Partners:								Shotfield Medical Practice
Dr. Heather Lings 							Jubilee Health Centre
Dr. Bernard Lewis							Shotfield
Dr. Joanna Munden							Wallington
Salaried GPs:							Surrey SM6 0HY
Dr. Hani Mahfooth							Tel. No:  020 8669 7612
Dr. Lauren Fisk							Fax No:  020 8773 1801

REPORT & ACTION PLAN FROM THE PRACTICE ESTABLISHED PATIENT PARTICIPATION GROUP & PATIENT SURVEY CONDUCTED JANUARY ‘14

The Practice Patient Participation Group

The practice first established a group during 2011/12.  It was decided to make this a ‘virtual’ group in the first instance and to review the format of the group again in subsequent years.  In 2012/13 and again in 2013/14 this was reviewed but it was decided to remain as a virtual group as we felt we did not currently have adequate resources to move to a face to face group.  Some resources had been provided by Sutton Link (now Healthwatch) last year but which we have been unable to act on fully.  The practice feels that the present virtual group delivers satisfactorily for the purposes of identifying the annual patient survey priorities and providing assistance in analysing the report from that survey.  The practice continues to advertise membership of this group via:

•	The practice website
•	Posters on site
•	The message boards in the waiting areas
•	Word of mouth from individual clinicians, staff or other PPG members

All these methods together have enabled the practice to attract membership from a fairly good cross section of the patient population.  As recruitment has continued, if it was felt more patients were needed from a specific group, i.e. age range, clinicians have attempted to approach patients in this group directly as they are seen.  At the end of 2011/12 the group had a total of 11 members, 8 females and 3 males.  In 2012/13 this increased to 17 members, 13 females and 4 males.  In 2013/14 the group has grown to 23 members, 17 females and 6 males.  The practice is very pleased that the group has grown so significantly this year.  The age/sex distribution of our PPG members is detailed below:

	40-49	50-59	60-69	70-79	80-89	
Female	2	3	6	5	1	
Male	1	2	2	0	1	
  
The age/sex distribution of the group is good with members aged 40-89.  The practice would like to encourage membership from patients in the younger adult age range and will actively attempt to do so in 2014/15 by way of direct messages to this age group, via clinicians internally and those associated with the practice such as Health Visitors.  

Please see below the current practice demography:

	0-4	5-16	17-24	25-34	35-44	45-54	55-64	65-74	75-84	85-89	90+	Totals	
Male	347	779	477	629	688	839	583	381	214	48	19	5004	
Female	347	691	534	749	758	930	591	458	334	108	78	5577	
Totals	694	1470	1011	1378	1446	1769	1174	839	548	156	97	10581	

This shows the practice has more female than male patients in 9 out of the 11 age groups, therefore, it is felt the membership of the PPG also remains representative of that fact.  

The patient group is also evaluated in terms of ethnicity and is as detailed below:

White British	Other White	Asian Indian	
21 (91%)	1 (4.5%)	1 (4.5%)	

Although the group was found to be predominantly white in ethnicity, in our locality of Sutton, data from the 2011 census suggests that 78.5% of residents are white, 3.8% are from multiple ethnic groups 11.6% are Asian (Indian/Pakistani/Bangladeshi/Chinese), 4.8% are Black African/Carribean and 1.3% are from other ethnic groups.  Therefore this result was felt to be reasonably typical of the local ethnicity in that members of our PPG are predominantly white in ethnicity.  

The practice ethnicity is also demonstrated below:

British or Mixed British	4450	42%	
African	212	2%	
Caribbean	112	1%	
Chinese	90	1%	
Bangladeshi	54	0.5%	

There are just over 3000 patients whose ethnicity is not currently recorded on the practice database.  The practice will make attempts to obtain ethnicity from patients when seen where it is not already recorded during the coming year.

The practice has been unable to encourage membership from any broader range of age groups or ethnicity in 2013/14 despite its best efforts to do so.  

The practice used the survey monkey toolkit again this year to produce the survey and to analyse the results.  

