DAPDUNE HOUSE · PDF fileDapdune House Surgery staff members have worked with the virtual PRG to establish and ... The NBSurvey Methodology 9 Input Channel Evaluation Criteria 12

DAPDUNE HOUSE SURGERY

Dapdune House Surgery

Dapdune House Surgery,

Wharf Road,

Guildford, GU1 4RP

Practice Manager: Mr Jeff Thomas

T: 01483 400227

Local Pat ient Part icipat ion Report March 2012

Da Dapdune House Surgery Local Patient Participation Report 2012 | 2

Executive Summary The following report outlines the results of the first year requirements for a Local Patient Participation Report to satisfy the PP-DES 2011 – 2012 as directed by; THE NATIONAL HEALTH SERVICE ACT 2006 The Primary Medical Services (Directed Enhanced Services) (England) (Amendment) Directions 2011 Insertion of new direction 12A - “Patient Participation Scheme”.

Dapdune House Surgery,

Wharf Road,

Guildford,

GU1 4RP

Practice Manager: Mr Jeff Thomas

Number of full time doctors 9

Number of patients 11371

Dapdune House Surgery engaged with NETbuilder to provide its comprehensive managed survey solution, NBSurvey. This enabled the collection of views from patients in multiple locations across various demographic groups and facilitated the canvassing of patients’ opinions via a suitable input channel, from in-practice touch screen kiosks / laptops, to virtual online surveys. The Surgery has a virtual Patient Reference Group. Patients are invited and encouraged to give their feedback via surveys on various aspects of the practice in a number of ways. PRG members currently number ~ 80 and recruitment is on-going.

Results Summary

Item Total

Number of Surveys 8

Number of Responses 701

Number of Input Channels 3

Summary of Outcomes & Action Plan

Dapdune House Surgery staff members have worked with the virtual PRG to establish and prioritise a series of surveys for use by the patient population. The numbers of patients taking part in the surveys (701 from 8 surveys) has been sufficient to enable surgery staff to evaluate and note forming trends. Results of the first three surveys, covering Access, Doctors and Overall Satisfaction, distributed to the PRG, have been evaluated and action plans derived from the data. These action plans, detailed towards the end of the report, will form the basis for continual improvement in the three areas noted. Further recruitment to the PRG will be ongoing and closer liaison is envisaged. This has been a very positive experience for those involved in the development of the PPG DES for Dapdune House. First and foremost, the real-time nature of the survey reporting has facilitated prompt change where appropriate. Longer-term plans for the evolution of patient services have also been enabled and will help to guide staff to focus resources where required.


We acknowledge that work is required to engage more closely with the PRG and, to that end, we are considering the formation of an actual PRG to help identify areas for improvement.


CONTENTS

Executive Summary 2

Results Summary 2

Summary of Outcomes & Action Plan 2

About The Practice 6

Services at the Surgery 6

The Partners 7

Associate GP 7

The Practice Staff 7

Practice Nurses 7

Community Midwives 7

Community Nurses 7

Health Visitors 8

Opening Hours 8

Extended Hours 8

Making & Cancelling Appointments 8

Home Visits 8

When the Surgery is closed 8

Local Survey Methodology 9

The NBSurvey Methodology 9

Input Channel Evaluation Criteria 12

Patient Reference Group 14

PRG Membership 14

Member Profiles 14

PRG Recruitment & Representation 14

PRG Agreement of Priorities 15

Results, Outcomes & Findings 17

Summary Information 17

Survey results by Input Channel 17


Summary of Demographics Survey 17

Representation of Registered Patients 18

Survey Results 18

Discussions & Action Plans 21

Discussions 21

Action Plans 21


About The Practice At Dapdune House Surgery we are a friendly, hardworking, dedicated and professional team

focused on the provision of top quality health care to our patients in the Guildford area. Our

doctors and nurses provide a full range of general medical services.

Services at the Surgery

Ante Natal Appointments: Held by a midwife on Monday, Tuesday and Wednesday

afternoons.

Post Natal Appointments: Can be made with their doctor during normal surgery times.

Child Immunisation Clinic: Held two Tuesdays in the month, run by the practice nurse.

Child Health Clinic: Held on Tuesday mornings between 10 – 12 am.

