DAPDUNE HOUSE SURGERY - · PDF fileDapdune House Surgery engaged with NETbuilder to provide...

DAPDUNE HOUSE SURGERY

Dapdune House Surgery

Dapdune House Surgery,

Wharf Road,

Guildford, GU1 4RP

Practice Manager: Mr Jeff Thomas

T: 01483 400227

Local Pat ient Part icipat ion Report March 2013

Da Dapdune House Surgery Local Patient Participation Report 2013 | 2

Executive Summary The following report outlines the results of the first year requirements for a Local Patient Participation Report to satisfy the PP-DES 2011 – 2013 as directed by; THE NATIONAL HEALTH SERVICE ACT 2006 The Primary Medical Services (Directed Enhanced Services) (England) (Amendment) Directions 2011 Insertion of new direction 12A - “Patient Participation Scheme”. The survey results in this report have been collated since 1st April 2012, and continue on from results in the 2012 Local Patient Participation Report.

Dapdune House Surgery,

Wharf Road,

Guildford,

GU1 4RP

Practice Manager: Mr Jeff Thomas

Number of GP Partners Number of Associate Doctors Number of GP Registrars

7 1 3

Number of patients 11599

Dapdune House Surgery engaged with NETbuilder to provide its comprehensive managed survey solution, NBSurvey. This enabled the collection of views from patients in multiple locations across various demographic groups and facilitated the canvassing of patients’ opinions via a suitable input channel, from in-practice touch screen kiosks / laptops, to virtual online surveys. The Surgery has a virtual Patient Reference Group. Patients are invited and encouraged to give their feedback via surveys on various aspects of the practice in a number of ways. PRG members currently number ~ 96 and recruitment is an on-going process.

Results Summary

Item Total

Number of Surveys 6

Number of Responses 381

Number of Input Channels 3

Summary Outcomes & Action Plan – PPDES Year 2 Results

Year 2 of the PPDES has, once again, proven to be informative to the Surgery with resultant positive outcomes for our patients. Data has been collected through a variety of surveys, some new and some re-run to measure effectiveness such as the Overall Satisfaction Survey. The year 2 PPDES has run against a backdrop of major NHS changes, which has impacted on the viurtual PRG as representation in the wider area patient participation groups has been called for. We have remained committed to an evolutionary approach to the changes we have made and this forms the basis for the 2013/14 period. This approach is particularly supported by the results of our


Overall Satisfaction survey, which show that a high percentage of our patients are happy with the care they receive from this surgery. We have identified several actions that we believe should be addressed over the 2013/14 period. In conjunction with our action plan we intend to re-invigorate interaction with our virtual PRG which, for Dapdune Surgery appears to be the most effective means of patient/surgery communication. During 2013/14 we intend to improve the accessibility and use of our website, increase patient access to their regular GP, further develop our training organisation and improve online appointment availability.


CONTENTS

Executive Summary 2

Results Summary 2

Summary Outcomes & Action Plan – PPDES Year 2 Results 2

About The Practice 6

Services at the Surgery 6

The Partners 7

Associate GP 7

The Practice Staff 7

Practice Nurses 7

Community Midwives 7

Community Nurses 7

Health Visitors 7

Opening Hours 8

Extended Hours 8

Making & Cancelling Appointments 8

Home Visits 8

When the Surgery is closed 8

Local Survey Methodology 9

The NBSurvey Methodology 9

Input Channel Evaluation Criteria 13

Patient Reference Group 15

PRG Membership 15

Member Profiles 15

PRG Recruitment & Representation 15

PRG Agreement of Priorities 15

Results, Outcomes & Findings 17

Summary Information 17

Survey results by Input Channel 17


Summary of Demographics Survey 17

Representation of Registered Patients 18

Survey Results 18

Discussions & Action Plans 22

Summary of Year 1 Outcomes & Action Plan 22

Implementation of Year 1 Outcomes and Action Plan 22

What Dapdune House Surgery did 22

Dapdune House Surgery’s outcomes 23

Year 2 of the PPDES – Discussions 23

Year 2 of the PPDES - Action Plans 23

Summary of the PPDES 2011-2013 24


About The Practice At Dapdune House Surgery we are a friendly, hardworking, dedicated and professional team

focused on the provision of top quality health care to our patients in the Guildford area. Our

doctors and nurses provide a full range of general medical services.

