Silverdale Practice H82072 - Patient Participation Group 2013/14 ReportGroup Profile

The patient group comprises 30 members

Attendance Gender

Ethnicity Age

 

Patient Representation and EngagementThe practice feels that the group is fairly representative of the entire patient list and specifically very representative of those patients that are regular users of the service. The practice and the PPG have worked together throughout the year to both engage patients and attract new members. Specific examples of this include posters in the waiting rooms, powerpoint slides on our TV screens, articles in the patient newsletter and information on our website www.silverdalepractice.co.uk. In addition the Practice and the PPG held a joint health awareness week in October 2013. Volunteers from the PPG manned the exhibition and sought opinions from visitors.

Press cutting from the Mid Sussex Times October 2013.

Action PlanThe PPG had agreed on an action plan for 2013/14 as detailed in last year’s report:-

1. Look at ways to improve telephone access as the 2012/13 survey had highlighted this as a problem for the surgery.

2. Make appointments available via an online system.3. Look at ways to improve wheelchair access to the Silverdale site.4. Is it possible to see test results online.5. Investigate why reception staff require a reason for emergency

appointments.6. Investigate ways to reduce waiting times to see GPs.7. Implement text reminders for appointments.8. Increase the number of chairs with arms.9. Put coat hooks up in the toilets.

The PPG met three times during the year June2013, September 2013 and January 2014. The June meeting focused on actions taken towards addressing points in the action plan. During the September meeting the PPG were given a progress update and agreed what questions should be asked in the Patient Survey for this year. At the January meeting the PPG reviewed the results of the survey and agreed a couple of main action points for 2014/15. The minutes of all of these meetings are included at the end of this report and are available on the practice website www.silverdalepractice.co.uk.

Progress Report 2013/141. Telephone Access

Many different solutions were explored throughout the year and the implementation of online appointment booking, text appointment reminders and a new appointment structure has improved access. The long term goal still remains to upgrade the telephone system and reconfigure staff capacity. A specific meeting with interested members of the patient group was held in February and a solution has been agreed and will be trialled in time to see results in the next patient survey. This item still remains a priority for the practice.

2. Online Appointments This was implemented in May 2013. Take up from the patients has been good with registered patients growing to 784 in January 2014 from only 326 in September 2013. Patients are using the system with 24 appointments being booked online in the month before the September PPG meeting and 92 appointments being booked in the month before the January PPG meeting. This item is now closed as a priority and will be monitored in future meetings.

3. Disabled Access The practice undertook a complete access audit of both sites. The findings were reviewed by the PPG in the September meeting. The practice has put aside a budget for making some improvements and a number of improvements have already been actioned. The practice recognises that the Silverdale site faces specific access issues that would be difficult to solve without a major redesign. NHS England have been approached with regard to premises improvement grants. This item still remains a priority for the practice.

4. Test Results Available Online The practice clinical system is not yet capable of delivering this functionality yet. This item still remains a priority for the practice.

5. Reception Staff Asking for Reasons when Booking Appointments The practice realises and respects that some patients may prefer not to be asked a reason why they are booking an appointment. All staff have received training on booking routine appointments. However, the practice needs this information when booking emergency or nursing appointments in order to direct them to the correct member of staff or location. This item is now closed as a priority however reception will receive ongoing training and guidance. The practice will continue to monitor how well it communicates via the annual practice survey.

6. Reduce Waiting Times for Appointments The practice has made significant steps towards improving the availability of appointments. During the year it undertook a complete review of the way appointments were structured. Time released appointments have been introduced ensuring that each day every GP will have appointments

available for emergency on the day, the next working day, in three days’ time and in a week. The appointments are spread out to provide a wide choice for the patients. Since the launch of the new structure in May 2013 it has been well received by GPs, reception and patients. This item is now closed as a priority. The practice will continue to monitor availability of appointments by continuous analysis and via the annual practice survey.

7. Text Appointment Reminders This has now been implements and many patients have expressed how useful it has been. The practice remains committed to investigating other ways of utilising technology. This item is now closed as a priority.

8. Chairs with Arms The practice has purchased 10 chairs with arms and implemented a priority seating sign which was suggested by one of the patient group members. This item is now closed as a priority however, the practice will continue to monitor the need for additional chairs as older ones come up for replacement.

9. Coat Hooks in Toilets The practice has installed coat hooks in to all patient toilets. This item is now closed as a priority.

Patient Survey 2013 /14The PPG met in September 2013 to agree the questions they wanted to put in the Survey that would be carried out during October and November 2013. It was agreed that most questions would remain the same as the practice and the group wanted to measure what progress had been made compared with last year’s results. The patient group also decided to include some specific questions for disabled patients based around how accessible they found the surgeries.The surveys were available online via our website, handed out by reception to patients during normal surgeries, available during the PPG health awareness week, handed out at flu clinics and also included in the email newsletter e-shot to over 2000 patients. The additional activity this year led to an increase in returned surveys from 182 last year to 327 this year.Please see below for details of the questions asked and the responses that were given. There is a comment next to each result which was reviewed by the patient group during the January 2014 meeting.

