Staverton Surgery E84080 Patient Participation DES 2012-13 (Year 2)
Report on Patient participation activity during 2012-13
Staverton Surgery is based in Brondesbury Park Ward. We have 7581
patients who are cared for by our team of doctors, nurses and support
staff. Our population is varied and reflects the make up of the Brent
population. The area we serve has some low deprivation; lots of multi
occupancy dwellings; with some pockets of affluence. Our practice
turnover is between 22-23% which makes for a very high workload. The
borough of Brent does have a very mobile population which is reflected
in all GP practice turnover figures. We cover an area approximately a
mile radius of the surgery and we register any patients living in our
catchment area.
Information on Access
Morning
Afternoon
Monday
8:30-13:00
13:45-18:30
Tuesday
8:30-13:00
13:45-18:30
Wednesday
8:30-13:00
13:45-18:30
Thursday
8:30-13:00
13:45-17:15
Friday
8:30-13:00
13:45-18:30
Saturday
09:00-11:00 (WIC) Closed
(WIC – walk-in clinic)
When We Are Closed
When we are closed we have an answer machine message which gives
our patients the following options to obtain medical care:
 After 6:30 please ring 111 if you have a problem that won’t wait
until we reopen.
 If you are calling when we are closed at lunchtime between 1:00
and 1:45 or on Thursday afternoon between 5:15 and 6:30 please
call 020 8969 0808 , this is the number for our out of hour service
provider and can also be used during 6:30pm and 8:00am
 Please do not ask to see a doctor out of hours unless you
genuinely cannot wait until the surgery re-opens.
 Call 999 in an emergency. Chest pains and / or shortness of
breath constitute an emergency.
Practice Population Profile
Details of our list of registered patients
We have reviewed our ethnicity, age, and sex breakdown for the
surgery. We have ethnicity data for more than 67% of our patients. This
data has been recorded using 2001 census codes.
Staverton Surgery Ethnicity Breakdown
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The age breakdown of our practice below shows that 19% of patients
are 16 or under, 52% are aged between 17 and 44, 20% between 45 and
64 and 9% being over the age of 65.
We have 3474 male patients and 4107 female patients
1200
1000
800
Series1
Series2
Series3
Series4
Series5
Series6
600
400
200
0
0-4
5-16
17-24
25-34
35-44
45-54
55-64
65-74
75-84
85-89
90+
We have identified country of origin for 3709 patients which are listed
below
African 349 / Asian 216 / Australian 94 / EU nationals 1430 / Far Eastern
32 / Indian 133 / Middle Eastern 194 / North American 26 / Arab 11 /
Caucasian 517 / Chinese 28 / Japanese 10 / S American 121 / West
Indian 121 / 427 declined
We have also identified language spoken for 2859 patients. This vey
much reflects the diversity of our patients and the information is
available to clinicians during consultations. We do make full use of local
interpreting services as well as SCOPE for our patients with hearing loss.
All documents are available in large print on request for our visually
impaired patients.
Information on occupation has been collected on 2849 patients but is
not searchable by an actual job role. We have conducted a search and
assessed a number of patients selected at random by our Clinical System
to assess the detail in individual patient’s records. There were 42
patients in the random selection all except 5 had details of their actual
occupation which was recorded in free text. Information on
unemployment if relevant to a patient would be captured within their
clinical record but would not be searchable. The practice offers support
for patients who have stress and other mental health issues related to
their employment situation and offer referral to the IAPT employment
support service and other counselling and support services.
PPG Profile
Patient Participation Group
Our Patient Participation Group (PPG) meetings are held every three
months. Dates are pre-planned for the whole year and are published on
our website as well as on our patient participation notice board and
emailed/posted to registered patients who currently or previously
attended our PPG or expressed an interest. The information is also
available at reception and in the waiting room. These meetings are
supported by the practice and attended by at least one GP and the
Practice Manager. The group has a rotating patient chair arrangement
and the agenda is set by the chair with support from the Practice
Manager.
Our patient representatives are aged between 50-90 years old and are
predominantly white British. The representatives are 30% male and 70%
female. The majority of the group are retired. As our patient group has
members mainly from the older age group they could not be said to be
fully representative either from an age or ethnicity point of view. They
have however supported the surgery consistently over many years and
have been instrumental in feeding back very constructive suggestions for
improvements in our services. We very much appreciate their long
standing commitment and support for the surgery. We are always
looking for ways to extend the membership but that has proved very
difficult.