Services at the Surgery

Ante Natal Appointments: Held by a midwife on Monday, Tuesday and Wednesday

afternoons.

Post Natal Appointments: Can be made with their doctor during normal surgery times.

Child Immunisation Clinic: Held two Tuesdays in the month, run by the practice nurse.

Child Health Clinic: Held on Thursday afternoons by appointment.

Children’s’ Development Review Sessions: By appointment with the Health Visitor.

Cervical Smear Appointments: Available on request with the practice nurse.

Family Planning Appointments: The full range of family planning advice is available to both

male and female patients. This is run by our family planning nurse. Coil and cap fitting

appointments, as well as oral contraception, can be made at this clinic.

INR Clinics: Run by one of the doctors and a practice nurse.

Diabetic Clinics: Held two Tuesdays in the month, run by Dr Jump and Dr Rimmer, the

Practice Nurse, Podiatrist and Dietician. Our diabetic patients are seen twice a year or more

frequently if required.

Respiration Clinics for Asthma & Chronic Chest Disease: We have a weekly clinic run by our

practice nurse, Ann Dawe, who is specially trained to promote quality respiratory care.

Telephone advice about asthma problems is available.

Hypertension (High Blood Pressure) Clinics: Run by the Practice Nurse, who will monitor

and help control high blood pressure.

Minor Operations & Cryotherapy Clinics: Appointments are made after discussion with the

patient's own doctor in normal consultation hours.

Travel Vaccinations: Routine vaccinations and those required for foreign travel are given by

the Practice Nurse.

Flu Immunisation & Pneumonia Vaccination Clinics: Appointments can be made in

September for vaccinations in October and November. Patients with asthma, diabetes,

heart, kidney or chest diseases and people over 65 are encouraged to attend.

Non NHS Examinations: Medical examinations can be arranged by appointment for special

purposes e.g. elderly drivers’ medicals, pre-employment medicals and insurance

medicals.


The Partners

Dr David G Eyre-Brook (m) MB BS (London 1977 Westminster) MRCGP DRCOG

Dr Anthony F Rimmer (m) MB ChB (Liverpool 1979) DA DRCOG

Dr Diane Ackerley (f) MA (Oxon) MB BS (London 1981 King’s) MRCGP DCH DRCOG

Dr Ian F Cunliffe (m) MA (Oxon) MB BS (London 1982 St Thomas’) MRCGP DRCOG

Dr Allison E Jump (f) MB ChB (Leeds 1982) MRCP

Dr Caroline Karanjia (f) MB BS (London 1983 Guys) MRCGP DCH DRCOG

Dr Fiona H Groom (f) MB ChB (Glasgow 1985) MRCGP DRCOG

Associate GP

Dr Emma Sattelle (f) MB BS (London 1995 King’s) MRCGP DCH DFFP

The Practice Staff

Practice Nurses

Nurse Ann Dawe SRN (Guy’s Hospital 1978) DN RM

Nurse Angie Tolan RGN

Nurse Louise Kettle RGN RM

Nurse Denise Matthews RGN

Community Midwives

The Midwives are involved in all aspects of maternity care, holding Ante Natal and Booking

Clinics at the surgery. The booking in appointment is a lengthy first appointment during

which all information and guidance is provided. The appointment is followed up with short

check-ups with the midwife and GP. The community midwife visits the patient at home with

their baby, providing continuity of care. The Midwives can be contacted at the Royal Surrey

County Hospital, St Catherine’s Ward – 01483 464147.

Community Nurses

A team of community registered nurses and health care assistants visit house bound patients with

nursing needs. They provide: wound care management and pressure ulcer prevention, care of IV

central lines (including chemotherapy pumps), and intravenous medication, chronic disease

management, continence care, palliative and end of life care. They can be contacted on 01483

563595, or at weekends and Bank Holidays on 01483 782300.

Health Visitors

The health visitors at Dapdune Surgery work closely with a qualified nursery nurse, and run a

weekly baby clinic. Post natal clinics are also offered. The health visitors can be contacted by

leaving a message on their answering machine on 01483 400221.


