Lordshill Health CentreFebruary 2013-14

We co-ordinate this survey to collect feedback on the experiences of patients in our practice, with a view to improving the service we provide. We forward the results to our Virtual Patient Participation Group for their comments and help.

Patient Participation and Annual Survey Report

WE WOULD LIKE TO THANK ALL THE PATIENTS WHO TOOK PART IN OUR SURVEY AND OUR VIRTUAL PRG FOR

THEIR INPUT AND HELP THROUGH THE YEAR

The Health Centre is open:Monday – Friday: 8:00 – 6:30

(doors close 12:30- 13:30hrs for lunch, phone lines still open)

Additional appointments for people who are unable to attend during normal surgery times are offered Monday and Wednesday Mornings 07:30hrs – 08:00hrs

and Monday evening 18:30hrs-19:00hrs. We are also open one Saturday morning in each month 08:00hrs – 10:30-hrs

All additional appointments to be pre-booked in advance

Practice Catchment Area: From the Health Centre go south to junction of Coxford Road and Romsey Road, then go north along Romsey Road until Brownhill Road and go east along

Lower Brownhill Road onto Brownhill Way to junction 1 of the M271. Keeping to the M271 boundary then across to Romsey Road taking in all of Rownhams, Lordswood and join up

again at the northern end of Coxford Road returning to Romsey Road. A map of the catchment area is available at reception.

LORDSHILL HEALTH CENTREPATIENT PARTICIPATION AND ANNUAL SURVEY REPORT

2013-14

During this year we have continued to strive to improve the service to patients and the ambiance of our Health Centre . Unfortunately we are not in control of the appearance of the outside of the building, but early in 2013 we had our reception area and waiting room refurbished which hopefully makes the interior of the Health Centre a much more pleasant place to visit and wait. We had comments on previous surveys that the waiting room was shabby and outdated so hopefully our patients will be pleased with the new surroundings.

We have continued to advertise our virtual Patient Reference Group and have three new members this year. However, unfortunately one of our original members has opted out and three have not been contactable, so we currently have 17 members.

PRACTICE PROFILEPractice profile:

10,150 patients

Patient Participation

Profile: 16 patients

Ethnicity of practice population

Ethnicity of PPG

Gender of all patients

registered

Gender of PPG

0-16 = 20%17-24 = 10%25-34 = 14%35-44 = 13%45-54 = 12%55-64 = 14%65-74 = 10%75-85 = 5%86-120 = 2%

0-16 = 017-24 = 025-34 = 5.55%35-44 = 045-54 = 27.77%55-64 = 27.77%65-74 = 16.66%75-85 = 22.22%86-120 = 0

British/Mixed British 88.1%Other White 5.36%White/Black Caribbean 0.22%White & Black African 1.5%White & other Asian 1.37%Other mixed background 3.45%

British = 83%White European= 11%Indian = 6%

Female = 51%Male = 49%

Female = 55.55%Male = 44.45%

CONSULTING WITH THE GROUP IN 2013 - 14

Following last year’s survey I forwarded the results to our virtual group for their comments and help. Although the group is small we received some interesting and constructive comments. We once again used these, together with the main points raised in comments on the survey forms, to construct an action plan.

The Action Plan we made last year was posted on our website and during the year we have been working hard on that plan.

In March 2013 we forwarded the Report, Survey Results and Action Plan to our PRG asking for their comments on the actions. Again we received some good suggestions and have taken these into account during the year.

The following is our Action Plan from last year. In bold we show our actions:

Question 3: Length of time waiting in the Practice to see a doctor/nurse:

I will be looking through the results of the questionnaires to see if this is general throughout all doctors and nurses, or whether there are specific doctors/nurses who seem to have a problem. Perhaps catch-up times are required to be built in to the appointment system. Poorly patients can take longer than their 10 minute appointment time and most patients understand and accept this and know they will receive the time required for their problem when they go in to see the doctor. However, we realise it would be better if patients knew an approximate time they may wait so that at least they know whether they can go to the toilet without missing their call.