Meeting dates for 2012-13
16th April 2012 / 9th July 2012 / 8th October 2012 / January meeting was
cancelled due to snow and rescheduled on 25th February 2013
15th April 2013 / 8th July 2013 / 14th October 2013
Our wider Kilburn PPG runs quarterly meetings and we have regular
attendance by members of our own PPG who attend alongside our
Practice Manager. Wider issues discussed at this meeting are then
brought back to the in-house PPG meetings as required.
Patient engagement strategy
To address this shortfall in and engage with a wider range of patients
when proposing services improvements we have specifically targeted
users of our services by asking those attending routine or specific
services. This had worked well for our child health and phlebotomy
services. The method we used was to go into the waiting room during
the clinics and with their permission have an informal discussion on pros
and cons of the existing service, which elements were important to them
and where services could be improved. These services were then
changed and have been running successfully since then with excellent
patient feedback.
This approach has worked extremely well as these patients confirmed
they would not have the time or interest to attend patient group
meetings during the day or evenings because of child caring or work or
other responsibilities. We also utilised this approach to confirming the
priorities for the refurbishments we have undertaken recently as well as
our on-line services. Feedback on these changes has been very positive.
In addition we work very closely with our local Nursing and Learning
Disability Care homes and group residential accommodation to ensure
patients have the relevant information and support to access to our
services and feed into service planning. Our team visit and provide
services such as flu vaccination and relevant health checks for those who
are housebound. We also have details of carers on individual patient
records and provide information, referral or signposting regarding
support services. We work closely with Carers support in Brent to ensure
information is disseminated. We also have a section on our website for
carers.
We operate a team based approach to care and work closely with
community staff to support and manage patients with physical and
mental health issues. We have been collaborating with Certitude
Support, which includes Southside Partnership and Support for Living
Ltd, this is a charity providing support for people with learning
disabilities and mental health needs. They provide local support groups
and drop in sessions often targeted at particular minority groups as well
as encouraging and supporting their clients to access medical services.
This approach also means we are able to engage with our population
across the whole spectrum of age and ethnicity.
Our website www.stavertonsurgery.nhs.uk which went live in August
2011 has proved very popular with patients with over 27,800 unique hits
recorded in the last twelve months. Information about all our services
and access details are available as well as health promotion advice and
links to other services and sources of information. We have several online services including repeat prescriptions; on-line appointments; updating health records and contact details; cancel appointments and
subscribing to our newsletter.
Additionally we have made available the General Practice Assessment
Questionnaire (GPAQ) on our website for patients to complete. Uptake
of this has been very low. During the course of the year we have
extended the range of services available on the website which allows
patients to communicate and share their views with us via the website.
Key actions arising from Patient engagement
Review outcome priorities of 2011-12 plan which were previously
agreed with the PPG (Details of 2011/12 reports, plans and minutes etc.
are shown on our website. This was completed at the patient group
meeting held in April 2012.
You said……
 We needed to improve our appointment system and waiting times
for the GPs.
 We need improved access to arranging appointments with the
GPs and Nurses online.
 We need to improve our lighting and facilities in the waiting
rooms.
We did......and the result was
 Appointment system – appointment system does seem to be
working. It is kept under regular review. There is still an on-going
issue with waiting times in the surgery. We are going to be looking
into our high attenders to see whether there are better ways of
dealing with their care.
 Appointments on line – appointments on line are available.
Patients need to come in with ID to receive passwords they can
then register on the website. Feedback has been very positive.
Patients can also request prescriptions on line. The website has
had more than 14000 hits (people viewing the website)
 Premises improvements – New lighting has been installed in both
waiting rooms. Options for flooring and seating are being looked
into. There maybe delays in undertaking flooring work. CQC
requirements are not yet clear as to whether all the flooring has
to be changed and what the funding implications of this may be.
Group noted the outcomes of the survey during the meeting. They
thought that the practice had done reasonably well, that the areas that
needed improvement were already identified and steps put in place to
improve them. They recognised that patients were more likely to
complete the survey if they had concerns than if they were happy with a
service. The practice acknowledged this but recognised this was the
same for practices elsewhere so the comparative data showed the need
for continued improvement. The group were pleased that the outcome
of the survey and the patient participation report was available on the
website and on the notice board within the practice.
Setting the Improvement plan for 2012-2013
In terms of the planned actions for 2012-2013 they had agreed at our
meeting in April 2012 that the following actions would be undertaken.
This was published within the surgery via hand outs, posters and
distribution of minutes of the patient group meeting. Comments on the
choice of actions were invited via information on practice notice boards,
copies of meeting minutes and handouts. No amendments were
received.