Children’s’ Development Review Sessions: By appointment with the Health Visitor

Cervical Smear Appointments: Available on request with the practice nurse

Family Planning Appointments: The full range of family planning advice is available to both

male and female patients. This is run by our family planning nurse. Coil and cap fitting

appointments, as well as oral contraception, can be made at this clinic.

INR Clinics: Run by one of the doctors and a practice nurse.

Diabetic Clinics: Held two Tuesdays in the month, run by Dr Jump and Dr Rimmer, the

Practice Nurse, Podiatrist and Dietician. Our diabetic patients are seen twice a year or more

frequently if required.

Respiration Clinics for Asthma & Chronic Chest Disease: We have a weekly clinic run by our

practice nurse, Ann Dawe, who is specially trained to promote quality respiratory care.

Telephone advice about asthma problems is available.

Hypertension (High Blood Pressure) Clinics: Run by the Practice Nurse, who will monitor

and help control high blood pressure.

Minor Operations & Cryotherapy Clinics: Appointments are made after discussion with the

patients own doctor in normal consultation hours.

Travel Vaccinations: Routine vaccinations and those required for foreign travel are given by

the Practice Nurse.

Flu Immunisation & Pneumonia Vaccination Clinics: Appointments can be made in

September for vaccinations in October and November. Patients with asthma, diabetes,

heart, kidney or chest diseases and people over 65 are encouraged to attend.

Non NHS Examinations: Medical examinations can be arranged by appointment for special

purposes e.g.

elderly drivers’ medicals


pre-employment medicals

insurance medicals

The Partners

Dr David G Eyre-Brook (m) MB BS (London 1977 Westminster) MRCGP DRCOG

Dr Anthony F Rimmer (m) MB ChB (Liverpool 1979) DA DRCOG

Dr Diane Ackerley (f) MA (Oxon) MB BS (London 1981 King’s) MRCGP DCH DRCOG

Dr Ian F Cunliffe (m) MA (Oxon) MB BS (London 1982 St Thomas’) MRCGP DRCOG

Dr Allison E Jump (f) MB ChB (Leeds 1982) MRCP

Dr Caroline Karanjia (f) MB BS (London 1983 Guys) MRCGP DCH DRCOG

Dr Fiona H Groom (f) MB ChB (Glasgow 1985) MRCGP DRCOG

Associate GP

Dr Nicola Valentine (f) MB BS (London 1990) BSc DFFP MRCGP DRCOG

Dr Emma Sattelle (f)

The Practice Staff

Practice Nurses Nurse Ann Dawe SRN (Guy’s Hospital 1978) DN RM

Nurse Angie Tolan RGN

Nurse Joan Dyas

Nurse Louise Kettle RGN RM

Community Midwives

The Midwives are involved in all aspects of maternity care, holding Ante Natal and Booking

Clinics at the surgery. The booking in appointment is a lengthy first appointment during

which all information and guidance is provided. The appointment is followed up with short

check-ups with the midwife and GP. The community midwife visits the patient at home with

their baby, providing continuity of care. The Midwives can be contacted at the Royal Surrey

County Hospital, St Catherine’s Ward – 01483 464147.

Community Nurses A team of community registered nurses and health care assistants visit house bound patients with

nursing needs. They provide: wound care management and pressure ulcer prevention, care of IV

central lines (including chemotherapy pumps), and intravenous medication, chronic disease

management, continence care, palliative and end of life care. They can be contacted on 01483

563595, or at weekends and Bank Holidays on 01483 782300.


Health Visitors The health visitors at Dapdune Surgery work closely with a qualified nursery nurse, and run a

weekly baby clinic. Post natal clinics are also offered. The health visitors can be contacted by

leaving a message on their answering machine on 01483 400221.

Opening Hours

The surgery is open from 8.30 am to 6.30 pm every weekday. Note: Telephone lines are closed between 1pm -2pm

Extended Hours The surgery offers extended hours appointments on Monday and Thursday evenings. These appointments (pre-booked only) run from 6.30pm to 8.00pm.

Making & Cancelling Appointments We would like patients to be seen by the doctor with whom they are registered. This will help to ensure that the GP that is consulted is familiar with their medical history. Appointments and cancellations can be made:

in person

by telephone - 01483 400200

online using our internet booking service

by automated telephone booking service We also offer an online service to order repeat prescriptions.

