LOCAL PATIENT PARTICIPATION REPORT
Practice Name:____The Microfaculty
code:___F86638____________
1 Establish a Patient Reference Group (PRG) comprising only of registered patients
The table below reflects the practice population and the PRG profile by age, ethnic group and
gender at the time of writing.
Practice
population profile
Number
% of total
PRG profile
A G E
% Under 16
% Under 16
868
20.6%
%
%
%
%
%
%
%
423
676
644
554
462
496
80
10%
% 17-24
16%
% 25-34
15.3%
% 35-44
13.1%
% 45-54
11%
% 55-64
11,8%
% 65-84
1.9%
% Over 84
ETHNICITY
White
17-24
25-34
35-44
45-54
55-64
65-84
Over 84
WHite
% British Group
% Irish
Mixed
% White & Black
Caribbean
% White & Black
African
% White & Asian
% Male
2067
% British Group
% Irish
Mixed
% White &
Black Caribbean
% White &
Black African
% White &
Asian
Asian or Asian
British
% Indian
% Pakistani
% Bangladeshi
Black or Black
British
% Caribbean
% African
Chinese/other
ethnic group
% Chinese
% Any other
GENDER
49.7%
% Male
% Female
2121
50.3%
Asian or Asian
British
% Indian
% Pakistani
% Bangladeshi
Black or Black
British
% Caribbean
% African
Chinese/other
ethnic group
% Chinese
% Any other
% Female
Number
% of total
1
0.2%
1
2
5
5
6
3
0.02%
0.05%
0.12
0.12
0.14
0.07
10
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a. Process used to recruit to the PRG:
From January 2012 (upon its inception) and to the present, leaflets and enrolment
forms were given to all clinicians to hand out and explain the benefits of Patient
Reference Group (PRG) membership.
Similarly, all patients were given these documents by reception staff with a verbal
explanation. We emphasise this for new patients at registration.
It is not feasible to display literature in all the languages spoken by practice patients.
We do however feel that we can try to expand the representation of the PRG by verbal
communication.
The latter is especially important as the demographics of our catchment area
manifest in our registered and newly registering population are changing because of
an increase in the quantity and breadth of housing stock as well big population
changes in North East London generally.
Posters explaining how to join PRG were and still are displayed in waiting area.
In addition ,the practice heavily promotes the practice website:
www.microfaculty.co.uk as another convenient means of joining.
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Poster:
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b. Differences between the practice population and members of the PRG: describe any
differences between the patient population and the PRG profile, what steps the practice took to
engage any missing group
The variances are noted above and in practice experience match the kind of discrepancies
and external profile.
We have explained the PRG enrolment process to all patients at reception and explained
the simple procedure to patients in their own language. This is especially true in the South
Asian ethnicity group.
In the age breakdown of the PRG group under 24’s shows lower representation than the
practice profile. The younger patients attend the surgery less frequently. When approached
explained aims and objectives felt could not commit to the PRG group. This may reflect the
trends towards longer working hours. We still will continue to endeavour participation as we
recognise that much feedback comes from this group.
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2 Agree areas of priority with the PRG
a. The areas of priority agreed with the PRG:
This year the Microfaculty commissioned the services of CFEP UK Surveys Ltd.
(https://www.cfepsurveys.co.uk) a national company specialising in conducting patients
surveys.
Generally the domains were kept simple augmented those remotely done by Department of
Health.
Emails were sent out to PRG participants to solicit their views and ask if they had any
further suggestions to promote their “ownership” of survey questions especially with respect
to raising issues in our service delivery that mattered to them.
b. How the priorities were decided:
Having actively emailed PRG group participants with a proposed list of questions .We
encouraged modification, rewording and/or new areas to cover by return email or other
channels.
The practice discussed the questions with staff the in the team meeting having had the
views of patient.
We also took seriously the feedback from NHS Choices and the MYHEALTH London
website about The Microfaculty .
In addition our, the suggestion box in our waiting area was a very important source to seek
patients’ views on “ how we are doing our job”.
All sets of feedback informed and generated the final set of questions.
The final questions generally consistent with the original set were used.
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3 Collate patient views through the use of a survey
a. When was the survey conducted? How was the survey distributed?
The survey was conducted by giving forms to the patients who attended the for
appointments or any other business. The forms were handed during 1 5th January- 7th
Febuary2014.
Patients were assured that the survey was anonymous.
