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Regal Chambers Surgery Patient Reference Group (PRG)Local Patient Participation Report – February 2014Welcome to Regal Chambers Patients Participation Report. The purpose of this report is to inform our patients of the activity and outcomes of our Patient Participation Group to date.Regal Chambers Surgery opening times:Monday 8.00am – 6.45pmTuesday 8.00am – 12.45pm and 1.45pm – 6.45pmWednesday 8.00am – 6.45pmThursday 8.00am – 6.45pmFriday 8.00am – 6.45pmExtended hours – last Saturday of each month, alternate Tuesday, Wednesday and Thursday mornings on a rota according to PartnerThe Patient Reference Group (PRG) met 6 times in 2013/14, and have now established themselves with a Chair and Secretary. They are in the throes of finalising the Constitution and Code of Conduct. The age/sex register of patients is amended each time a new member joins, however, there has been little turnover this year and the group has remained stable.Each time a member joins their ethnicity is requested along with information regarding whether they have a long-term condition or are a carer. However, this information is entirely voluntary and will account for the disparity between membership numbers and additional information.We are aware that there are not a lot of younger members on the PRG. It is Regal Chambers Surgery policy to write to patients when they reach 16 years of age to invite them along to a health check. This letter includes information about the PRG. Patients are also offered this information when they join the practice. Leaflets are constantly available for patients to take and there is information on our main noticeboard for anyone who may be interested.We have varied the days of the week and times of day of PRG meetings in order to make them as accessible to as many patients as possible. We do find that some older patients are less likely to attend during the winter months, and that bus services to some surrounding villages do not allow those who require public transport to attend.The Business Manager, Yvonne Pope, has attended all but one of the PRG meetings and given either a presentation or report. The only meeting she did not attend, and this was at the request of the group, was so that they could decide between themselves what the purpose and set-up of the group would be. This was after an unsettled period between group members.Priorities and EngagementSince the early stages of the formation of the group there has been a significant change in the patients who actually attend the meeting. The ‘virtual’ group has been very stable but it’s really only in this past year that there have been the same representatives at every meeting. In the early stages, it was quite difficult to avoid personal agendas creeping into discussions and so it was hard to set group priorities. However, the patient questionnaire has always been the driver for effecting change.One of the areas we scored most poorly on in our 2012/13 patient questionnaire was around the telephone system. Therefore, this was an area we set as a priority. In particular, some on-going concerns had been raised around the greetings messages when patients rang into the surgery. In 2012 the practice had bought a high-tech phone system which has enabled the practice to identity more accurately peak periods when staff could be relocated to answering phones.As part of this on-going development, the PRG were invited to suggest the ‘script’ they would like to hear when contacting the surgery by phone. This proved a really worthwhile exercise. We also sought help regarding our noticeboards and notices in general. In collaboration with PRG members we reviewed the wording of messages and these also now have a ‘corporate’ look.Once again, during 2013’s Flu Campaign, PRG members volunteered to help act as ‘signposters’ and to be available to listen to patient comments.Jenny Piggott, one of the PRG members, undertook to spend a day with Dr. Fiona Sinclair to see exactly what the day of GP felt like. She has subsequently written a report which was made available to patients. (see below)All notes and presentations from each meeting are sent to PRG members and are also available on the website.Patient Questionnaire No. 3Once again, it was agreed by the PRG that this year’s format should follow that of last years in order to achieve continued comparison. Three simple questions were asked – ‘What are the three things you like most about Regal Chambers Surgery?’ and ‘What three things would you change about the surgery if you could?’ The collection period was from 13.1.2014 – 7.2.2014The practice provided paper copies of the questionnaire and offered them to patients as they arrived for an appointment. The questionnaire was also added to the practice website and patients with mobile phones were texted to let them know the questionnaire was available.Significantly more responses were obtained this year although patients still did not take part in huge numbers. Despite questionnaires being given, they were often found left blank on waiting room chairs. The practice was concerned that continued bombardment of information would desensitise patients and devalue the use of the texting options and so resisted sending more than one reminder. It maybe the decision of the PRG that next year they will be more actively involved in distribution and collection of questionnaires. This was due to be discussed at the first PRG meeting which follows the availability of the results on 24.2.14. However, due to sick leave, a follow-up meeting was arranged for 11.3.14. The Business Manager collated the information at the end of the collection period and grouped the results into relevant headings. Please see a copy of the results attached.The results, as always, are posted on the practice website and in reception, and we will text patients (who have agreed to be contacted) with the information that the results are available. A copy of the results are attached.The Partners and staff have discussed the results and feel that there has been significant improvement. There remain issues which the practice can do nothing about e.g. parking but will make every effort to action those areas which are possible e.g. holding the Warfarin Clinic on the ground floor.The results have been circulated to the PRG members ahead of general circulation on the practice website and in the surgery .Identified Action Points by PRG as a result of the patient questionnaireThe overall comments from the PRG members present were that there had been a noticeable improvement in general and that they would struggle to find areas to improve. The completed questionnaires and the combined results were available in paper form and also projected on to a screen. After discussion, it was agreed that only 2 areas could be identified as a priority. Clarification of the ‘Sit & Wait’ clinics which were available. PRG members suggested that the procedure and justification of this procedure were clarified, why they are necessary, and how we can improve publication of best use of these appointments.Improve communication of all services available e.g. Saturday appointments and why they might not appear on-line etc.In order to make this achievable, Yvonne Pope, Business Manager, has agreed to make the Katie Duguid, Assistant Manager and Chris Duguid, IT Administrator available to the working party of the PRG who will take this forward. The plan is that, once gathered, the information will be reviewed and made more ‘patient-friendly’ if it’s not already absolutely clear. A Day in the Life of…At one of the Practice’s Patient Reference Group (PRG) meetings we were offered the opportunity to shadow a practice doctor for a day. The PRG exists to represent the patients, their concerns, their positive experiences and problems, to the practice team. The aim being to inform the practice and try to help improve the service we receive. So your first response might be “Why would spending a day shadowing a doctor be useful?”