Survey Results2013/14 Silverdale Patient SurveyNumber of Responses: 327 (Increased from 182 2012/13) About Making Appointments: How easy is it to get through to someone at the Practice on the phone? Very Easy  11%Fairly Easy  37%Varies  32%Difficult  14%Not tried  1%No response  5%

Comparison with 2012/13Very Easy  14%Fairly Easy  21%Varies  35%Difficult  26%Not tried  1%

SummaryAlthough a decrease in patients who find it “very easy” to get through on the phone there is a significant increase in those who now find it “fairly easy”. There is also a welcome decrease in patients who find it “difficult” to get through on the phone.

If you need to see a GP or Nurse urgently, can you normally get an appointment on the same day? Yes  65%No  13%Not Tried  19%No response  3%

Comparison with 2012/13Yes  66%No  16%Not Tried  16%No response  2%

SummaryLargely the same as 2012. As a practice we never turn down an emergency appointment.

How easy is it to book ahead a scheduled appointment? Very Easy  40%Fairly Easy  36%Varies  14%Difficult  2%Not Tried  4%No response  4%

Comparison with 2012/13Very Easy  41%Fairly Easy  33%Varies  18%Difficult  4%Not Tried  2%

SummaryA slight improvement on 2012.

How confident do you feel about being able to get an appointment at a time and on a day which suits you? Very Confident  12%Confident  57%Not Confident  25%Not Tried  3%No response  3%

Comparison with 2012/13Very Confident  17%Confident  48%Not Confident  29%Not Tried  3%No response  3%

SummaryA slight increase in confidence with 69% feeling “confident” or “very confident” this year compared with 65% last year.

How often can you get to see the GP or Nurse of your choice? Always  26%Very Often  42%Some Times  21%Almost Never  2%Not Tried  6%No response  3%

Comparison with 2012/13Always  26%Very Often  40%Some Times  23%Almost Never  4%Not Tried  5%

SummarySlight improvement on 2012.

Patients were asked to give comments on contacting the surgery. Here is a breakdown of the subjects and nature of comments.

Subject of comment Positive NegativeContact with Reception Staff 23 5Access by Phone 3 22Online Appointment System 5 0Appointment Availability 5 2

Based on your experience of seeing a GP or Nurse how good were they at each of the following?

Giving you enough time? Very Good  65%Good  30%Fair  3%Poor  0%Very Poor  0%

Much better than 2012

Listening to you?

Very Good  70%Good  25%Fair  3%Poor  0%Very Poor  0%No response  2%

Much better than 2012

Explaining any tests, treatments or referrals? Very Good  64%Good  28%Fair  4%Poor  0%Very Poor  0%No response  4%

Much better than 2012

Involving you in decisions about your care? Very Good  57%Good  33%Fair  5%Poor  0%Very Poor  0%No response  5%

Much better than 2012

Treating you with care, concern and respect? Very Good  72%Good  24%Fair  1%Poor  0%Very Poor  0%No response  3%

Much better than 2012

Patients were asked to give comments on the clinical staff at the surgery. There were 43 comments, all positive.

Thinking about the care you get from your doctors and nurses, how well does the practice help you to:

Understand your health problems? Very Well  79%Unsure  11%

Not Very Well  0%Does Not Apply  7%No response  3%

Much better than 2012

Cope with your health problems? Very Well  77%Unsure  10%Not Very Well  1%Does Not Apply  9%No response  3%

Much better than 2012

Keep yourself healthy? Very Well  67%Unsure  16%Not Very Well  0%Does Not Apply  12%No response  5%

Slightly better than 2012

Access to our sites: Do you have a visual impairment that impacts your day to day life? (ie Blindness or severe sight loss) Yes  2%No  96%No response  2%

Do you have a hearing impairment that impacts your day to day life? (ie Deafness or severe loss of hearing) Yes  7%No  90%No response  3%

Do you have a physical impairment that impacts your day to day life? (ie In a wheelchair, use a frame or on crutches) Yes  4%No  94%No response  2%

What do you think about the accessibility of our sites? Very Accessible  54%Accessible  36%Difficult to Access  3%No response  7%

The above chart shows the overall result from all patients. The accessibility questions were changed from 2012 as it was felt by the patient participation group would like to see if the percentages rating the accessibility of the practice would be different amongst patients with a disability.

Impairment Very Accessible Accessible Difficult to AccessVisual (8) 87.5% 12.5% -Hearing (25) 60% 40% -Physical (14) 57% 24.5% 14.5%

Thinking about the Practice in general: How acceptable do you feel the waiting times are once you have been booked in by reception? Very Good  30%Acceptable  62%Not Acceptable  3%Far Too Long  1%No response  4%

CommentA slight improvement on 2012.

Patients were asked to provide comments about our sites in general. Here is a breakdown of the subjects and nature of comments.

