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Shanklin Medical Centre Local Patient Participation Report & Patient Survey Report December 2012 Prepared by: Jason McLean Practice Manager December 2012 Approved by: Patient Representative Group December 2012 -1- Background Shanklin Medical Centre is committed to a Patient Representation Group (PRG) for 2011 – 2013. Our PRG aims for 2012/13 are: Agree with the PRG which issues are a priority and include these in a local practice survey. Collate patient views through local practice survey and inform PRG of the findings. Provide PRG with opportunity to comment and discuss findings of local practice survey. Reach agreement with PRG on changes in provision and manner of delivery of services. Publish survey report on the practice website Agree with the PRG an action plan setting out the priorities and proposals arising out of the local practice survey. Seek PRG agreement to implement changes and where necessary inform the PCT Participate in ad-hoc projects as arise. -2- PRG Profile of Members Practice population profile PRG profile Age % Under 16 % 17 - 24 % 25 - 34 % 35 - 44 % 45 - 54 % 55 - 64 % 65 - 74 % 75 - 85 % Over 85 13% 11% 9% 11% 15% 15% 19% 9% 4% % Under 16 % 17 - 24 % 25 - 34 % 35 - 44 % 45 - 54 % 55 - 64 % 65 - 74 % 75 - 85 % Over 85 0 0 0 0 7% (1) 36% (5) 21% (3) 36% (5) 0 Ethnicity White White % British Group 99.27% % British Group % Irish 0.35% % Irish Mixed % White & Asian Mixed 0.03% % White & Asian Asian or Asian British % Indian % Pakistani Asian or Asian British 0.18% 0.05% % Indian % Pakistani Chinese or other ethnic group % Chinese % Any Other 92.86% (13) 7.14% (1) Chinese or other ethnic group 0.13% 0.98% % Chinese % Any Other Gender % Male % Female 49 51 % Male % Female -3- 50% (7) 50% (7) What steps did we take to ensure the PRG was representative of our practice patients? Practice leaflets created asking for patient participation Advertised on practice website Word of mouth invitations via team members Open forum meeting for any interested parties It was recognised that we were struggling to attract the hard to reach groups and this was highlighted as part of the PRG set up exercise involving an external consultant Roy Bromley. It was discovered that there were already organisations and groups e.g. Link, local council etc that have access to these groups and were best placed to facilitate future discussions. In agreement with the PCT and CCG, practices were able to concentrate on patients that expressed an interest in participating in the PRG, regardless of demographic. The hard to reach groups would fall under the wider remit of the PCT/CCG in future consultation exercises. Shanklin Medical Centre held an open forum meeting on 21 July 2011, attended by Dr John Rivers (Senior Partner), Jason McLean (Practice Manager) and Roy Bromley (PRG Consultant). In excess of 40 patients attended, 14 of whom expressed an interest to participate and form the Shanklin Medical Centre PRG. Throughout 2012/13 ongoing advertising and targeting of various groups was maintained. However, the membership for 2012/13 remained as per 2011/12. The PRG will once again be reviewing its structure and formation in 2013/14 with aims to increase involvement from patients. What steps did we take to reach agreement on issues which had priority and were included in the local practice survey? The PRG maintained overall responsibility for the creation of the survey, to include specific areas, questions and distribution objectives. Historic national MORI and local GPAC surveys were reviewed to ensure consistency in questioning. These were agreed at the PRG meeting of 1 October 2012. How did we seek the views of our registered patients? As agreed by the PRG, the survey was circulated as follows: Online via website Direct to patients presenting in surgery Via patient information kiosk -4- What steps were taken for the PRG to review the survey findings? Full results, broken down to individual GP, including all free text comments were circulated to the PRG for review and comment. This review took place at the second PRG meeting on 11 December 2012. The results, findings and actions of the survey follow. Patient Survey 2012/13 