Patient Reference Group (PRG)
2011/2012 Report
This report summaries development and outcomes of the South Holderness Medical Practice PRG for 2011/2012.
Contents
- Profile of practice population and PRG, including process of recruitment to PRG.
- Agreed areas of priority with PRG for patient survey.
- Patient survey – method and results
- Discussion of survey findings
- Agreed areas for action between PRG and Practice with timeline.
- Publication of actions agreed with timeline.
1.1 Profile of practice population
The Practice works from three sites with the main surgery at Withernsea and smaller surgeries at Patrington and Roos. The practice area covers a large area with boundaries running from Ottringham, Spurn Point and Burton Pidsea and has a mixed population of rural, with a number of outlying villages, and an urban population based at Withernsea. The disease prevalence for the area is larger than the national average in almost all disease areas.
| Surgeries | Patient numbers | Dispensing |
| Withernsea | 8171 | 1493 |
| Patrington | 3308 | 1423 |
| Roos | 978 | 954 |
| Totals | 12,457 | 3870 |
| Age range | Male | Female | Total |
| 0 - 15 | 1064 | 924 | 1988 |
| 16 - 24 | 677 | 596 | 1273 |
| 25 - 34 | 671 | 576 | 1247 |
| 35 - 44 | 656 | 665 | 1321 |
| 45 - 54 | 869 | 843 | 1712 |
| 55 - 64 | 984 | 980 | 1964 |
| 65 - 74 | 884 | 836 | 1720 |
| 75 - 84 | 443 | 469 | 912 |
| Over 84 | 105 | 215 | 320 |
| Percentage | 51% | 49% | |
Ethnicity
5317 patients have their ethnic status recorded. The breakdown of stated ethnicity is as follows -
| White | | | | | |
| British Group | 5243 | Irish | 12 | | |
| Mixed | | | | | |
| White & Black Caribbean | 5 | White & Black African | 6 | White & Asian | 14 |
| Asian or Asian British | | | | | |
| Indian | 9 | Pakistani | 1 | Bangladeshi | 0 |
| Black or Black British | | | | | |
| Caribbean | 1 | African | 4 | | |
| Chinese or other ethnic | | | | | |
| Chinese | 3 | Any other | 19 | | |
Ethnicity chart copied from PCC Toolkit
The practice population is predominantly White British, with a small number of those remaining spread across a number of ethnic groups.
Prevalence of Chronic Conditions
| Disease Area | Practice Prevalence | National Prevalence | Prevalence Comparison |
| Asthma | 7.1% | 5.9% | 121.1% |
| Atrial Fibrillation | 2.5% | 1.4% | 181.5% |
| COPD | 3.7% | 1.6% | 229.0% |
| Cancer | 2.8% | 1.4% | 197.6% |
| Cardiovascular Disease Primary Prevention | 1.9% | 0.6% | 308.7% |
| Chronic Kidney Disease | 5.8% | 4.3% | 135.9% |
| Coronary Heart Disease | 6.4% | 3.4% | 188.4% |
| Dementia | 0.6% | 0.5% | 118.7% |
| Depression | 9.0% | 10.9% | 82.8% |
| Diabetes | 7.3% | 5.4% | 134.5% |
| Epilepsy | 0.9% | 0.8% | 115.3% |
| Heart Failure | 1.2% | 0.7% | 173.0% |
| Hypertension | 17.4% | 13.4% | 129.8% |
| Hypothyroidism | 4.0% | 2.9% | 138.8% |
| Learning Disabilities | 0.7% | 0.4% | 180.4% |
| Mental Health | 0.8% | 0.8% | 97.2% |
| Obesity | 11.7% | 10.5% | 111.0% |
| Stroke and TIA | 3.3% | 1.7% | 194.3% |
Recruitment to the PRG
There is an existing Patient Group, which has met 3 to 4 times a year for over a decade. This original group consists of 7 members at present.
After discussion with the existing members it was decided to enlarge the group to meet the needs of the Patient Participation DES, which requires the PRG to be representative of the practice population.
It was envisaged that a mixed PRG, with some attending meetings and others being ‘virtual’ members, would give the best chance of maintaining the good work the original Patient Group has been doing, whilst giving the widest range of patients the chance to ‘have their say’. It was agreed that all members would have the opportunity of attending any of the meetings.
Recruitment process
1st stage
· Patient Contact forms (PCC Toolkit) were handed out to all patients attending the surgeries at Withernsea, Patrington and Roos. Which also included a ‘Frequently asked questions’ section. (PCC Toolkit)
· Posters (PCC Toolkit) were put up on the waiting room notice boards.