Subject of comment Positive NegativeGeneral comments about Silverdale 2 2General comments about Avenue 2 0Parking 0 4Physical Access 1 3Waiting Times 7 4Surgery Layout 0 1

Overall, how would you describe your experience of your GP surgery? Excellent  37%Very Good  43%

Good  13%Fair  3%Poor  0%Very Poor  0%No response  4%

CommentA slight improvement on 2012.

How likely are you to recommend the surgery to a friends and family? Highly Likely  60%Likely  24%Probably  9%Doubtful  1%Unlikely  1%Highly Unlikely  0%No response  5%

This is a new NHS question for 2013.

It will help us to understand your answers if you could tell us a little about yourself: Are you? Male  41%Female  56%No response  3%

How old are you? Under 16  0%16 - 24  2%25 - 34  5%35 - 44  10%45 - 54  15%55 - 64  18%65 - 74  27%75 - 84  16%85+  2%No response  5%

How would you best describe your ethnic background? White British  94%White Other  2%Mixed or Black Carribean  0%Mixed or Black African  0%

Mixed Asian  0%Asian British  0%Indian  0%Pakistani  0%Bangladeshi  0%Asian Other  0%Chinese  0%Other Ethnic Background  0%No response  4%

How would you describe how often you come to the practice? Regularly  24%Occasionally  58%Very Rarely  15%No response  3%

CommentThe number and type of patients who took part in the survey are representative of our patients.

Patients were offered the chance to leave a general comment about the practice. All 75 comments were positive. There were a number of suggestions as detailed below which will help the practice to develop the service.

Suggestions Perhaps you could have more cover between 8.30-9.30 or better still open @ 8.00? Maybe email contact for non-urgent yet necessary advice could be an option. The new online appointment booking arrangement is an excellent idea but has the limitation

that if you need to make a doctor’s appointment but already have a routine appointment for blood tests or another clinic you are blocked from doing so because of exceeding the appointment limit which is set at two. Is it possible to differentiate between doctor and nurse clinics so doctor appointments can be booked.

Would like the surgery to be open at weekends, say 9am till 5pm both days. This survey is too broad in the parameters you use - you should separate the doctors and the

nurses when asking questions as in the above section. I would have answered differently if they had been itemised separately

It would be helpful when having tests if information/instruction were given about whether to phone/call in for results or whether to assume if no contact is initiated by the surgery then all is well

It's difficult to answer some of the questions, as it combines nurses and GPs whereas in some cases my responses would differ.

Travel Clinic - as I take two holidays a year, I always find it a bit of a waste of your time to have to book a double appointment to ensure my jabs are up to date. It would be helpful if you could offer a service, where a Nurse could review my completed form to see if any jabs are needed, and then contact me / leave a note on my file, if any jabs are required.

I have answered "Unsure" to above questions because the range of responses allowed is insufficient

I would find the ability to email a/my doctor or reception useful in preventing visits. I would also like to say that I would like to see alternative medicine and treatments at the

practice. I think this would be of benefit and perhaps take some of the strain off the medical profession.

Opening hours need to be 24hrs not the 9-5 week days only. We cannot predict when we are ill sadly.

Personally I think having later/weekend appointments, even if it means that a weekday morning is closed, would help people who just want to chat about a medical concern without wishing to take time off work.

Action Plan 2014/15Following the PPG meeting in January 2014 the following areas will be focused on during the coming year.

1. Continue to improve phone access to both surgeries.

Action Owner – Sean WheatleyTimescale – Ongoing (Trial of new configuration before next survey)

2. Focus on patient education to use services correctly and reduce DNAs.Action Owner – PPGTimescale – Ongoing through newsletter and events

3. Investigate ways to provide test results online in a secure manner.Action Owner – Sean WheatleyTimescale – As Emis release this functionality

4. Continue to improve physical access to both sites by investigating reasonable adjustments.Action Owner – Sean WheatleyTimescale – Ongoing improvements through regular needs assessment.

Additional InformationInformation on Burgess HillSilverdale Practice has two sites based in Burgess Hill which has a population of approximately 30,000 people and is situated about ten miles north of Brighton. It has expanded rapidly since the 1950s to its present size. The town has several industrial estates providing employment and there are also good commuter links between the town and Gatwick Airport, Croydon and London.

There are two railway stations servicing the town, Burgess Hill and Wivelsfield. Both are on the London-Brighton line with trains to Eastbourne and Lewes from Wivelsfield.

There are six primary schools within the town, an independent school and two comprehensives, one of which has a sixth form. There are also sixth form colleges in Haywards Heath and Brighton. In addition, there is an adult education centre offering a variety of courses.

The shopping centre offers a good variety of shops ranging from well-known chain stores to smaller independent traders. There is a large Tesco store on the ring road to the western side of the town.

There is a pedestrianized shopping mall which is home to many retailers and the library, along with the Martlets Hall which plays host to many well-known and local entertainers. Also situated on the ring road is a leisure centre with a swimming pool, gym, sports hall and playing fields. Burgess Hill also has its own cinema.

