Action Plans

Action Plan 2016/17

Increase Nurse Practitioner from 3 days to Whole Time Equivalent to further relieve the demand on GP appointments.

Develop a scripted flow chart to enable staff to better direct patients to the appropriate source of support within the constraints of available capacity.

External consultants to carry out a review of the Patient Access System and marry the PPG Survey results with an analysis of activity, backlog, capacity, and demand to ascertain how the current system can be optimised to better meet patient demand and why telephone access still isn’t working as effectively as it could.

Carry out a review of car parking arrangements.

Fit whiteboard in waiting area to communicate Nurse and GP locations.

Action Plan 2015/16

The Practice Manager has drawn up an Action Plan in consultation with the Practice Management Team and the Patient Participation Group. The Patient Participation Group will assist in monitoring and providing further feedback.

To review the types of appointments offered and make a monthly report available to the PPG showing the 1st and 3rd available appointment for GP’s.
 
The Practice is about to appoint a nurse practitioner to offer a triage service within the practice.
 
Staff will undertake training re nurse triage and directing patients to the best source of care.  A member of the PPG will also be invited to attend the training session.

The surgery is advertising for an additional salaried GP for 5 sessions a week to improve access.

By monitoring the appointments the aim is to predict trends and monitor availability on a long term basis.

By appointing a nurse practitioner and a new salaried GP the aim is to increase capacity and direct patients to the most appropriate source of care for their problem.

By continuing to work with the PPG the surgery aims to make more of their appointments pre-bookable to make it easier for patients to contact the surgery with urgent on the day problems.

Action Plan 2014/15

QUICK FIXES

  1. If the text on the self-check-in system can’t be altered to indicate “upstairs” then try changing the doctors / nurses names to “Dr Fleet upstairs” and “Nurse Jones upstairs”. If this is not possible obtain a firm date from the supplier EMIS for when this upgrade will be available.
  2. Ensure that the “diary” is able to take 6 week ahead bookings for all doctors and introduce a “flowchart” and training for all staff. As the Primary Care Foundation report indicated starting a conversation with “I don’t have anything left for today” and advising patients to phone back next day need to be avoided wherever possible.
  3. Unless a locum deals with all the medicals, as Dr Williams did after he had retired, then the current arrangement has a negative effect on continuity of care.
  4. Ensure that the volume of the TV screen downstairs is left set at a sufficient volume each day.
PROPOSED ACTION PLAN

The Practice has produced an action plan which includes reviewing the types of appointments offered and making a monthly report available to the PPG showing the 1st and 3rd available appointment for GP’s.

The Practice is about to appoint a nurse practitioner to offer a triage service within the practice.

Staff will undertake training re nurse triage and directing patients to the best source of care. A member of the PPG will also be invited to attend the training session.

The surgery is advertising for an additional salaried GP for 5 sessions a week to improve access.

By monitoring the appointments the aim is to predict trends and monitor availability on a long term basis.

By appointing a nurse practitioner and a new salaried GP the aim is to increase capacity and direct patients to the most appropriate source of care for their problem.

By continuing to work with the PPG the surgery aims to make more of their appointments pre-bookable to make it easier for patients to contact the surgery with urgent on the day problems.

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Action Plan 2013/14

You said… We did… The result is…
Waiting time in surgery for doctors has continued to improve and comparison with the England average confirms this. Waiting times varied from day to day, dependent upon whether there were students in the practice and/or locums We added 10 min catch up slots mid morning and mid afternoon on all the doctors schedules.  We monitored waiting times throughout the year and continue to do so. Improvement in waiting times in surgery . It was identified that Thursday was the worse day for waits and this requires further investigation, however, on the whole patients were satisfied.
Phone System there was difficulty making appointments early morning. It could take several attempts to get through to the practice We removed the greeting from the phone system between 8 a.m and 9 a.m. so that calls could be processed quicker.

We have at least 6 members of staff on the phone each morning at 8 a.m.

