Survey Report March 2014

Our Patient Participation Group (PPG) currently has 9 active members who ages range from 44 years to 81 years of age. Of those 9 members 3 are new recruits within the last 4 months.

We have a wide range of skills and knowledge within the membership and everyone is passionate about healthcare and wanting to support the Practice in providing a link between patients and clinicians. Within our group we have the following professions:

• Someone who worked as a senior manager in the NHS, is academically qualified to PhD level and lectures at Keele University
• A retired teacher and statistician who has a special interest in the care of people with dementia and is also an active member of Staffordshire Healthwatch
• A retired businessman from the hospitality trade who has worked with young people in recent years
• A teacher who now works in property development
• A retired midwife
• A retired administrator who worked in local government
• An HR manager who changed track and had her own retail business
• A senior manager who worked for Staffordshire Social Services department who is also the Chairman of ‘Approach’ a local charity for dementia
• A retired professor involved in pioneering work to develop the first hip replacement joints and who is now the chairman of the University Hospital PPI forum

Our PPG as a whole is also member of the National Association for Patient Participation.

Like many PPG’s within North Staffordshire we have encountered difficulty in recruiting new people to the group, particularly younger people. We have promoted the existence of the group through articles in the Practice newsletter, the moving message board in the waiting room along with a notice board and on the Practice website. We have been very fortunate to recruit three new members within the last few months. Whilst we are still actively seeking new members we cannot allow the group to get too large otherwise it would become unmanageable.

The PPG meet every month on the last Wednesday and we discuss what’s going on in the local health economy, any issues or problems members wish to raise about the Practice and it’s services, feedback from any other meeting members attend, articles for and the progress of the Practice newsletter and developing the next patient survey.

Given that we had done a very comprehensive survey last year around appointments and the quality of care provided this year it was agreed, after some discussion, that we wanted to find out more about the way in which our patients prefer to communicate and also whether they know about all the various services the Practice provides.

The mode of communication was deemed to be important as we have been discussing whether it is appropriate to use Facebook and Twitter alongside the website. Also to find out how many of our patients have access to and use text messaging, e-mail and the internet. This information will be useful for the future.

All group members had the opportunity to contribute ideas and questions for the survey. These were pulled together, discussed and accepted or rejected by consensus within the group and the final set of questions agreed. The Practice Manager arranged for the survey to be set up on Survey Monkey and paper copies were placed on the chairs in the waiting room before each morning and afternoon consulting sessions. Patients were also handed surveys at reception when they called in to make appointments or collect prescriptions. A total of 576 surveys were completed. All the data was input to Survey Monkey and collated independently using this software.

The survey results were sent to PPG members for consideration prior to the meeting in March where the results were discussed and the development of an action plan started to address those issues which were identified by the group as being important. The action plan will be further developed and implemented during the coming months and there will be more discussion at future PPG meetings.

Summary Of Survey Results 2014

The full survey results can be found using the following weblink:

http://www.keysurvey.com/report/581566/-1/2d7e30c6?afterVoting=5c8ce53fd5ab

The survey was carried out between 20th January and the end of February 2014. The data was input and the final collated information was available on 13th March.  Here follows a basic summary of the survey results.

We had 596 responses of which 61% were from female patients and 39% from male patients. Nearly 505 of all responses were from patients aged 61+ with just 8% from the 0 to 30 year old age group.

In terms of how patients like to communicate:

85% communicate face to face
79% use a mobile phone
63% use text messaging
60% use e-mail
29% use Facebook
6% use Twitter

Given the way the data is available it is not easy and would be very time consuming to drill down further to try and find out what these percentages would look like in specific age bands. However, we were a little surprised that so few patients use Twitter although 29% use Facebook to communicate. Having input some of the questionnaires myself I know that all age groups fell into the Facebook users including patients over 75 years old.
Overall across the 10 questions in part 1 of the survey 53% of patients are aware of the various services provided and 47% are not. However within that there were some significant differences e.g. 65% of respondents knew they could get advice and medication to help them stop smoking but only 39% knew they could get individual help and support to lose weight.

It is apparent from the survey results that we need to provide more information about the services available to patients and this is addressed in the action plan.

It was encouraging to find that 81% of patients knew how to contact a Doctor when the surgery is closed but this still means that 19% (potentially 1,582) patients do not know how to do this.

Just over 50% of patients know about NHS 111 but 48% are in the dark. This should increase with the North Staffs CCG promotional campaign which started in March 2014. However, we need to promote this in the Practice so that patients know about the change from NHS Direct and know how NHS 111 should be used.

We asked patients how they would prefer the Practice to tell them about the services available and asked them to tick all that apply so most respondents ticked several boxes. The breakdown is as follows:

It would appear that there is very little interest for communication via Facebook or Twitter which helps the PPG to make the appropriate decision about investing time and resource in social media.