There are many sports clubs in the town – football, rugby, cricket, hockey etc and a variety of other clubs and activities. There is also a very popular nature reserve and footpaths which connect to Ditchling Country Park on the northern edge of the new South Downs National Park.

To find out more about Burgess Hill the following websites might be useful:http://maps.google.co.uk/maps?hl=en&tab=wl www.burgesshill.gov.uk/ourtown_index.htmwww.localauthoritypublishing.co.uk/councils/burgesshill/index.html www.westsussex.gov.uk/ccm/portalwww.sussexexpress.co.ukwww.neighbourhood.statistics.gov.uk/dissemination

Silverdale Practice (PMS Practice)The practice currently has five partners and two part time salaried GPs. The practice operates from two sites – Silverdale Surgery and The Avenue Surgery in London Road. Silverdale Surgery is an approved training practice and at times accommodates Y5 medical students from Brighton Medical School, giving them the opportunity to gain experience in a primary care environment.

There are three other GP surgeries in the town, with Silverdale being the largest. There are in excess of 11,000 patients registered at the practice. The doctors currently prefer to operate a personal GP list as it is felt that this offers a higher quality of service.

The practice is open from 8am through to 6:30pm Monday to Friday. The practice also offers regular extended hours to cater for patients who find it difficult to attend during normal surgery times. The extended hours are every Monday from 6:30pm to 8pm and every Saturday Morning from 8:30am to 12pm.

Both GP and Nurse appointments are available during the extended hours.

The practice offers the following clinics and services:

Asthma/Respiratory clinic Child health including vacs and immsHeart Disease/Stroke clinic Foreign travel advice and

immunisationsDiabetes clinic Maternity medical servicesContraceptive advice and services

Minor surgery

Vaccination and Immunisations Smoking cessationFlu and Pneumococcal vaccinations

Well woman – breast and cervical screening

Health checks

Appointments are booked via telephone, online or in person. Same day appointments are available for emergencies and each GP sees emergencies at the end of their normal clinics.

Referrals are made either directly to the provider under Patient Choice or via the Choose and Book Service giving patients the opportunity to book their own appointments.

All GPs make home visits if necessary. Out of hours duties are covered by Harmoni, as commissioned by Horsham and Mid Sussex Clinical Commissioning Group..

Prescriptions are ordered in person, via the website: www.silverdalepractice.co.uk or by post.

The practice clinical team consists of:

Practice nurses Midwifery teamPhlebotomist Health Visiting teamDistrict nurses Community Psychiatric nurseHealth Care Assistant

The practice is registered under the Data Protection Act. Patients have the right to see computerised data by written request. West Sussex PCT monitors for Access and Quality to ensure that the practice is meeting Department of Health Quality Markers.

Key Objectives for Patient Participation GroupsThe purpose of PPG is to ensure that patients are involved in decisions about the range and quality of services provided, and over time, commissioned by their practice. It will help to encourage and reward practices for routinely asking for and acting on the views of their patients. This includes patients being involved in decisions that lead to changes, to the services their practice provides or commissions, either directly or in its capacity as gatekeeper to other services. The aim is to promote the proactive engagement of patients through the use of effective PPGs and to seek views from practice patients through the use of a local practice survey. The outcomes of the engagement and the views of patients are now published on the practice website.

Minutes of all PPG meetings are included at the end of this report and on the practice website www.silverdalepractice.co.uk

Index of Silverdale PPG meetings:-

Minutes from 13th June 2013

Minutes from 17th September 2013

Minutes from 28th January 2014

Silverdale Practice

Minutes of Patient Participation Group MeetingThursday 13th June 2013 – 6:45pm

Avenue Surgery

Members Present: Mr SAMr BLMr CHMrs HIMrs SWiMr HC

Mr DKMr MMMr TRnMrs JHMr PH

Practice Staff Present: Dr Robert Denney (RD)GP Partner

Sean Wheatley (SW)Practice Manager

1. Matters Arising and Actions from the Minutes from February Meeting

1.1 Telephone System SW explained that following a meeting with our current supplier the initial hunt group idea would not work with the equipment and lines in place. SW had three companies in to discuss a possible solution and each time all the companies wanted to do was to sell or lease us a new system. Our Local Medical Committee (LMC) has an independent telecoms consultant. Partners have agreed to fund the consultant for half a day to make sure we use what we have to the best configuration. The current system is still available to buy so we need to figure out the best way of using what we have got. There is a queuing option and we can limit it to two calls as patients will be charged from the moment they enter the queue.

Action Point: SW to continue to investigate solutions that address our access issues and provide value for money.

1.2 On-line Appointment Booking SW announced that this was now live and we are asking for feedback. SWi asked how we were advertising it as she had not heard about it. SW said that it is new and we are still getting feedback and enhancing the service. We plan to email all patients who we have consent for and make them aware of the service.