.Well, I am really interested in how we see the service we get; especially whether what we expect, and what our doctors expect of us, is reasonable and well understood by both sides. Does what constitutes “reasonable expectations” need greater clarification and communication? So, for me, the offer to come along and have a sense of the context of practice life seemed ideal. After all I know what it is like to be a patient but my views of the service I get is affected by what I think it can do for me. The experience I thought might help me be clearer in my thinking and know whether my expectations are reasonable. I actually spent two half days “shadowing” one of the doctors, a Friday morning and a Tuesday afternoon. This brief story is written to share with you what I experienced on those two days. It is followed by some extra notes regarding outcomes and reflections that arose out of my time “inside the system”.On Friday….Today Dr Sinclair is a duty doctor so the main activity of the day is to see, with one other doctor in the practice, the “sit and wait” patients. There are five hour long sessions throughout the day with the two doctors seeing, or telephoning, up to 16 people in each slot. For many of us, using this surgery means ringing the surgery to get a same-day appointment. Duty doctors are also responsible for sorting the bulk of the repeat prescriptions and organising the home visit rota for the day.I arrived just before 7.30am and Dr Sinclair had already been at work for a quarter of an hour. She likes to get in early to make sure she is ready when the patients start to arrive.Task 1: The doctor checks and signs approximately 100 repeat prescriptions that are waiting in the office. There are two that need to be followed up on the system, so Dr Sinclair goes to her office to log in and look at the patient records.There are about 4000 drugs that can be prescribed, all listed in an online database and a 1000 page book!At 8.02am someone is ringing on the surgery door because it is not open yet!!Task 2: The doctor starts checking all the requested non-repeat prescriptions for her own patients and for a doctor who is away, she looks at each patient’s record before signing. There are a couple of problems with the prescriptions, people needing to come in for tests and a request the practice cannot meet because the item is not in the “magic book”. All the rest are signed and returned to reception.We discuss the overhead associated with prescription signing, the fact that as soon as a prescription is signed the doctor has accepted responsibility. Although there appears to be some duplication it is the need to check that is important. For example, it is important to check that have had any necessary tests, that the drug being requested is appropriate, or that there is not over prescription going on. The surgery has just employed someone to manage the prescription system.Task 3: Dr Sinclair looks at home visit requests to decide which doctors will go out to visit which patients.Task 4: Dr Sinclair talks to reception about adding some extra drop in slots to the morning sessions to ease the afternoon because of other commitments.Task 5: Dr Sinclair has a few minutes before she is due to see the first patient and so she starts to check test results that have been received. They are flagged on the system in different ways so the doctor can immediately see those that are normal and those that are not, helping her to prioritise. One patient’s results look worrying and although Dr Sinclair wants to deal with it urgently she feels it is a bit early in the day to ring and decides to wait until she has seen a few patients. She looks at a few more results, all of which seem fine.It is now 8.45 and time to start seeing patients. She has been working non-stop for an hour and a half before the first patient steps through her door.The “come and wait” sessions are timed at 8 minutes each but everyone gets the time they need.Outside Dr Sinclair’s surgery I talk to some of the patients waiting to go in. I also do this on the Tuesday afternoon and notes from these sessions are given later.Dr Sinclair sees four patients before stopping to phone the patient with the abnormal results. In the next half hour she makes three calls to the patient (including one where she arranges to do a home visit at lunch time), these are interspersed with calls to various health agencies.Back to the waiting patients. Dr Sinclair sees another seven patients. At one point she comes out of the office to check something and is stopped in the corridor by the nurse asking for advice. During the morning she also has to deal with a phone call from the local police.Although the morning was meant to be split into two blocks of appointments with a small space in between them, Dr Sinclair has worked straight through.I left at 1pm, at the end of the morning surgery and just as Dr Sinclair was off to do her lunch time home visits. Desperate to get home for a cup of tea and feeling exhausted, I asked about her lunch,“I will buy a sandwich” She said. …Tuesday…..I arrived at 2pm and Dr Sinclair arrived back from her lunch time home visits at 2.15pm. Straight into the surgery, she opened her pack of sandwiches (were they the ones from Friday that she had not found time to eat?) and picked up the phone to follow up on the outcome of one of the visits. Dr Sinclair was not only sorting out the needs of the patient concerned in these calls, but also the needs of their dependent partner. Several phone calls to various agencies later and awaiting return calls….A letter is written and faxed munity matron pops in to discuss a patient .Phone call to another patient. In addition to their main health problems, this patient has tried a number of drugs to help with a separate condition and none of the medicines have worked. However, the Quality Outcomes Framework requires the doctor to address the problem and so, as this has not been possible, Dr Sinclair has to add an “exception” to the patient’s record to explain that all possible approaches have been tried and now abandoned, as they have caused the patient more problems that the condition itself.At 3pm Dr Sinclair is due to visit a local care home, where she will see six patients. Just as she is about to leave the awaited phone call is returned. She answers but a further follow-up call is planned for later. She is now ready to leave for an estimated hour of visits. The surgery makes regular visits to care homes in the area and is working with other local surgeries to rationalise these and reduce the current duplication of effort. However, this negotiation requires some delicacy as it may result in a reduction in patient choice.Whilst Dr Sinclair is out on her visit, I spend some time looking at the queuing at reception (as this is something that has been mentioned at PRG meetings), some brief notes are given below. During the observation an emergency occurs. Someone comes into the surgery accompanied by two members of their family, reception immediately calls for one of the duty doctors, who is with the patient in two minutes. The patient is taken to a room for examination and some primary care. The receptionist phones for a “blue light” ambulance, which takes twenty minutes to arrive.. Dr Sinclair arrives back from visit at 4.20pm (a little late for her first booked appointment) but within two minutes the first patient is in her surgery. The last patient of the day leaves at approximately 6.40pmAt 7pm I left as surgery staff were locking up. Dr Sinclair had some things still to do, including a further home visit and more outstanding administrative duties. She left at about 10pm, by which time I was in bed exhausted..NB During my visits, I did not have access to any patient records or personal information. I was not in the surgery with patients, only when Dr Sinclair was undertaking administrative and other non face-to-face activities. I also signed a confidentiality agreement.NotesTalking to fellow patientsI asked about the phone call they made to obtain appointments. On the Friday morning, all but one of the patients said the phone was answered almost immediately and the one said they waited less than 5 minutes. A quite unexpected but pleasing set of responses.Queuing at receptionShort observation at one minute intervals 15.39 to 16.09 on the Tuesday15.39-15.50 a person being seen or no one at reception (no one waiting).15.51-15.52three people arrive (one goes straight to reception, two queue).15.52-15.53two people arrive with emergency. Receptionist is just finishing with person at window and then goes immediately to emergency and calls doctor. Another person arrives (three waiting).15.53-15.54second reception window opens and deals with queue16.00no one at reception. 