Home Visits

Home visits are available for patients who are too ill to visit the surgery.

When the Surgery is closed

If patients telephone the surgery they will hear a recorded message. When the surgery is closed,

ring 01483 400200 for further directions to the Out of Hours service, which is provided by

Thamesdoc (0300 130 1305), and organised by Surrey PCT.

https://dapdune-house-surgery.appointments-online.co.uk/


Local Survey Methodology The Practice engaged with NETbuilder to provide its comprehensive managed survey solution, NBSurvey. This enabled the collection of views from patients in multiple locations across various demographic groups. Surgery staff then canvassed patients opinions via an input channel most suited to them, from paper surveys and in-practice touch screen kiosks / laptops, through to virtual online surveys. Findings from previous studies carried out by NETbuilder exposed that, multiple short surveys with a maximum of 8-10 questions each are more effective than one long survey running continually throughout the survey period. Each survey was customised using the investigational design and measures e.g. using a short survey (The Access Survey) to measure the effectiveness of patients requesting an appointment. Additionally, short surveys encouraged patients to give feedback for the areas relevant and important to them.

The NBSurvey Methodology


Step Description Surgery Comments / Experiences

Continual Development of Patient Reference Group (PRG)

The PRG is a representative group of patients from the practice. They are responsible for providing feedback to surveys and collaborating with the practice to analyse the results and agree realistic change opportunities.

Although we had an initial drive to recruit as many people as possible, this is an on-going process so that any of our patients, new or current, have the opportunity to contribute.

Determine Priority Areas

Key areas include but are not limited to the following:

Access

Overall Satisfaction

Seeing a Doctor

See a Nurse

The Reception

The Surgery Environment

Demographics

Specialised Clinics (e.g. Flu, Vasectomy)

The PRG and other patients complete the Patient Priorities Surveys to priorities the areas (above) to determine the order in which key areas are addressed by the practice. Patients are also given the opportunity to provide comments regarding other areas they would like to see addressed.

A good response to the survey gave us three areas of priority that patients wished to look at first. Results can be seen in the next section.

Design & Build Surveys

The practice works closely with NETbuilder to design and build the surveys. Each survey is designed to measure the patient’s view of the identified key areas. Each survey contained between 8-10 questions. Patients are able to choose to complete the surveys they believe are relevant to them and ignore those that are not.

The practice collaborated with NETbuilder and the PRG to agree the questions in each survey.

Decide on Input Channels and Publish Surveys

The practice worked closely with NETbuilder to agree which input channels are suitable for the surgery and patients. Input channels available are:

We used the Input Channel Evaluation Criteria to help us decide which channels to use for Dapdune House Surgery:

In-surgery Kiosk (We have one Kiosk in both waiting rooms): to


Surgery Kiosk

Web Portals

Laptop

Paper

Face to Face Each survey can be used on (published to) one or more of the input channels listed above.

capture patients from all demographics visiting the surgery

Staff appraisal portal, used to gain specific feedback on individual doctors.

PRG Web Portal: specific portal for PRG Members

Web Site: open to all practice patients

Advertise Feedback Channels

Inform patients of the available input channels and current surveys, in order to create a greater number of participation responses. Types of promoting include but is not limited to:

Encouragement slip given by the doctor

Posters

Leaflets

News Letters

Encouragement from all Practice Staff & PRG

Surgery Website

Notice Board

The Surgery produced links via the web site and internal posters publicising the kiosks. Receptionists were encouraged to inform patients that the kiosks were available. Paper surverys were available for those unfamiliar with electronic facilities. Various clinics were provided with information leaflets.

Capture Patient Experience

Patients complete surveys using the available input channels as listed above.

The relatively slow initial uptake was improved by staff providing help and encouragement with kiosks when necessary. The Surgery website provided an effective portal for those patients wishing to contribute but not frequent visitors to the Surgery. Paper surveys were made available (but taken up) for those with a preference for more traditional means.

Produce & Distribute Reports

Results in the form of reports are produced for each individual survey and distributed via the Practice Website, Practice Meetings, Surgery Notice Board, PRG consultations.

Results from the initial surveys were distributed to the PRG via e-mail. Results were also posted on the Surgery website and noticeboards.