Unfortunately, with the introduction of the self- booking in screen for patients, the receptionist is unable to tell the patient how many patients are in front of them. If a doctor is called out on an emergency we do put a message on the patient call board that the doctor has been called out and will be running late. One of our PRG suggested we have a chalk board or similar so that any delays can be written up throughout the surgery sessions, but this puts quite a lot of pressure on the receptionists – amongst all their other jobs – to watch the appointment screens most of the time. I will discuss with the doctors and nurses if it would be possible for them to alert reception if they are running 20 minutes or more late and then a message could be put on the patient call board. We will also enquire if there has been any progress in being able to put the number of patients waiting on the patient booking in system. I think it will also be helpful to perform a simple interim survey specifically about waiting times in the practice and ask patients to put the length of time in minutes that they have waited. I think this will enable us to see the true extent of the perceived problem. Are patients booking in early – therefore making their wait seem unacceptably long?

We enquired whether our self-booking in screen could tell the patient either how many patients were in front of them, or approximately what the waiting time was for the doctor. However this is not possible with our system. The doctors and nurses do try to alert reception if they are running 20 minutes or more late so the patients can be notified. On our 2013-14 survey I have added the question “how long after your appointment time were you seen” so we can see if there is a real problem.

Question 2: Ease of contacting the Practice on the telephone:

At peak times we have three or four receptionists manning the phones and calls are answered within 6 rings. It is sheer volume of calls that makes it impossible to answer them any quicker. We feel it is best for the calls not to be answered and stacked, as this would cost the patient money. The staff do their best to get through the calls.

The staff have continued to do their best.

Question 4: Opportunity of speaking to a doctor/nurse on the telephone when necessary:We cannot quite understand the low score for this as all the doctors have telephone slots and message slots built into every surgery session. I will discuss this with the Reception

Manager to see if she feels this is a problem but it is important to note this is a relatively low number who find this a problem. We do have a leaflet “How to See Your Doctor” and telephone appointments are explained on these.

We have just had a new website posted and it is possible for a lot more information to be placed on it. Information about our telephone appointments will be put on the website.

Question 13: Information about the services this Practice provides:

Again – rather a surprise. New patients are always given a Practice Leaflet detailing all the services in the Practice but long-standing patients probably do not have this any longer. We will put a supply of Practice Leaflets in the waiting areas and make it available on our Practice website. We also have leaflets on Repeat Prescriptions and “How to see your GP” which are available on the front reception desk. Again this apparently applies to a small number of patients.

We have put a supply of Practice Leaflets in the waiting areas. As stated above we have just had a new website posted and it is possible for a lot more information to be placed on it. We will be putting as much information as possible on the website over the next few months and encouraging our patients to look at it.

Question 14: The ease of making compliments or complaints to this practice about its service and quality of care:

We have a notice behind the front reception desk saying to ask for the Practice Manager if patients have any compliments or complaints. This is also stated in our Practice Leaflet. If the Practice Manager is unavailable the patient can be given a Complaints Form which gives details of our in-house complaints system. We also have a card system on the wall in the waiting room – one card for “bad” comments and one for “good” comments, which the patients can complete – named or unnamed - and put in the suggestion box next to the cards. Obviously not all patients have noticed this and we will try to make this more prominent. Again a small number of patients were dissatisfied.

Since our waiting room refurbishment we have added more notice boards. We have tried to advertise the Compliments and Complaints procedure more prominently on these boards and will be putting this on our new website.

“Comments”:

With regard to “getting an appointment” and the “appointment system”, we are always trying to think of ways to improve this. No-one is ever refused an appointment on the day if they say they need to be seen. We do recognise that our appointment system does cause problems – especially for patients needing to be seen “soon” rather than “urgently” or “in advance”. This is something that we will continue to review.

We have just purchased an appointment card printer and software so that there will be no errors in transferring the appointment information from the screen to a card, and we are also purchasing a text messaging system which will remind patients of their appointments the day before they are due.

COMMUNICATION WITH OUR VIRTUAL PRG DURING 2013-14:

During 2012-13 we performed an audit to determine whether patients would like to be able to order their repeat prescriptions on-line. The survey was done on-line with the PRG and with paper questionnaires to patients when collecting their prescriptions. The results were put in my last year’s report and were overwhelmingly in favour of this. In June 2013 I contacted the PRG and asked if they would like to be able to book appointments on line. There were mixed views but the majority were in favour of this. We had these facilities installed on our computer system in September 2013 and more and more patients are signing up to use these services. I emailed the PRG in October 2013 and let them know that these systems are in place.

