Brook House Surgery
Patient Participation DES Report
2013 - 2014

Practice Profile

Brook House surgery is a well-established general Practice in urban Southampton, an area with high depravation. The practice covers an area of mixed housing. The practice population is balanced with all age groups and disease mix. We have a high prevalence of COPD and obesity (www.gpcontract.co.uk).  We have 21 main spoken languages not including English recorded on our clinical system (recording started approx. 3 year ago). These languages include: Arabic, Spanish, Polish, Russian, Farsi, and Urdu (to name but a few).

Please see Appendix A – for Practice & Patient Participation Group Information

List size		4561

3 Partners		Dr Roland Simpson		
			Dr Rosalind Simpson			
			Dr Majid Jalil – left 31.1.14
			Dr Lisa Manalang – to start 1.4.14			

Practice Manager	Miss Adrienne Ely (Full time)

Nurse Practitioner	1 (Part-time – covering 3 days a week)

Practice Nurses		1 (Part time – covering the whole week)

Healthcare Assistants	2 (Part time) 

Secretary		Part time

Computer 
Administrator		3 (Part time)

Receptionists		6 (all part time)

Link Staff
			
District Nurses		4 (Based at Regents Park Surgery)

Health Visitor		1 (Based at Adelaide House - Sure Start also operates in this area)

Counsellor	1 (attends weekly)

Quitters Advisor	1 (attends weekly)

Premises 

The building is a purpose built surgery in Practice since 1993, with 5 consulting rooms, offices, two separate treatment rooms and full nursing cover. The practice has adequate accommodation for all clinicians.

There is close liaison with other local surgeries within our locality area and also within the Southampton City area.

We are fully computerised with EMIS Web, which is linked with the PPSA in Winchester. We are also linked with the Pathology Lab of Southampton General Hospital and OOH’s. We operate largely without paper records and look towards refining and developing our use of IT within the practice. Changing to EMIS Web in April 2013 will allow us to develop procedures within the practice for clinicians, admin staff and patients.

We operate an advance and urgent appointment system for GP’s, Nurses and Healthcare Assistants each appointment is 10 minutes. Telephone consultations with a GP or Nurse are also available.

Patients are registered with the practice and can see a GP of their choice; we do encourage patients undergoing treatment to return see the same doctor for continuity of care.

Patient Participation Group Representation

Brook House Surgery’s Patient Participation Group was formed in December 2009.

On-going Invitation:
•	Notice board in the waiting room advertising the Patient Participation Group
•	Patients continuing being informed / invited during consultations
•	Patients continuing to be made aware of the Patient Participation Group by the reception & administration staff 

The size and profile of the PRG
When the Patient Participation Group was first formed there were 8 patient members and 3 practice members.

Please see Appendix A – for Practice & Patient Participation Group Information

Since December 2009 when the Patient Participation Group was first formed some members have left and others have joined, the numbers of males to females and age groups remain very similar. There are 5 members of the Patient Participation Group that have remained stable and attend all or the majority of meetings. Although there are currently 11 members.
	
Agree areas of priority with PRG 

The areas that were considered to be included in a local survey

There were various issues / ideas raised that were felt could be improvements for patients attending the surgery some examples of the ideas are listed below:

•	Nurse  / HCA appointments and care received by the patients
•	Patient understanding of urgent / same day appointments 
•	Treatment received from reception staff via the telephone or face to face. 

The method used to identify the areas to be considered and the priority areas agreed with the PRG and the rationale for making those decisions

•	The ideas raised came from staff meetings, clinical meetings, PPG meetings and general comments made by the patients.
•	All of these ideas were taken to a PPG meeting and discussed. 

The method used for discussing and agreeing the priorities

•	All discussions for agreeing the areas of priority were done face to face during agreed Patient Participation Group meetings. 
•	The format was agreed to use create our own survey on this occasion as we could tailor make the survey to answer the questions that required answering. 

The date(s) the discussions took place

•	The discussion regarding the content and format of the survey was discussed on:
6th November 2013 and 12th December 2013.