Collaborate with The Practice Manager will discuss & Initial findings have been exposed to


Input Channel Evaluation Criteria

Input Channels should be thoroughly evaluated for their suitability for use by patients belonging to a practice. The following table describes the advantages and disadvantages of each input channel currently supported for practices.

Input

Channel

Advantages Disadvantages

Paper Surveys

Suitable for a large percentage of

patients across most services

Known and trusted media for many

patients

Production, deployment and

collection of surveys required

Data input required

Public Web Surveys

Instant feedback

Fast deployment of survey

Easily changeable

Limited to patients with internet

access

Limited to patients with the ability

to use technology

Email Surveys

Instant feedback


Easily changeable

Excellent for tracking feedback for

specific treatments (e.g. specialised

Limited to patients with internet

access


to use technology

Limited to patients with email

PRG to Analyse Results

analyse the survey results with the Practice Doctors and then discuss with the PRG for further analysis.

the Doctors and the PRG has received e-mails requesting feedback to the survey results. However, very little feedback from the PRG has been received thus far and, therefore, other methods are being investigated. This may include the formation of an actual PRG, which will be invited to the Surgery about twice per year.

Agree Action Plan An agreed action plan between the PRG & Surgery will be created according to the outcome of the analysis from the results.

Details provided in the section Discussions & Action Plans below.

Implement Change Practice must obtain the agreement of its local PCT to its proposals for any significant change, e.g. change of opening hours. Approved changes can then be implemented.

Details provided in the section Discussions & Action Plans below.


clinics) accounts

Limited to patients who have

provided Trust with email addresses

Phone Surveys

Instant feedback


Easily changeable

Excellent for tracking feedback for

specific treatments

Limited to patients with telephone

access


to use a telephone

Additional cost to practice

Touch Screen Kiosks

Immediately and conveniently

accessible before and after

appointments

Instant feedback


Easily changeable


and willingness to use a touchscreen

kiosk

Requires suitable physical location

Touch Screen Tablets / Laptops

Instant feedback


Easily changeable


accessible before and after

appointments

Portable

Fashionable


and willingness to use a touchscreen

tablet

Requires overnight charging

Standard Desktop

Instant feedback


Easily changeable


accessible following treatment


and willingness to use a desktop PC

Requires suitable physical location

Requires protection from being

damaged, lost or stolen

Face to Face interviews

Instant feedback (proving tablet

used to input response)


Easily changeable


accessible following treatment

Patients able to converse with a

person, puts at ease

Rapport building

Canvasser must be independent

Additional resource required

Patients may be reluctant to give

honest answers to canvassers


Patient Reference Group

PRG Membership

Member Profiles

Members of the Patient Reference Group are recruited from patients registered at Dapdune House Surgery. The practice has a ‘virtual’ Patient Reference Group. This means that patients are invited and encouraged to give their feedback on various aspects of the practice by using the PRG Web Portal that is sent to them on a regular basis by the Practice Manager.

PRG Recruitment & Representation

In order to ensure that members of the group are fully representative of our registered patients, the Surgery can use the following means to recruit:

The practice website

The practice newsletter

Posters on full view in reception and waiting areas

Leaflets available on reception desk

Leaflets in consulting rooms for GP’s to recruit individuals, in particular those who may not be aware of the PRG in the methods already mentioned or are unable to access them in any way

On new patient registration forms The current number of PRG Members is ~ 80 and recruitment is on-going using all the methods described above. Note: Feedback is not solely reliant on the PRG, surveys are also completed by other Patients from the Practice via the surgery kiosks and web portals etc.

PRG Agreement of Priorities

The Practice referred to the Patient Reference Group for agreement of priorities by organising a Patient Priorities Survey. The Patient Priorities Survey asked which of the following were considered a priority area to look at; Access (getting an appointment), Overall Satisfaction, Seeing a Doctor, Seeing a Nurse, The Reception and The Surgery Environment. The results are:


The Results show that Patients prioritised the areas as follows:

1. Access (Getting an appointment) (95.00%) 2. Seeing a Doctor (90.00%) 3. Overall Satisfaction (82.50%) 4. Seeing a Nurse (75.00%) 5. The Reception (40.00%) 6. The Surgery Environment (27.50%)

Additional comments regarding areas provided by the PRG were:

Where possible these will be incorporated into the next round of Surveys to understand the full opinion of the Practice Patients.