16.06 – 16.08person at reception no one waiting.16.08-16.09no one at reception.If no one is waiting to be seen at reception the staff work on administrative tasks. It is impossible to avoid queues when people arrive randomly. However, even with a major incident, the reception staff worked cooperatively and efficiently to deal with waiting patients. There was no evidence of long waits, the longest was approximately four minutes. Home visitsEveryday doctors make home visits. In addition the practice makes regular visits to residential and care homes to save those patients having to be brought into the surgery (although one off needs have to be dealt with by residents making surgery visits, normally accompanied by a member of the home staff). On the day I was observing, the doctor made nine home visits. Two at lunch time to individuals, six in the afternoon - all in the same home, and one in the evening.Who does the doctor care for?A doctor tries to take the total needs of the patient into account, this includes, amongst other things, a holistic view of their medical needs (not just what they are asking about today) as well as how their illness affects and is affected by those around them. The doctor’s workThe doctor I observed was in at 7.15am on the Friday and was still there at 7pm on the Tuesday she did go home for the weekend I hope!. Even if these were exceptional days there was no sense that the lack of time to relax or have a break was unusual. I am not sure this is a healthy lifestyle! Dr Sinclair is described as part time but this just means, like a number of the doctors at the surgery, she spends the rest of their working week doing something else, in her case being a member of the local Clinical Commissioning Group. I agree with the Dr Sinclair when she said that it helped to make the intensity of the days in the surgery manageable. I think a full time job in the surgery could be overwhelming.And finally….I cannot thank Dr Sinclair and the surgery staff enough. Dr Sinclair was open and free with her time and energy. Everyone I spoke to was helpful and friendly. I found the whole experience a revelation and made me realise just how hard the whole team work. If you want to contact me to talk to me about any of this article or about the PRG, my email address is jsp38@cam.ac.uk.Some thoughts for the surgeryTextingAlthough relatively new patients were all asked on registering a out using text on mobile phones, patients who have been in the surgery longer do not seem to know about the texting option. There is potential for getting more patients a form for registering for the online system but nothing for texting, perhaps something could be put here. Also a way of asking people when they arrive for appointments may help. I note a blitz on this is being attempted for the flu clinics.ReceptionIt does not appear easy for reception staff who are in the public area to see what the queue is like. Abbi had to lean around the window to see whether there was a queue and this first required her to think there might be a problem and get up to look. I believe there are cameras but screens are in the non-public area of reception (I think). Consider small convex mirrors high up on top left corner of reception “windows” so that a view into the waiting room is possible from seating position.Surgery registrationThere was some misunderstanding concerning the idea that you are registered at the practice and the name of “your doctor” is pretty meaningless in the bigger picture. One older patient did not know who her doctor was and I said that it was not important but if she wanted to know she could ask at reception (where there was not queue) but she wouldn’t ask (??). I found myself explaining the system of practice registration several times. I know that this information is on the screens but I did not notice anyone reading them. Perhaps a “thought for the week” might be a good idea? A bit like the flu flags – one unusual small and separate information may be noticed..AnalysisI might be useful to have someone occasionally do some random time analyses of surgery operations, such as phone calls or queues or waiting times, or patients looking at posters…. just to inform responses. This might be something the PRG could do if given appropriate guidance.I know I left this quote at reception on the Tuesday but just in case you did not see it on the notice board….“This is the best surgery I’ve been in. Doctors and reception are all friendly and helpful. The doctors are really thorough, It’s great”.A patientWith thanksJennifer Piggott.Notes of the meeting held on 23 April 2013 Welcome New Members and apologiesPresent : Susan Apthorpe, Michael Taylor, Ginny Wilson, Dianne Groves, Di Blockley, Lorna Rea, Peter Whybrow, Frances Moreland, Eleonora Martorana, Pat Cherry, Jenny Piggott, Vida Field.Apologies: Vivienne Goodwin, Laurel Farrington, David Leal-Bennett, Deborah Segalini, Jane Cave, Sacha Pierre, Janet Piesse, Judi Billing, Keith HoskinsReview of patient questionnaire resultsYP was thanked for analysing and summarising results of the recent survey which were displayed on the screen grouped by topic and in two columns showing responses “Thing Liked” and “Things Disliked” . YP advised these now are available on the surgery’s web site.In discussion note was made emails received by YP which had been circulated to PRG prior to this meeting. Fuller discussion in item 3 below. Discussion points included: Particularly pleasing to note was made of the improvement of staff on last year.Patient preferences re access to doctors – age ranges, ratio of women to men, full time part-time etc.. Monitoring phone message/times - and shortening the surgery message . Consider change wording from “we are very busy” to you are e.g - 5th in the queue.Considered constraints on toys, magazines e.g Health and Safety Legislation and Fire Regulations. Patient expectation : demonstration fo GP workload/offer to shadow GP for the dayMuch of the meeting time centred around these issues. There was fruitful discussion of Primary Care in 2013 and Regal Chambers’ responses to change. GPs present described increasing national pressure on workload and use of resources and explained in some detail the current complexities of medicines and prescribing with patient safety paramount. GP’s also described their monitoring of the appointments system, “sit and wait” and “passage of care” It was felt that there is some misconception about Surgery resources. They have not been reduced but there has been a shift in demand e.g work that was at one time done mainly in hospitals is now undertaken by GPs and nurses in surgeries. This, like GP recruitment, Is a national issue. Comparisons with other surgeries - “how are we doing” ? (presentation available along with these notes on the practice website)Points to follow up:Encourage on more on line access . text, email web pagesInvestigate further repeat dispensing systems (beginning to be used elsewhere)Volunteer (JP) to take up offer to shadow GP fo day (subject to confidentiality constraints)Continue patient education and discussions (item 3 above)Flu 2013 – Planning The practice will be planning this year’s ‘flu campaign on Tuesday 14th May 2013 at 12.00 noon. If any member of the PRG would like to attend to offer input, please let YP know as they would be most welcome.Noticeboards – does the PRG want its own? What do you want to know about the noticeboards? Not discussed in any detail. No board needed now. Forming a committee?Item deferred to next meetingAOBPRG member reported on E & N Herts NHS Trust work towards Foundation status and encouragement of public to join. 8 Date of next meeting3 July 2013. 6 p.m. Regal Chambers SurgeryThe meeting closed at 7.03 pmNotes of the meeting held on 23 April 2013 Welcome New Members and apologiesPresent : Susan Apthorpe, Michael Taylor, Ginny Wilson, Dianne Groves, Di Blockley, Lorna Rea, Peter Whybrow, Frances Moreland, Eleonora Martorana, Pat Cherry, Jenny Piggott, Vida Field.Apologies: Vivienne Goodwin, Laurel Farrington, David Leal-Bennett, Deborah Segalini, Jane Cave, Sacha Pierre, Janet Piesse, Judi Billing, Keith HoskinsReview of patient questionnaire resultsYP was thanked for analysing and summarising results of the recent survey which were displayed on the screen grouped by topic and in two columns showing responses “Thing Liked” and “Things Disliked” . YP advised these now are available on the surgery’s web site.In discussion note was made emails received by YP which had been circulated to PRG prior to this meeting. Fuller discussion in item 3 below. Discussion points included: Particularly pleasing to note was made of the improvement of staff on last year.Patient preferences re access to doctors – age ranges, ratio of women to men, full time part-time etc.. Monitoring phone message/times - and shortening the surgery message . Consider change wording from “we are very busy” to you are e.g - 5th in the queue.Considered constraints on toys, magazines e.g Health and Safety Legislation and Fire Regulations. Patient expectation : demonstration fo GP workload/offer to shadow GP for the dayMuch of the meeting time centred around these issues. There was fruitful discussion of Primary Care in 2013 and Regal Chambers’ responses to change. GPs present described increasing national pressure on workload and use of resources and explained in some detail the current complexities of medicines and prescribing with patient safety paramount. GP’s also described their monitoring of the appointments