king edward street patient participation group annual

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King Edward Street

Patient Participation Group

Annual Report 2014/2015 Introduction

This report summarises the continued development of the King Edward Street

Surgery’s Patient Participation Group (PPG), which was formed in 2011/12. The report

considers the:

• group’s membership and activities over this fourth year of its existence;

• the group’s priorities for the patient survey and how they were agreed;

• method and results of the patient survey;

• the implementation of last year’s action plan and the development of future actions;

The Patient Group, established in line with national guidance, continues to give

patients a voice in the organisation of their care. The purpose of the Patient Group

remains to ensure that patients are involved in decisions about the range and quality

of services provided and, over time, commissioned by their practice. In so doing the

Practice has brought a formal mechanism to its longstanding practice of listening to

patients and acting on their views.

The Practice profile and population remains relatively unchanged from last year, in

that it is skewed towards the young adult age group (being a city-centre practice that

works closely with the University) although its list size has increased slightly from

around 4,000 patients to closer to 4,400. Observations on the practice population set

out in previous year’s versions of this report continue to apply.

Changes to the Group’s membership and activities

A number of the original members of the group, who were invited to join, have

continued to participate, which has helped the group to preserve some continuity over

the years. At its inception members were carefully chosen to ensure a representative

group covering as many different constituencies as possible, taking into account not

just age, sex, ethnicity, etc. but also factors such as employment status, connection to

the university (or absence thereof), medical history, and social roles (such as parent or

carer). Inevitably, the inclusion of representatives from the university Junior and

Middle Common Rooms (from the three main colleges for whom we are the college

doctors), means there has been a degree of turnover each year, since these members

are replaced annually through a college election process. It is vital that these JCR and

MCR reps are included within the Patient Group, since so many of our patients are

students, but it does mean the gender and ethnic balance of the group fluctuates

according to these changes in personnel. For example, a welfare Rep may be a Chinese

woman one year and then a white or Afro-Caribbean man the next.

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The Practice itself continues to experience a large degree of change, as a result of the

phased retirement of Dr Gancz – the Practice’s Principal GP for over 35 years. A

number of patients who had remained on the Practice’s list specifically because they

wanted to have Dr Gancz as their GP took this as their cue to register elsewhere, and

unfortunately as a result the Patient Group’s chair (Marianne Johnson) is no longer

able to be part of the group. The Practice would like to formally take this opportunity

to put on record our heartfelt thanks to Marianne for everything that she has done

in taking forward the development of the group. Here energy and enthusiasm will

certainly be missed.

This year saw (as mentioned above) a change in the hosting arrangements for the

Practice’s website. This was partly driven by the need to make the Friends and Family

Test available electronically, in addition to having paper slips that can be completed in

the practice itself. The website was moved in January 2015 and now has a prominent

“Have Your Say” area on the home page with a link to both the Patient Group section

of the site and the Friends and Family Test. This now includes a “virtual group” page

inviting patient to sign up and we anticipate that this will help the group to attract

more patients. Recruitment information continues to be displayed within the practice

on notice boards in both the upstairs and downstairs waiting rooms, and on the

practice’s website and the group would welcome any expressions of interest from

potential new members, especially from those with disabilities and/ or in the 70+ age

bracket.

The Group usually meets three times per year (to coincide with the university’s three-

terms), although the loss of the chair mid-way through the year impacted adversely on

our meeting schedule this year. Dr Gancz’s resignation also proved something of a

distraction over the summer/autumn as lots of staff resources were diverted to

getting the new Partnership up and running as smoothly as possible whilst minimising

disruption to patients. As things begin to settle down the Patient Group hopes to get

back on track. Meetings are presently chaired by the Practice Manager but will once

again be run by the group’s (s)elected Chair, as soon as one is identified. Secretarial

support is provided by the Practice Manager and the senior GP partner of the Practice

attends some but not all of the meetings.