THIS YEAR’S PATIENT SATISFACTION SURVEY – 2013-14:

Once again we felt it best to use the same questionnaire as in the previous two years so that results can be easily compared. I added two questions this year: “How long after your appointment time did you see your doctor?” and “Would you recommend this practice to other people?” In December 2013 the questionnaire was forwarded to the PRG asking them to look at it and to let me know whether they thought anything further should be added. One member suggested asking “what hours and days would you like the surgery open?” We already do extended hours on Mondays and Wednesdays and open one Saturday morning a month and feel this should be adequate, so this question was not added this year. No other suggestions were made.

PERFORMING THE SURVEY:

We chose the same two weeks in February as last year to perform the survey. This year we have 7 partners, 3 nurses and 1 HCA. 20 questionnaires were given out per partner/nurse making a total of 220. 183 were returned.

Once again we examined the results of the survey and compared the results to last year and picked out the areas that statistically were least satisfactory. In past surveys we have divided the results into “poor and fair” and good, very good and excellent” to give a picture of our overall rating, this year we have divided into “poor and fair”, “good” and “very good and excellent”. Breaking it down into an extra group, shows where there is more room for improvement, as we don’t just want to be a rated as a good surgery but an excellent one in all areas.

86% of patients rate their satisfaction with surgery between “very good and excellent”, 10% thought it was “good” and 1% thought it was “fair and poor”

94% of patients rated their satisfaction with their visit to the doctor/nurse between “very good and excellent”, 3% thought it was “good”

80% of patients rated their treatment by reception staff between “very good and excellent”, 14% “good”, 1% “fair and poor”

Comments on the forms:

About the Practice:

Fabulous I am very happy with the service I receive Wish the practice could be on ground level Appointment system could improve greatly. Sometimes not possible to get an

appointment within 2 weeks Quite satisfied overall Cannot get much better More appointments available when ringing for emergency appointments Difficulty in getting an appointment for urgent problems/registered GP I find reception staff –ie. one of them to be rubbish on phone and thinks they are

higher than Drs are I cannot see how it can get any better The availability of appointments when needed is excellent Never had any problems Open more hours When phoning the surgery certain members of the staff could be more helpful over

the phone. ie when booking appointments you are told to phone on a certain day and when you do you are told to phone again the next day.

Getting appointments needs to be addressed. Difficult to get one with your GP Opening slightly longer. More staff on phones Unable to think of any at this time At the moment satisfied with things as they are Great practice Would be difficult to do better I don’t think you can Saturday AM appointments. Own out of hours care I have no complaints Happy with the service I think this practice is excellent I understand the need to keep last minute appointments which can only be accessed

48 hours in advance, but it is frustrating at times not being able to book a week ahead.

More appointments. Not able to get through on phone at 8am to 8:20 when all appointments are all gone

No very satisfied with everything about the practice They are all great, nothing I can say

No happy with service Sometimes a little hard to get an appointment but this is just due to patient demand

and unfortunately is hard to fix I find it difficult to understand why I cannot call in the day before for an appointment

but have to ring up at 1:30 to see my GP. This just seems a waste of my time and an added call to answer at the surgery, yet I can make an appointment well in advance

None whatsoever. I think the practice is superb as it is. No complaints Couldn’t improve Sometimes a problem getting an appointment You couldn’t improve it anymore Practice has an excellent service already. No change required Very good Better availability to see your GP outside of 8:00 – 5:00pm. Why hold appointments

back when appointments are needed? Why have to call back? No, very good I would like an obesity clinic to help me with my weight issues Was not aware of early opening times until I rang up to book todays appointment Nice to get an appointment when we want them. 3 days after or even more. BAD,

BAD, BAD

About the Dr/Nurse:

She could not improve. I feel great with Dr…………. My Dr is excellent Cannot get much better Dr and nurses are at the top of their tree Dr ……. Has been our family Dr since I was 5 years old and he’s the only Dr I would

want as my children’s family doctor Good doctor. I feel that he is easy to talk to and explains things easily No – Impossible! You can’t better perfection No. She was very approachable and friendly She is a lovely nurse and will ask to see her next time No, very approachable and helpful Dr ……….. is a great doctor. I am very happy with her. She always listens to me.

When I go in she always has a great smile. No very happy thank you Dr …….. shows compassion and concern every time I visit him. He is a superb Dr.