system, “sit and wait” and “passage of care” It was felt that there is some misconception about Surgery resources. They have not been reduced but there has been a shift in demand e.g work that was at one time done mainly in hospitals is now undertaken by GPs and nurses in surgeries. This, like GP recruitment, Is a national issue. Comparisons with other surgeries - “how are we doing” ? (presentation available along with these notes on the practice website)Points to follow up:Encourage on more on line access . text, email web pagesInvestigate further repeat dispensing systems (beginning to be used elsewhere)Volunteer (JP) to take up offer to shadow GP fo day (subject to confidentiality constraints)Continue patient education and discussions (item 3 above)Flu 2013 – Planning The practice will be planning this year’s ‘flu campaign on Tuesday 14th May 2013 at 12.00 noon. If any member of the PRG would like to attend to offer input, please let YP know as they would be most welcome.Noticeboards – does the PRG want its own? What do you want to know about the noticeboards? Not discussed in any detail. No board needed now. Forming a committee?Item deferred to next meetingAOBPRG member reported on E & N Herts NHS Trust work towards Foundation status and encouragement of public to join. 8 Date of next meeting3 July 2013. 6 p.m. Regal Chambers SurgeryThe meeting closed at 7.03 pmNotes of the meeting held on 3 July 2013 Welcome New Members and apologiesPresent : Michael Taylor, Di Blockley, Frances Morland, Jenny Piggott, Vivienne Goodwin, Elly Martorana, Laural Farrington, John MachenApologies: Judith Nixon, Lorna Rea, Janet Piesse, Victoria Tizzard, Helen Ruggles, Keith Hoskins, David Leal-Bennett, Ginny Wilson, Sue Apthorpe, Diane GrovesWelcome Laurel Farrington Hertfordshire Healthwatch Herts and to Dr John Machen (patient).Feedback since meeting held on 23 April 2013 Patient expectation : demonstration of GP workload/offer to shadow GP for the day : JP reported - date to be arranged.The other items noted at our April meeting are ongoing: Comparisons with other surgeries - “how are we doing” ? (presentation available along with these notes on the practice website)Action Points to follow upEncourage on more on line access . text, email, web pagesInvestigate further repeat dispensing systems (beginning to be used elsewhere)Continue patient education and discussions (item 3, notes of our April (meeting)Flu 2013 – Planning JP reported on the to discussions at the May planning meeting about this year’s ‘flu campaign. Offers came from this group to assist patients in surgery waiting area on the four Saturdays in October to encourage a smooth flow of people. Noted that letter to patients about the campaign had in the past been sent out by the PCT (now dissolved). Concern expressed that any increased cost may not be funded. Noticeboards – does the PRG want its own? Extensive discussion of reception and access. Four people are going to look at “welcoming” and notices. Forming a committee? To be principal item in agenda for next meeting. Staff Changes YP led discussion of changes including the appointment and training of 3 new receptionists and current recruitment of urgent care nurse. Changes of shift patterns and new configuration of hours allow for increased support and time for whole team to meet together. Systems continue to be reviewed and updated. 5 Kings Fund Video“An Alternative Guide to the new nhs in England” .uk/altguidenhsShort video giving sketches of possible views about recent re-configuration of NHS structure, (and confusion(?) of overlaps and vast number of new roles) 6 Regal Chambers Lift. New one being installed in next few weeks. 7Forming a CommitteeAgreed this would be the principal agenda item for our next meeting which would give us time for discussion of roles. 8 Patient Leadership Group . JP circulated paper on 3 day course she had attended and the PLACE briefing and assessment session she had taken part in. 9 A.O.B. Hertfordshire HealthwatchLF circulated paper on HHW activities (weekly update 21.6.13) and their current interest in collecting views of patients’ experience of getting GP appointments “when you need one” and views on customer service. There was discussion of the “when you need one” and patient expectations in the fast changing NHS. Discussion ranged widely and included e.g. increasing work that might at one time have been done in hospital moving to local surgeries, the number of patients, demographic change, and changes to Regal Chambers appointments, telephone and other systems. Agreed: to continue open discussions. 10 Date of next meeting Tuesday 4 September 2013. 6 p.m. Regal Chambers SurgeryThe meeting closed at 7.03 pm Notes of the meeting held on 3 September 2013 Welcome and apologiesPresent : Pat Cherry, Dianne Groves, Vivienne Goodwin, Eleonora Martorana, Frances Morland, M. Piggott, Jenny Piggott, John Machen Michael TaylorApologies: Di Blockley, Vida Field, Margaret Warren, Janet Piesse, Gwyn Jones, David Leal – Bennett, Keith Hoskins, Ginny Wilson.2 Forming a committee? (Principal agenda item) 2a What do these Groups do? Information on Patient Reference Groups had previously circulated to the Group by Yvonne Pope, Surgery Practice Manager, but not everyone had seen this. The meeting discussed a web page introduction to Patient Groups which listed some of the things these groups do. Those listed are: Advising the practice on the patient perspective. Organising health promotion events. Communicating with the wider patient body. Running volunteer services. Carrying out research into the views of those who use the practice and their carers. Influencing the practice or the wider NHS to improve commissioning. Fundraising to improve services provided by the practice. The Group agreed to discuss these further and plan priorities Action All 2b The meeting discussed the role of the wider group (YP’s PRG circulation list), the smaller group present at this meeting and the role of chair and secretary. It was agreed that terms of reference are be developed and considered. Action All 2c Consensus was reached (without formal voting) that Michael Taylor would become Chair and Frances Morland Secretary. These appointments are for one year ending 2 September 2104. Action MT/ FM 2d JM, MT & FM drew attention to the Standards in PPG work on The Care Quality Commission’s web pages and mentioned the possibility of inspection of the surgery which we may wish to be more aware of at some later date. Action All PRG2e The Group wished to record their thanks and appreciation to Yvonne Pope for all her hard work and support to the Group2f Further Action Points :Check YP’s circulation list and its use by PRG - data protection MT/YPProduce place name’s for Group to use at next meeting FMWrite formal Standing Invitation to Surgery staff to attend PRG meetings MT Check next meeting 15 October 2013 and surgery room availability FMFind out about contacts with other PRG’s ( terms reference etc) All PRGThanks to Yvonnne for all her hard work and support to PRG MT Prepare agenda items next meeting Action All PRGFinalise and circulate agenda FM (deadline: week before meeting? Take AOB items at meeting?) Patients views Surgery telephone system? Check with YP MT PRG Notice Board – cost ? space? Check with YP FM PRG records & archiving space check with YP FM 3 Brief feedback from previous meeting 3 July 2013Flu 2013 – Planning Since the May planning meeting about this year’s ‘flu campaign offers have come from this group to assist patients in surgery waiting area on the four Saturdays in October to encourage a smooth flow of people. Patient expectation : demonstration of GP workload/offer to shadow GP for the day : JP reported – 2 half days have been arranged and she will write a report for our next meeting. 