Initial feedback has been good however the registration log on is not straight forward. CH said it took him a couple of attempts. BL said he had no problem with the logon but had emailed SW some comments on the system.

Action Point: SW to fully launch online system to the patients when ready.

1.3 Wheelchair Access No real news. The lease at Silverdale was still in negotiation and previous quotes for automated doors represent a significant investment. TRn asked about a Disability Survey of both buildings. SW has got one to complete and confirmed this would be done and distributed prior to the next meeting.TRn also suggested two further options:-

Having a ramp at the Silverdale site side door. SW would look at this in the survey but raised concerns that the route would then go through a tight kitchen area and pass by confidential paper notes.

Having and intercom or bell at the side entrance to the Avenue surgery. A camera was suggested for security. SW said this would be considered as a suggestion in the survey. This could also be considered for Silverdale.

Action Point: SW to complete disability survey for both sites and distribute results.

1.4 Appointment System and Accessing Registered GP The new system has had a positive effect on appointments, with many being available at short notice for all GPs. Reception are also able to find appointments faster, which means calls are dealt with quicker and patients are finding it easier to get through. Average wait for an emergency was 25 minutes now they are timed. Reception staff had been trained on how to use it.

1.5 Text and Email Reminders The practice has been gaining consent and now have over 1000 patients.

Action Point: SW Trials will take place over the summer with the plan that Text / Email reminders go live in September.

1.6 Survey TRn asked if a specific survey had been done of how people with a disability found accessing the sites. SW pointed out that the practice normally only does one survey a year but would happily do a specific survey of patients with disabilities if that is what the patient group wanted.

SW said that HI had showed him where the hooks were required.

Action Point: SW to arrange for hooks to go up in the ladies toilets at Silverdale.

Sally Brind will be advising as to which clinics or services can be offered at the Avenue now that harmoni have finally moved out.

SW said that we need to think over the summer about what questions should be in the survey as we would plan to do it at the flu clinics.

Action Point: SW to put forward some suggestions before the next meeting of the PPG.

1.7 Other Points from the last meeting TRn asked why the minutes from the CCG CPRG had not been forwarded to him. CH replied that as yet they were waiting to be produced.

Action Point: CH to see if they are available to distribute and he will pass them on to SW.

TRn raised a point that he had been to a Brighton and Hove meeting where they discussed the Francis Report and how they would ensure it could not happen locally. Has there been such a meeting in the Horsham and Mid Sussex CCG. CH thought that this might be the remit of Healthwatch but there has been no sign of the organisation in action yet.

Action Point: CH to suggest it to the CCG Board.

2. PPG Constitution and Terms of Reference

SW passed out a draft copy of the Terms of Reference. CH said that this had been drawn up by using examples from other PPGs. It was suggested that people read it in their own time and feed comments back to SW.

TRn raised the point of whether the meeting should be more regular either monthly or every other month. SW said that this would be a matter for the group to decide.

The Nolan principles also needed clarifying.

Action Point: SW to send a copy of the Terms of Reference to all members and ask for feedback, specifically about the frequency of the meetings. Also to forward the Nolan principles with the minutes.

3. Extended HoursSW reported that we offered a number of appointments outside of normal working hours. After auditing these it was noted that only 47 out of 80 early AM appointments had been used whereas almost all the evening appointments had been booked. The survey had produced comments from patients about the possibility of opening on Saturday mornings.

SW proposed that we in order to make the appointments more accessible that the practice trials having extended hours appointments every 3rd Monday evening and every 1st Saturday. This was agreed.

Action Point: SW to feedback uptake at next meeting.

4. Silverdale Health DayCH said that he had visited the Dolphins surgery in Haywards Heath who had just had a Carers week. CH explained the concept and asked if the group though it was a good idea. It should be aimed at our demographic. SW can produce some patient data breakdown. It was accepted as a good idea and we would try and aim for early 2014.

Action Point: SW to provide data breakdown.

5. AOBCH reported the patients can now become members of the CCG.

SW reported that the practice is having a trial of a new patient usable BP machine for two weeks from 24th June.

SW gave an update on 111 and that it seemed to be settling down now.

Meeting Closed

Silverdale Practice

Minutes of Patient Participation Group MeetingTuesday 17th September 2013 – 6:45pm

Avenue Surgery

Members Present: Mr SAMr CHMrs HI

Mr CBMr TRnMr PH

Practice Staff Present: Dr Esther Bird (RD)GP Partner

Sean Wheatley (SW)Practice Manager

1. Matters Arising and Actions from the Minutes from June Meeting

1.1.1 Telephone System

Action Point from last meeting: SW to continue to investigate solutions that address our access issues and provide value for money.

On hold as current contract is tied in until June 2014

1.1.2 On-line Appointment Booking

Action Point from last meeting: SW to fully launch online system to the patients when ready.

Reception now actively offering service. It is on our website and posters on notice boards.Last month 24 GP appointments booked via it and 326 patients registered.