Collate the views through the use of a survey

The method used for the survey, the date the survey was issued and the period in which feedback took place

•	The survey was done in paper format only and patients attending the surgery were asked to complete the survey.
•	Reception team members asked all patients attending an appointment with the Nurse Practitioner, Practice Nurse or HCA to complete the survey, assistance in completing the survey was offered to those that may have required it.
•	The Practice Survey results were discussed at the PPG meeting on 18th March 2014.

The method and rationale used to agree the questions (these should reflect the areas of
priority agreed with the PRG), also the date and how the practice demonstrated to the
PRG that the methodology chosen to support the survey is credible. 
•	Practice meetings 
•	PPG meetings
•	General Patient feedback
•	Discussions at PPG meetings

An analysis of the number of patients surveyed and the number of responses together with the themes emerging from patient feedback

Appendix B – Patient Survey Questions & Results

Provide the PRG with the opportunity to discuss the findings and reach agreement with the PRG on changes to service

The method used for those discussions and the date that discussions took place

•	Patient Participation Group meeting that took place on 18th March 2014

The changes that have been agreed with the PRG

The changes that have been agreed with the Patient Participation Group are to:
•	Practice Open Day 
o	Repeat the Open Day again in 2014 if possible if not to reinstate in 2015. These have been well received in the past.
•	Patient Communication
o	Noticeboard separate from others purely for PPG
o	Practice Newsletter – simple & short 
o	Patient Surveys to be available to complete via website / new patient check in system
o	Look to the practice to allow patients to book appointments online. 
o	Go live with a Face book page to try and encourage involvement of younger patients
o	Television in waiting area giving patient information

Agree action plan with PRG and seek PRG agreement to make changes

The actions agreed with the PRG and/or NHSH
An indication of the priorities (if appropriate)
The timeframe for implementing the changes
Actions Agreed with PPG	Priority	Timeframe	Achieved	
Practice Open Day	Mod	Open Day to be held October 2014? If not reinstate in 2015	Yes (Nov 12), successful to do again in 2014 or 2015	
Patient Education Meetings	Mod	To reinstate the Patient Education Meetings. To hold 3-4 a year. Topics to be readdressed and reviewed	To reestablish these in 2014	
Patient Communication
1.	Noticeboard
2.	Newsletter
3.	FB
4.	Website	
High
High
Mod
Mod	
Newsletter – within few weeks to inform patients of changes in practice.
FB – 6m
Website make more attractive for PPG	
Notice board achieved although this needs to be improved and more visual	

Practice Opening Times

Day	Opening Time	Closing Time	Comments	
Monday	8:30am	7:45pm	Late Surgery	
Tuesday	8:30am	6:30pm	Closed from 12:30pm – 2:00pm	
Wednesday	8:30am	6:30pm		
Thursday	8:30am	6:30pm		
Friday	8:30am	6:30pm		
Saturday	8:30am	11:00am	The second Saturday of the month	

Patients are able to contact the practice via telephone from 8:00am to 6:30pm Monday to Friday, or face to face during the above opening times.

During surgery open hours the following Healthcare Professionals are available.

Doctors
Appointments for the doctors are available Monday to Friday. We provide appointments in the morning and afternoon / evening.

We offer extended hours appointments with a doctor on a Monday evening and the second Saturday of every month.

Nurse Practitioner
Appointments available Monday, Thursday & Friday in both the morning and the afternoon. Patients requesting same day urgent appointments are seen by the Nurse Practitioner on those days.

Practice Nurses
Appointments for the Practice Nurse are available Tuesday to Friday. We provide appointments in both the morning and afternoon. There is no Nurse available on a Monday, Tuesday or Wednesday afternoon.

Healthcare Assistant
Appointments for the HCA’s are available on a Tuesday morning, Wednesday morning and afternoon and a Friday morning.