4 Date of Next meeting: Tuesday 15 October 2013 at 6pm at Regal Chambers surgeryNotes of the meeting to held on Tuesday 15 October 2013at 6pm at Regal Chambers Surgery Welcome and apologiesPresent: Sue Apthorpe, Vivennne Goodwin, John Machen, Elly Martorana, Frances Morland, Jennifer Piggott, Margaret Piggott, Yvonne Pope, Michael Taylor.Apologies: Jane Cave, Gwyn JonesNotes of the Meeting held on 3 September 2013Approved (with correction of minor typing error).Matters arising (not already on the agenda)Item 2f: Finding out more about other surgeries.EM reported she had looked at other a sample of other surgeries’ web sites and had found variation in content and presentation with Regal Chambers very comparing well. JM reported that he had visited two surgeries known to have similar telephone systems to Regal Chambers and compared certain aspects e.g on waiting times etc.. and had found Regal Chambers to be good. Some statistics are on display on the surgery’s screens in the patients’ waiting areas. JP reported that when she visited this surgery (see item 4 below) she the opportunity to ask a small number of patients about the telephone system.Feedback from JP on work shadowingJP’s verbal was very informative with key points : no evidence of problems with the telephone system, patients waiting/queuing was well managed, 12 hour day worked by doctor with very few and very short breaks, reception staff - good atmosphere. JP thanked all the surgery staff. Her written report will circulated. Action YP Report from YP (Surgery Business Manager)YP gave a verbal report (copy attached)Patient Survey January 2014Following discussion it was agreed to use similar questions and format to those in the two previous surveys which asked which three things do you like about the Surgery Practice and which three do you dislike/want to change. Patients may complete on line or in the surgery. Agreed Conduct the survey in mid -January 2014. Some PRG members may volunteer to assist with handing out in the surgery. Action All PRGPRG Newsletter 2014 There was brief discussion of some pros and cons. The outcome is consider the format and produce “Snippetts” which would highlight some of the PRG’s observations e.g on telephone system and JP’s work place shadowing, and YP’s reports. Contact to be made with Ginny Wilson about publishing. Action FM Any Other BusinessJP passed on a message from Dr Sinclair who will be attending the next Locality Meeting in Letchworth. MT and FM who have attended previous meetings encouraged others to attend and meet people from other PRGs.Agreed: Date and further information to be emailed. Action YPAgreed: Linda Dent (Locality Meeting) to be invited to speak to Regal Chambers PRG. Action MT Date of Next meeting: Monday 9 December at 6pm at Regal Chambers surgeryReport from Yvonne Pope for Patient Reference GroupThe practice experienced a particularly busy summer. At a time when we would usually expect for things to quieten, we had the busiest summer in living memory!As we approach the Autumn, it’s time for our annual ‘flu campaign. We are going to be open every Saturday in October and, depending on the number of patients who take up these appointments, may need to add some additional sessions in November. On 5.10.13 we vaccinated 544 patients with flu, 12 with Varicella (shingles) and 11 children aged 2-3 for nasal flu vaccination. This year has been extremely stressful as the Government decided to implement 3 new vaccine schedules – Varicella, Flu for 2-3 year olds and rotavirus. The shingles vaccine is only available for patients aged 70 OR 79. The original documentation was less than clear and some practices have vaccinated patients aged between 70 AND 79 thus causing a shortage of the vaccine!Saturday 12th October saw us vaccinate 379 for flu as well as an additional 18 for with shingles or under 5’s flu.We tried something different this year and used a separate mobile phone number solely for the booking of flu appointments. This relieved the main reception of over 2000 calls. We have always staggered the posting of invitation letters in order to spread the pain, but this additional step seemed to work well. We also employed a ‘Saturday girl’ just to deal with weekend calls.We have also worked more collaboratively with other Hitchin practices when vaccinating patients in nursing and residential homes. Rather than 4 practices all go to every home they have patients registered in, we have divided them up so that we each vaccinate the entire home. We did Minsden, Benslow and Elmside.We have had a few PRG members volunteer to come in on Saturdays to collect mobile phone numbers and email addresses in order for us to reduce the number of letters we send, and to be able to use our new ‘toy’ – MJog! We have some software on trial for three months which will enable us to send AND RECEIVE information. We’ll be able to target patients for whom our information is out-of-date and they will be able to send the information we need back without being seen (stuff like height, weight, smoking, exercise etc). Patients will also be able to cancel their appointments by text and the software will enter the information without the need for a receptionist to deal with it,Our new receptionists are settling in well. They’ve had a steep learning curve but are all brilliant.We interviewed for an Urgent Care Nurse last Friday and have now appointed a new nurse who is due to start with us sometime in November. This is an essential post for the management of on-the-day problems.We have made a slight amendment to the Sit & Wait clinic, in that it’s not just for medical emergencies. This has significantly affected the number of complaints – there are fewer of them!The Health and Social Care Information Centre (HSCIC) want to link patient information from all the different places patients receive care in order to provide a full picture.? Information such as postcode and NHS number (but not name) will be used to link information to a secure system which does not reveal identify, but will enable researchers and those planning health services to make sure they provide the best care for everyone.Patients will have a choice of whether the wish their data to be included or not.? Please go to the following website for more information. of the meeting held on Monday 9 December 2013at 6pm at Regal Chambers Surgery Present : Di Blockley, Ellie Martorana, Frances Morland, Maraget Piggott, Michael Taylor, Ginny WilsonWelcome and apologies The meeting welcomed Mrs Linda Dent, Public Engagement Lead, E&N Herts Clinical Commissioning Group to speak to agenda item 7.Apologies were received from Yvonne Pope and Jenny PiggottNotes of the Meeting held on Tuesday 15 October 2013ApprovedMatters arising (not already on the agenda)3.1 Regal Chambers Flu Jab Sessions held in OctoberComments: most sessions went well but on occasions the volumes were a little difficult to handle with queues developing into the street. Report from YP (Surgery Business Manager)No report on this occasion. Patient Survey January 2014The format and content that were suggested at the previous meeting were confirmed with the addition that the Surgery consider the following i) the possibility of giving patients the option to patients to respond using text messaging ii) add any further comment. Iii) mention joining PRG and give contact detail.Action YP It is expected that the Surgery will conduct the survey in mid -January 2014.Action YPPRG Newsletter 2014 Prior to the meeting FM had contacted GW and JP. GW had published the previous two newsletters and has now drafted suggestions for part content and layout. The meeting thanked her for her hard work. JP had emailed FM and agreed to author some snippets e.g of her visit to the Surgery. LD, CCG Lead for Public Engagement, agreed to send information to YP and FM about the recent antibiotics misuse publicity (don’t expect a pill to cure a cold) for further circulation to PRG and to edit for the Newsletter if there is space. As the newsletter is 90% ready it may be possible to publish this next weekAction JP GW YP FM to email JP Action FM 7 Patient Reference Groups – Locality Meeting. Next meeting is to be held on 14 January 2014, Goldsmiths Building, Letchworth 6.45 – 8.45pm. FM and EM would like to attend. There will be opportunities for other PRG members wishing to attend in future.Action FM.EM LD spoke briefly to the meeting about patient participation and the Patient Reference Groups’s background and political developments. She sketched the structure of the N Herts Clinical Commissioning Group, including an outline of its budget and decision making process. There are 6 Localites (which are largely based on GP surgeries and are key for decision making). Dr Sinclair, Regal Chambers is an elected representative on the CCG. LD distributed copies of papers to assist our PRG :- i) What is a PRG and N Herts CCG: ii) Locality Patient Commissioning Groups; iii) Example PRG constitution; iv) PPG Code of Conduct Action All Date of Next meeting: Monday 24 February 2014at 6pm at Regal Chambers surgeryReport from Yvonne Pope 9.12.13I am sorry I am unable to attend the meeting but, for reasons known only to the NHS Pensions Agency, I can only work 16 hours a week for a calendar month after taking my pension. It is essential that I am in the practice for the regular, planned, business meetings and so am only working Tuesdays and Thursdays until 18th December 2013.FluWe have now almost completed our flu campaign for 2013 with only 30 more vaccines left to administer. We learned a lot this year from doing things differently and will make further improvements for 2014. The sharing of nursing homes between Hitchin practices worked really well and we may consider