 The appointment system should be kept under review (This was
done by checking the 3rd available appointment each day, this has
enabled us to check our supply and capacity in line with capacity
and demand surveys we also complete)
 Appointments on line – improve awareness an uptake (This is
measured by the uptake figures available within our online tool
via the website)
 Continue with the premises improvements (These were identified
following the Care Quality Commission (CQC) recommendations)
Review of the outcomes of these improvements were discussed at our
Patient Participation meeting on the 25th February 2013. Minutes are
included below.
Patient Survey 2012-13
In discussion with our patient participation group, feedback from users
and areas identified for improvement in the National Patient Survey. The
following questions were agreed as simple to complete and the most
useful in measuring our service provision and patient satisfaction
(Shown in Green text):
Staverton Patient Survey Questions
Please take part in our patient survey and help us improve our services.
How helpful and welcoming are our reception team
Excellent
Good Fair Poor
What
improvements
could
……………………………………………………………………………
we
make
Surgery premises (Coming soon: new front doors, new flooring
downstairs and new chairs in waiting rooms)
Excellent
Good Fair Poor
What
improvements
could
we
make
……………………………………………………………………………
Opening times
Excellent
Good Fair Poor
What
improvements
could
……………………………………………………………………………
Nurse services
Excellent
Good
Fair
Poor
we
make
What
improvements
could
……………………………………………………………………………
Doctor services
Excellent
Good Fair Poor
What
improvements
could
……………………………………………………………………………
we
make
we
make
Do you know about our Patient Participation Group?
Yes or No (information on notice board in waiting room)
Do you know about our web site and that you can register to make
appointments or order repeat prescriptions
Yes or No (Please ask at reception)
Please could you complete the following information and put in the box
with your survey form.
Age
Sex
male
or
female
Ethnicity
Thank you for completing this questionnaire – Jenny Poole Practice
Manager
In House Survey February 2013
An in-house survey of 200 patients using the above questionnaire was
conducted in February 2013. These questionnaires were given to every
patient who came into the surgery until they had all been issued. Copies
of the outcomes are displayed in the waiting rooms and posted on the
website, paper copies are also available. The results were shared and
discussed at the Patient Participation Meeting held on the 25th February
2013. Minutes are shown below in blue text:
Staverton Patients Group Meeting Minutes
25th February 2013 6:30 - 8:00
Attendee/Apologies lists held on file
1. Minutes - Agreed
2. Matters arising
 CQC registration: it has been confirmed that the practice
registration had been accepted. A mock visit by a company
recruited by Brent to undertake an assessment of practice
compliance and readiness is booked for the 13th March 2013
 Flu campaign: Achievement of 70% for our patients aged over 65.
Patients who have a chronic disease scored much higher with
uptake over 90%. This years campaign utilised booked clinics
rather than walk in (though walk in patients were fitted in). We
utilised telephone and MJOG text messages as well as letters and
promotion during consultations and on notice boards throughout
the surgery.
 A further discussion was had about the effectiveness of the TV
which showed health related information in the waiting room
downstairs. Several of the patients present thought that it was not
necessary to have this playing and that when you felt unwell you
wanted to sit quietly. Feedback from other patients has been
mixed, with some liking it and some finding it irritating.
 Patients using mobile phones in the waiting rooms. The general
view was that it was rude and intrusive and that they would prefer
if it was banned in the surgery. It was discussed whether that was
possible. AC / JP agreed to take it back to the partners for
discussion on options. They will report back at the next meeting
3. Patient survey outcome
 Patients reviewed copies of the outcome of our latest patient
satisfaction survey which was conducted in-house. This involved
the issue of 200 questionnaires. These questionnaires were given
to every patient who came into the surgery until they had all been
issued. The return rate was significantly higher at 71.5% than
previous surveys and patient informal feedback on the process was
that it was helpful.
