University of Sussex Health Service

Patient participation report

This report summarises development and outcomes of the University of Sussex Health Service patient reference group (PRG) in 2012/13 and the results of the 2012 patient survey.

It contains:

1. Profile of practice population and PRG

1. Process used to recruit to our PRG

1. Review of Action Plan from the previous year.

1. Priorities for the 2012 survey and how they were agreed

1. Method and results of patient survey

1. Resulting action plan and how it was agreed

1. Progress made with the action plan

1. Confirmation of our opening times.

1 Profile of practice population and PRG

Practice population summary

This practice is located on the University campus and the services we provide are designed primarily to meet the needs of our students. 

Practice Population on 13th November 2012 = 15,007 patients.

Gender of patients

No. of male = 6816            = 46½%

No. of female = 7834        = 53½%

Proportion of patients

who are students

No of students = 11,055 = 78.68%

No. of non-students = 2996 = 21.32%

Age range of patients

<15 years= 248 = 1.69%

15-25 years 9116 = 62.23%

25-35 years = 4035 = 27.54%

35-45 years = 880 = 6.01%

>45 years = 371 = 2.53%

Ethnicity

Black = 3.6%

Asian = 16.5%

Mixed background = 3.1%

Other = 3.8%

Choose not to disclose = 25.5%

In the past, it had not been possible to analyse some demographics such as sexual orientation or religious belief as the practice has not collected this information in the past.  However, since January 2012, we have started to ask these questions of all new patients as they register and the number of patients for whom we have this information is starting to increase.  However, it is not available for all patients currently registered. As patient turnover is high (around 24%), this information should be significantly more robust in the next few years.

PRG profile

It is important that our Patient Representative Group has similar demographics to our patient population so that it can represent their views.   Here is the demographic outline of our PRG

Age

Ethnicity

Students

Religion/faith

Sexual Orientation

We are confident that the demographics of our PRG matches quite closely to the characteristics that we measure in our patient population such as gender, student status and age.  It is harder to be confident that the PRG matches our patient population in terms of ethnicity as so many patients when registering, have chosen not to disclose this information (which is of course, their right and entirely acceptable.)

2 Process used to recruit to our PRG

In 2011, we recruited over 100 people who agreed to join the PRG.  In October 2012, we e-mailed all participants and asked them if they would be prepared to continue to help us for another year.  6 patients kindly agreed.  It was decided that for a virtual group, we really needed more than 6 patients and so we started another round of recruitment, similar to the previous year. 

We offered leaflets to every patient attending the practice on a single morning.  The leaflets invited patients to fill in their contact details and explained that they would be contacted by e-mail for their views on the services provided by the practice.  The leaflet also asked some questions about the profile of the person completing it, so that we could ensure that the demographics of the PRG matched quite closely to the demographics of the patient population of the practice. The leaflets were handed out by staff who answered questions

After one morning of handing out the leaflets, we reviewed the demographics of the people who had agreed to help us out.  From this review, it was clear that we had the right proportion of patients from the various age groups and the right proportion of students and non-students. 

However, the majority of the patients who had offered to join the group were female whereas we know that the proportion of male and female patients registered with us is ~45% male and 55% female. 

To ensure that male patients were appropriately represented, we carried out a second “recruitment drive”, inviting every male patient who attended on a specific day until the proportion of male to female had risen.

3 Review of Action Plan from the previous year.

In March 2012, the practice created an action plan based upon the results of the 2011 survey.  In this action plan, several areas were identified for attention.  Below is a summary of the progress that the practice has made with some of these areas, written in February 2013.

•  Explaining tests and treatments

The Practice has spent considerable time discussing how we might improve in this area with each clinician thinking about their communication skills.  The results of the survey show that according to the survey respondents, we have not improved, remaining <78% saying that we were “good” or “very good”.  It had been suggested that part of the issue may relate to the high numbers of our patients for whom English is not their first language and with this in mind, we are considering providing more information in written format, and translated into different languages.

• Waiting times

We have increased the number of clinician hours this year and we are pleased to note that the number of survey respondents who stated that they felt that they had to wait “a bit too long” or “far too long” for their appointment has reduced from 40% to 27%.

• Conversations being overheard at the reception desk

Last year, only 65% of patients were satisfied with this whereas, this year, 85% of respondents were satisfied.  Other practices use such strategies as asking patients to stand back from the desk while queuing or put up glass screens around their reception desk.  We have started the process of making an application for funding to support the redesign of our reception area and we will continue to pursue this.  In the meantime, we have had some negative feedback about the choice of broadcasting Radio 2 which we will follow up.

• Providing information about our services

This has not progressed this year – however, we are fully committed to a complete redesign of our Website in the coming 12 months which will hopefully address this.

• Availability of our practice leaflet

This will be addressed as part of the redesign of the website.