Respondees were asked to place the completed responses, on completion, in a sealed
envelope. The completed questionnaires were sent to CFEP for analysis and report.
The survey results are on the surgery web:www.microfaculty.co.uk and our waiting area.
b. Which questions in the survey relate to the priorities in (2a)?
Clinician and reception satisfaction ratings, opening times, telephone access and respect
scores are highlighted within the report.
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4 Provide the PRG with an opportunity to discuss survey findings and reach agreement with
the PRG on changes to services
a. Describe the survey findings:
Please see attached sheet.
b. Describe how the survey findings were reported to the PRG:
The PRG were alerted to publication of the report on the website www.microfaculty.co.uk
Also, the PRG were alerted to the publication of the report by post.
The results of the survey report were presented at the practice waiting area and at the
Reception desk.
c. Changes the practice would like to make in light of the survey findings:
The time waiting in the reception area and delays in being seen for a secured appointment
were the main area of contention. 46 % of the patients who participated in the survey were
unhappy with the waiting time to be seen by the clinicians. We are concerned by this and
wish to address or explain this to our patients.
Many patients were unhappy as to the change to new seating furniture from fabric seats to
plastic. We seek to explain the rationale for this in terms of infection control, patient safety
and overall practice cleanliness.
d. Recommendations from the PRG based on the survey findings:
Although there was an acknowledgement of these findings no suggestions as how to reduce
this was offered.
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e. Agreement reached with PRG on changes to be made?
YES
f. Changes the practice cannot make, and the reasons why:
We cannot change the seating because of the necessity of compliance with Care Quality
Commission (CQC) standards with respect to infection control. We can however explain the
need for this change and will display this with a poster at reception.
It must be said that the comments about the new plastic seating is not universal. Several
patients were unhappy with the lower slung fabric seating for both perceived uncleanliness
but most because the newer chairs are higher and easier to get out of for people with
difficulty in rising from low seats .In addition, many, even the patients critical of the new
chairs, agree that it has brightened and improved overall presentation of the
reception/waiting area.
g. Changes the practice will make:
The practice discussed the report feedback and the response of the PRG at a “wash-up”
team meeting on Tuesday 24th March 2014. Clinician (both medical and nursing), Reception
Staff and Management/Administration representation was evident and document.
Key points raised were;
a) Chairs
Although it was evident that we could not revert back to the older non-CQC compliant
seating we could at least explain why we had done so. Patients are aware of the CQC
through media reports about hospital and general news items regarding infection
control/cleanliness in the NHS.
ACTION: All staff to communicate the changes when prompted by patients and a notice to
be placed at the reception desk and the log in screen.
b) Waiting Times after arrival to be seen
This took up a lot of time, in the team meeting. This is a very difficult one to solve and was
acknowledged by all concerned. There are separate competing priorities that compete with
this:
- Many patients are a lot more complex at present as more management of longer term
conditions is moving into the domain of Primary Care
- Even for single problem consultations the burden of documentation, explanation and even
documentation of the explanation given is rising.
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- Many patients present with several problems that cannot be covered in a ten minute time
frame and are exceptionally dissatisfied sometimes very angry if most but usually all of their
list of problems is not dealt with to their satisfaction.
- Any increase of consultation times is likely to impact upon the availability of appointments
and access. This in turn will have a deleterious effect upon usage of access on
Unscheduled Care and Accident and Emergency usage. We were very concerned that at
present we were offering over 80-90+ appointment slots per week. We offer substantial
extended hours. Even a modest 5 minute increase in consultation time would impact on this
performance.
-Most patients were actually understanding of the reasons for having to wait especially in
those with experience in hospital outpatients of waiting for far longer time horizons.
-Patient punctuality was an issue raised. We don’t tend to refuse patients whom attend up to
20 minutes late even in the busiest surgery. Only 1-2 such patients can knock a schedule
back more than 40 minutes and if their problem is in itself longer than their nominal ten
minutes can cover. Although there are habitual late attenders, most especially the frail have
genuine problems getting to us and there are significant transport issues on the locality’s
roads.
- To save time and avoid repeat visits we tend to do referral letters etc. in the consultation
so that the patients go away with their needs already fulfilled as far as we can.
- There are issues with patients who have not fully completed the ”self-check in” process on
the screen provided. This can cause problems as the clinician would not be aware that the
patient has arrived.
-Some patients remain unaware that we offer extended hours.