Opening Hours

The surgery is open from 8.30 am to 6.30 pm every weekday. Note: Telephone lines are closed between 1pm -2pm

Extended Hours The surgery offers extended hours appointments on Monday and Thursday evenings. These appointments (pre-booked only) run from 6.30pm to 8.00pm.

Making & Cancelling Appointments We would like patients to be seen by the doctor with whom they are registered. This will help to ensure that the GP that is consulted is familiar with their medical history. Appointments and cancellations can be made:

in person

by telephone - 01483 400200

online using our internet booking service

by automated telephone booking service We also offer an online service to order repeat prescriptions.

Home Visits

Home visits are available for patients who are too ill to visit the surgery.

When the Surgery is closed

If patients telephone the surgery they will hear a recorded message. When the surgery is closed,

ring 01483 400200 for further directions to the Out of Hours service, which is provided by Harmoni

(0300 130 1305).

https://dapdune-house-surgery.appointments-online.co.uk/


Local Survey Methodology The Practice engaged with NETbuilder to provide its comprehensive managed survey solution, NBSurvey. This enabled the collection of views from patients in multiple locations across various demographic groups. Surgery staff then canvassed patients opinions via an input channel most suited to them, from paper surveys and in-practice touch screen kiosks / laptops, through to virtual online surveys. Findings from previous studies carried out by NETbuilder exposed that, multiple short surveys with a maximum of 8-10 questions each are more effective than one long survey running continually throughout the survey period. Each survey was customised using the investigational design and measures e.g. using a short survey (The Access Survey) to measure the effectiveness of patients requesting an appointment. Additionally, short surveys encouraged patients to give feedback for the areas relevant and important to them.

The NBSurvey Methodology


Step Description Surgery Comments / Experiences

Continual Development of Patient Reference Group (PRG)

The PRG is a representative group of patients from the practice. They are responsible for providing feedback to surveys and collaborating with the practice to analyse the results and agree realistic change opportunities.

Recruitment of members to the PRG remains an on-going process. This past year has seen an increase in numbers joining from about 60 to over 90. Patients are asked to join when registering at the Practice.

Determine Priority Areas

Key areas include but are not limited to the following:

Access

Overall Satisfaction

Seeing a Doctor

See a Nurse

The Reception

The Surgery Environment

Demographics

Specialised Clinics (e.g. Flu, Vasectomy)

The PRG and other patients complete the Patient Priorities Surveys to priorities the areas (above) to determine the order in which key areas are addressed by the practice. Patients are also given the opportunity to provide comments regarding other areas they would like to see addressed.

The Patient Priority survey in 2011 gave us the areas of priority that patients wished to look at first. Results were reported in the 2012 report. The surveys we ran in year one (2011/12) were:

Demographics

Access


Seeing a Doctor

Reception

Seeing a Nurse

Surgery Environment In year two we repeated the following surveys which were available in year one:


Reception

Seeing a Nurse

Surgery Environment In year two we also added the following new surveys:

Continuity of Care

Website Survey

Design & Build Surveys

The practice works closely with NETbuilder to design and build the surveys. Each survey is designed to measure the patient’s view of the identified key areas. The majority of surveys contained

The practice collaborated with NETbuilder and the PRG in 2011 to agree the questions in the 2011/12 surveys. We then worked with both NETbuilder and the PRG again early


between 8-10 questions. Patients are able to choose to complete the surveys they believe are relevant to them and ignore those that are not.

in 2012 to agree the next set of surveys and agree the questions for 2012/13 In 2012/13 we have continued to collect views on the original surveys to establish changing trends and open up additional ones for comment.

Decide on Input Channels and Publish Surveys

The practice worked closely with NETbuilder to agree which input channels are suitable for the surgery and patients. Input channels available are:

Surgery Kiosk

Web Portals

Laptop

Paper

Face to Face Each survey can be used on (published to) one or more of the input channels listed above.

In year 1 of the PP DES, we used the Input Channel Evaluation Criteria to help us decide which channels to use for Dapdune House Surgery:

In-surgery Kiosk (We have one Kiosk in both waiting rooms): to capture patients from all demographics visiting the surgery

Staff appraisal portal, used to gain specific feedback on individual doctors.