This year the group finished its research project looking into the reasons behind

patients’ decision not to participate in the National Bowel Cancer Screening

programme. It continues to consider the results of the Patient Survey and the

contents of the practice’s Suggestion Boxes, which are opened and emptied at each

meeting. The group discuss a range of issues, some of which are identified by the

group and some are put forward by the practice. The previous year’s interest in issues

raised by the government’s ‘Care.data’ programme have halted while the government

suspends its controversial plans for harvesting patient data from GP computer systems

in a non-anonimised form. This year has seen the start of the Friends and Family Test

and the Patient Group has at its most recent meeting begun to review this additional

source of patient feedback for the first time. This will become a regular feature of the

group.

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Priorities for the survey

The PPG wished to retain the survey’s focus on its established priorities, which remain

the same as in the previous year – flexible access, polite and friendly treatment, and

excellent levels of care. It was felt that there were no new issues emerging from the

previous survey that were not already addressed by the existing questions.

The group agreed that the survey worked well in the previous year and that its largely

closed question format ensured the survey was quick to complete and easy to analyse.

Consistency with previous surveys was maintained by the use of a 5 point rating

scale.1

Last year it was decided to revert to the GMC’s patient survey, instead of using the

one designed by this group back in 2012. We wanted to stick with this survey again

this year to enable direct comparability of results. Using the GMC’s survey has the

added bonus of being available for completion by patients via an online process using

the GPs appraisal software. The group agreed that making the final question open for

comment was an effective way to obtain constructive feedback to drive future surveys

and to establish patients’ needs and wishes.

Method of the patient survey

The survey was carried out in two distinct periods to feed into the appraisal process

for two different GPs. All patients with an appointment to see the relevant doctor

during these two distinct periods were invited by the receptionists to complete a

survey. The first round of surveys took place in paper form over a two week period, in

October. This survey focussed on patients seeing Dr Wilkinson. The second survey

period was in mid- February, and was undertaken electronically. Email address of

patients seeing Dr Drury and Dr Kirkaldy were collected by reception and then the

survey emailed to those patients using the ‘Clarity toolkit’.

All surveys were anonymous to encourage more honest outcomes. For the paper

survey, the completed sheets were posted into one of two sealed post boxes (one in

each waiting room) to ensure confidentiality and anonymity. Surveys were

subsequently analysed by the Practice manager without any involvement from the

GPs. For the electronic surveys, the results were collated by the ‘Clarity toolkit’ and

the final results forwarded to the Practice Manager by the doctors concerned.

By the end of the two processes 101 surveys had been completed, representing some

2.32% of the entire practice population. This was agreed as being a sufficiently large

enough number of responses to be considered representative. Answers were coded

onto an Excel spreadsheet by the Practice manager for sharing with the Patient Group.

1 1 = terrible 2 = poor 3 = fair 4 = good 5 = excellent

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Key findings

Last year the chair described the results as “glowing” and it is clear that this year the

Practice continues to perform very well. There is now considerably consistency

between the results of each of the last four year’s surveys, as the practice continues to

experience very high levels of satisfaction from patients. For those questions with

identical wording a direct comparison shows there is a slight dip this year in the

number of respondents awarding the very highest rating of 5; however these results

still show a sustained improvement when compared to the year before that (i.e. the

year 2012-13). These questions cover patients’ satisfaction with how well GP listen to

them, explain things to them and involve them in decisions.

As in prior years, for almost all of the questions where a rating scale was used, the

highest available rating was by far the most common answer. The full results are

given in Annex 1 (see pp.7-11) and summarised below.

Q4. How good was your doctor today at each of the f ollowing:

(a) Being polite Terrible or poor 0% Good or excellent 100%

(b) Making you feel at ease Terrible or poor 0% Good or excellent 100%

(c) Listening to you Terrible or poor 0% Good or excellent 99%

(d) Assessing your medical condition Terrible or poor 0% Good or excellent 95%

(e) Explaining your condition and treatment Terrible or poor 0% Good or excellent 90%

(f) Involving you in decisions about your treatment Terrible or poor 0% Good or excellent 83%

(g) Providing or arranging treatment for you Terrible or poor 0% Good or excellent 84% Not applicable 15%