The 2012/13 Patient Survey was devised by the Shanklin Medical Centre PRG. The 2011/12 survey was reviewed to ensure consistency in questioning, whilst also ensuring the survey was compact enough to ensure maximum response levels. The PRG agreed the following: 5 sections to survey o o o o o Communication (new) Access GP Nurse Did you know Distribution & Time length o o o o Paper survey to patients presenting at surgery Online survey on SMC website Online survey on information kiosk 4 week collection period mid October to Mid November 2011 Questions & Format o All questions collated and approved by the PRG along with the survey format. Rate of Return: 357 completed returned surveys. (2011/12 563 returns) Paper survey to patients presenting at surgery: 600 distributed, 344 returned. 57.33% Online survey on SMC website, 4 responses Online survey on Information Kiosk, 9 responses -5- Statistics: About you: Your age: Under 18 6(2%) 18-24 25-34 14(4%) 18 (5%) 35-44 34 (10%) 45-54 81(20%) 55-64 65-74 75-84 85+ 64(18%) 103 (29%) 33(9%) 4(1%) Current demographic 12% 11% 10% 15% 16% 9% 14% 9% 4% Communication: Email: You can communicate with your GP by email, for example, sending them blood pressure readings or if your have queries with your medication etc. Yes No Do you have email facilities? 237 (66%) 120 (34%) Do you use this service? 105 (29%) 252 (71%) Would you use this service? 202 (57%) 152 (43%) When would you expect a response, (working days) 2days 3 days 4 days 275 (77%) 62 (17%) 9 (3%) Website: Apart from a great deal of surgery information, there is also the facility to order your repeat medications Yes 199 (56%) 143 (40%) 243 (68%) Are you aware of this service? Do you use this service? Would you use this service? 5days 11 (3%) No 158 (44%) 214 (60%) 114 (32%) Telephone Appointments: These can be used for matters that do not require an examination, and can save you a visit to the surgery. Just call the surgery, give them your details and a GP will call you back. Yes 212 (59%) 168 (47%) 299 (84%) Are you aware of this service? Do you use this service? Would you use this service? No 145 (41%) 189 (53%) 58 (26%) Access How satisfied are you with: Very Satisfied 222 (63%) Satisfied 124 (35%) Dissatisfied 3 (1%) Helpfulness of the Receptionists: 260 (73%) 95 (27%) 1 (0%) 1 (0%) 7 Ease of access to and around the building: 239 (67%) 118 (33%) 0 (0%) 0 (0%) 0 Layout of reception area: 255 (71%) 100 (28%) 2 (1%) 0 (0%) 0 Surgery opening hours: 229 (64%) 125 (35%) 2 (1%) 0 (0%) 1 Booking routine appointments 217 (62%) 122 (35%) 9 (3%) 1 (0%) 8 Booking urgent/emergency appointments 221 (66%) 100 (30%) 12 (4%) 0 (0%) 24 Making contact with the surgery by phone: Making appointments: Do you prefer to see or speak to your own registered GP? Yes 217 (61%) How often do you see or speak to your registered GP? Very Dissatisfied 1 (0%) No 23 (6%) No Experience 7 No Preference 117 (33%) Always/Almost always Most times Sometimes Never/hardly 144 (40%) 129 (36%) 51 (14%) 33 (9%) When making GP appointment how quickly are you offered an available appointment (tick one option for each of the following) -6- Same Day Next Within 2 Working Working Day Days Within 3 Working Days Within 4 Working Days 5+ Does Working Not Days Apply Routine with your registered GP 131 (38%) 73 (21%) 87 (26%) 34 (10%) 11 (3%) 5 (1%) 16 Routine with any other GP 160 (50%) 91 (29%) 587 (18%) 9 11 (3%) 2 (1%) 0 (0%) 38 Urgent / Emergency with your registered GP 234 (79%) 44 (15%) 19 (6%) 1 (0%) 0 (0%) 0 (0%) 49 Urgent / Emergency with any other GP 247 (89%) 28 (9%) 6 (2%) 0 (0%) 0 (0%) 0 (0%) 49 GP Consultations How satisfied are you that the: Very Satisfied 238 (67%) Satisfied 117 (33%) Dissatisfied 2 (1%) GP listened to you 234 (66%) 119 (33%) 4 (1%) 0(0%) 0 GP explained tests & treatments 243 (69%) 105 (29%) 4 (1%) 0(0%) 0 GP involved you in decisions about your care 213 (62%) 125 (35%) 4 (1%) 0(0%) 5 GP treated you with understanding 106 (30%) 6 (2%) 0(0%) 3 GP gave you enough time 242 (68%) Very Dissatisfied 0(0%) No Experience 0 Nurse Consultations How satisfied are you that the: Nurse gave you enough time Very Satisfied Satisfied Dissatisfied Very Dissatisfied 239 (72%) 94 (26%) 0 (0%) 0(0%) No