PRG Web Portal: specific portal for PRG Members

Web Site: open to all practice patients

In year 2 we added a paper survey option, and continued to use the following input channels;

In-surgery Kiosks: to capture patients from all demographics visiting the surgery

Staff appraisal portal, used to gain specific feedback on individual doctors.

Web Site: open to all practice patients

Paper surveys were made available for those with a preference for more traditional means of completing a survey.

Advertise Feedback Channels

Inform patients of the available input channels and current surveys, in order to create a greater number of participation responses. Types of

The Surgery produced links via the web site and internal posters publicising the kiosks. Receptionists were encouraged to inform patients


promoting include but is not limited to:

Encouragement slip given by the doctor

Posters

Leaflets

News Letters

Encouragement from all Practice Staff & PRG

Surgery Website

Notice Board

that the kiosks were available. Paper surveys were available for those unfamiliar with electronic facilities. Various clinics were provided with information leaflets.

Capture Patient Experience

Patients complete surveys using the available input channels as listed above.

The relatively slow initial uptake was improved by staff providing help and encouragement with kiosks when necessary. The Surgery website provided an effective portal for those patients wishing to contribute but not frequent visitors to the Surgery. Paper surveys were made available for those with a preference for more traditional means. The use of paper surveys became increasingly effective throughout the year.

Produce & Distribute Reports

Results in the form of reports are produced for each individual survey and distributed via the Practice Website, Practice Meetings, Surgery Notice Board, PRG consultations.

Results from the initial surveys were distributed to the PRG via e-mail. Results were also posted on the Surgery website and noticeboards. Increased uptake of patients accessing the Dapdune website provides an effective communication path.

Collaborate with PRG to Analyse Results

The Practice Manager will discuss & analyse the survey results with the Practice Doctors and then discuss with the PRG for further analysis.

Findings from the results of the surveys run in 2012/13 have been discussed internally and areas for improvement noted and acted upon where possible. Attempts made in 2012 to create a real PRG were unsuccessful. However, members of the Dapdune PRG were invited to engage with the wider Guildford & Waverley Patient Group and this approach has proved


Input Channel Evaluation Criteria

Input Channels should be thoroughly evaluated for their suitability for use by patients belonging to a practice. The following table describes the advantages and disadvantages of each input channel currently supported for practices.

Input

Channel

Advantages Disadvantages

Paper Surveys

Suitable for a large percentage of

patients across most services

Known and trusted media for many

patients

Production, deployment and

collection of surveys required

Data input required

Public Web Surveys

Instant feedback

Fast deployment of survey

Easily changeable

Limited to patients with internet

access

Limited to patients with the ability

to use technology

Email Surveys

Instant feedback


Easily changeable

Limited to patients with internet

access


partially successful and will be further developed.

Agree Action Plan Detailed action plans are created at the end of year one (2011/12) and the end of year two (2012/13) of the PPDES

An agreed action plan between the PRG & Surgery was created after the year one results (2011/12) according to the outcome of the analysis from the results. A further action plan has been created following the year two results (2012/13). Details of the year two action plan are provided in the section Discussions & Action Plans below.

Implement Change Practice must obtain the agreement of its local PCT to its proposals for any significant change, e.g. change of opening hours. Approved changes can then be implemented.

Details provided in the section Discussions & Action Plans below.


Excellent for tracking feedback for

specific treatments (e.g. specialised

clinics)

to use technology

Limited to patients with email

accounts

Limited to patients who have

provided Trust with email addresses

Phone Surveys

Instant feedback


Easily changeable

Excellent for tracking feedback for

specific treatments

Limited to patients with telephone

access


to use a telephone

Additional cost to practice

Touch Screen Kiosks

Immediately and conveniently

accessible before and after

appointments

Instant feedback


Easily changeable


and willingness to use a touchscreen

kiosk

Requires suitable physical location

Touch Screen Tablets / Laptops

Instant feedback


Easily changeable


accessible before and after

appointments

Portable

Fashionable


and willingness to use a touchscreen

tablet

Requires overnight charging

Standard Desktop

Instant feedback


Easily changeable


accessible following treatment


and willingness to use a desktop PC

Requires suitable physical location

Requires protection from being

damaged, lost or stolen

Face to Face interviews

Instant feedback (proving tablet

used to input response)