A significant number of people would like us to use e-mail and we have tried to set this up on a previous occasion without success as the Health Informatics Service were not able to provide us with the facility to do this en masse. It is something we can review.

We already have a text messaging system in place to remind patients about appointments and it can also be used to promote vaccination programmes such as seasonal influenza and shingles. Text messaging, along with e-mails requires patients to keep us up to date with any changes to phone numbers or e-mail addresses. There are also information governance issues to be considered. However, we would not be using these media to send personal, confidential information to patients.

There is still a demand for traditional forms of communication including posters and leaflets although many people are increasingly using the internet to access information almost instantly and in the comfort of their own homes. 35% of patients said they always use the internet to get information and 26% said they often use the internet. At the other extreme 20% say they never use the internet the assumption being that most of those patients do not have internet access.

Within the questionnaire at part 2 there was also the opportunity to add qualitative information in the form of comments which is much harder to analyse than the quantitative data. Patients had the chance at Q4 to add comments about additional services they would like the Practice to provide and at Q6 to add any other comments.

The most popular request in additional services was for blood tests to be done in the Practice along with comments about extended hours, counselling, support for mental health issues, out of hours cover, podiatry, physiotherapy and so on.

The other comments at Q6 included grumbles about the appointment system, Doctors not keeping to time, parking arrangements but also some very positive feedback about the Practice as a whole, admin team and Doctors. More time is needed to extract objective data from the comments to then see what can be done to address the issues raised in both Q4 and Q6.

Action Plan

The following actions were agreed at the PPG meeting on 26th March 2014:

1. To develop information about each of the main services mentioned in Qs 1-9 of the survey and to produce a Newsletter devoted solely to Practice services. The same information to be uploaded to the Practice website.
2. To actively promote NHS 111 in the patient waiting room, through the Newsletters and on the website
3. To invite Mike Malpas from Staffordshire Doctors Urgent Care to do an evening session for patients about how NHS 111 works. (Invite issued and accepted on 26th March – date to be agreed May/June 2014)
4. To put all Practice Newsletters onto the Practice website.
5. To use the website more effectively to provide information about immunisation programmes, changes within the Practice, new services etc. (Susan Ryder, PPG member to work with website provider and have access to web pages)
6. Designated PPG members to regularly review notice boards and leaflet stand in the waiting room and reception area to ensure that information displayed is up to date and relevant.(This is an ongoing task)
7. Practice leaflet, issued when someone registers as a new patient with the Practice, to be reviewed and more service information to be included where appropriate.
8.  To thank patients for the excellent response to the survey with messages on the moving message board and website. (Done 26th March 2014)
9. Presentation of survey results to Practice staff at the April clinical meeting and feedback of discussion to PPG members.
10. April PPG meeting to be devoted to further discussion and analysis of the survey data with further actions expected as a result along with agreed timescales for the above actions to be completed.
11. Review the practicality of providing service information to patients via e-mail.

Previous Survey

The patient survey results from February 2013 were very good and did not highlight any single issue that the PPG felt needed to be addressed other than to monitor appointments which came out well in the survey but are a perennial problem. Members were most encouraged by the results relating to the quality and standard of care provided by our clinicians as indicated by the patients in the survey results.

The appointment system has been under continuous consideration and discussion during 2013 by both the PPG and the Practice team. Consequently in August the number of bookable appointments per Doctor was increased by 2 per day, we changed the Practice partner meeting from 9.00a.m to 8.00a.m on a Tuesday and we put more ‘minor illness’ slots into the Nurse Prescriber’s consulting sessions. After an audit in September of phone calls, refused appojntment requests etc, Dr Lee put forward proposals to make some changes, allow more pre-bookable appointments and to introduce a daily ‘emergency’ surgery for acute conditions needing that day consultation. This was introduced from 1st November 2013.

A further audit undertaken after the introduction of this system demonstrated that the number of phone calls and patient personal encounters to request appointments had reduced by 40%. This dramatically improved the working environment of the admin team and the number of complaints about not being able to get an appointment reduced significantly. The Doctors have also benefitted with fewer ‘extra’ appointments being added to their morning surgeries. The number of urgent appointment requests for the duty Doctor in the afternoons has also reduced.

Practice Opening Hours

The Practice is open as follows:

Patients can access services by telephone, attending in person at the surgery or can book Doctor’s appointments and order repeat prescriptions over the internet. We have a mobile phone number which patients who have severe hearing difficulties can use to text us to request appointments or make any other enquiries.

Cover outside of these hours is provided by Staffordshire Doctors Urgent Care who are based in Campbell Road, Stoke on Trent.

Saturday morning is our opening time under the extended hours arrangements. A doctor is on site from 8.00a.m to 12.00p.m. The first available appointment is 8.00a.m. and the last 11.45a.m.

Anne Sherratt
Practice Manager
26th March 2014