sharing home visits for flu vaccinations in 2014.StaffWe recruited, appointed and then lost an Urgent Care Nurse. She accepted the post and worked here for almost 2 weeks before returning to her previous employer so we’re back to square one. We’ve not yet decided how we will proceed i.e. try again or look to re-configure the nursing team.Xmas and New YearThere will be no booked appointments between Xmas and the New Year. All appointments will be ‘sit and wait’ with every GP working as Duty Doctor. Regal Chambers Surgery Patient Reference Group (PRG) Draft Notice of meeting to held on Monday 24 February 2014at 6pm at Regal Chambers Surgery AGENDA Welcome and apologies Notes of the Meeting held on Monday 9 December 2013To amend the notes of the previous meeting to record that YP had emailed her report on 3 December and to apologise to YP that this had not been noted by any the Group. Matters arising (not already on the agenda)Reports from YP (Surgery Business Manager)4.1 To receive the 3rd December Report4.2 To receive the 9th February Report Patient Survey January 2014To note the date the was survey conducted and to receive results. PRG Newsletter January 2014 To thank contributors and note publication date. To receive comments. Other Patient Reference Groups7.1 Locality Meeting 14 January 2014 in Letchworth. To receive feedback - EM, MT,FM. 7.2 To note patient representation NHS 111 E&N Herts Clinical Commissioning Group and receive feedback from the meeting held on 16 January - FM 8 Papers circulated (9th December Meeting) by Lynda Dent Lead for Public Engagement, East and North Herts Clinical Commissioning Group (CCG)To consider these with a view to producing our own versions and agreeing them at, or before, our next meeting.8.i) What is a PRG and N Herts CCG8.2 ii) Locality Patient Commissioning Group8.3 iii) Example PRG constitution8.iv) PPG Code of Conduct Comments received1) The 7th paragraph of the Objectives section can contradict with paragraph 4 of the signed agreement for each member ?2) The 2nd paragraph of the Membership section, we have over 12 members via email? ?I thought that the more members were present the better? Can one really specify a maximum number for this? Date of Next meeting: 11.2. 2014at 6pm at Regal Chambers surgeryMinutes of the P.R.G. meeting held at Regal Chambers on Monday 24th Feb. 2014 at 6 p.m.Present: Di Blockley, Elly Martorana, Judith Nixon, Hazel Ospalak, Margaret Piggott, Michael Taylor and Ginny Wilson.Apologies had been received from Yvonne Pope and Frances Morland.Michael welcomed the group, especially our new member Judith Nixon.Unfortunately in Yvonne’s absence the meeting had to be shortened to 30 minutes as the building had to be locked early.Notes of the meeting on 9th December 2013 were agreed.Matters arising – we all agreed it was necessary to convene a final meeting with Yvonne’s supervision before she leaves, even more necessary after such a short meeting.Results from the Patient Survey, January 2014 were considered. It was felt that many patients (and some members of the PRG) did not fully understand the options for appointments, even the process for “sit and wait” . The on-line booking system was appreciated and the group wondered whether this could be extended to nurse appointments.Other Patient Reference Groups – it was agreed by all that involvement with other groups is relevant and necessary.The meeting was abandoned at 6.30. Michael said he would liaise with Yvonne regarding the date of our next meeting and that all members of the PRG would be informed.Report from Yvonne Pope to Patient Reference Group Meeting 24.2.14Thank you to everyone who contributed to Patient Questionnaire No. 3. The practice has reviewed the results and feels that there has been a positive improvement since last year. Whilst we recognise it is not possible to please every patient, in general we felt that patients were happier with the staff, systems and services. This has been supported elsewhere too by a reduction in complaints received to the practice both written and verbal. I have attached our responses to some of the points made. It would seem that there are still patients who are unfamiliar with the services and systems available as they are requesting us to do things which have been in place some time e.g. extended hours, on-line booking of appointments etc but, fortunately, they are in the minority.We would ask for the support of the Patient Reference Group in identifying areas of achievable improvement to work towards in 2014. I would suggest you think about repeating this questionnaire in Autumn 2014 – preferably during the flu clinic – when we see close on 2000 patients in order to achieve greater representation of opinion. Although the response rate has improved on previous years, it is still only about 1% of the list. The positive side to this is that we could take that to mean that 99% of our patients feel they have no comment to make as they are satisfied – but that could just be my ‘glass half-full’ side coming out!We have two new members of staff joining us. Sarah Perry is a new receptionist owing to the resignation of a receptionist who is going to be working from home in future. We also have a new Urgent Care Nurse joining us, Lynne Keen. She is a very experienced nurse and will be offering Urgent Care appointments each day alongside our other Urgent Care Nurse, Lucy Blevings.Care.data has been in the news but I understand some sense has prevailed and this is now being deferred until later this year. We have been very proactive in the practice in having provided opt-out forms since October 2013. We have also kept patients informed with updates via the website.As you may know, I shall be leaving Regal Chambers at the end of March to manage a practice closer to home (I have already met their Patient Forum Chairman!). Due to some potential changes locally involving collaborative working between practices, it is not exactly clear what the plans are for my immediate replacement. I’m happy that the practices will be able to continue to function in the short-term without a Business Manager as there is a strong band of Team Leaders to work alongside the Senior Partners to form the Management Team. The practice is committed in its continued support for the Patient Reference Group and will send representation to any meetings they are invited to.Finally, a big, big ‘thank you’ to Ginny for another brilliant job on the PRG Newsletter. Once again it was full of useful and interesting information and looked fantastic.Yvonne Pope21.2.14Patient Questionnaire No. 3 – January/February 2014 A total of 8950 patients were sent text reminders that this questionnaire was available on-line or in the surgery168 Responded in the practice29 Responded on lineThings you likeThings you would changeStaffStaffPleasant, polite, friendly, helpful, courteous, cheerful/efficient128Two people at reception at all times4Everything ok1To be treated as staff would like to be treated 1Smiling faces1Reception to be open as well as check-in1Reception are great2Need more staff3Prompt1Stern/rude receptionist1Nice/considerate/lovely/patient6Reduce queue at reception1Customer care/good service2First contact is working well1Improved reception staff (finally nice ones!)2Telephone manner1DoctorsDoctorsHaving confidence in the treatment given2Inability to see your own doctor soon11Doctor always gives me time/very patient6Wait to see your own doctor8Doctors professional5Waiting times/running late/keeping to time13Nice/helpful doctors13Better communication between doctors1Efficient/good/caring/polite/considerate/great/friendly/brilliant /excellent/reliable doctors51Out of hours GP visits1Personally named GP8GP continuity1Good number of doctors and nurses5More time to speak to doctors1Quality of healthcare2Turnover of doctors1Correct diagnosis and treatment/knowledgeable2Drs to work in shifts for better patient care1Very obliging1Drs to work at night1Availability of GPs/medical assistance2To have a regular GP/see same GP/own GP5Doctors are very thorough/get to bottom of problem4Not having to comeback for same problem1Choice of GP1Doctors sometimes seem rushed 2The new doctors5More thorough questions and examinations1Utmost dedication and commitment to care2No, or lack of, continuity8Good with children1Bring back that family doctor concern1Excellent general practitioners2Attitude of named GP2Doctors you can talk to/listen to you4Get more GPs like named GP1Speed of being seen by appropriate medical person1Not kept waiting1Good follow-up1NursesNursesNursing system/nurse availability2More nurses1Great/good/excellent/professional nurses9More minor illness appointments with nurse1Helpful/kind nurses2Fine nurses1Urgent Care Nurse system2Good with children1Excellent