Easily changeable


accessible following treatment

Patients able to converse with a

person, puts at ease

Rapport building

Canvasser must be independent

Additional resource required

Patients may be reluctant to give

honest answers to canvassers


Patient Reference Group

PRG Membership

Member Profiles

Members of the Patient Reference Group are recruited principally from patients registering at Dapdune House Surgery. The practice has a ‘virtual’ Patient Reference Group. This means that patients are invited and encouraged to give their feedback on various aspects of the practice by using the PRG Web Portal, the Dapdune website and the Practice based survey terminals should they be at the Surgery.

PRG Recruitment & Representation

In order to ensure that members of the group are fully representative of our registered patients, the Surgery can use the following means to recruit:

The practice website

The practice newsletter

Posters on full view in reception and waiting areas

Leaflets available on reception desk

Leaflets in consulting rooms for GP’s to recruit individuals, in particular those who may not be aware of the PRG in the methods already mentioned or are unable to access them in any way

On new patient registration forms The current number of PRG Members is ~ 96 and recruitment is on-going using all the methods listed above. Note: Feedback is not solely reliant on the PRG; surveys are also completed by other Patients from the Practice via the surgery kiosks, web portals and paper surveys. Furthermore, feedback is often received from individuals via the phone and letter.

PRG Agreement of Priorities

The Practice referred to the Patient Reference Group for agreement of priorities by organising a Patient Priorities Survey. The Patient Priorities Survey asked which of the following were considered a priority area to look at; Access (getting an appointment), Overall Satisfaction, Seeing a Doctor, Seeing a Nurse, The Reception and The Surgery Environment. The results are:

The Results show that Patients prioritised the areas as follows:

1. Access (Getting an appointment) (95.00%) 2. Seeing a Doctor (90.00%) 3. Overall Satisfaction (82.50%) 4. Seeing a Nurse (75.00%) 5. The Reception (40.00%)


6. The Surgery Environment (27.50%)

These surveys were then made available to all patients during year one (2011/12) by the variety of input methods shown in the table above. We then repeated the following Surveys in year two (2012/13) to get a results comparison

1. Overall Satisfaction 2. Seeing a Nurse 3. The Reception 4. The Surgery Environment

We then also added 2 new surveys to get feedback on areas that we had previously not surveyed to ensure that all elements of the surgery experience were surveyed:

1. Continuity of Care 2. Website Survey


Results, Outcomes & Findings Summary Information

Item Total

Number of Surveys 6

Number of Responses 381

Number of Input Channels 3

Survey results by Input Channel

Input Channels

Survey Kiosk Website Paper Terminal

Total

Continuity of Care 17 2 44 63

Continuity of Care v2 2 0 20 22

Overall Satisfaction 21 4 42 67

Website Survey 65 12 0 77

Reception 57 3 0 60

Seeing a Nurse 14 1 28 43

Surgery Environment 46 3 0 49

Total 222 25 134 381

Summary of Demographics Survey

The following report provides a summary of the demographics for patients that have completed surveys during year 1 of the PP DES, although we plan to repeat this demographics survey again in 2013. This includes both PRG Members and other practice patients. The Summary of the demographics is:

36. 36% of the patients were female and 63.64% of the patients were male

The breakdown of age category of the patients were; 0% under 18, 11.36% 18-30 years old, 15.91% 31-40 years old, 18.18% 41-50 years old, 40.91% 51-65 years and 13.64% old Over 65

The breakdown of employment status was; 20.27% Full-time education, 9.09% Unemployed, 4.55% Permanently sick or disabled, 4.55% Other, 20.45% Fully Retired, 59.09% Employed

Of those who answered ‘Employed’ 70.37% worked 30 hours or more per week

59.09% of patients said they have long standing conditions including age related conditions

The breakdown of long standing conditions reported were; 31.03% Other 55.17% Physical, 6.90% Psychological/emotional, 6.90% Deafness/hearing impairment, 0% Blindness/partially sighted, 0% Learning difficulties

79.55% of patients said that they were not a parent or legal guardian of children under 16 years currently living at home