The phone system has improved to a point that it is working more effectively and any more changes at this time may begin to have a detrimental effect on the patient experience when patients are still struggling with the actual availability of appointmentsConsideration will be given to devising a “flow chart” to assist staff in signposting patients to a suitable available appointment and to avoid unnecessary DNAs (did not attends) for pre bookable appointments, at one extreme, and being directed to phone back on the day at the other extreme.
Appointments it is still a struggle to get an appointment on some days and the awareness of patients in relation to the book ahead process seems not to be as effective as the group would have expected. The practice employed another salaried doctor (Dr Alison Hughes) who works 7 sessions per week

The practice have collaborated with the Primary Care Foundation.  A week was selected in 2013 during which all phone calls for appointments were audited. The Primary Care Foundation produced a report which was made available to the PPG. There have been several discussions with regard to allocation of appointments and availability of pre-bookable appointments.  The report indicated that having appointments available to book 6 weeks in advance was helpful. The practice have changed pre-bookable appointments from 4 weeks to 6 weeks in advance.

The practice constantly monitor appointments and liaise on a regular basis with the PPG to better understand our appointment information/data.

The survey indicated a statistically significant increase in satisfaction in arranging an appointment from 67% to 81%.  However, comparison with the Ipsos MORI figures, both for England and the PCT, indicate more people having to ring back on the next day than normal, significantly more people than normal not being able to book ahead, and up to twice the average using A&E or a Walk in Centre because they couldn’t get an appointment.

We will continue to analyse information with the PPG looking at: availability of book ahead appointments; relative proportions of different types of appointment / activities# and the relative advantages / disadvantages from a patient experience perspective.

The practice are also shortly to introduce on-line booking of appointments.

# Medicals, special clinics etc.

Patient Call patients were missing call to appointment in reception as they could not hear the alarm on the TV screens or missed the call due to the length of time the message ran Increased the volume of the alarm. Added a “Next Patient” alarm message after the initial “ding dong”  Doubled the length of time the message is shown on screen. Decreased the font size so that all the information about the patient, doctor and room location is now visible on the screen. Recent liaison with patients since the survey indicate greater satisfaction with the patient call system now that these changes have been introduced.

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PATIENT PARTICIPATION GROUP REPORT 2011-12 This report summarises development and outcomes of Eastham Group Practice’s  Patient Participation Group Survey and agreed Action Plan in 2011/12.

Practice Population Summary The Practice Population at 1st March 2012 is 11625.  The average age of patients is 42 with a slighter higher ratio of female patients to males. The age breakdown of the practice population is:

Age Range (years) Number of Patients
0-5 730
6-15 1323
16-21 775
22-45 3400
46-64 2954
Over 65s 2443

PPG profile Membership of the PPG is open to all patients of the Practice aged 16 and above. There is a maximum of 12 members at any time including the four Officers, Chairman, Vice-Chairman, Secretary and Treasurer.   Membership of the Group aims to mirror as far as possible the practice population. Efforts have been made to attract patients from all minorities and ages but this does prove difficult, however, the PPG will continue to review their membership periodically.   The website currently has a campaign to attract members of the younger population and the PPG Secretary has recently contacted local schools in an effort to attract some sixth form representation.

The group meet monthly on the first Wednesday of each month and the meetings commence at 6.00 p.m. in the Practice’s training room and finish at approximately 7.30 p.m.   Dates for the year are set at the beginning of the year. The Senior Partner, Dr K Bush, and Practice Manager, Diane Moon are invited to attend each meeting, which they do.

The PPG hold an annual AGM

The group have recently elected a new Chair, Alec Wood, and Alec has recently attended the Wirral Health Commissioning Consortium’s Away Day and represents EGP at the Consortium’s monthly Forum meetings.

The PPG’s Mission Statement is: Co-operation between the Practice Patient Population and the Practice to bring about tangible improvements for the benefit of all.