1.1.3 Wheelchair Access

Action Point from last meeting: SW to complete disability survey for both sites and distribute results.

This is now done and a copy has been distributed. More information provided later on in meeting.

1.1.4 Appointment System and Accessing Registered GPNo Action Points

1.1.5 Text and Email Reminders

Action Point from last meeting: SW Trials will take place over the summer with the plan that Text / Email reminders go live in September.

Email trial has worked. Policy for email correspondence is being reviewed.

Action Point: Full role out by Christmas.

1.1.6 Survey

Action Point from last meeting: SW to arrange for hooks to go up in the ladies toilets at Silverdale.DONE

Action Point from last meeting: SW to put forward some suggestions before the next meeting of the PPG.

Agenda Item later on.

1.1.7 Other Points from the last meetingTRn asked why the minutes from the CCG CPRG had not been forwarded to him. CH replied that as yet they were waiting to be produced.

Action Point from last meeting: CH to see if they are available to distribute and he will pass them on to SW.

CH informed everyone that minutes from the CCG Patient Group were currently not in the public domain. This is an issue for the CCG to solve and not for this PPG. Minutes were available for the public meetings and CH urged the group to become members of the CCG or at lease attend their open meetings. SW confirmed that dates were displayed in both receptions when he was informed.

TRn raised a point last meeting that he had been to a Brighton and Hove meeting where they discussed the Francis Report and how they would ensure it could not happen locally. Has there been such a meeting in the Horsham and Mid Sussex CCG. CH thought that this might be the remit of Healthwatch but there has been no sign of the organisation in action yet.

Action Point from last meeting: CH to suggest it to the CCG Board. - Done

SW informed that Healthwatch had been in contact and he distributed the new Healthwatch leaflet.

CH suggested this would be an ideal question to ask at the Public meetings of the CCG.

1.2 PPG Constitution and Terms of Reference

Action Point from last meeting: SW to send a copy of the Terms of Reference to all members and ask for feedback, specifically about the frequency of the meetings. Also to forward the Nolan principles with the minutes.

DONE feedback was that the majority of PPG members who responded wanted to adopt the TOR as proposed until the AGM in April next year.

In accordance with point 4 of TOR the practice has appointed Colin Holden as temporary chair until the AGM in April.

Action Point: PH asked for the Nolan principles to be redistributed.

1.3 Extended Hours

Action Point from last meeting: SW to feedback uptake at next meeting.

NHS England rejected the proposed changes for a monthly session of Evening and Saturday AM’s. Practice has now gone to a weekly offering on the same basis with a single GP. SW pointed out that this was less efficient, harder to manage and more confusing to the patients.

EB confirmed that the Saturday mornings were almost fully booked and popular with patients.

1.4 Silverdale Health Day

Action Point from last meeting: SW to provide data breakdown on patients so that the people could be exhibitors could be invited.

Agenda item for later in the meeting.

2. Kings Fund VideoCH / SW showed a short video from the Kings fund outlining the new structure of the NHS.

3. Health Awareness Week / ExhibitionCH gave outline of the format. Visited Life Day at East Grinstead with SW and Vicky. Relevant exhibitors have been invited to attend. Dates will be 23rd October to 25th October with a reception on the evening 23rd October. CH asked for volunteers.

Action Point: SW to send around shifts for volunteers.

There will also be a reception for local council members on the evening of 23rd 7pm til 8:30pm. All members of the PPG will be invited.

TRn suggested members of the Health and Wellbeing Board to be invited.

7. Access AuditSW explained that it was a work in progress and some of the larger projects would require NHS Grants to fund them. The process is currently unclear in the new structure as to how the practice can apply for grants. SW asked group for questions.

In general it was felt that the report was quite comprehensive.

SW explained that a budget had been allocated by the partners and that SW was trying to get the best value for money on different jobs and look at the needs of the majority of patients.

Action Point: Other simple suggestions could include putting priority chairs in to corners and looking at the possibility of a Radar Lock on the side door.

8. Patient Survey QuestionsSW explained he would ideally like to run the same questions to try and gauge progress on last year but asked if there was anything specific the group would like to know.TRn suggested that it would be a good idea to do a subsection on access for those with a disability. SW agreed and it will be added to this years’ survey.

Action Point: SW to go ahead with survey and try to think of different ways to distribute it.

9. AOB

CH gave an update on the CCG in general with projects like the Proactive Care team and the adoption of thinking about “No decision about us, without us” as a way of working across the CCG.

CCG consists of 23 practices with around 223,000 patients.

Further information can be found at www.horshamandmidsussexccg.nhs.uk

SW advised :-

that Dr Walters was now an associate.

DNA’s accounted for over 80 hours of lost clinical time in the last 3 months.

326 patients are now registered to book appointments online and 24 were booked last month.