 The results are detailed below:
February 2013
Surveys issued: 200
Returned: 143
Return Rate %: 71.5%
Age range of returned survey
Ages 21 - 29 = 12
Ages 30 - 39 = 35
Ages 40 - 49 = 21
Ages 50 - 59 = 15
Ages 60 - 69 = 22
Ages 70 - 79 = 6
Ages 80 - 90 = 4
28 Blank
Male or Female
35 males answered questionnaire
85 females answered questionnaire
23 Blank
How helpful and welcoming are our reception team
Excellent = 51%
Good = 39%
Fair = 7%
Poor = 2%
Outcome 90% of respondents thought the reception team were good or
excellent
Surgery Premises
Excellent = 23%
Good = 46%
Fair = 19%
Poor = 5%
Blank = 7%
Outcome 69% of respondents thought the premises were good or
excellent
Opening Times
Excellent = 32%
Good = 57%
Fair = 7%
Poor = 2%
Blank = 1%
Outcome 89% of respondents thought the opening times were good or
excellent
Nurse services
Excellent = 47%
Good = 43%
Fair = 3.5%
Blank = 6%
Outcome 90% of respondents thought our nurse services were good or
excellent
Doctors Services
Excellent = 47%
Good = 41%
Fair = 8%
Blank = 3.5%
Outcome 88% of respondents thought the Doctor services were good or
excellent
Aware of Patient Participation Group
Aware = 39
Not aware = 73
Blank – 14
Outcome 27% of those completing the survey were aware of the
patient Group
Aware of Website and on-line services
Aware = 70
Not aware = 58
Blank – 14
Outcome 49% of those completing the survey were aware of our website
and on-line services
The following ethnicity was reported by those who returned the survey:
we considered that the responses reflected the ethnic breakdown of our
practice population:
African / Afro Caribbean /Arab / Asia / Asian / Asian Pakistani /
Bangladeshi / Black / Black Caribbean / Black West Indian / Bosnian /
British / British Indian / British Pakistani / Caribbean / Caucasian / Cofe /
English /Indian / Irish / Italian – Brazilian / Kurdish / Latin American /
Mediterranean / Middle Eastern / Mixed / Mixed Black / New Zealand /
Other / Pakistani / Pakistani British / Philippines / Spanish / UK white /
WASP / White Black Caribbean / White / White Asian / White British /
White Caucasian / White European / White Irish / White other / White
Portuguese / 45 declined to say
The group thought that the scores were excellent and showed high
satisfaction levels. The scoring outcome for the practice last year (while
not directly comparable with this year’s survey) was lower at 80%. The
meeting thought this showed an increase in patient satisfaction which
was reflected in their experience of the practice service provision.
The group thought the scores for awareness of the patient group and the
on line service mean the messages where getting through.
4. Action plan outcomes
Review out come of 2011-12 plans: This was completed at the patient
group meeting held in April 2012. A brief summary from those minutes is
shown below
i.
ii.
iii.
Appointment system – appointment system does seem to be
working. It is kept under regular review. There is still an on-going
issue with waiting times in the surgery. We are going to be looking
into our high attenders to see whether there are better ways of
dealing with their care.
Appointments on line – appointments on line are available.
Patients need to come in with ID to receive passwords they can
then register on the website. Feedback has been very positive.
Patients can also request prescriptions on line. The website has
had more than 14000 hits (people viewing the website)
Premises improvements – New lighting has been installed in both
waiting rooms. Options for flooring and seating are being looked
into. There maybe delays in undertaking flooring work. CQC
requirements are not yet clear as to whether all the flooring has to
be changed and what the funding implications of this may be.
Improvement plan 2012-2013
In terms of the planned actions for 2012-2013 the participants had
agreed at our meeting in April 2012 that the following actions would be
undertaken. This was published within the surgery via hand outs, posters
and distribution of minutes of the patient group meeting. Comments on
the choice of actions were invited via information on practice notice
boards, copies of meeting minutes and handouts. No amendments were
received
a) The appointment system should be kept under review:
Outcome: This review has been undertaken in house and as part of a
Brent wide initiative to improve access and includes a demand and
capacity survey to ascertain whether the appointments provided were
sufficient to meet the demand. The surgery currently provides 116
appointments per 1000 patients per week which is far higher than the
expected 72 per 1000 patients. The surgery does continue to have a
problem with significant numbers of high attenders some of who have
attended more than 90 times in the year.
b) Appointments on line – improve awareness an uptake:
Outcome: The uptake has improved significantly with increasing numbers
opting to book their appointments in this way. Satisfaction amongst
users has been very positive with 49% of those completing our survey
reporting awareness of the on line booking service. The number of
unique hits on our website has soared to more than 27,800 in the last
year.
c) Continue with the premises improvements :
Outcome: Patients have noticed the improvements that have been taking
place over the last few months. These include the lighting and new
seating as well as the relocation of a consulting room from the top floor
to the first floor which has improved accessibility and meant some
patients no longer have two flights of stairs to climb to be seen.
Replacement flooring and doors has been scheduled for March.