• Parking – request of additional bays

We contacted the University and we asked whether it would be possible to have an additional 1 or 2 patient’s bays.  This request was not only turned down but we were warned that the University was considered taking away the 3 bays we have.  We are glad that this has not happened but we have no influence over how the University manages its parking facilities. 

• Test results

We will review our process for providing results of tests to see if it can be improved.  Hopefully, this will be addressed with our review of written information available to patients.

4 Priorities for 2012 survey and how they were agreed

When recruiting patients to our PRG, as well as contact and demographic details, they were asked to indicate areas that we should focus on for review and improvement.  They were given a list of options to choose from and were encouraged to choose as many as they felt appropriate from that list.  The options given were:

Getting an appointment

Clinical care

Telephone answering and access

Waiting room facilities

Customer service

Time keeping

Patient information

Opening times

Parking

The results of their choices were collated and then reported back to the PRG. The most popular 4 areas were:

Getting an appointment

Time keeping

Waiting room facilities,

Opening times

These were reported back to the PRG via an e-mail sent on 16th November 2012 and were agreed via a survey monkey.  PRG members were sent a summary and invited to complete a simple 2-question survey monkey questionnaire to indicate their support or otherwise. 14 members of the group responded (just under 50%) and the agreement was unanimous. 

4 Method and results of patient survey

Once we had established the priorities, a patient questionnaire was required.  This practice recognised how very difficult it is to write questions for a survey that are unbiased and provide appropriate responses. 

With this in mind, this practice opted to use a selection of the questions from last year’s survey.  These questions were an organisation called PPC who were approved by the CCG.

Paper copies of the questionnaire were available in each consulting room and treatment room and also handed out to patients in the waiting room.

See appendix 1 for the survey.

We carried out the survey during December 2012 and 203 responses were received.

Survey results

A full report on the results of the survey is attached. 

Ssx Uni Patient Survey Results 2012.pdf

5 Resulting action plan and how it was agreed

To develop the action plan, the practice e-mailed the PRG outlining the areas highlighted by the survey to be address in the action plan.  A survey monkey was used to collected comments from the PRG.  The suggestions for some of the action plan put forward by the Practice were approved unanimously – these were the review of seating in the waiting room and the redesign of the website. There was a majority approval for the other suggestions, namely the provision of more written information, translated into different languages and the further investigation of alternatives to Radio 2 being broadcast in the waiting.  We were questioned as to why we had not addressed the confidentiality issues at the desk, negating the need for music at all.  This was a very reasonable question, to which the answer is that we are pursuing options to redesign the reception area but this will take time and the continued broadcast of music is a temporary solution only.

To get comments from the PRG on the draft action plan we e-mailed the group on 21st March 2012 and another survey was used to allow members to indicate their support or otherwise for the Plan. 

We agreed the action plan with the group on 26th March 2012 with 100% approval from the PRG.

For the Action Plan, see appendix 2

6 Confirmation of our opening times

You can call the surgery on 01273 249049.

The Practice is open:

Monday – Thursday, 8.30am – 6.30pm and Friday 8.30am – 5.00pm in University Term Time and

Monday – Friday, 9.00am – 5.00pm in University vacation time. 

Outside of these times please call “out of hours” advice on NHS 111.(for when its less urgent than 999.)

Appendix 1                     UNIVERSITY OF SUSSEX HEALTH CENTRE

Patient Feedback Survey

Welcome to this survey

This survey is completely confidential and anonymous. Your answers cannot be attributed to you personally in any way.

A very small number of questions are noted as compulsory. This lets you know the most important sections of survey. All others are voluntary but the more answers you give us the better we can respond to the feedback.

The survey should take you 10 to 15 minutes to complete depending on how much contact you have had with the practice over the past 12 months.

You and the practice

How often do you visit the practice?

Seeing a doctor or nurse

When did you last see a doctor or nurse at the practice? (Compulsory Question)

Do you normally see a doctor or nurse… (Compulsory Question)

Seeing a doctor or nurse quickly

In the past 12 months have you tried to see a doctor or nurse quickly? That is, on the same day or in the next two weekdays that the practice was open. (Compulsory Question)

Think about the last time you tried to see a doctor or nurse quickly. Were you able to see a doctor or nurse on the same day or in the next two weekdays that the practice was open? Answer this question if answer to previous question was ‘Yes’.

If you were unable to be seen during the next two weekdays that the practice was open, why was that? Please tick all that apply. Answer this question if answer to previous question was ‘No’.

In the past 6 months, have you tried to book ahead for an appointment with a doctor or nurse? That is, an appointment more than two weekdays in advance.

Last time you tried, were you able to get an appointment with a doctor or nurse more than two weekdays in advance?

Attending an appointment

How long after your appointment time do you normally wait to be seen?

How do you feel about how long you normally have to wait?

When you last visited the practice, how much time did you spend with the doctor or nurse?

In your opinion was this the right amount of time?