Silverdale Practice

Minutes of Patient Participation Group MeetingTuesday 28th January 2014 – 6:45pm

Avenue Surgery

Members Present: Mr SAMr CHMr JHMr TR

Mr MMMr TRnMr DK

Practice Staff Present: Sean Wheatley (SW)Practice Manager

1. Matters Arising and Actions from the Minutes from September Meeting

1.1 Telephone System

To be highlighted later during survey.

1.2 On-line Appointment Booking Update

Last month 92 (increased from 24) GP appointments booked via it and 786 patients registered (increased from 326).

1.3 Access

Some items on access audit have been installed such a hand rails and step nose painting.

Action Point: SW to forward hard copy of Access Audit to TRn.Action Point: SW to chase the builders on finishing the step nose painting and other alterations.Action Point: SW to investigate if a RADAR lock can be installed on a fire exit.

1.4 Text and Email Reminders

Roll out now complete.

1.5 Survey

Agenda Item later on.

1.6 Other Points from the last meeting

Update on CCG CRPG

CH informed the group that the minutes from the CCG CPRG were not in the public domain. CH encouraged the group to become members of the CCG. It was also noted that Sussex Community Trust were also looking for members. CH confirmed that questions about how Brighton had addressed the Francis Report had been passed on to the CRPG Chair. CH advised that the new CRPG chair was proving to be very effective. TRn would be interested in hearing about any CCG public engagement events.

CH advised that there was a parking consultation going on which involved Silverdale Road.

Action Point: SW to check CCG websites to see what minutes and events are available and print out.

Health Awareness EventCH thanked everyone for their help at the Health Awareness event in October. Around 300 patients looked around it and we hope to improve on it this year.

2. Patient Survey Results

SW showed the results of the survey and highlighted the comments where performance could be compared to last year. Various discussions were had over several questions and the comments left by participants. SW highlighted that the comments about phone access were better than last year but still needed a marked improvement. Participation had grown and the new section about access split in to disability showed that patients with a physical disability found the surgery more difficult to access. The PPG should consider splitting out Silverdale and Avenue next year. SW highlighted the significant improvement in patient perception of better care. SW thought that this may be down to the appointment system review meant the GPs were happier. Overall the survey showed an improvement in service.

PPG suggested that instead of list all the comments that perhaps they were summarised in to a grid.

3. Review of last year’s action plan.

3.1 Telephone AccessMany different solutions were explored throughout the year and the implementation of online appointment booking, text appointment reminders and a new appointment structure has improved access. The long term goal still remains to upgrade the telephone system and reconfigure staff capacity. A specific meeting with interested members of the patient group was held in February and a solution has been agreed and will be trialled in time to see results in the next patient survey. This item still remains a priority for the practice.

3.2 Online AppointmentsThis was implemented in May 2013. Take up from the patients has been good with registered patients growing to 784 in January 2014 from only 326 in September 2013. Patients are using the system with 24 appointments being booked online in the month before the September PPG meeting and 92 appointments being booked in the month before the January PPG meeting. This item is now closed as a priority and will be monitored in future meetings.

3.3 Disabled AccessThe practice undertook a complete access audit of both sites. The findings were reviewed by the PPG in the September meeting. The practice has put aside a budget for making some improvements and a number of improvements have already been actioned. The practice recognises that the

Silverdale site faces specific access issues that would be difficult to solve without a major redesign. NHS England have been approached with regard to premises improvement grants. This item still remains a priority for the practice.

3.4 Test Results Available OnlineThe practice clinical system is not yet capable of delivering this functionality yet. This item still remains a priority for the practice.

3.5 Reception Staff Asking for Reasons when Booking AppointmentsThe practice realises and respects that some patients may prefer not to be asked a reason why they are booking an appointment. All staff have received training on booking routine appointments. However, the practice needs this information when booking emergency or nursing appointments in order to direct them to the correct member of staff or location. This item is now closed as a priority however reception will receive ongoing training and guidance. The practice will continue to monitor how well it communicates via the annual practice survey.

3.6 Reduce Waiting Times for AppointmentsThe practice has made significant steps towards improving the availability of appointments. During the year it undertook a complete review of the way appointments were structured. Time released appointments have been introduced ensuring that each day every GP will have appointments available for emergency on the day, the next working day, in three days’ time and in a week. The appointments are spread out to provide a wide choice for the patients. Since the launch of the new structure in May 2013 it has been well received by GPs, reception and patients. This item is now closed as a priority. The practice will continue to monitor availability of appointments by continuous analysis and via the annual practice survey.

3.7 Text Appointment RemindersThis has now been implements and many patients have expressed how useful it has been. The practice remains committed to investigating other ways of utilising technology. This item is now closed as a priority.

3.8 Chairs with ArmsThe practice has purchased 10 chairs with arms and implemented a priority seating sign which was suggested by one of the patient group members. This item is now closed as a priority however, the practice will continue to monitor the need for additional chairs as older ones come up for replacement.

3.9 Coat Hooks in ToiletsThe practice has installed coat hooks in to all patient toilets. This item is now closed as a priority.