2013-2014 improvement proposals
The meeting agreed three proposals for the 2013-14 improvement plan,
these will be publicised within the surgery and on the website to check
with a wider audience whether these are the most appropriate areas to
target.
The current proposals for 2013-14 improvement plans are:
 Waiting times in surgery
 Promotion of the patient participation group utilising patients to
promote engagement
 Development of a process for informing patients about changes to
the local health service which will impact on the way services are
provided in this practice and in networks with other local
surgeries.
5. Patient complaints summary
The patients were given an overview of the process undertaken in the
practice to review concerns raised by patients.
We operate a full NHS complaints process in the practice and have
information on who to contact in our leaflet, on posters and on our
website. We have a specific complaints leaflet and complaints form
which is issued from reception. We also have a consent form for patients
to sign if someone is complaining on their behalf. Our Practice Manager
will see any patients with concerns immediately if at all possible or will
contact them by phone.
Our most recent complaints review meeting was held on the 1st February
2013. It was attended by 6 GPs, nurse practitioner, practice nurse,
practice manager and all 6 receptionists. The meeting noted and
discussed the following complaints/concerns that have been raised over
the year.
We have received one complaint passed verbally via PALS which was
later followed up in writing.
Three written complaints (two of which involved on-going discussions
with PALS) and one regarding a visit to the surgery with a child.
We also received a letter of concern regarding the care of one of our
patients by community services which asked for patient consent to pass
to the community service manager for action
6. Open Space
Information was given about the proposed HUB in Kilburn and in the
other four localities across Brent, all have received funding approval. This
HUB will provide additional GP appointments for practices in Kilburn to
access provided that they provide a minimum of 72 appointments per
1000 patients in there surgery. It does mean that patients will attend
another surgery for these appointments. It will also provide
appointments for patients re-directed away from A & E and Urgent Care
centres. Further information will be available at the next meeting.
7. A.O.B
None
Date of next meeting 15th April 2013
Improvement plan 2012-2013
In terms of the planned actions for 2012-2013 the participants had
agreed at our meeting in April 2012 that the following actions would be
undertaken. This was published within the surgery via hand outs, posters
and distribution of minutes of the patient group meeting. Comments on
the choice of actions were invited via information on practice notice
boards, copies of meeting minutes and handouts. No comments or
amendments were received.
You said……
 The appointment system should be kept under review:
 Appointments on line – improve awareness an uptake:
 Continue with the premises improvements :
We did ………the results are
 Appointment System outcome: This review has been undertaken
in house and as part of a Brent wide initiative to improve access
and includes a demand and capacity survey to ascertain whether
the appointments provided were sufficient to meet the demand.
The surgery currently provides 116 appointments per 1000
patients per week which is far higher than the expected 72 per
1000 patients. The surgery does continue to have a problem with
significant numbers of high attenders some of who have attended
more than 90 times in the year.
 Appointments online outcome: The uptake has improved
significantly with increasing numbers opting to book their
appointments in this way. Satisfaction amongst users has been
very positive with 49% of those completing our survey reporting
awareness of the on line booking service. The number of unique
hits on our website has soared to more than 27,800 in the last
year.
 Premises improvements outcome: Patients have noticed the
improvements that have been taking place over the last few
months. These include the lighting and new seating as well as the
relocation of a consulting room from the top floor to the first floor
which has improved accessibility and meant some patients no
longer have two flights of stairs to climb to be seen. Replacement
flooring and doors has been scheduled for March.
2013-2014 improvement proposals
The PPG suggested………….
The practice should look at the following three proposals for the 201314 improvement plan, these will be publicised within the surgery and on
the website to check with a wider audience whether these are the most
appropriate areas to target:
 Waiting times in surgery
 Promotion of the patient participation group utilising patients to
promote engagement
 Development of a process for informing patients about changes to
the local health service which will impact on the way services are
provided in this practice and in networks with other local
surgeries.
Summary of our Patient Participation Report
In summary we have had a considerable level of support and
engagement from our patient population. We do believe that we have
taken into account when eliciting views the make up of our patient
population both in terms of age and ethnicity. We have had clear
direction as to our priorities for the current and coming year. We intend
to repeat our last successful patient survey in July 2013 to ensure we are
monitoring progress.
We would like to thank all the patients who attended meetings, gave
feedback via the website and the patient questionnaires as well as those
who gave service specific feedback both formal and informal.
This report is being posted on our website, displayed within the surgery
on the Patient Participation notice board. We will also have hard copies
available and will post or email to current and past Patient Participation
group members
Jenny Poole
Practice Manager
Staverton Surgery