Harewood Medical Practice Patient Participation Group

 

Are you a patient at our Practice? 

 

Would you like to be more involved in the Practice?

 

Could you spare a couple of hours periodically to respond to our questions?

 

If you have answered 'yes' to the above questions, we would love to hear from you and involve you in our group.

 

Please contact Grahame Dickinson on 01748 833904 to register your interest or alternatively email him at:

 

                            grahame.dickinson@gp-B82104.nhs.uk

 

Thank you.

Attached below is our Local Patient Participation Group Report for 2013.

 

 

Harewood Medical practice

 

Local Patient Participation Report  for year ended 31 March 2013.

 

Formation of the and membership of the patient participation group.

 

We established a group in 2011/12 by various means including an open evening, text messages and direct approaches to patients.  Since then we have asked patients who have contacted the surgery about issues if they would be interested in participating.  We also include an invite on our web site.

 

The result from all of these was to recruit 9 members to the group.  The profile of the group is

 

Age	Sex
82	F
71	F
61	F
58	F
56	F
28	F
83	M
69	M
66	M

 

Whilst we accept this was not properly representative of the patient profile we believe we had made efforts to achieve this.

 

Identification of the issue for consideration by the group.

 

As a subject matter we looked to pick up the issues from last time, review progress and identify any further issues.  This therefore covered DNA’s and the appointment system.

 

Consultation process

 

Having identified the group and the subject we produced an update letter / report (see appendix1).  This was sent to all the PPG members and in addition we copied this into 2 folders suitable identified and put these in the waiting room together with a response form.

 

The consultation period ran from the 12 December 2012 to the 17 January 2013.

 

We then took all the replies received (4) and summarised the comments and attached a practice response to these which we sent to the PPG members for comment (see appendix 2).

 

No further comments were received from the PRG.

 

Actions taken since producing report.

 

We have for a February 2013 sent a second SMS reminder to patients on the day of their appointment.  In that month a reduction was seen in the number of DNA’s from an adjusted monthly average (i.e. adjusting for the number of days in a month) of 131 a month to 103 for the trial month.  On this basis we will continue to send out second reminders and monitor the progress.  We are also having a drive to obtain mobile numbers for as many patients as possible.

 

We have also set up some appointments on line for GP’s and ANP’s (Advanced Nurse Practitioners) on the day consultations and are trying to set it up for smear appointments with nurses, there are currently some technical difficulties.  We will monitor the usage of the appointments.

 

 

Additional information

 

Opening hours of the practice are Monday to Friday, 8am to 6pm

 

Access to the services are through telephone calls and attending at reception.

 

Access to extended hours are on a Thursday morning form 7.30 to 8 am and Thursday night from 6.30 to 7.30.

 

 

Manager                                                                                 12 December 12

 

 

 

 

 Appendix 1

 

 

 

12 December 2012

 

Dear

 

Re patient Participation Group

 

You may recall last year being contacted by myself and being asked for comments about how to reduce our DNA rate and also about changes to our appointment system.  We would like to update you on what has happened since then and to see if there are any other suggestions you may have.  At the end of this communication there is a form detailing how you can reply.  We would appreciate it if you could respond by the 17 January 2013 please.

 

DNA’s

 

Detailed below is the number of DNA’s per month, overall opinion is that the rate may have marginally improved.

 

 

The actions we have taken since we reviewed it at the beginning of the year are:-

 

• When patient registers they are informed about how to cancel appointments and effect of DNA’s on other patients.  Also inform them that if they DNA three or more times we will consider removing them from the list.

 

• The information in the waiting room has been made clearer about the level of DNA’s and how to cancel an appointment.

 

• When a patient makes an appointment either on the phone or at the desk, a text is automatically sent to those with a mobile phone of the appointment details.

 

• When appointments are made at the desk we also offer a print out on a card of the appointment details.

 

• A text reminder is automatically sent the day before the appointment for patients with mobile phones.

 

• Where a patient DNA’s a text is automatically sent to them informing them that they have not attended and it has been recorded in their notes.

 

• We have had a look at the high offenders to see what action may be appropriate.  It was not felt appropriate to remove anyone from the list.

 

We are going to give a try to sending out a further text reminder on the day of the appointment for one or two consulters for a period to see if that affects the number of DNA’s.

 

A further thought we have had to try and increase the awareness of the DNA problem is to link in with a fundraising event e.g. Children in Need, and to set up for say a month a system of writing to patients who DNA asking for a voluntary contribution to the charity.   The letter would make it very clear this was in the spirit of fundraising.  The advantage for us is that we could raise the profile of DNA’s by doing a display in the waiting room identifying the number per week and also show any monies raised.