Results, Outcomes & Findings

Summary Information

Item Total

Number of Surveys 8

Number of Responses 701

Number of Input Channels 3

Survey results by Input Channel

Input Channels

Survey Kiosk PRG Portal Website Total

Patient Priority Survey 0 40 0 40

Demographics 0 44 0 44

Access 139 0 15 154

Overall Satisfaction 122 0 13 135

Seeing a Doctor 137 0 14 151

Reception 53 0 20 73

Seeing a Nurse 21 0 10 31

Surgery Environment 56 0 17 73

Total 528 84 89 701

Summary of Demographics Survey

The following report provides a summary of the demographics for patients that have completed surveys during the data collection period. This includes both PRG Members and other practice patients. The Summary of the demographics is:

36. 36% of the patients were female and 63.64% of the patients were male

The breakdown of age category of the patients were; 0% under 18, 11.36% 18-30 years old, 15.91% 31-40 years old, 18.18% 41-50 years old, 40.91% 51-65 years and 13.64% old Over 65

The breakdown of employment status was; 20.27% Full-time education, 9.09% Unemployed, 4.55% Permanently sick or disabled, 4.55% Other, 20.45% Fully Retired, 59.09% Employed

Of those who answered ‘Employed’ 70.37% worked 30 hours or more per week

59.09% of patients said they have long standing conditions including age related conditions

The breakdown of long standing conditions reported were; 31.03% Other 55.17% Physical, 6.90% Psychological/emotional, 6.90% Deafness/hearing impairment, 0% Blindness/partially sighted, 0% Learning difficulties

79.55% of patients said that they were not a parent or legal guardian of children under 16 years currently living at home

97.73% of patients were ‘White’, 2.27% ‘Asian or Asian British’, 0% ‘Other’

95.45% of patients were ‘Heterosexual or Straight’, 2.27% ‘Would prefer not to say’, 2.27% ‘Gay/Lesbian’

36.36% of patients were not religious, 56.82% were religious, 6.82% Preferred not to say

The patients who said they were religious described their religions as; 96.00% ‘Christian’, 4.00% ‘Other’


Representation of Registered Patients

Dapdune House Surgery can confirm that the feedback is not currently being provided by a wholly representative group of its registered patients as there is missing representation from the following:

Ethnicity. We are under represented from Irish and Chinese patients. However, based on our clinical system search there are very low percentages (0.4% and 0.5%) respectively of these groups.

Age. There has been poor response from those aged 65 and over (13.64%) The following steps are being taken to increase representation:

Reception staff will be tasked to promote the PRG on new registration forms from both of these ethnic groups. On-going recruitment for the PRG will actively request representation from these and other under represented groups.

Surgery staff will actively seek alternative methods to recruit the over 65 age group to the PRG. Furthermore, consideration is being given to creating an actual PRG.

Survey Results

Detailed reports for each survey can be found on our website www.dapdune.co.uk. Opportunities to discuss the results were given to the PRG and relevant practice staff. The key outcomes for each survey are highlighted below. Please note that the reports found on the website display the latest feedback captured and therefore may contain more results than are summarised in this report.

Access

79.25% of patient book appointments to see a doctor or nurse by phone

60.26% of patient prefer to book appointments by phone

Patients that have tried to contact the surgery by phone rated the service as ‘good’ or ‘excellent’ 77.46% or more in the following areas; getting test results; getting through; speaking to a doctor; speaking to a nurse

53.90% of patients were able to get an appointment within the same or two working days

The patients that said they couldn’t get an appointment on the same day or within 2 working days gave the following reasons; 49.45% ‘no appointments left’, 29.67% ‘couldn’t see my doctor’, 14.29% ‘times offered didn’t suit’, 6.59% ‘another reason’

77.27% of patients have tried to book an appointment with a doctor more than 2 days in advance, of those patients 77.31% said they were able to book the advance appointment

Seeing a Doctor

When patients were asked about the following areas when Seeing a doctor; ‘giving you enough time’, ‘listening’, ‘displaying care and concern’, ‘taking your problems seriously’, ’putting you at


ease’, patients rated the doctor as ‘satisfactory’ or ‘excellent’ 97.93% or more for each of the areas.