4. New Action Plan for 2014/15

Further items may be decided at the AGM in April but unresolved items from last year and increased patient education in terms of DNAs and services will be prioritised.

5. Continue to improve phone access to both surgeries.6. Focus on patient education to use services correctly and reduce DNAs.7. Investigate ways to provide test results online in a secure manner.8. Continue to improve physical access to both sites by investigating reasonable adjustments.

5. Questions

SW had asked all members of the PPG by email or letter whether they had any specific questions. A number had been sent in and they were answered:-

Can you explain how the Nursing Appointments are structured in order to make sure there are:-

a) Enough appointments to meet demand.b) Appointments available at short notice to cater for hospital / specialist requests.

Nurse availability is monitored on a continuous basis by both our Nurse Manager and Practice Manager this includes trying to reduce wasted appointments. (300 in last 3 months).

There are a number of appointments that are kept aside as emergencies for short notice requirements.

In addition our nurses will often accept us squeezing in an appointment where possible.

I would like to point out also that there are a number of requests from hospitals that we carry out such as post-operative tasks that are done for the convenience of the patient and they are not in our contract.

When I checked on Monday there were nurse appointments available every day this week.

Nurse appointments are different from GPs because they are split into different types such as BTs or minor ops to coincide with GP work.

Is there space in the consultancy times for patients to be squeezed in if possible?

We never turn away a patient who needs an emergency appointment, many surgeries do. We allocate space at the end of the morning surgery and afternoon surgeries. If a patient comes in off the street either registered with us or not with an immediate need then they are dealt with there and then (this is a clinical decision). I have witnessed this here with a stroke in progress.

However, we are not a general walk in centre. The nearest is either A & E at PRH, Crawley or Brighton.

Can we keep a list of those patients after an urgent appointment and when someone cancels ring the next one on the list.

This is a good idea or though not sure how we can implement it. Appointments are very dynamic and with 3 receptionists and online they come and go very quickly.

An example one of our GPs had a meeting cancelled for which their PM session was blocked out. I released the session and it was fully booked within 3 hours.

Action point: SW to look at a way of implementing this in some way.

How many missed appointments are there?Last 3 months 225 GP and 300 Nurse appointments missed. In newsletter and hoping text reminders will help to reduce.

Staffing Availability:There was a report of no nurse appointments for 2 weeks. Is this a case of raising it with the CCG to request more funding.

There is good availability with both GPs and Nurses. The survey confirms we are on or above the national satisfaction average in this area. There are other factors such as reception staff training in order to identify the nearest appointment to suit the patient’s needs. However if a patient is only available on a specific day at a specific time then this becomes more challenging.

It is not the CCG who funds us. Our contract is with NHS England and this is negotiated at a national level.

Priority seating in the waiting rooms with arms are being used by patients who do not need them despite signs.

Would it help if the signs were in different languages?

Probably not as the vast majority of our patients speak English. Also we use a pretty self-explanatory symbol.

Could the reception team monitor abuse and ask people to move aside?

A member of staff can help however, I would not want to cause any friction. Another 10 seats with arms have been ordered.

Please clarify the support the patient group can expect from the patient group representative to the CCG in taking forward requests and comments to the CCG.

Dealt with earlier in the meeting.

What measures does the practice take to ensure patient confidentiality is retained?

All staff have regular mandatory training on patient confidentiality and what this means in the context of a GP surgery. Staff have access to medical records on a continuous basis in order to carry out daily tasks. Communication is vital to the smooth running of the practice.

Breach of confidentiality is treated as a disciplinary matter for the members of staff involved. If a complaint is received several actions can take place:-

Our clinical system can be audited to show what records were accessed and by whom.

The practice manager or a partner will interview the member or members of staff involved to establish a sequence of events surrounding the allegation.

The person making the complaint will be treated with respect at all times and their ongoing treatment will in no way be effected by the complaint they have made.

A conclusion will be made and clearly explained to all parties along with any action taken.There was a discussion about complaints in general and SW said that the statistical information was readily available.

Action Point: SW to look up statistics from last year and bring to next meeting.

Who should discipline a patient?

SW was not sure in what context this is but if it is a clinical matter then an any clinician with the appropriate training or knowledge can advise. If it procedural such as missing appointments or making unreasonable demands then this would normally be the Practice Manager.

What is the practice policy on patients presenting on an emergency basis?

We take the standard NHS Choices website approach to walk in emergencies where a GP will be notified immediately if a patient is exhibiting:-

loss of consciousness acute confused state and fits that are not stopping persistent, severe chest pain breathing difficulties severe bleeding that cannot be stopped

A GP will assess the situation and take the necessary action. The general rule of thumb is if you think you need immediate treatment then A & E is the best place for you. If in doubt call 111 or us to make an emergency appointment at the end of a session.

If someone calls us with these symptoms then we will advise to call 999.

The group were shown the right care right now leaflet and website from CCG.

6. Next MeetingAGM in April date to be arranged.

7. AOBThe radio at Silverdale need to be looked at as it was not on last time.