I’ve never come across a better GP in all of my 78 years. No complaints None. Excellent care and consideration on all accounts Generally, not have to push for certain medication No, very good Nothing, I am very happy with my GP I trust my GP has my best interests at heart

Summary

Once again we feel very happy with the outcome of the survey in most areas. The fact that 97% of patients would recommend us to a friend is really positive and encouraging. We still feel disappointed the questions scoring the lowest ratings appear to be similar to past years. However, question 4 – opportunity of speaking to a doctor/nurse on the telephone when necessary - scored 64% of patients thinking we provide a very good to excellent service and 24% a good service. This was on our lower rating last year, so we are happy that patients rate the service better. We have worked very hard to improve all areas but must continue to ensure we keep seeking ways to improve our service. Next year we will look at the way we word our questions so patients feel they can give an answer, rather than giving “no response”.

The 4 questions scoring the lowest ratings were:-

1: Question 2: Ease of contacting the practice on the telephone2: Question 3: Length of time waiting in the practice to see a doctor/nurse?3: Question 3i: How long did you wait after your appointment time?4: Question 14: The ease of making compliments or complaints to this practice about its service and quality of care.

Question 2 - With regard to the ease of contacting the practice by telephone, unfortunately our phone lines are weighted at 8:00am when we open and at 13:30hrs when we release our afternoon emergency appointments. On a Monday morning we have 4 staff answering the telephones and 1 Receptionist on the front desk. The phone lines are extremely busy but we aim to have answered the initial Monday morning rush by 08:40am, after this time it should be much easier to get through on the phones. During the rest of the week all the initial calls are answered within approx. 20 minutes and from 08:20 should be easier to get through. We do encourage patients not to call for non-urgent requests before10:00am and have posters in our main reception area reiterating this. Also patients are encouraged not to put their phone down if they get an engaged tone as it means when they call back they go to the back of the queue.

Patients are also now able to book appointments on line. We have added this to our new website and put posters around the surgery and are trying to encourage as many people as possible to use this service. Keeping patients phone numbers up to date is also a priority, as any patient signed up to our texting service will receive a reminder 2 days prior to their appointment, hopefully causing less DNA’s and encouraging patients to cancel their appointment if no longer needed.

Question 3(i) -41% of patients did not respond to question 3(i). As 9% of patients thought the wait was only “fair and poor” we didn’t get an accurate answer to the

length of time waited to validate why we had a low mark. 47% of patients were seen within 10 minutes which we hope is a reasonable wait. Next year we need to change the question so that our “No response” is not so high.

Our computer system does enable us to run a “waiting time statistical report” calculating the time from patient appointment start time to when they were called for their appointment. We ran this from 01/02/2014 – 28/02/2014 and did not include any late patients (patients will still be seen up to 10 minutes after their appointment time). Of the 4902 appointments made, 1234 were seen after their appointment time and had a wait of between 2 – 21 minutes with the average being 8 minutes. Report enclosed

Question 14 -14% of patients gave “no response” to question 14. We assume this is because they have never tried to complain or compliment but next year it may be better to add N/A to the answers. This would give a more accurate account of our patients’ experiences of complaints and compliments. Our main board in our reception area does inform patients of the above, and we have added details to our website.

Appointments - As always being able to book an appointment was raised on the “comments” by many patients. This is clearly a problem with GP surgeries throughout the country. Hopefully our online booking service will help patients be able to book appointments in advance and cancel them if unable to attend. We keep a daily check on our online appointments to ensure we have some available to book. Patients are able to book with their own registered GP or one of our 2 registrars online. All patients that need to be seen on an emergency basis are seen on the same day. We never turn patients away. We do NOT operate a triage system, so patients are asked to attend the surgery and are always seen by a doctor. The wait time depends of the amount of patients.

We define “emergency appointment” as not being able to wait until the next routine appointment with any GP (not just patients own registered GP). We stress that they will be 5 minute appointments for one problem only.

We were able to run off a “Did Not Attend” Report which shows how many appointments were booked between requested periods and how many were DNAs(Did not attends.) During the month of February we booked 4512 appointments of which 203 did not attend. Asking patients to join our texting and online service so they are able to cancel their appointment without having to phone the surgery will be one of our priorities for this year. Report enclosed.

Patients are able to book appointments 6 weeks ahead. We also offer a small amount of appointments on a 48hr basis. This means appointments are held and released 48hrs prior to appointment day. This helps GPs enormously if their appointments are booked for a week ahead, as we still have some appointments to offer on a daily basis.