Experience 24 Nurse listened to you 235 (71%) 98 (27%) 0 (0%) 0(0%) 24 Nurse explained tests & treatments 230 (71%) 94 (26%) 0 (0%) 0(0%) 33 Nurse involved you in decisions about your care 230 (71%) 93 (26%) 0 (0%) 0(0%) 34 Nurse treated you with understanding 93 (26%) 0 (0%) 0(0%) 25 239 (72%) Did you know? We are open until 8.00pm on a Monday evening Yes 187 (52%) No 170 ( 48%) We are open 08.00 – 11.00 am each Saturday 233 (65%) 124 (35%) You can pre-book routine appointments months in advance 248 (69%) 109 (31%) You can telephone our reception to obtain test results, saving you time 258 (72%) 99 (28%) Overall Experience of Shanklin Medical Centre Very Satisfied Satisfied 256 (72%) Overall, how satisfied are you with Shanklin Medical Centre -7- Dissatisfied Very Dissatisfied 101 0 0 (28%) (0%) (0%) Findings: The PRG were pleased with the return rate from in surgery attending patients, however it was noted that significantly more patients did not want to complete a survey as they felt there were so many going on in general that the exercise was devalued. Access: Excellent results across all access questions, ranging from 96 – 99 % satisfaction. An increase on 2011/12. Average overall access questions 98.5%, up from 97.5% in 2011/12 GP Appointments: The historic requirement for access to a Healthcare Professional within 2 working days has not been required for the last 2 year. Under the old targets, the survey highlighted a 96% positive response to patients seeing any GP within 2 working days. This is an improvement from 87% the pervious year For urgent/ emergency appointments a 98% positive response was received (89% seen on same day, 9% the next working day). This is an improvement from 97% (78% say day and 19% the next working day) from the previous year GP Consultation Satisfaction: Excellent results across all questions, ranging from 98 – 99% satisfaction up from 96 – 97 % in 2011/12. Overall satisfaction over all areas 98.8 %, up from 96.5% in 2011/12 Nurse Consultations: Excellent results across all questions with 100 % satisfaction. An increase from 96.5% in 2011/12 Overall Satisfaction with Shanklin Medical Centre: 100% satisfaction up from 99% -8- Improvements / Learnings: The PRG were delighted to see an increase in the “Did you know section” (results as below): We are open until 8.00pm on a Monday evening Yes 52 % (42%) No 48% (58%) We are open 08.00 – 11.00 am each Saturday 65% (55%) 35% (45%) You can pre-book routine appointments months in advance 69% (55%) 31% (45%) You can telephone our reception to obtain test results 28 (46%) 72% (54%) The PRG felt that this improvement came about due to the successful completion of actions from the last survey. As noted below: 1. Newsletter – Dedicated “Did you know” edition. 2. Update to website – Patient Information Section (Highlighted on main page) 3. In practice advertising e.g. via notice board, prescriptions etc The actions above will be continued and regular updates made to all areas. From the 2012/2013 survey there was a clear indication that patients were happy to embrace consultations / information sharing via telephone and/or email with a GP. Or aim is to continue to increase this offering though GP and reception staff reminders to patients at appropriate times. The other clear area for improvement was the 1st floor waiting room, where the layout, heat and general feel was seen to be letting the surgery down. This was discussed and the actions below agreed. Subsequent Recommendations and Actions: Newsletter – Continue on 6 monthly update basis. - Agreed Information Kiosk – update with relevant information on an ongoing basis. - Agreed GPs and staff to promote use of email and telephone consultations – Agreed Update 1st floor waiting area to include: o New seating. Agreed o New flooring. Agreed o Air Conditioning. Agreed -9- PRG Review of 2011/12 Actions: Newsletter – Dedicated “Did you know” edition. Completed In practice advertising e.g. via notice board, prescriptions etc. Completed Review of LifeChannel system with view to replacing with standard television/radio. Completed. Radio system installed Review of automated check in facility – Completed. Check in system purchased, installed and awaiting