 

We would appreciate any comments you have about the actions taken / proposed and also if you have any further suggestions to offer.

 

Appointment system

 

We wrote to you in February about changes in the appointment system re doing more consultations over the phone for patients who want to be seen on the day.  This went well and we had no complaints from patients, we did have some comments from patients but when we explained what we were doing they were happy with.

 

However we lost Dr Peter Chan back in July 2012 who was a keen advocate for doing telephone consultations and we have replaced him with a combination of Dr Nicky Mason and Carol McArthur, Nurse Practitioner.  Neither of them at the moment wish to do telephone consultations.  As a result we don’t have enough consulters to do telephone consultations for all the patients who wish to be seen on the day so we now have a system whereby we offer either consultations on the day or telephone consultations and patients can choose.  This we feel is beneficial to patients as they have choice and can therefore pick the option which best suits them.

 

A further development we are considering is to make available on our web site the ability for patients to book an appointment direct for cervical smear and possibly contraception services.  This is one of the largest areas of work we have and given that the system available to us for booking of appointments via the web site will not allow us to differentiate between types of appointments we have to identify specifically what you can book an appointment for.  We would have loved a more flexible system but that is outside of our control.

 

We would appreciate any comments you have about

 

Appointments on the day particularly in relation to offering both face to face consultations and telephone consultations.

 

The proposed system for booking appointments for cervical smears and family planning consultations via the internet / web site

 

Any other comments you have about the appointment system.

 

 

Yours sincerely

 

 

 

 

Grahame Dickinson

Executive Manager

 

 

Harewood Medical Practice

 

Consultation on Patients not attending appointments and appointment system

 

 

Name

 

 

 

 

 

 

Date of Birth

 

 

 

 

 

 

 

Suggestion / Comments

 

 

 Please post or hand this to reception by the 17 January 2013.

 

Thank you for your time.

 

Grahame Dickinson

 

 

Appendix 2



30 January 2013

 

Dear

 

Re Consultation on DNA’s

 

Firstly can I thank those of you who responded to the information we sent on the 12 December 2012.   We also made this information available to patients attending the practice via booklets in the waiting room.

 

We received a total of 4 replies, the comments on which I have summarised in Appendix 1.

 

Having reflected on the comments we identified some further actions we are considering detailed are detailed in appendix 2.

 

The last stage in this consultation exercise is to seek your agreement to our strategy as outlined.  Can I therefore ask that if you have any further comments that you let me know by 20 February 2013.

 

We will publish a final report on the whole exercise by the end of March on our web site (harewoodmedicalpractice.co.uk).

 

Thank your for your time and input into this exercise.

 

Yours sincerely

 

 

 

 

Grahame Dickinson

Executive Manager

 

Harewood Medical Practice

                                                                                                            Appendix 1

 

Summary of replies received.

 

Comment	Number of responses	HMP comments
SMS text reminders good idea	1	We think this has had a small effect and we intend continuing with this.
Telephone appointments good idea	2	We believe this offer patients more choice and an option which is hopefully more convenient to some patients.
Letter to patients with 3 DNA’s saying removal is an option	1	Will look at doing this on an annual basis.  The number of repeat offenders however is low, the majority only DNA one or two times.  In 2012 37 patients DNA’s 3 times, 11 DNA’s 4 times and 20 patients DNA’s between 5 and 8 times.  This was out of a total of 470 patients who DNA’d in the year.  When looked into in the past the high non attenders have had a health problem which was contributing to their DNA’s and actually needed medical intervention.
Consider repeat reminders about how to cancel appointments	1	We have the information on appointment cards, SMS text’s, web site, practice leaflet and are now including on letterheads.  Any other idea’s welcomed.
Don’t overload notice boards, already too much information	1	Couldn’t agree more, we are always getting requests form health bodies, charities, local authorities etc to display information on notice boards which is a real problem
Update DNA notice showing monthly numbers more regularly and make more prominent	2	We are trying to do this regularly, however when something is up all the time then people start to ignore it.  We may consider doing periodic bursts of information.
What is the level of DNA’s compared to number of appointments and what is an acceptable level.	1	Our level of DNA’s compared to the number of consultations is slowly declining.  Our average DNA’s per month in 2011 was 143 per month and in 2012 was 129.  This relates to about 200 GP consultations a month.   Currently percentage 6.45%.  Other practices vary but my guess is that they are about half our rate.  A big factor seems to relate to the turnover rate of patients where again we have at least double other practices, about 1200 patients a year.
Contact patients who DNA asking for a charitable donation, what level of fine, is it legal and needs careful wording	2	Fine would be voluntary, probably up to £5 maximum.  Need legal advice and consultation on wording.