Patient Participation meeting Monday 11 February 2013 Thomas Walker Surgery Patient Participation meeting Monday 11 February 2013

Last time…. We discussed our MORI poll results, largely in line with the experience of those attending the last meeting (17 December) , with the exception of “ease of getting through on the telephone”. The perception and experience of those present at the last meeting was it remains difficult to get through on the telephone, particularly first thing in the morning.

Also we discussed… Our forthcoming Care Quality Commission registration, what we believe will be inspected, and expected of us. As we went through the multiple categories we will be measured against, the general view was, we are meeting those targets already.

We also covered…. Clinical Commissioning Groups – taking over the Primary Care Trusts on 1 April 2013. We discussed the ways in which they will lead the development of new services and monitor the ways surgeries work, reviewing prescribing, referrals and patient attendances for unplanned Accident & Emergency care.

What did we feel we could improve, both fairly quickly & locally? We felt many of our patient did not understand what services and options were already available to them A questionnaire was created to gauge the level of knowledge of what was already on offer & offer some choices on change.

The questionnaire & the results 110 questionnaires were completed. Once the content was agreed, the questionnaire was simplified to just YES & NO answers. Staff said they did still struggle to get patients to fill in the questionnaires.

Over 65% said they already knew they could register to book appointments on-line. 59% realised they could cancel appointments on-line too 52% knew that they could order their prescriptions this way. 31% said they would like access to on-line services, but 41% said they would not. We have seen a rise in registrations, currently almost 18.5% of our patients are signed up for on-line access.

What about the number & spread of appointments on-line? 20% of patients felt there were not enough on-line appointments to choose from, 23.5% said there was already enough choice. Where a wider choice was requested, 18% wanted more morning appointments, 30% wanted more afternoons, 32% said they wanted more appointments mixed between morning & afternoon.

71% of patients already knew that they could book a telephone consultation with a GP Just over 50% knew they did not need to book an appointment with a Doctor to get a form filled in. 88% of patients knew you could order a repeat prescription without having to come and see a Doctor. 60% of patients have already had a consultation with the Nurse Practitioner.

Approximately 63% of those who filled in our questionnaires order their own repeat medication & collect their prescriptions & indicate they actively check their counterfoils. Where a pharmacy orders on behalf of the patient, 4.5% said they did not ring the pharmacy to let them know what medication they needed that month & 27% said the pharmacy did not contact them.

29% of the patients who had their medication delivered by the pharmacy said they did not receive their prescription counterfoil. 64% of patients indicated they knew that medication returned to a pharmacy, even if it was untouched – could not be re-used and ended up being destroyed.

Drawing conclusions It would appear that a number of patients that use pharmacies to order, dispense & deliver their medication – have minimal engagement with the pharmacy to ensure, just the medication they actually need that month is ordered on their behalf. This could inevitably lead to a significant amount of wasted drugs, which has a monetary value too.

Patients who arrange their repeat medication via a local pharmacy, could be missing out on instructions or messages from their GP, because they are not given their prescription counterfoil, alongside their medication. Doctors & Nurses need to remind patients that they actively need to discuss their repeat orders with their chosen pharmacy every month. That they need to tell us if excess drugs are delivered to them, medication they no longer want or use. To look regularly at their medication counterfoil, which is used for reminders or prompts for care or treatment.

Our reception staff already offer appointments with the Nurse Practitioner but this will require an explanation of her role, so patients understand exactly what skills she has & how they may benefit from an appointment with her, rather than with a GP We need to review the number and availability of appointments that can booked on-line.

We will not reserve appointments exclusively for on-line booking, use of any appointment will be on a first come, first served basis – but we will need to monitor their use & how they were booked. Our aim will not be to disadvantage patients who do not have internet access, those who cannot benefit from being able to book an appointment when the surgery is closed.

We invite your views, should we start by offering half of all available appointments for on-line booking? If not half, then what would you suggest? We could start this in April 2013 and keep these changes in place for 3 calendar months and then review how the appointments were used? We could meet again in the summer to see what has happened?

Comments added to questionnaires Although these were not invited some patients did add comments: “I love this Doctors, better than the others” “The receptionist was absolutely wonderful….our previous visit the receptionist made me sign in at the stupid computer… I much prefer the personal touch”

More comments “Don’t have a computer but staff always very helpful when you call” “Reception is brilliant” “Friendly and excellent service from the Receptionist”

Anything else to discuss? For information & interest, a patient enquired about drugs changes, ie swapping a patient from one drug to another brand. Why is that done? Who decides who is changed? What happens if the new drug doesn’t suit the patient the way the previous one did.

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