nurses1Caring nurses1PremisesPremisesGood facilities/ambience4Not enough privacy when talking to reception – move sign back 2 metres1Can see reception1Reading material for waiting room/more up-to-date/better magazines6Reception in a convenient position1Parking8Closeness to where we live/location21Difficult to access lift – no automatic doors2Cleanliness/modern/warm/tidy40Warfarin clinic on ground floor1Good wheelchair access1Rooms too warm1Welcoming/friendly environment – light and bright11Waiting room on first floor is claustrophobic1Toys for children3Waiting room with kids and toys/no children in waiting room2Easy access/spacious/comfortable6External lighting poor after dark1Rooms easy to find1Comfy seats when waiting/sofa5Quiet1More toys/children’s play area7Easy to get good parking2More children’s books2Upstairs area1Become more like a medical centre with own x-ray and ultrasound machinery1Waiting area1Cold water dispenser on 1st floor in summer1The surgery is big2To have a clock1Some relaxing music upstairs to drown out noise of road1Walls are a bit bare – feels sterile1Depressing floor and wall colours1More modern/decorate1Water dispenser1Clearer signposting1More patient toilets1Lack of seating for midwife area1Toilets1Upstairs waiting area1Better seating arrangements1AppointmentsAppointmentsEase of getting/booking an appointment/availability27Appointments by phone impossible1Fast waiting times1More last minute appointments1Ease of getting/flexibility of same day/Sit & Wait appointments40Appointments early morning/after 6.00pm and at weekends19Text messages re appointments2Availability of appointment for same week/routine18Option to have telephone appointment/callback6Length of time to wait for an appointment12Always seen on time2Appointment system2Variety of appointment/clinician options3Better availability/options4Quick appointments2More book on the day appointments1Young children seem to get priority1Making an urgent appointment1Good opening hours1Telephone appointments spread more throughout day1Diabetic management service1Less waiting for same day appointments1Can book on-line/ease of system15Appointment availability in the morning1Ease of getting a home visit1Be able to book Sit & Wait the day before1Shorter turnaround for appointments2On-line appointment booking1Sit & wait can take a long time3Appointment system not patient friendly1To see children more quickly in sit and wait1Only open ‘on-line’ appointments 1 week in advance1Be able to book Sit & Wait on-line1Access to on-line appointments Monday morning1Next day on-line appointments1Make it possible to make face-to-face appointments1Sit and wait does not provide continuity1Be able to book nurse appointments on-line1Impossible to get early morning or late evening appointments1Stagger appointments instead of everyone given the same time1Own doctors to cover out-of-hours1Duty Doctor service at weekends1Long queue for Warfarin clinic1Quicker emergency clinic – more doctors1TelephonesTelephonesQuick to contact via phone1Less waiting time/getting through on phone27Helpful recorded messages/know where you are in queue2Being able to phone for an appointment easier1Telephone system and being able to queue1Telephone/queuing system5Telephone system much better/impressive5Long preamble when phoning practice/telephone message3Ansaphone open after 8.00am2Telephone system confusing to elderly1Look into telephone upgrade2Phones being open lunchtime3Difficulty when phoning1Telephone booking system1Would prefer not to have to wait in a queue to speak to receptionist1To be able to speak to nurses on the phone1Improve awful telephone booking system1SystemsSystemsGeneral organisation and management4Unable to contact surgery during lunch hour1Midwives should allow you to book latest appointment when earlier ones are not booked up1Use of self check-in6More GPs or nurses available to fit coils1Very good/wide range service2Being able to book closer appointments on-line1On-line system not as easy as phoning1Speed of repeat prescriptions2More interesting health info on TVs1Efficiency of Saturday flu clinics2A way for Sit & Wait to check in on screen2Check in without having to queue/touch screen facility3Updates on if doctors/nurses are running late2Ordering prescriptions on line1Would like to be able to email GP with small queries2Good to have all the information2Order prescriptions by phone3Web access1Repeat prescriptions take a long time3Good communication1Self-log-in machines working1Electronic reminders/texts5TV screens too small1Good patient support – regular check-ups1General administration1Helpful/informative information screens1Get rid of booking in machines – they never work1Blood testing available1Text reminders/seasonal public health updates1The ability to speak to trained staff who know what they’re talking about1Twitter account1Nurse appointments on line1Internet option did not work1Vague/generic text messages re results2Quicker referrals1What is the point of the results line? You need to see a GP anyway1Dietary advice for weight loss1On-line options to make appointments2Reliability of automatic booking service1Longer opening hours1Unable to order prescription if due for a review1Test results line available for longer period1Repeat prescription arrangements unclear/slow2Only contact patients when all results are in. Texts are confusing as you don’t know which ones they apply to1GeneralGeneralAlways made to feel at ease1Specifically stated ‘Nothing ‘33Access to Food Bank1Might be nice to have a cup of tea1Great selection of services1Internet access in waiting room1Good team who are capable and pleasant to deal with1Always room for improvement1Clear and prompt service1To see more patients talking to each other1Very pleased with practice1Getting an appointment and seeing a doctor has greatly improved1Advertise ‘Sit & wait’ more1Refurbishment has made a big difference1Charge for visits1Overall service1Crowded at times1Feel that you will do your best to give the help needed1I feel like a number of the staff now know me and that is great – it would be good if more patients felt like me1The personal and dedicated attention to the patient that make patients feel they are important and well cared for1Check wording and grammar for on-line questionnaireEvery time I have come out feeling looked after well and the amount of personal attention is great1Has a ‘did not attend’ on record as did not know how duty doctor system worked1Friendly service1When unable to provide treatment make a referral rather than some suggestions of places that might help1Opening hours2Whole operation not customer friendly and outdated. Not set up for those who work1To be assured to be put in the right hands with health problemsWhen x-rays are taken, make them available rather than patient having to pay for them again1Thank you3Free wi-Fi1When I was having chemotherapy the reception staff offered me a separate room to wait in1Efficient service1Patient Questionnaire No. 3 – January/February 2014 A total of 8950 patients were sent text reminders that this questionnaire was available on-line or in the surgery168 Responded in the practice29 Responded on lineThings you would changeRegal Chambers Surgery responseStaffTwo people at reception at all timesThere are never fewer than 2 people at any time. One may be out of view temporarily, but there are always at least 2 with our secretaries offering additional support at peak times each day.To be treated as staff would like to be treated This will be addressed during in-house trainingReception to be open as well as check-inReception and check-in are always open at the same timeNeed more staffDue to the current constraints in primary care this is not possible at the present time.Stern/rude receptionistThis patient did not identify the receptionist concernedReduce queue at receptionWe have re-organised staff timetables in order to provide the most staff at the busiest times.DoctorsInability to see your own doctor soonThe majority of patients canvassed wanted same day access which, obviously, affects the ability for us to provide routine, pre-bookable appointments.Wait to see your own doctorWaiting times/running late/keeping to timeEach patient is given the time their medical condition requires.Better communication between doctorsOut of hours GP visitsPatients are encouraged to contact the Business Manager with any concerns about Out of Hours GPs who have visited themGP continuityMore time to speak to doctorsWe have bookable telephone appointment slotsTurnover of doctorsWe are a training practice which means that more junior GPs will only stay for between 3 months – 1 yearDrs to work in shifts for better patient careDrs to work at nightTo have a regular GP/see same GP/own GPPatients are encouraged to make