97.73% of patients were ‘White’, 2.27% ‘Asian or Asian British’, 0% ‘Other’


95.45% of patients were ‘Heterosexual or Straight’, 2.27% ‘Would prefer not to say’, 2.27% ‘Gay/Lesbian’

36.36% of patients were not religious, 56.82% were religious, 6.82% Preferred not to say

The patients who said they were religious described their religions as; 96.00% ‘Christian’, 4.00% ‘Other’

Representation of Registered Patients

During year one we confirmed that early feedback was not being provided by a wholly representative group of our registered patients as there was missing representation from the following:

Ethnicity. We were under represented from Irish and Chinese patients. However, based on our clinical system search there are very low percentages (0.4% and 0.5%) respectively of these groups.

Age. There was poor response from those aged 65 and over (13.64%) The following steps have been taken in an attempt to increase representation:

Reception staff members were requested to promote the PRG on new registration forms from both of these ethnic groups. On-going recruitment for the PRG will actively request representation from these and other under-represented groups. We are aware that the very low percentage ethnic representation of both groups has changed little over the last 12 months and it remains challenging to achieve a balanced representation.

Surgery staff members have actively sought alternative methods to recruit the over 65 age group to the PRG. Specifically, this has been done on a face-to-face basis at reception, principally during the registration process.

The increased numbers of those signing up to the PRG provide a better basis for achieving a more balanced representation over time.

The focus for 2013 will be to continue to build the PRG numbers and to press on with the steps above.

Survey Results

Detailed reports for each survey can be found on our website www.dapdune.co.uk. Opportunities to discuss the results were given to the PRG and relevant practice staff. The key outcomes for each survey are highlighted below. Please note that the reports found on the website display the latest feedback captured and therefore may contain more results than are summarised in this report.

Continuity of Care (2 reports are available due to change of doctors at the Surgery)

69.51% of patients said that their consultation required a follow up plan

25.86% of the follow up plans were for ‘Blood Tests’, 15.52% were for ‘Referral’ and the remaining 58.62% said that the reason was ‘Other’.


85.96% of patients said that a care plan was agreed with the clinician and that they are clear what will happen next.

When asked if a written follow-up care plan would be helpful 24.56% of patients said ‘Yes’ and 75.44% of patients said ‘No’

81.18% of patients said that it was ‘Very Useful’ to see the same Doctor or Nurse for the same problem and a further 16.47% said it was ‘Fairly Useful’

When asked how successful they had been in seeing the same Doctor or Nurse for the same problem patients said that 70.59% of the time they were ‘Very Successful’ and a further 25.88% of the time they were ‘Somewhat Successful’


96.67% of patients said they were happy with the care they get at the surgery

92.54% of patients said they would recommend the surgery to someone who has just moved into the area

86.57% of the patients said that they were always treated with respect and dignity whilst in the surgery

89.55% of patients indicated that the staff worked well together for their care Compared to last year’s results (2011/12) for Overall Satisfaction the percentages have remained reasonably consistent throughout. Only 0.32% less people said that they were happy with the care they get at the surgery this year (2012/13) compared to last year (2011/12). The other 3 areas measured increased in satisfaction by between 1-3%.

Seeing a Nurse

When seeing a nurse, patients gave their reasons for having a consultation as: . 39.53% routine check-up . 32.56% other . 16.28% on-going problem . 9.30% for a one off problem . 2.33% to ask or advice

Patients rated nursing staff as good or satisfactory on the following areas: . Asking about symptoms – 97.36% . Explaining tests and treatments – 97.30% . Giving patients enough time – 100% . Treating patients with Care and concern 97.56% . Involving patients in decisions about their care – 97.37% . Listening – 97.56% . Taking problems seriously 100%

97.56% of patients said that they had confidence in the nurse they saw and the other 2.44% said ‘Yes, to some extent’

97.67% of patients said they would be happy to see the nurse again


Compared to the reasons given last year for the patients visit to the nurse the number of patients visiting for on-going problems has decreased from 29.03% to 16.28%. The number of patients visiting the nurse for a routine check-up has increased from 35.48% to 39.53% and patients visiting to ask advice have decreased from 6.45% to 2.33%. The patients rating of the nurses as good or satisfactory has increased from last year in all areas measured. The percentages also increased for the confidence the patients had in the nurse they saw and for whether they would be happy to see the nurse again.

