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Patient Participation Enhanced Service 2014/15 Annex D: Standard Reporting Template London Region North Central & East Area Team Complete and return to: [email protected] no later than 31 March 2015 Practice Name: Glen Road Medical Centre Practice Code: F84092 Signed on behalf of practice: Dr S Madipalli Date: 29.03.2015 PPG meeting 2014-2015.tif Signed on behalf of PPG: Mrs Sheila Doshi 1. Date: 30.03.2015 Prerequisite of Enhanced Service – Develop/Maintain a Patient Participation Group (PPG) Does the Practice have a PPG? YES Method(s) of engagement with PPG: Face to face, Email, Other (please specify) We communicate with PPG team members Face to Face Telephone Email where possible Number of members of PPG: 8866 Page 1 of 12 Patient Participation Enhanced Service 2014/15 Annex D: Standard Reporting Template Detail the gender mix of practice population and PPG: % Practice PRG Male 49.6 37.5 Detail of age mix of practice population and PPG: Female 50.4 62.5 % Practice PRG <16 26 17-24 11 25-34 22 1 35-44 17 45-54 12 2 55-64 7 2 65-74 3 3 > 75 2 Detail the ethnic background of your practice population and PRG: Practice PRG Practice PRG British Irish 1150 2 124 White Gypsy or Irish traveller Indian Pakistani 408 4 500 1 Other white 802 Asian/Asian British Bangladeshi 1254 White &black Caribbean 92 Chinese 5 Mixed/ multiple ethnic groups White &black White African &Asian 33 17 Other Asian 218 Other mixed 35 Black/African/Caribbean/Black British African Caribbean Other Black 981 339 36 1 Arab 23 Other Any other 407 Describe steps taken to ensure that the PPG is representative of the practice population in terms of gender, age and ethnic background and other members of the practice population: The practice has endeavoured to make PPG as diverse as possible by ensuring that the members are from a cross section of the population in terms of gender , age and ethnicity so that it complies with the ‘Equality Act’ and all views and feedbacks are equally represented. However it has not been possible to make the PPG truly representative as some groups show more interest in the Practice decision making process than the others. We managed to recruit a new member in the age range 20yr -30 years to obtain their view of the services provided. Glen Road Medical Centre has a very diverse patient Population as shown above The practice also has a very diverse ethnicity consisting mostly of White British, Black African, Black Caribbean, Indian, Bangladeshis, Pakistanis, Indians, Eastern Europeans and Filipinos. Aside from the ethnic groups the Practice has attempted to Page 2 of 12 Patient Participation Enhanced Service 2014/15 Annex D: Standard Reporting Template involve the minority groups such as those that are disabled, housebound, suffering from long term illnesses. One of the PPG members is a councillor for Newham and takes an active interest in the welfare and needs of the practice The PPG was brought together by displaying posters in the waiting room and the reception area and also informing the patients opportunistically such as during consultations with the clinicians. New patients are also informed at the time of registration. The Practice has attempted to recruit more members especially from the lower age group by writing letters, asking opportunistically and by telephone using a list of patients under 30 years old .We were able to recruit one member under 30 years old. Following this, those who showed an interest in joining the group were advised of the face to face meeting date and time. Our practice web site also encourages patients to become part of the PPG so that they provide an invaluable insight into how the patients in that age group perceive the practice and their level of satisfaction with the service we provide Are there any specific characteristics of your practice population which means that other groups should be included in the PPG? e.g. a large student population, significant number of jobseekers, large numbers of nursing homes, or a LGBT community? Yes If you have answered yes, please outline measures taken to include those specific groups and whether those measures were successful: The practice makes continued efforts to recruit the younger population such as students and the job seekers and we have written letters to them , sent texts to those below 30 but we managed to recruit only one patient 2. Review of patient feedback Outline the sources of feedback that were reviewed during the year: Comments from Patient Satisfaction survey done last year Patients complaints and comments , suggestion box Page 3 of 12 Patient Participation Enhanced Service 2014/15 Annex D: Standard Reporting Template NHS choices Friends and Family test Feed from Infection Control visit : The above sources of feedback were reviewed with practice team and the PPG The following priority areas were discussed with the PPG and them three areas were chosen to develop a strategy , action plan and time scales to implement the changes 1. Strategy to reduce the waiting time to see the doctor Team members to be involved: Doctors, HCA and Reception Staff/Administrator To set up posters and message on the Jayex board Reception staff and HCA to take up the printing of blood test forms and other investigation forms, Choose and Book Weekly meeting with key members to assess the progress and provide the necessary training It was also noticed by the PPG that the rating was better than last year and better than the national average which shows that the issue is not just with the practice. The patients expectations and demand reflect the increase in consultation time required compared to the allocated time of 12 -15 minutes for each patient The reasons for the delay was due to several reasons such as patients presenting with complex medical problems, early discharge from hospital, language problems, patients having poor understanding of their medical condition, IT issues However the PPG and practice staff have put forward the following suggestions to reduce the consultation time with each patient and subsequently the waiting time for patients waiting to see the doctor To utilise the