AGREED ACTIONS:
a) COMMUNICATE TO PATIENTS THE REASONS WHY WE RUN LATE (citing the above
action points)
b) TRY TO MATCH APPOINTMENT TIMES TO NEED BETTER.(i.e. frailer patients getting
double slots).
c) SLOT IN BLOCKED “CATCH UP” SLOTS OF 10 MINUTES, TYPICALLY 2-3 PER
CLINICIAN SESSION TO CUSHION THE EFFECT OF DELAYS.
d) RECEPTION STAFF TO PATIENTS APPRAISED OF CLINICIAN DELAYS.
e) ALL CLINICIANS (THEY ALREADY DO) TO CONTINUE TO ACKNOWLEDGE AND
APOLOGISE THAT THE PATIENT HAS BEEN KEPT WAITING FOR THEIR SCHEDULED
APPOINTMENT.
g) IMPROVEMENT OF WAITING AREA EXPERIENCE (better reading material etc.)
f) ALL OF THESE ACTIONS TO IMPLEMENTED BY OCTOBER 2014 TEAM MEETING.
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5 Agree an action plan with the PRG and seek PRG agreement on implementing changes
Action
(change in practice)
Person
responsible
(to lead the
change)
Completion
Review
date
(what result the practice/patients saw as a result of the
(when the
change)
change will be
applied)
1 Communication to patients regarding new
Dr Shahid
April 2014 for
A reduction in complaints about seating.
seating
Dadabhoy
review October
2014
THESE ACTIONS ARE WITH RESPECT TO FEEDBACK REGARDING WAITING TIME TO BE SEEN
2 COMMUNICATE TO PATIENTS THE
Dr Shahid
April 2014 for
Improved satisfaction in the next report.
Dadabhoy
review October
REASONS WHY WE RUN LATE
2014
Dr Shahid Dadabhoy to draft a letter for
patients entitled “Why we run late: We
have heard you and accepted what you
have told us about waiting times. We
wanted to tell you what we have done
about it”
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TRY TO MATCH APPOINTMENT TIMES
TO NEED BETTER
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SLOT IN BLOCKED “CATCH UP” SLOTS
OF 10 MINUTES, TYPICALLY 2-3 PER
CLINICIAN SESSION TO CUSHION THE
EFFECT OF DELAYS.- change format of
session grids on the appointment
templates
RECEPTION STAFF TO PATIENTS
APPRAISED OF CLINICIAN DELAYS
Develop a simple system to inform
patients of delays
ALL CLINICIANS (THEY ALREADY DO)
TO CONTINUE TO ACKNOWLEDGE
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6
Reception Staff.
Lead Kathy
Christou
Reception Staff.
Lead Kathy
Christou
April 2014 for
review October
2014
April 2014 for
review October
2014
Improved satisfaction in the next report.
Reception Staff.
Lead Kathy
Christou
April 2014 for
review October
2014
Improved satisfaction in the next report.
All clinicians
Immediate and
ongoing
Improved satisfaction in the next report.
Improved satisfaction in the next report.
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AND APOLOGISE THAT THE PATIENT
HAS BEEN KEPT WAITING FOR THEIR
SCHEDULED APPOINTMENT
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IMPROVEMENT OF WAITING AREA
EXPERIENCE
Practice Manager
April 2014 for
review October
2014
Improved satisfaction in the next report.
Update on action plan for 2012/13: what result the practice/patients saw as a result of the change(s)
Similar issues were raised in 2012/113. These concerns are addressed in this report.
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6 Additional Information
a. The opening hours of the practice premises and the method of obtaining access to
services throughout the core hours:
Opening hours
:Monday
Tuesday
Wednesday
Thursday
Friday
Out of hours:
AM
7.30am-1pm
7.30am-1pm
8am-1pm
7.30-1pm
7.30-1pm
PM
2-6.30pm
2-6.30pm
2-6.30pm
2.-6.30pm
Please phone 111 between 6.30pm-8am during weeks days and all
weekends and bank holidays for medical attention or advice that cannot
wait until next surgery opening hours.
b. The times individual healthcare professionals are accessible to registered patients under
an extended hours access scheme:
Extended hours:
Monday : 7.30-8am
Tuesday: 7.30-8am
Thursday: 7.30-8am
Friday:
7.30-8am
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7 Publicise actions taken – and subsequent achievement
a. Where the report is published:
www.microfaculty.co.uk
Signature of behalf of practice:
Name of signatory: DR S DADABHOY
Date: 25/03/2014
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