The practice asked all members of the patient participation group to pick priorities for the survey again this year.  The practice then compiled the survey in accordance with these priorities and we asked patients to complete the survey during a 3 week period in January.  Surveys were available at reception, via the website, directly from clinicians following consultation and were also sent in some general mailings to try and capture a reasonable number and selection of patients this year.  

Contact is made with PPG members by email but for those without email post or telephone contact will also be used.  It was important that those wishing to participate in this group do not feel excluded if they did not have email or internet access and this is highlighted in the advertising to patients.  

The practice is continuing to advertise for new members of the group and will continue to consider moving to face to face group in the future.  

The practice currently has 2 PPG members who are also Sutton CCG Patient Reference Group members and they are keen to liaise with them to be aware of what the priorities of this group are throughout the year.  

The 2014 Patient Survey 

The priorities for the survey were again determined by responses from members of the Practice PPG.  The most popular priorities were; getting an appointment, telephone answering and access, clinical care, and patient information provision.  These were the same highest priorities identified for the previous year’s survey.  

The survey was made available online, via a direct link from the practice website and in hard copy from reception or one of the clinicians following consultation.  Posters were displayed to alert patients to the survey and both clinicians and reception staff routinely asked patients if they could spare time to complete the survey while they were on site.  Some surveys were also sent out with routine letters and other correspondence to patients.  

A total of 96 surveys were completed during January 2014.  Of these and who answered the question, 22 respondents were male and 71 were female, again fairly representative of the higher female population to male within the practice.  A good cross section of the practice population took part with surveys completed by those from all age groups and employment statuses listed.

Survey Results

Firstly it was felt that the tool used for the annual survey was a little basic and left little flexibility for the way in which results were analysed or presented.  It was not clear how the average ratings were achieved or what they indicated.  This will be reviewed before we use this tool again.  

General observations from the results were that the practice scored positively in many areas including:

•	82% of patients said they had found it either very or fairly easy to get through to reception on the phone in the last 12 months and just over 5% said they had not tried
•	67% of patients said they had found it either very or fairly easy to see a doctor in an emergency in the last 12 months (ie same day), and 24% said that they didn't know or hadn't tried to do so, 
•	77% of patients said they had found it either very or fairly easy to see a doctor routinely in the last 12 months, and 9% said that they didn't know or hadn't tried to do so
•	79% of patients said they felt they had been given enough information about the practices and the services offered, this was up 6% on last year’s responses

Other observations were:

•	64% of patients said they were aware of the practice leaflet, this was up 5% on last year, and 77% who said they were aware of the practice website, a drop of just 2% on the previous year
•	60% of patients said they found information provided to them about other services either very good or good, an increase of 6% on the previous year
•	nearly half the patients said that they would prefer to receive information about the practice or other services by email, the next most popular method of communication was the website closely followed by posters and leaflets on site 

We also took the opportunity in this year’s survey to ask patients who were already familiar with our new telephone triage service for emergencies on the day how they felt about this service.  This a relatively new service only introduced after the appointment of our new Physician’s Associate in October 2013, so understandably over 81% said they had not experienced it yet, but of the rest over 92% said they had found it very or fairly useful.  

Once again, we took the chance to ask patients about our premises which we have now been in for just over 18 months.  Overall nearly 92% felt it was either very good or good.  Nearly 7.5% felt that signage was either poor or very poor and this is something that has also been picked up in the most recent Healthwatch report and is being reviewed with all tenants and the building management team.  

Action Plan

The survey results were shared with the Practice Patient Representative Group and the following action plan was developed: 

1.	Further highlighting the availability of the practice leaflet.  This is routinely offered to all new    patients enquiring and registering and is also available from reception to any patients attending.  The position has significantly improved year on year.  In 2011/12, 53% had said they were unaware of our leaflet, in 2012/13 this reduced to 41% and now this year just 36% said they were unaware of the practice leaflet.   