skills of the trained HCA to do simple measurements such as Blood pressure, weight, life style education, use of equipment such as glucometers and provide secretarial support To utilise the reception staff to print forms for investigations by sending EMIS WEB message and to arrange Choose and Book Patients should be made aware of the comments from the results of the survey by putting the report on the notice board. Posters and notice board clearly indicating that the doctor can deal with only one major problem or 2 minor problems at a time if they have to run on time and to reduce the waiting time for the next patient. If they have a list of problems, to discuss the list first and then deal with most important one or two problem Time for implementation -3-6 months 2. Improvement to 48 hour access to doctors: Team members to be involved: Doctors, Nurse, HCA and reception Page 4 of 12 Patient Participation Enhanced Service 2014/15 Annex D: Standard Reporting Template Training for the practice team: to attend the CCG organised training for doctors and reception staff for telephone triage. Experience from Local practices has shown that, by telephone triage, face to face appointments could be reduced and more slots are made available for patients wishing to see the doctor within 48hours Weekly brief meeting with key members to assess the progress Time for implementation: 3- 6 months 3. Improvements to waiting room Team members to be involved involved-Doctors and Practice Administrator Time for implementation: 3 -6 months 4. Develop structured group education for patients with Type 2 Diabetes Mellitus How frequently were these reviewed with the PRG? 3 times a year . The following three priority areas were discussed with the PPG and the action plan agreed. Please see minutes of the meeting minutes of PRG PRG meeting held on meeting 17th December March 2014-2.rtf 25th 2015.docx Page 5 of 12 Patient Participation Enhanced Service 2014/15 Annex D: Standard Reporting Template 3. Action plan priority areas and implementation Priority area 1 Description of priority area: Improve access and provide appointments within 48 hours or earlier when required to all patients and reduce the waiting time for patients requesting a an appointment to see a doctor identify those who need an urgent appointment and avoid booking appointment for patients who can be dealt with on the phone reduce the number going to A/E for conditions that can be treated in Primary Care What actions were taken to address the priority? The initiative was discussed with the PPG and approved all staff members clinical and non-clinical had the opportunity to attend a training session for telephone triage and consultations organises by the CCG From October 2014Telephone calls from patients excluding administrative and non-clinical calls are triaged by the doctor in the morning and afternoon Patients are booked on the telephone consultation slots and called back The doctor after taking full history will either book an appointment to see the doctor or nurse practitioner and some may need only advice The Practice Nurse who is a Qualified Nurse Practitioner is able to see some of the patients on the telephone triage Time created for Practice nurse by moving the phlebotomy services to the trained HCA We also provide a slot in each session for patients referred from streamer in Urgent Care Page 6 of 12 Patient Participation Enhanced Service 2014/15 Annex D: Standard Reporting Template Result of actions and impact on patients and carers (including how publicised): By telephone tri age reduce the face to face consultations and demand for booked appointments Most patients are given an appointment the same day Some may need only advice which releases the appointments for patients who are really ill and need to see the doctor. Patients are initially unhappy when they cannot get an appointment with the first call to book an appointment but when they realise the benefit of getting the appropriate service the same day they do appreciate it. The change in how we book appointments is publicised Through practice leaflet New registration Posters Practice Website The Friends and Family Test shows that some patients are unhappy with change but we assess the impact in the next few months and make any changes necessary (January 2015) (Feb 2015) Feb.2015 Jan.2015 Patient_Survey_Form_feed_back_with Patient_Survey_Form_feed_back_with comments-.doc comments-24.3.2015.doc Page 7 of 12 Patient Participation Enhanced Service 2014/15 Annex D: Standard Reporting Template Priority area 2 Description of priority area: To improve the heating and lighting in the waiting area and other parts of the premises including the car park lighting Install new heaters and taps in all clinical rooms to comply with the infection control regulations after the visit in May 2014 What actions were taken to address the priority? The lighting and heating has been improved in the waiting and also the security lighting at the entrance and car park to improve safety for staff and patients . Electric dryers installed in the toilets in place of hand towels We are in the process of changing the taps and water heaters in clinical rooms to comply with the health and safety requirements To improve the experience on sitting in the waiting room a New TV screen has been set up. We are in the process of providing interactive health related programmes which promote healthy life style and self-management of minor illnesses The conference room is now equipped with large TV screen to provide training for doctors, staff and for various presentations such as PPG meeting and Primary Care Team meetings Result of actions and impact on patients and carers (including how publicised): Patients are happy with the above improvements Some request Fans or A/C during summer months. We are in the process of considering installation of ceiling fans Page 8 of 12 Patient Participation Enhanced Service 2014/15 Annex D: Standard Reporting Template Priority area 3 Description of priority area: Provide structured Diabetic education in the practice for all Newly diagnosed Type 2 Diabetic patients As the prevalence of Type 2 Diabetes is very