94.04% of patient rated the doctor as being ‘adequate’ or ‘thorough’ when asked about their feelings and symptoms

90.73% of patients said the doctor ‘adequately’ or ‘fully’ involved them in the decision about their care

96.03% of patient said the doctor did ‘fairly well’ or ‘very well’ when explaining about problems or treatments needed

95.71% of patients said that the doctor explained their test results to them (where applicable)

96.67% of patients said that they had confidence and trust in the doctor they saw

Overall Satisfaction

96.99% of patients said they were happy with the care they get at the surgery

89.63% of patients said they would recommend the surgery to someone who has just moved into the area

85.93% of the patients said that they were always treated with respect and dignity whilst in the surgery

87.41% of patients indicated that the staff worked well together for their care

Seeing a Nurse

When seeing a nurse, patients gave their reasons for having a consultation as: . 35.48% routine check-up . 29.03% on-going problem . 19.35% other . 9.68% for a one off problem . 6.45% to ask or advice

Patients rated nursing staff as good or satisfactory on the following areas: . Asking about symptoms – 87.10% . Explaining tests and treatments – 93.55% . Giving patients enough time – 96.77% . Treating patients with Care and concern 90.32% . Involving patients in decisions about their care – 90.32% . Listening – 90.32% . Taking problems seriously 93.54%

80.65% of patients said that they had confidence in the nurse they saw

93.33% of patients said they would be happy to see the nurse again

Reception

Receptionists were rated by patients as being ‘fairly good’ or ‘very good’ in the following areas: . Friendly – 87.68% . Helpful – 86.31% . Knowledgeable – 77.78%


. Welcoming 83.57%

The reception area was rated as ‘fairly good’ or ‘very good’ in the following areas: . Bright and Airy – 94.52% . Clean and tidy – 93.15% . Comfortable – 82.20%

The waiting room was rated as ‘fairly good’ or ‘very good’ in the following areas: . Bright and Airy – 90.41% . Clean and tidy – 95.89% . Comfortable – 87.68%

The Surgery Environment

82.43% of patients rated the overall level of privacy in the surgery as ‘good’ or ‘excellent’

67.13% of patients rated the comfort of surgery furniture as ‘good’ or ‘excellent’

71.24% of patients rated the appearance furniture as ‘good’ or ‘excellent’

89.04% of patient said that they were enough facilities for both children and adults in the waiting area.

91.78% deemed there to be easy access to hand sanitizers around the surgery

Cleanliness was rated as ‘fair’, ‘good’ or ‘excellent’ at the surgery in the following areas: . Car Park – 93.55% . Reception – 98.59% . Toilets – 96.87% . Treatment Rooms – 98.53% . Waiting areas – 98.59%


Discussions & Action Plans

Discussions

The results of the surveys have been disseminated to the PRG and discussed by surgery staff both during the build up to the end of year report and during early publication of the surveys. This has provided opportunities to react to some of the recommendations. For example, we acted quickly to improve access by changing our 0844 telephone number to a local geographical code and we opened more GP consultations to web booking. Also, we improved physical access for wheelchair users by replacing the front door ramp. As we evaluated and interpreted survey data over the last year, we have sought to look for trends, rather than one-off comments, that suggest areas for future improvement. As an example, we realise that better access for patient appointments is an area requiring attention. Also, clinicians will seek to involve patients more effectively in decisions about their care. Lastly, we appreciate that continuous training of staff, both medical and non-medical, will improve overall patient satisfaction. In general the survey results thus far indicate that we should adopt an evolutionary, rather than revolutionary approach to improving patient services.

Action Plans

In developing an action plan for the forthcoming year, we have concentrated on the results of the first three surveys prioritised by the PRG; Access, Seeing a Doctor and Overall Satisfaction. The results of these have indicated that we look to: 1. Improve appointment availability. Notwithstanding, the changes already made, we intend to review and improve the availability of nurses appointments to patients booking online. 2. Increase patient involvement. Medical staff will be invited to discuss methods to improve the involvement of patients in decisions about their medical care. 3. Provide staff continuous training. Plans are underway to organise and implement a more focused training plan for all staff. It is acknowledged that this will have a direct and indirect impact on all areas of the services we provide to patients.

Documents

DAPDUNE HOUSE · PDF fileDapdune House Surgery staff members have worked with the virtual PRG to establish and ... The NBSurvey Methodology 9 Input Channel Evaluation Criteria 12