Appendix A – for Practice & Patient Participation Group Information

Information checklist for local patient participation report

Practice Population Profile	PRG Profile	Difference	
AGE	
% under 16 = 23%	0		
% 17 – 24 = 11%	0		
% 25 – 34 = 15%	0.04%	14.96%	
% 35 – 44 = 15%	0		
% 45 – 54 = 13%	0.02%	12.98%	
% 55 – 64 = 11%	0.02%	10.98%	
% 65 – 74 = 7%	0.08%	7.92%	
% 75 – 85 = 4%	0.07%	3.93%	
% Over 85 = 1%	0		

Ethnicity	
Ethnicity	Practice Population	PRG	
White			
% British Group	51	0.2	
% Irish	0.2		
Mixed			
% W&B Caribbean	0.8		
% W&B African	0.6		
% White & Asian	0.4	0.02	
Asian or Asian British			
% Indian	1.5		
% Pakistani	0.4		
% Bangladeshi	0.5		
Black or Black British			
% Caribbean	0.1		
% African	0.06		
Chinese or other ethnicity			
% Chinese	0.04		
% Any other	0.7		

Gender	
Gender	Practice Population	PRG	
% Male	50	0.06	
% Female	50	0.2	

Appendix B – Patient Survey Questions & Results

Brook House Surgery
Patient Questionnaire Results
2014

Number of questionnaires received back = 47

Age of patient completing questionnaire

<25 years	25-59 years	60+ years	Not Recorded	
4 (9%)	26 (55%)	14 (30%)                                                                                                                                                                                                    	3 (6%)	

Gender of patient completing questionnaire 

Male	Female	Not Recorded	
15 (32%)	30 (64%)	2 (4%)	

Member of the Nursing Team seen 

Nurse Practitioner	Practice Nurse	HCA	Not Recorded	
8 (17%)	17 (36%)	6 (13%)	15 (32%)	

1.	How would you rate your overall satisfaction and confidence in the ability of the nursing team member:

1	2	3	4	5	Not Recorded	
1 (2%)	0	1 (2%)	5 (11%)	40 (85%)	0	

2.	On the visit I would rate the nursing team members ability to listen to you / allow you to express your concerns or fears:

1	2	3	4	5	Not Recorded	
1 (2%)	0	1 (2%)	2 (4%)	43 (91%)	0	

3.	How would you rate the nursing team members explanation of diagnosis / procedure / results etc.:

1	2	3	4	5	Not Recorded	
1 (2%)	0	1 (2%)	8 (17%)	35 (74%)	2 (4%)	

4.	How would you rate the respect and concern shown to you by the nursing team member on this visit:

1	2	3	4	5	Not Recorded	
1 (2%)	0	1 (2%)	3 (6%)	41 (87%)	1 (2%)	

5.	Do you feel the amount of time given to you for this visit was adequate for your requirements:

1	2	3	4	5	Not Recorded	
1 (2%)	0	0	4 (9%)	40 (85%)	2 (4%)	

Reception / Administration Team

6.	How would you rate the manner in which you were treated by the reception staff via the telephone or face to face at the surgery:

1	2	3	4	5	Not Recorded	
0	0	1 (2%)	6 (13%)	38 (81%)	2 (4%)	

7.	How would you rate the respect shown for your privacy and confidentiality:

1	2	3	4	5	Not Recorded	
0	0	1	4 (9%)	39 (83%)	3 (6%)	

8.	How would you rate information provided by the practice about its services it provides (eg: repeat prescription / test results / private charges)

1	2	3	4	5	Not Recorded	
0	0	1	9 (19%)	34 (72%)	3 (6%)	

Urgent Appointments

9.	Was your appointment today and urgent / same day appointment?

Yes	No	Not Recorded	
12 (26%)	23 (48%)	12 (26%)	

10.	Do you feel that the urgent problem you came for today could have been dealt with on the telephone?

Yes	No	Not Recorded	N/A	
2 (4%)	10 (21%)	11 (23%)	24 (51%)	

11.	Do you feel your urgent problem could have been dealt with by an experienced Nurse Practitioner? (only relevant if seen by a GP)
 
Yes	No	Not Recorded	N/A	
9 (19%)	2 (4%)	12 (26%)	23 (48%)	

Comments from survey to help the practice improve it service:

•	I think the service at the practice is very good
•	Great team work, keep it up
•	Found the nurse very understanding & compassionate, no improvements , very happy with the service
•	Overall very pleased with the service received over the time registered, surgery up to date, at times GP’s run late
•	Would like to receive a text message for blood results if they are satisfactory
•	More doctors or sooner availability of appointments.
•	Came for baby immunisations, nurse very friendly. Given room to feed baby. Felt very cared for.