Could a phone call from the doctor or nurse have saved you having to visit the practice?

The practice opening hours

How satisfied are you with the opening hours at the practice?

As far as you know, is the practice open… Please select one option for each row

Would you like the practice to open at other times?

Clinical care

The last time you saw a doctor or nurse at the practice, how good were they at each of the following? Please choose one option for each row

Did you have confidence and trust in the doctor or nurse you saw?

Did you feel you were treated with respect and dignity while you were in the practice?

In your opinion how much does your doctor or nurse know about your medical history?

General comments about the practice

In general, how satisfied are you with the care you get at the practice?

Would you recommend the practice to someone who has just moved to your local area?

Does your doctor or nurse give you enough information about any diagnosis or treatments?

How satisfied are you with the skill and competency of the staff?

Reception facilities at the practice

How helpful do you find the receptionists at the practice? (Compulsory Question)

In the last 12 months have the receptionists ever made it difficult for you to see or talk to a GP and/or nurse? Answer this question if answer to previous question was any of ‘Very helpful; Fairly helpful; Average; Not very helpful; Not at all helpful’.

How easy do you find getting into the building at the practice?

In the reception area, can other patients overhear what you say to the receptionist? Answer this question if answer to previous question was any of ‘Very easy; Fairly easy; Not very easy; Not at all easy’

Do you like our automatic check-in service? This service is a computer screen that lets you register your arrival at the practice.

About the practice building itself

How clean is the practice building?

Are any of the following available in your practice building?

How satisfied are you with the condition of the waiting rooms?

How satisfied are you with the condition of the treatment rooms?

Do you have any suggestions for improving the waiting rooms?

Practice staff

In the past year has the way we treat patients:

Were the practice staff efficient and responsive to your needs?

Were the practice staff pleasant?

About you

Remember this survey is anonymous and confidential. The following questions are about you. Providing this information will help us analyse the responses as a whole and give us an overview of our patients’ feedback.

Gender

Which of the following best describes how you think of yourself?

Are you a parent or a legal guardian of any children aged 16 years of younger living in your home?

Do you have carer responsibilities for anyone in your household with a long-standing health problem or disability?

How old are you?

Which of the following best describes your religion?

Which is your ethnic group?

Which of these best describes your employment status? If more than one of these applies to you, please tick the main one. (Compulsory Question)

Thank you for your feedback

Appendix 2 – Action Plan for 2013

University of Sussex Health Service

Patient Participation Group DES

Following the completion of a recent patient survey, several areas have been highlighted that patients would like to see improved.  The practice has agreed to review the following areas to address some of the issues raised.

ACTION PLAN - 2013

Review of Seating in the Waiting Room

Although 84% of respondents said they were either satisfied or very satisfied with the facilities in the Waiting room, the majority of suggestions for improvement related to the seating in some way.

We recognise that with increasing student numbers at the University, the waiting room can become overcrowded and we will review the existing seating with a view to making improvements both in terms of capacity and comfort. 

Who will be responsible?

Practice Managers in discussion with GPs

Timescale:

Review of current systems – 3-6 months

Implementation of identified changes – 6-12 months

Providing information about our services – updating website

We are aware that we do not make use of our website as fully as we might to provide general information our services and also updates and newsletters about current issues.  Part of this is due to our website being difficult to access and not being very “user friendly” to update.  

We will undertake a review of all the information currently being provided to patients and consider how other practices use their web sites to share information with their patients. We will then redesign and commission an updated website that is easier to navigate and easier to maintain.. 

Who will be responsible?

Practice Managers

Timescale:

Research -within the next 3-6 months

Implementation - 6-12 months

Explaining tests and treatments

Although the feedback from respondents regarding clinical care is generally good, 78% of respondents said that we were “good” or “very good” at explaining tests and treatment – this is in comparison with other areas of clinical care where the scores re 85+%. 

We would like this to be higher. We will consider providing more written guidance on common tests and treatments and for them to be translated into other languages, commonly spoken on campus. 

Who will be responsible?

Practice Managers in liaison with clinical management team including GPs and nurses.

Timescale:

Review of current guidelines – 3-6 months

Implementation of identified changes – 6-12 months

Review of the music being broadcasted in the waiting room

We currently broadcast Radio 2 into the waiting room.  The purpose of this is to provide background noise that makes it more difficult for patients in the waiting room to overhear what is being said at the Reception desk.  This is common strategy used in many practices were the design of the Reception area is such that it is located close to where patients sit when they are waiting to be seen.  We received a number of comments in the survey suggesting that Radio 2 was not a favoured choice of radio station.  We will consider undertaking another survey to test patients’ view.  We have started the application process to apply for funding to redesign our Reception area and it is hoped that the need for music in the waiting room will be a temporary measure.

Who will be responsible? 

Practice Manager

Timescale:

6-9 months

Lindsay Coleman, Practice Manager

21st March 2013