final staff training. Scheduled completion January 2013 Practice Profile: Shanklin Medical Centre serves the population of a small thriving seaside and semi-rural town on the south east coast of the Isle of Wight. The partnership was originally formed in 1968. The building is owned by the partners and has undergone a number of improvements over the years including a major extension, and lift installation, completed in March 2010. The practice serves a population of some 11,500 patients. This number has grown slowly but steadily over the past 5 years. There is a higher than average proportion of patients aged 65 and over, and an associated high prevalence of chronic medical problems. This along with relatively high individual list sizes means that there is a high demand for medical services. The practice has responded to this with the development of a constantly evolving and well managed systematic approach to health care with an emphasis on involvement of all members of the “team”. We provide a service to a large number of holidaymakers during the summer months. The philosophy of the practice is simply to provide the highest possible standard of medical care to the practice population. - 10 - Vision The Doctors, nurses and all staff are committed to the provision the best possible clinical, patient, partner and staff experience within available resources. Values To uphold and the Practice Vision, personally and as a Team. To work smartly aiming to achieve the most possible within available resources. To respect and trust individual strengths and weaknesses. There is a shared ownership and responsibility by partners, staff and patients. Be a positive ambassador for the practice and patients. Listen to and understand the needs of our patients, and wherever possible reflect those needs on our services. Provide excellent customer service, by ensuring we respond to patients in an open, caring and timely fashion and importantly keep our promises Objectives Provide an environment which is clean, safe, and conducive to high quality patient care. Continue to develop a culture of high trust and delegation – minimise micromanagement. Develop trust towards management and partners from employees, patients and from other parties. Ensure the Practice remains a viable going concern; meeting all parties’ aspirations where possible. Offer patients, with on-going health issues, a clinical programme, jointly owned by both of us, to ensure that reviews and medication are managed effectively Ensure that clinical and non-clinical staff partake in Continuous Professional Development. Ensure we practice in accordance with national guidelines, recognise best practice, enable our patients and the Practice to benefit from continuous improvement and working with the wider healthcare environment to deliver innovative solutions. Utilise available technology to enable all our clinical staff to respond effectively to healthcare needs. - 11 - Provide urgent appointments that enable patients, as a minimum, to talk to a clinician on the day. Ensure prescriptions are ready for collection with 48 hours. Provide non-NHS services in a timely fashion against an agreed tariff. Regularly communicate on Surgery performance. Respond quickly and pro-actively to any concerns about our services. Maximise individual professional fulfilment and pride in organisation. Maximise individual personal fulfilment. Improve internal communication. To be flexible in delivery of work and time. To be positive and maintain a forward looking attitude. Make quick clear decisions and deliver on decisions as agreed. Use external resources to inform and improve practice [CCG, appraisals, QOF etc] The surgery is open as follows: Core Hours Monday Tuesday Wednesday Thursday Friday Saturday 08.00 – 18.30 08.00 – 18.30 08.00 – 18.30 08.00 – 18.30 08.00 – 18.30 Extended Hours 18.30 – 20.00 08.00 – 11.00 Throughout our core hours, access to services can be made via our appointments system. These can be booked in person, over the phone or via our website. During expended hours, access is available via our appointments system. These can be booked in advance in person, over the phone or via our website, or on the day in person. - 12 -