Telephone appointments are available daily for GPs as are home visits for patients unable to attend the surgery.

Actions

To advertise our website more widely. Advertise our ability to book appointments and order

prescriptions on line more widely. Update our patient leaflet and place in prominent places in the

surgery as well as giving to all new patients. Ensure we always check patients’ mobile phone numbers are

up to date, so they are able to cancel appointments by text without having to phone the surgery.

Ensure we continue to let patients know if there is going to be a

wait to see their GP, either by informing them how many patients are in front of them and/or by putting a message on the calling system.

To make sure leaflets, posters and telephone numbers

advertised in surgery are up to date. To ensure we all give a better service than patient expects.

Lordshill Health CentreIMPROVING PRACTICE QUESTIONNAIRE (1)

 Excel Report (click here for full dataset )Number of Responses: 183

IMPROVING PRACTICE QUESTIONNAIRE1: Your level of satisfaction with the Practice's opening hoursPoor  0%Fair  2%Good  24%Very good  31%Excellent  40%No response  0%

2: Ease of contacting the Practice on the telephonePoor  0%Fair  10%Good  24%Very good  31%Excellent  32%No response  0%

3: Length of time waiting in the Practice to see a doctor/nursePoor  1%Fair  8%

0 0 /w EWAgLYiZTxD

Good  27%Very good  33%Excellent  27%No response  0%

How long did you wait after your appointment time?on time  21%5-10 mins  26%10-20 mins  9%20-30 mins  2%longer  1%No response  39%No response  2%

4: Opportunity of speaking to a doctor/nurse on the telephone when necessaryPoor  0%Fair  4%Good  24%Very good  30%Excellent  34%No response  4%No response  4%

5: Respect shown for your privacy and confidentialityPoor  0%Fair  1%Good  8%Very good  26%Excellent  63%No response  1%

6: The doctor's nurse's explanation of things to you wasPoor  0%Fair  0%Good  6%Very good  16%Excellent  74%No response  0%No response  4%

7: The confidence in this doctor's/nurse's ability is ..Poor  0%Fair  0%Good  3%Very good  20%Excellent  74%No response  1%No response  2%

8: The amount of time given to me for this visit was ...Poor  0%Fair  0%Good  3%Very good  26%Excellent  68%No response  1%

9: The extent to which you felt comfortable and able to express your concerns wasPoor  0%Fair  0%Good  2%Very good  22%Excellent  73%No response  0%

10: The doctor's/nurse's consideration of my personal situation in deciding a treatment or advising me was ...Poor  0%Fair  0%Good  2%Very good  20%Excellent  75%No response  0%No response  3%

11: Your overall satisfaction with this visit to the doctor/nurse is ...Poor  0%Fair  0%Good  3%Very good  20%Excellent  74%No response  0%

12: The manner in which you are treated by the reception staffPoor  0%Fair  1%Good  14%Very good  36%Excellent  44%No response  1%No response  4%

13: Information about the services this Practice providesPoor  0%Fair  2%Good  19%Very good  38%Excellent  39%No response  0%

14: The ease of making compliments or complaints to this Practice about its service and quality of carePoor  1%Fair  2%Good  19%Very good  27%Excellent  33%No response  14%

15: The information provided by this Practice about illness prevention and healthy livingPoor  0%Fair  3%Good  13%Very good  32%Excellent  44%No response  4%No response  4%

16: Your overall satisfaction with this PracticePoor  0%Fair  1%Good  10%Very good  32%Excellent  54%No response  0%No response  3%

17: Would you recomment this Practice to a friend or other peopleYES  97%NO  1%No response  0%No response  2%

How old are you in years?15-20  1%21-30  12%31-40  11%41-50  12%51-60  17%61-70  22%71-80  13%81-100  4%No response  3%No response  5%

What is your Nationality?WHITE  87%BLACK OR BLACK BRITISH  0%ASIAN OR ASIAN BRITISH  0%MIXED  0%CHINESE  0%OTHER  2%No response  7%No response  4%

Are youFemale  67%Male  31%No response  0%No response  2%

If this visit was to see a doctor was it your usual GP?YES  54%NO  12%N/A  29%No response  4%

How many years have you been attending the Practice?Less than five years  16%Five to ten years  17%More than ten years  63%No response  2%

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