The practice will continue its efforts to try and ensure leaflets are available to all patients as widely as possible and will do so by:

•	maintaining a message on the digital display boards 
•	introducing a message or label to repeat prescriptions* advertising the leaflet and the website (this has not happened despite being raised previously as our move to a new clinical system last year disabled previous message options)
•	ensuring the leaflet is prominently positioned at reception for patients to see when they attend
•	highlighting the availability of the leaflet via our website
•	sending a text to all patients currently registered with a mobile number to advertise the leaflet at reception or via our website

2.	Promoting the use of our online facility to book routine appointments with the doctor or to  
      request repeat medication.  The survey results showed that just over 33% of patients said they 
      preferred to make appointments online and yet our records show that only 20% of our total 
      practice population are actually registered to use the online service.  This has increased by 
      about 2.5% from last year’s survey.  In 2012/13 the online service changed so that patients 
      can now register for it online via our website without the need to attend and collect initial 
      registration/log in information from the practice, making it easier to establish online access 
      remotely, although that access is later confirmed by the practice when the patient next attends 
      an appointment.  We will continue to promote use of the online service by:

•	maintaining a message on the digital display/calling boards
•	introducing a message or label on repeat prescriptions* (again same as point 1 above)
•	ensuring information about how to sign up and use the online service is available to those patients registering with the practice and also at reception for others attending
•	highlighting this service on our website and in our practice leaflet
•	sending a text to all patients currently registered with a mobile number to advertise the online access facility and registration for it via our website

* We are currently unable to add a message to acute prescriptions issued, however, this will be logged as a developmental request with our clinical system supplier in the hope it can be resolved in future.

3. Nearly 77% of respondents said they were aware of the practice website.  This is clearly a very useful method of keeping patients informed and provided additional information so the practice will ensure that this website is regularly updated and that we use it as fully as possible to share information about our services and others available to patients.  We will add to the website:

•	More information about voluntary and other services available in the local area
•	More information about services provided by local pharmacies (including minor ailments and the move to electronic prescribing in 2014)
•	Regular updates on clinical commissioning, new services and developments for patients within the entire Sutton area (e.g. getting the right treatment in Sutton)
•	Adding a recruitment page to enable us to advertise our own vacancies within the practice
•	Adding a leaflet on ‘what is an emergency appointment’ and details of our on the day telephone triage service

We will also send a text to all patients currently registered with a mobile number to alert them to the website and ask them to check it periodically for important and useful updates. 

4.	Nearly 50% of respondents said their preferred method of communication was by email so the practice will continue to collect email addresses from patients having now added this to our new registration form and general update questionnaires available at reception or from the website.  Presently there is not a mechanism for the practice to send general emails to patient groups and we do not have a practice email address but we will continue to collect email addresses from patients pending this being introduced.  During 2012/13 the practice introduced MJOG which is a text messaging service that automatically reminds patients of their appointments 24 hours before, offers the option to cancel that appointment if it's no longer required and which can also be used for other text messaging to notify patients of health campaigns, such as flu vaccination, NHS health checks, etc.  The practice will continue to use this service, which is very useful, but it will also continue to look at how it might develop the use of MJOG to include email contacts for a broader provision of information to patients than can be achieved via text messaging.  

It has also been agreed that next year we will use the text message facility to alert patients to the annual survey or any other surveys in-year and have them available via the website so that patients can compete them remotely online hopefully encouraging more to do so. 

Timescale for Actions

Points 1-3 above will all be addressed by the practice within the next 1-2 months from completion of the survey and report.  Point 4 will be maintained for regular review as there is no current process available for using patient emails.  

Confirmation of Practice Opening Times

Monday to Friday	08:00 to 19:00 

We have a wide selection of appointments with GPs, the Physician’s Associate, Nurses and Health Care Assistants throughout our opening times.  We also offer some extended hours appointments* with a doctor, the Physician’s Associate, and a nurse as follows:

Monday		18:30 to 19:30
Tuesday		07:30 to 08:00
Wednesday		18:30 to 19:30
Thursday		07:30 to 08:00

* patients attending extended hours appointments before or after normal opening hours for the building will be buzzed in by intercom at the front door by relevant reception staff, this is to maintain security to the building as a whole for all providers outside normal working hours and to address lone working issues for staff

SK – 12.03.14 (final)