Q5. Please decide how strongly you agree or disagre e with the following statements:

(a) this doctor will keep information about me conf idential Terrible or poor 0% Good or excellent 96%

(b) this doctor is honest and trustworthy Terrible or poor 0% Good or excellent 95%

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Q6. I am confident about this doctor’s ability to p rovide care No 0% Yes 99%

Q7. I would be completely happy to see this doctor again No 0% Yes 99%

In short, patients rated the surgery very highly and indicated that they were very

happy with their clinical consultations for all doctors. In particular they:

• found GPs were polite, put patients at ease, listened to them, explained things

well, and involved them in their care;

• felt GP’s were honest and trustworthy and would keep information about

them confidential;

• were extremely confident in the GP’s ability to provide care;

• would be completely happy to see the GP again.

Patients completing the survey were invited to add any comments. Most respondents

did not leave a comment but of the 26 that did, the vast majority left very positive

remarks. Just one person left a negative comment, criticising the amount of the time

they had had to wait before being seen by the doctor. As in previous years this has

been the only issue that attracts criticism. However, this was identified by far fewer

respondents this year, which the Group took to be a positive sign.

Given this highly positive picture, it is perhaps unsurprising that no new actions were

identified as arising from the survey.

In terms of the demographics of the survey respondents, these bore a very strong

correlation to previous years. The majority of respondents were female (60%) and the

majority of respondents reported their ethnicity as white (90%). Of the non-white

respondents 1% described themselves as ‘black’, 1% as ‘Asian’, 1% as ‘Chinese’ and 6%

as ‘mixed’. There was a less even spread in terms of age ranges than in previous

years, with the clear majority of respondents being aged either 15 – 20 years, or 21 –

40 years.

“By far one of, if not

the nicest doctor I have ever met”

“A fantastic

doctor…”

“Usually have to wait for 20 –30 mins"

“First-rate

doctor, first-rate

practice.”

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Action plan and next steps

The results of the survey have been posted on the Practice website and are displayed

on notice boards in the upstairs and downstairs waiting rooms. The Patient Group

met on Thursday 12 March to enable members to comment on the survey results and

to discuss new priorities and actions for the year ahead.

No clear changes emerged from the survey findings, which were overwhelmingly

positive and suggest that patients are extremely satisfied with the way the Practice

operates and the service they receive.

The Group were satisfied that all of its actions from last year had been effectively

implemented.

Action By whom Status

Continue to take ownership for the Suggestions Box (and the on-line virtual suggestions box), including collating and acting upon the views of all patients – not just those in the PPG

PPG Chair in conjunction with the Practice Manager

Ongoing

Continue with the research project to establish the reasons for low take-up of the National Bowel Cancer Screening programme and make some recommendations to increase compliance

PPG members and Practice Manager

Completed

Continue to act as a sounding board for patients’ views in relation to developments around the Practice’s response to the ‘Care.data’ programme


Completed

Promote the ‘Neighbourhood Return’ scheme within the practice, especially to carers and family of patients with dementia


Ongoing

Maintain the PPG area of the website by posting details of each meeting, along with the annual report and survey results

Practice Manager in conjunction with the PPG Chair

Completed

Increase the frequency of the PPG newsletter from annually to six monthly


Completed

Whilst the positive results of this recent survey has not identified any major actions

for the Patient Group to pursue, the Group has decided that the Practice should be

doing more to promote online services to increase their uptake by a greater number

of patients. Developments to the website go hand-in-hand with this, and more needs

to be done to ensure its content is up to date and interactive wherever possible, so

that patients can use the site as a means to submit information to the Practice (such

as completing Travel Risk Assessment questionnaires, or updating their contact details

online).

The Patient Group also wishes to take steps to support its own on-going role within

the Practice, and to this end has made recruitment of new members a priority. The

full list of the Group’s priorities for the coming year is provided in Annex 2 (see p.13).

Annex 1

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King Edward St Patient Survey Results 2014-15

Number of Responses: 101

Q1. Are you filling in this questionnaire for?

Q2. Which of the following best describes the reaso n you saw the doctor today?