appointments with the same GP for the same problem.Not having to comeback for same problemThis is sometimes necessary in order to allow a problem to settle.Doctors sometimes seem rushed More thorough questions and examinationsNo, or lack of, continuityEach patient is able to book with the GP of their choice so, if they prefer to see the same doctor, it’s possible for this to happen. We rely on patients to tell us who they would prefer to see.Bring back that family doctor concernAttitude of named GPThis will be fed back to relevant GPGet more GPs like named GPThis will be fed back to relevant GPNursesMore nursesDue to the current constraints in primary care this is not possible at the present time.PremisesNot enough privacy when talking to reception – move sign back 2 metresUnfortunately, patients ignore this signReading material for waiting room/more up-to-date/better magazinesWe are happy to receive donations of magazinesParkingWe are unable to change thisDifficult to access lift – no automatic doorsThis is in the process of being changedWarfarin clinic on ground floorGood idea – we will review room availabilityRooms too warmWaiting room on first floor is claustrophobicWaiting room with kids and toys/no children in waiting roomExternal lighting poor after darkLights are on a timer – we can review thisComfy seats when waiting/sofaDue to infection control, we are unable to have fabric seatsMore toys/children’s play areaWe are happy to review thisMore children’s booksWe are happy to accept donations of books – most of ours are taken.Become more like a medical centre with own x-ray and ultrasound machineryThere are very specific building requirements to house such services and these premises would not conform to the regulationsCold water dispenser on 1st floor in summerHowever tempting, this could be a Health and Safety risk with water spillageTo have a clockWe are happy to consider thisSome relaxing music upstairs to drown out noise of roadWe are constrained by licensing laws regarding the playing of music in public. Walls are a bit bare – feels sterileDepressing floor and wall coloursMore modern/decorateClearer signpostingThis person did not specify so difficult to know what exactlyMore patient toiletsLack of seating for midwife areaToiletsWe don’t know what in particular about the toilets?AppointmentsAppointments by phone impossibleMore last minute appointmentsAppointments early morning/after 6.00pm and at weekendsWe offer extended hours appointments which start at 7.00am and also ones which finish at 8.00pmAvailability of appointment for same week/routineIn order to provide 2 Duty Doctors each day, it means that fewer routine appointments are available. We can’t provide both unfortunately.Length of time to wait for an appointmentAppointment systemBetter availability/optionsThis seems to contradict the majority opinion that we offer a good variety of availability and options.More book on the day appointmentsMaking an urgent appointmentPatients can be seen the same day in Sit & Wait surgeriesTelephone appointments spread more throughout dayThere are 4 telephone appointments available each hourLess waiting for same day appointmentsThere is no wait for same day appointmentsAppointment availability in the morningBe able to book Sit & Wait the day beforeYou can book Sit and Wait for the next dayShorter turnaround for appointmentsOn-line appointment bookingWe have on-line appointment bookingSit & wait can take a long timeUnfortunately, we cannot predict what is wrong with each patient and so there may be delays if a patient is particularly unwell.Appointment system not patient friendlyTo see children more quickly in sit and waitChildren are identified as ‘Baby’, ‘Toddler’ and ‘Child’ so that the Duty Doctor can see and prioritise according to urgency of the problemOnly open ‘on-line’ appointments 1 week in advanceOur appointments are available up to 2 months in advance.Be able to book Sit & Wait on-lineAccess to on-line appointments Monday morningAll appointments are available. It will be that they have all been taken if there are none available to see.Next day on-line appointmentsMake it possible to make face-to-face appointmentsSit and wait does not provide continuityTrue, but it’s the responsibility of the patient to see the same GP each time.Be able to book nurse appointments on-lineOur nurses have different areas of expertise and booking appointments on line would run the risk of a patient booking to see a nurse who would be unable to give them the treatment they wanted.Impossible to get early morning or late evening appointmentsThese are very popularStagger appointments instead of everyone given the same timePatients are brought down to Sit & Wait in groups at 30 minute intervals.Own doctors to cover out-of-hoursThis option was removed in a previous GP ContractTelephonesLess waiting time/getting through on phoneBeing able to phone for an appointment easierTelephone/queuing systemLong preamble when phoning practice/telephone messageThis is necessary to avoid patients speaking to the wrong person.Ansaphone open after 8.00amTelephone system confusing to elderlyLook into telephone upgradeThis was last done 18 months ago.Phones being open lunchtimeIn order to provide more staff throughout the day, we have a reduced staff at lunchtime.Difficulty when phoningTelephone booking systemWe no longer have a telephone booking systemWould prefer not to have to wait in a queue to speak to receptionistTo be able to speak to nurses on the phoneNurses do have telephone appointments availableImprove awful telephone booking systemWe no longer have a telephone booking systemSystemsUnable to contact surgery during lunch hourThe practice is open from 8.00am – 6.30pm but, in order to provide more staff throughout the day, we have a reduced staff at lunchtime.Midwives should allow you to book latest appointment when earlier ones are not booked upThe current system is one which has been requested by the midwives.More GPs or nurses available to fit coilsWe have 2 GPs who are able to do this.Being able to book closer appointments on-lineOn-line system not as easy as phoningMore interesting health info on TVsA way for Sit & Wait to check in on screenUpdates on if doctors/nurses are running lateWould like to be able to email GP with small queriesThe practice has a generic email address E82075.regalchamberssurgery@ but GPs do not use this routinely.Order prescriptions by phoneFor reasons of patient safety this is not possible.Repeat prescriptions take a long timeWe have a member of staff dedicated to processing the repeat prescriptions each day. Our turnaround time is 72 hours. Self-log-in machines workingTV screens too smallGeneral administrationGet rid of booking in machines – they never workText reminders/seasonal public health updatesThis is done alreadyTwitter accountInternet option did not workVague/generic text messages re resultsOur clinical provider is working on a solution to this. Currently, our results come in in batches and we accept that this can be confusing for patients.Quicker referralsWhat is the point of the results line? You need to see a GP anywayA GP will always phone a patient if they are concerned. The results line is for patients to use.Dietary advice for weight lossOn-line options to make appointmentsReliability of automatic booking serviceLonger opening hoursWe are open from 8.00am – 6.30pm with extended hours from 7.00am – 8.00pm and Saturdays throughout each monthUnable to order prescription if due for a reviewThis is for patient safetyTest results line available for longer periodRepeat prescription arrangements unclearOnly contact patients when all results are in. Texts are confusing as you don’t know which ones they apply toOur clinical provider is working on a solution to this. Currently, our results come in in batches and we accept that this can be confusing for patients.GeneralSpecifically stated ‘Nothing ‘Might be nice to have a cup of teaInternet access in waiting roomAlways room for improvementIndeed – which is why we like to conduct these questionnaires.To see more patients talking to each otherAdvertise ‘Sit & wait’ moreCharge for visitsCrowded at timesI feel like a number of the staff now know me and that is great – it would be good if more patients felt like meCheck wording and grammar for on-line questionnaireThis has been addressedHas a ‘did not attend’ on record as did not know how duty doctor system workedWhen unable to provide treatment make a referral rather than some suggestions of places that might helpWhole operation not customer friendly and outdated. Not set up for those who workWhen x-rays are taken, make them available rather than patient having to pay for them again ................
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