high in the area the PPG were happy for the practice to start the sessions based in the practice and run by the Diabetic specialist nurse As a high proportion of patients have poor educational background and poor understanding of their illness it was considered a priority to improve the health of patients with this long term condition. Evidence shows that early diagnosis and strict control in the first few years of diagnosis with life style changes and medication reduces the complications in the long term. It improves quality of life for the patients and would be less strain on the limited resources. What actions were taken to address the priority? The proposal was agreed by all PPG members The Diabetic Specialist nurse visited the practice and explained the process of referral , the duration of the session and the requirements to hold the session As most patients are newly diagnosed the session is conducted with Conversation Maps which takes the patient through the journey of Type 2 Diabetes The attendance at the session was variable and it was felt that the presence of an interpreter for patients who cannot speak English properly could help with the attendance. Result of actions and impact on patients and carers (including how publicised): Patients find it very useful and with the improved knowledge there is an impact on the patient’s life style such as diet ,exercise Page 9 of 12 Patient Participation Enhanced Service 2014/15 Annex D: Standard Reporting Template and better compliance with medications One of the PPG member who used to work as an interpreter for Hindi, Gujerati patients expressed interest in attending the session and help those with language difficulties and promote the education to other patients To discuss the issue with the Diabetic Specialist Nurse Progress on previous years Is this the first year your practice has participated in this scheme? No If you have participated in this scheme for more than one year, outline progress made on issues raised in the previous year(s): Staff training: ongoing It was agreed in the last year PPG meeting to provide staff training to improve the use of the new EMIS software –EMIS web so that they can take on administrative work such as Choose and book, printing blood test and other investigation forms This releases the doctors time and reduces the waiting time for the patients as they were complaining about the waiting time in the reception before they are seen. Improve the comfort of the waiting area: we are constantly improving the premises to comply with the health and safety and infection control requirements. The new Children’s area was built 2 years ago and it is being used effectively Inability to see the doctor of their choice has been an ongoing issue: we do explain to the patients that in an emergency they should be able to see any doctor and if they wish to see the doctor of their choice they would have to wait Telephone access: the telephone system was upgraded to be able to answer calls more effectively and also advise patients to book appointments online or call at non urgent times which will reduce the burden of calls during peak hours Implementing the strategy to reduce the waiting time to see the doctor -ongoing The report accepted by the PPG has been ofpublished on the website Page 10 12 copy posted to the members of the PPG Copies have also been placed in the waiting area and one posted on the notice board Patient Participation Enhanced Service 2014/15 Annex D: Standard Reporting Template 4. PPG Sign Off Report signed off by PPG: YES Date of sign off: 30.03.2015 How has the practice engaged with the PPG: The practice ensures that the PPG are involved in decisions about the range and quality of services provided by the Practice and the PPG are invited to make suggestions and comments to improve the care provided the by the practice. The PPG are constantly updated with the new developments and constant changes which are affecting General Practice and how the PPG by active involvement can make a difference. The Practice seeks to promote the proactive engagement of patients through the PPG. How has the practice made efforts to engage with seldom heard groups in the practice population? The practice makes an ongoing effort to reach the seldom heard groups such as housebound elderly ,carers of those with learning difficulties, students to take part in the PPG by putting up posters, sending them texts and also encouraging them opportunistically during consultations Has the practice received patient and carer feedback from a variety of sources? Yes The practice makes an effort to discuss the complaints received by the practice in depth Patient satisfaction survey is also discussed with a presentation in depth and the all comments are taken seriously.Every effort is made to address the issues where possible Friends and Family test – the results of the First month Friends and Family test were presented to the PPG at the last Meeting Page 11 of 12 Patient Participation Enhanced Service 2014/15 Annex D: Standard Reporting Template Was the PPG involved in the agreement of priority areas and the resulting action plan? Yes . The three priority areas were discussed and agreed with the PPG – How has the service offered to patients and carers improved as a result of the implementation of the action plan? As a result of the implementation of the action plan patients are seen with 48 hours or less and able to get advice for conditions which do not require an appointment. Doctor is able to decide who needs an urgent appointment able to make appointments appropriately. This also reduces the number of patients going to A/E for conditions which can be dealt with in Primary care. The waiting area looks much better with better lighting and the newly installed heaters provide better heating and it is more comfortable The Idea of structured education for type 2 Diabetic patients is very good as diabetes very common and people do not understand the seriousness of the condition. Do you have any other comments about the PPG or practice in relation to this area of work? Complete and return to: [email protected] no later than 31 March 2015 Page 12 of 12