2. Process used to recruit to our PPG EGP’s patient group has been in existence for some years now and have regularly surveyed the patient population to gather views and address any patient issues.

The PPG have their own notice board in the surgery inviting patients to get involved and displays items of information. The main contact is via a generic patient email address egp.patientsforum@yahoo.co.uk.

From time to time there is a campaign to capture the email addresses of patients and with their consent the PPG email information and news on a regular basis. The PPG currently hold approximately 160 email addresses. This email is administered by the PPG Secretary, Tracey Fisher.

The Practice website has a designated Patient area where patients can register their interest in the patient group and also email direct any comments that a patient may wish to register.  The website also includes copies of:

  • PPG Constitution
  • Minutes of Meetings
  • Practice Newsletter
  • Patient Surveys

3. Priorities for the survey and how they were agreed The initial priority for the survey was around accessing appointments based on comments made to the group. Some of the other questions were formed following the PPG’s AGM in April 2011.

4. Method and results of patient survey A substantial in-house practice survey of patients was carried out by members of the PPG during a two week period Monday 10th October – Friday 21st. October 2011.  A total of 1029 patients (approximately 9% of practice population) completed the tick box survey. In addition 500 of these respondents also wrote comments regarding improvements they would like to see. About 200 of these covered more than one topic. 77% of respondents still rate their overall satisfaction as excellent or good.

5. Resulting action plan and how it was agreed The PPG compiled a formal report which was discussed at the Patient Group Meeting held on Wednesday 7th December 2011. This meeting was attending by members of the PPG as well as Dr Karalie Bush, Senior Partner, Gerry Devine, current Practice Manager (until 23 December 2011) and newly appointed Practice Manager Diane Moon (in post w.e.f. 1st February 2012)

The action plan also incorporates issues raised at the AGM in April 2011 The main actions were:

    • Frustration at inability to get through on the phones at 8.30 a.m.
    • Continuity of care with same GP
    • Inappropriate referrals to Walk in Centre
    • Difficulty in making appointments
    • Long wait in surgery
    • Poor communication with patients (call system)

6. Practice Mangers Report on Progress made as at 31st March 2012

You said… We did… The result is…
Difficulty getting through to surgery on telephone at 8.30 Phones now open at 8.00 a.m. and the number of staff answering the phones first thing in the morning has increased. Either no queuing or very few people queuing at the front door at 8.30 for appointments. Patients who work have commented that this change has been beneficial.
Continuity of Care with Same GP The  proportion of appointments available on the day – v – prebookable appointments was reveiwed. 55% of appointments are available on the day, pre-bookables now amount to 45%.  This is slightly different on Mondays due to the demand for on the day appointments following the weekend If a patient has to come back and see the same GP this is possible, albeit there may be a wait for a few weeks, however the knock on effect is that appointments on the day have reduced. The surgery continually looks at the apportionment of appointments to ensure best practice for patients.
Communication Problems The practice has financed an electronic call system to negate the need for GPs to call patients. Text messaging to remind patients about appointments will be implemented in April 2012. This will remind patientsabout their appointments and give them the opportunity to cancel via text if needed To be installed 8thMarch 2012 To be implemented April 2012 following a campaign to obtain consent to use mobile numbers.
Long wait in surgery Inserted a 15 minute break in all sessions to allow GPs the opportunity to catch up should there be a delay at some point Complaints in this regard have decreased and it appears that appointments are now kept at or nearer to time
Improvements in reception area Following specific comments a child’s activity table is now available in the waiting room with two small chairs. The practice is looking to enhance this children’s area further in the near future Magazines for patients to read have also been placed on a table in the waiting room. These are renewed weekly Children have been using the activity table

7. Confirmation of our opening times As a result of the survey we have not changed our opening times, however the phone lines are now open from 8 a.m. Monday – Friday. You can call the surgery 8.00 a.m. – 6.00 p.m. Monday to Friday on 0151 327 1391

The surgery reception is open from 8.30 a.m. – 6.00 p.m. Monday – Friday