(Please tick all the boxes that apply)?

Q3. On a scale of 1 to 5, how important to your health and wellbeing was your

reason for visiting the doctor today?

1

2

3

4

?

ask for adviceongoing problem

treatment (incl prescriptions)

one-off problem

routine check

1

2

3

4

5

?

n/a

rating % Yourself 92 Your child 6 Your partner 0 Relative/ friend 1 No answer 1

rating % Asking for advice 34 On going problem 48 Treatment (prescription) 31 One-off problem 19 Routine check 5 Other 2 n/a 2

rating % 1 2 2 10 3 26 4 32 5 27

n/a 3

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Q4. How good was your doctor today at each of the f ollowing:

a) Being polite?

b) Making you feel at ease?

c) Listening to you?

d) Assessing your medical condition?

1

2

3

4

5

?

n/a

1

2

3

4

5

1

2

3

4

5

1

2

3

4

5

?

n/a

rating % 1 0 2 0 3 1 4 21 5 74

n/a 4

2014-15 2013-14 2012-13 rating % % %

1 0 0 0 2 0 0 1 3 0 0 3 4 11 6 18 5 88 94 70

n/a 1 0 1

rating % 1 0 2 0 3 0 4 9 5 91

n/a 0

rating % 1 0 2 0 3 0 4 5 5 95

n/a 0

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e) Explaining your condition and treatment?

f) Involving you in decisions about your treatment?

g) Providing or arranging treatment for you?

Q5. Please decide how strongly you agree or disagree wi th the following statements:

a) This doctor will keep information about me confi dential?

1

2

3

4

5

1

2

3

4

5

1

2

3

4

5

1

2

3

4

5

rating % 1 0 2 0 3 1 4 16 5 68

n/a 15

rating % 1 0 2 0 3 0 4 14 5 82

n/a 4

2014-15 2013-14 2012-13 rating % % %

1 0 0 0 2 0 0 1 3 4 3 3 4 11 6 26 5 72 87 61

n/a 13 6 9

2014-15 2013-14 2012-13 rating % % %

1 0 0 0 2 0 0 1 3 0 0 4 4 25 7 17 5 65 89 70

n/a 10 6 8

2014-15

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b) This doctor is honest and trustworthy?

Q6. I am confident about this doctor’s ability to p rovide care

Q7. I would be completely happy to see this doctor again

Q8. Was this visit with your usual doctor?

1

2

3

4

5

99

0 1

yes

no

n/a

99

0 1

yes

no

n/a

yes

no

n/a

answer % yes 50 no 48 n/a 2


rating % 1 0 2 0 3 0 4 9 5 86

n/a 5


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Q9. Please add any other comments you want to make about this doctor:

Patients were asked this open question and encouraged to free text whatever they wished to express about their consultation. A total of 26 patients chose to include a comment. The space was left blank by 75 patients.

Of these 26 comments, 1 was critical and 24 praised the GP and 1 was neutral.

The critical comments concerned the length of time the patient was kept in the waiting room before their consultation started (20 – 30 mins).

Exactly what one wants in a GP - friendly, professional, knowledgeable.

Very good at dealing with several problems in one visit. Dr xxxx explained each of them clearly and didn't try to rush through them.

Reassuring, excellent explanation supported with drawing.

Although he is not the doctor I normally see, he is kind & knowledgeable. I can trust him.

Very, very helpful

I've seen Dr xxxx a few times in the past & have always been completely happy with the treatment I have received.

Very competent, polite & explains various options for treatment & their side effects.

Very informative, patient & kind.

Dr xxxx is a fantastic doctor and I am very happy with the care that she has provided

This doctor is new to the practice, and I am unsure as to whether it will be my usual doctor, following the retirement of my previous usual doctor who had known me for more than thirty years.

With a change-over in doctors following the retirement of the practice leader today's doctor is a new addition to the team. I have every confidence in her ability and expect to see her on future visits.

I was completely satisfied by the doctor's competence and diagnosis. I was referred immediately and told clearly what the follow-up procedure would be. The surgery was calm and I felt in safe hands.