Reception

Receptionists were rated by patients as being ‘fairly good’ or ‘very good’ in the following areas: . Friendly – 90.00% . Helpful – 90.00% . Knowledgeable – 86.67% . Welcoming 86.67%

The reception area was rated as ‘fairly good’ or ‘very good’ in the following areas: . Bright and Airy – 91.67% . Clean and tidy – 98.34% . Comfortable – 88.34%

The waiting room was rated as ‘fairly good’ or ‘very good’ in the following areas: . Bright and Airy – 86.66% . Clean and tidy – 95.00% . Comfortable – 90.00%

Compared to last year’s results (2011/12) the patients have rated all areas slightly higher except for how ‘Bright and Airy’ the reception and waiting room areas are. Both these percentages are however still high percentages. Three additional questions were also added to the survey when it was published for the second year (2012/13). The results were as follows:

When asked what information they found useful in the reception area the patients advised: . Leaflets, Pamphlets etc – 16.91% . Information on a screen – 18.38% . Directions to rooms – 13.24% . Notice board – 12.50% . Posters – 13.97% . Booking-in kiosk – 25.00%

95% of patients surveyed said that there wasn’t any other information that they would find useful in the reception area

96.67% of patients surveyed said that they didn’t have any suggestions regarding the reception. The 2 comments left by patients were to request a water fountain and to comment ‘good services and very friendly’.

The Surgery Environment

85.72% of patients rated the overall level of privacy in the surgery as ‘good’ or ‘excellent’

72.92% of patients rated the comfort of surgery furniture as ‘good’ or ‘excellent’


77.08% of patients rated the appearance furniture as ‘good’ or ‘excellent’

85.42% of patient said that they were enough facilities for both children and adults in the waiting area.

91.67% deemed there to be easy access to hand sanitizers around the surgery

Cleanliness was rated as ‘fair’, ‘good’ or ‘excellent’ at the surgery in the following areas: . Car Park – 95.13% . Reception – 100% . Toilets – 97.36% . Treatment Rooms – 100% . Waiting areas – 100%

89.58% of patients said that they found the information around the surgery helpful Compared to last year’s results (2011/12) for The Surgery Environment the percentages have remained reasonably consistent throughout with some area increasing to 100% satisfaction.


Discussions & Action Plans

Summary of Year 1 Outcomes & Action Plan

Dapdune House Surgery staff members have worked with the virtual PRG to establish and prioritise a series of surveys for use by the patient population. The numbers of patients taking part in the surveys (701 from 8 surveys) has been sufficient to enable surgery staff to evaluate and note forming trends. Results of the first three surveys, covering Access, Doctors and Overall Satisfaction, distributed to the PRG, have been evaluated and action plans derived from the data. These action plans, detailed towards the end of the report, will form the basis for continual improvement in the three areas noted. Further recruitment to the PRG will be on-going and closer liaison is envisaged. This has been a very positive experience for those involved in the development of the PPG DES for Dapdune House. First and foremost, the real-time nature of the survey reporting has facilitated prompt change where appropriate. Longer-term plans for the evolution of patient services have also been enabled and will help to guide staff to focus resources where required. We acknowledge that work is required to engage more closely with the PRG and, to that end, we are considering the formation of an actual PRG to help identify areas for improvement.

Implementation of Year 1 Outcomes and Action Plan

What Dapdune House Surgery did

Having posted the findings of the Year 1 Report on our website and to the PRG, we received only limited feedback. However, the findings of the surveys were also discussed internally and this provided an appreciation of how our patients perceived the Surgery from a variety of points of view. As a starting point we were encouraged to note that, through the Overall Satisfaction survey, over 96% of patients said they were happy with the care they got at the surgery. However, we acknowledged that there was room for improvement as confirmed by the development of the first action plan, which resulted in partial success. For example, whilst we were unable to improve the availability of nurses’ appointments online because of technical and procedural constraints (this will remain an aspiration), we did establish that our patients were, overall, content with the involvement they had in their care. Of note we took the results of the initial surveys into account when developing a robust and flexible training organisation to improve overall performance. Aside from the surveys, we have reacted to patients’ requests for improvements received via other channels. As an example, we have increased the number of hand sanitisers available to patients and made small improvements to waiting areas, which include redecoration of the 1st floor waiting area and the addition of notice boards in the ground floor waiting room.


