Fairly satisfied

Neither satisfied nor dissatisfied

Quite dissatisfied

Very dissatisfied

Don’t know opening hours

Are you aware that the surgery offers early morning surgery from 7 am onwards?

Yes

No

Are you aware that you can request the following? (Please tick)

An appointment at either Winscombe or Banwell.

A telephone Consultation with the Doctor.

In the past 6 months, if you needed an urgent appointment, were you able to see a Doctor on the same day?

Yes

No

Can’t remember

If you weren’t able to be seen that day, why was that?

No appointments

The times offered didn’t suit me

Appointment was with doctor I didn’t want to seeWas offered an appointment at a different locationAnother reason (please specify)

Can’t remember

How often do you see the doctor you prefer?

No preferenceAlways or most of the time

Some of the time

Never or almost never

Not tried at this surgery

How easy is it for you to get an appointment with a practice nurse at the surgery?

Haven’t tried

Very easy

Fairly easy

Not very easy

Not at all easy

Don’t know

Are you aware of the following clinics, self-testing facilities and services available?

Yes No

24 Hour blood pressure testing

Self-test blood pressure

Ante-natal Clinic

Asthma Clinic

Baby Clinic

Blood tests (Phlebotomy)

Chiropody and Podiatry

COPD Clinic

Counselling

Cryotherapy Clinic

Diabetes Clinic

Ear Microsuction

Hearing tests

Heart Disease Clinic

Joint injections

Minor surgery

Palpitation diagnosis

Physiotherapy

Stop Smoking support

Urinary incontinence

Warfarin Clinic

What other Clinics would you like to see offered?

How do you order your prescriptions?

In person

By post with repeat counterfoil

Online through the surgery website

Through pharmacy

Are you happy with the pharmacy provision?

Winscombe BanwellYes Yes

No No

How happy would you say you are with the level of the services you currently receive?

Very happy

Quite happy

Neither happy nor unhappy

Slightly unhappy

Very unhappy

Comments

How likely are you to recommend the surgery to family and friends?

Very likely

Quite likely

Not sure Not very likely

Not at all

What aspects do you like in particular, and at any cost would you want to keep? Are there any changes you would like to see introduced?

This survey has been organised by the Patient Participation Group, which is made up of patients and practice representatives. We are very grateful for their time, and for the time and care you have taken in completing this questionnaire. If you are interested in joining the Patient Participation Group, please fill in the attached form and return with your survey.

Are you aware we have a Patient Participation Group?

Yes

No