She was by far one of, if not the nicest doctor I have ever met. She made me feel at ease. I was comfortable discussing things with her that I wouldn't be with others. I feel well taken care of and reassured. Well done and thank you!

Having been one of Dr Gancz's patients for over 25 years I was very apprehensive about meeting a new doctor but she was lovely and put me completely at ease. I have every faith in her as my new doctor. Dr xxxx listened to my concerns and took them seriously even though we were unable to arrive immediately at the cause of my health problems. It was my first visit with her but I would definitely see her again in the future.

Very pleased with everything.

Dr xxxx is one of the most kindest doctors I've ever seen. She is very polite and understanding. Down to earth and someone you can relate to and not to forget she's extremely professional. May God bless her. Always pleasure to see her, I hope to see her in future. Dr xxxx is a wonderful doctor - she is so empathetic and caring as well as being first-rate at diagnosing problems and referring for additional NHS care when needed. I would be very unwell at the moment had it not been for Dr xxxx's early intervention and the constant reminders she gave the xxxx Hospital while I was on their referral waiting list to ensure I was seen sooner. Dr xxxx always involves me in my care and explains treatment options clearly and patiently. She is happy to listen to me when I disagree with suggested treatments and is willing to prescribe medications that I ask for after researching my condition myself. She ensures I have regular blood tests so that she can check the medication is working as it should. I have already recommended Dr xxxx to a friend suffering with the same condition and hope that she will be my doctor for many years to come. Dr xxxx never rushes me and is always calm and patient, no matter how busy she is. I feel totally conformable confiding in her and trust her implicitly. Thank you so much! I am very happy to see this doctor as a very high standard of care is provided at all times by both this doctor and the practice in general.

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This was a first visit to a usual doctor (due to my change of address).. Because of continuous bad experiences with other doctors, I was ready to give up with the NHS altogether and meeting Dr xxxx changed my mind! I now know I have a regular doctor I can trust, and I intend to remain with the system.

Personal interest, wanting to help, very pleasant and understanding.

First-rate doctor, first-rate practice. Under Q11 I have stated that this is not my usual doctor. This is because it is the first appointment with my NEW doctor, my previous doctor at this practice having retired very recently. Always takes time to listen and is extremely caring. I have the utmost confidence in her.

Dr xxxx is fantastic. She's the best doctor I've ever had. She has helped me immensely with her practical support and sympathetic understanding.

Note that my usual doctor has retired

Usually have to wait 20 - 30 mins.

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Demographic breakdown of survey respondents

Gender

Age

Ethnicity

The breakdown of the 10% non-white respondents is given in this pie-chart.

male

female

under 15

15 - 20 yr

21 - 39 yr

40 - 59 yr

60 or

over

mixed

white

black

asian

chinese

other

no answer

gender % male 40 female 60 no answer 0

age range % Under 15 4 15 to 20 22 21 to 40 46 40 to 60 13 Over 60 15 no answer 0

ethnicity % mixed 6 white 90 black 1 Asian 1 Chinese 1 other 0 no answer 1

mixed

black

asian

chinese

other

no answer

Annex 2

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New Priorities

At its meeting on Thursday 12 March the Patient Participation Group identified the

following Action Points as priorities for the year ahead.

Action By whom By when

Find a new Chair for the Patient Group and recruit new members

Practice Manager and staff

01 Jun 2015

Update the new look website to ensure its content is as informative and accurate as possible. Improve the website as means for patients to submit information to the Practice.


01 Jun 2015

Promote Vision online throughout the practice and increase the number of patients that have registered to use it.

Practice Manager, staff and PPG Group members

30 Nov 2015

Raise awareness amongst as many patients as possible that telephone consultations can be requested.

Practice Manager, staff and PPG Group members

Ongoing

Increase the frequency of the Patient Group newsletter from six monthly to three times per year


Ongoing

Continue to take ownership for the Suggestions Box (and the on-line virtual suggestions box), including collating and acting upon the views of all patients – not just those in the PPG


At each meeting

king edward street patient participation group annual

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