Dapdune House Surgery’s outcomes

We believe that the outcome stemming from the 1st year’s work with the PPG DES was positive for both patients and staff as it provided the base-level information required to establish an informed patient/practice relationship. Soon after the first year’s report was delivered we tried to establish a ‘real’ PRG but not enough volunteers were forthcoming and we eventually decided to maintain the virtual PRG approach. Concurrent to this activity, we were frequently asked to provide representatives of our virtual PRG to take part in the wider patient participation of the emerging Guildford and Waverley CCG. Whilst representation has been achieved it will remain our aspiration to (providing there is the desire from patients) create a real patient group in addition to the virtual PRG. Requests for recruitment to the virtual PRG remain a part of the registration process.

Year 2 of the PPDES – Discussions

Throughout 2012-13 we have continued to collect data using a variety of surveys. This has allowed us to benchmark progress in relation to year 1 and to gain greater insight into our patients’ perceptions and requirements. We found that, in year two, patients were less inclined to use the touch screens for surveys without more encouragement from the receptionists. To off-set this, greater use was made of paper surveys and further internal advertising may be required to optimize the use of the touch-screens. In addition to new surveys; to measure the effect of our surgery website and gauge continuity of care, we have also been able to report on feedback from 3 surveys run last year, which include: Seeing a Nurse, The Reception and Surgery Environment. In the case of the former two surveys; Website and Continuity of Care, each has provided good indicators of changes that may result in improved service to our patients. The website survey, whilst proving popular has clearly shown that only 47% of patients are aware of the Dapdune Website – clearly we can, and should, do more to advertise its use, particularly as more patient access will be conducted through IT in the future. The Continuity of Care survey has confirmed that patients still prefer a regular doctor or nurse to whom they would like to have consistent access. Given that 70% of patients were successful in achieving this access, there appears to be scope for improvement. In general, our adopted ‘evolutionary advance’ borne out of last year’s results remains our intent as, overall, the surveys indicate that we should not make any radical changes. This approach is particularly supported by the results of our Overall Satisfaction survey, which show that a high percentage of our patients are happy with the care they receive from this surgery.

Year 2 of the PPDES - Action Plans

Taking all the previous responses to our surveys and last year’s action plan into account, we have identified several actions that we believe should be addressed over the 2013/14 period. In conjunction with our action plan we intend to re-invigorate interaction with our virtual PRG which, for Dapdune Surgery appears to be the most effective means of patient/surgery communication.


Furthermore, we will continue to seek volunteers to join the virtual PRG, thereby ensuring the group remains proportionate to registered patient numbers. The following actions form the basis of our plan for the 2013/14 period: 1. Endeavour to increase take-up of patients using the Surgery Website by improving advertising of the site wherever appropriate. 2. Given that 81% of our patients prefer to see their regular GP and that 70% are successful in doing so, we will work towards increasing these percentages in order to support continuity of care at the Practice. 3. We will continue to develop our training organisation with a view to improving overall services to our patients. 4. Improve online appointment availability. We will again take forward last year’s action to review and improve the availability of nurses’ appointments to patients booking online.

Summary of the PPDES 2011-2013

As reported last year, involvement in the Patient Participation Directed Enhanced Service was a positive experience for Dapdune House Surgery and continues to be so. The establishment of, and communication with, our virtual PRG at the start of the DES set the scene for worthwhile follow- on work. We believe that the information gained from our patients, via the surveys, has provided a good indication of where we can improve services. In contrast to 2011, prior to commencement of the DES, we now have a clearer understanding of our patients’ requirements and we have established a benchmark from which we can continue to improve. However, we are not complacent and understand that we will need to remain flexible and responsive to changing circumstances. The last year in particular has been challenging as we have needed to factor into the DES work the effects of the latest NHS changes. We regard our good relationship with the Netbuilder Team as vital to the success of our involvement with the PPDES, and we look forward to the 2013/14 period.

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