· An entry informing patients of the PRG and how to apply was added to the Practice Booklet and Website.
· Staff education was given and staff briefed to explain the commitment requirements.
Outcome
Unfortunately despite handing out over 200 contact forms only 5 were returned.
Stage 2
It was decided to approach individual patients, face to face or by telephone, to explain the variable level of commitment that could be given to be a member of the group. Using local knowledge of the original Patient Group, clinicians and staff at the three surgeries, a number of patients were identified as people who, if recruited, would fulfil the need for the PRG to be representative of the practice population.
Outcome
A further 15 patients were recruited to the PRG giving a total of 22 members.
1.2 Profile of the PRG
Geographically
Members live in –
· Withernsea
· Patrington
· Roos
· Skeffling
· Tunstall
· Hollym
This gives a good representation of village, town and rural dwelling patients.
Age
| Age range | Male | Female | Total |
| 0 - 15 | 0 | 0 | 0 |
| 16 - 24 | 0 | 2 | 2 |
| 25 - 34 | 0 | 2 | 2 |
| 35 - 44 | 1 | 1 | 2 |
| 45 - 54 | 1 | 6 | 7 |
| 55 - 64 | 2 | 1 | 3 |
| 65 - 74 | 0 | 2 | 2 |
| 75 - 84 | 1 | 2 | 3 |
| Over 84 | 0 | 0 | 0 |
| Percentage | 24% | 76% | |
Both sexes were given equal opportunity to be part of the PRG however, the percentage of male and female on the group do not represent the practice population split of 51% male and 49% female, or split of patients taking part in the patient survey of 42% male and 58% female. It will be interesting to see if this finding was repeated in surveys carried out by other practices.
Ethnicity
PRG representatives describe themselves as –
White British – 21
Irish - 1
Patient groups
There is representation on the PRG for the following specific patient groups –
· Carers
· Cared for
· Housebound
· Chronic Disease
· Learning Disabilities
· Nursing/residential homes
· Disabled
· Wheelchair users
· Parents with young children
· Workers (In and out of the area)
· Unemployed
· Dispensing
The patient groups not represented at present are –
· Under 16yrs old
· Patients using the ‘residential’ caravan sites in and around Withernsea.
The practice is in contact with representatives from the local High School and one of the caravan sites in the area and expects to have representation on the PRG shortly. (Since completion of the patient survey discussion the PRG now has representation from the caravan dwelling population).
2. Agreed areas of priority with PRG for patient survey
PRG members were asked to indicate the areas they considered to be priorities when they filled in the contact forms on joining the PRG. When collated the votes for the priorities were as follows -
1. Appointments - 16
2. Parking – 14
3. Telephone Access - 13
4. Time-keeping - 11
5. Opening hours - 5
6. Waiting rooms - 3
7. Patient information - 2
8. Clinical care - 1
9. Others - 1 ( Saving late appointments for workers/Saturday opening)
Given that we had to bear in mind that we needed to tackle something that we could realistically expect to do something about, parking was chosen as the ideal choice for this year. Though appointments came out at number one, the practice is putting new systems into place and it was thought logical to wait until the changes have fed through and look at its priority level for the next round. It was noted that as well as coming second on the PRG priority list there has been a number of complaints from external groups (e.g The Older Peoples Charter Group) as well as individual patients.
3. Patient survey – method and results
The next step was a patient survey. This ran for one week at the Withernsea surgery, to allow coverage of the whole range of patients visiting the practice for various services. Withernsea was chosen on this occasion, as again the PRG agreed we have to be realistic in what can be achieved, and Roos and Patrington have little room for action to improve parking if needed.
Method
The survey was conducted as a paper survey. (The questionnaire was disseminated to all PRG members for approval prior to the survey) All patients 17yrs or over, attending the surgery, were offered the opportunity to complete a questionnaire. The questionnaires were offered by receptionists and dispensers, who also gave support in completing the questionnaire if required. Over the period of a working week 173 questionnaires were completed.
The week chosen did not include any unusual activity at the surgery e.g. Retinal Screening, Ultra sound clinics etc.
Results and Questionnaire
| How often do you visit the surgery? | Male (73) | Female (100) | Total (173) |
| Daily (not available on questionnaire given to patients) | | 1 | 1 |
| Weekly | 5 | 6 | 11 |
| Monthly | 23 | 38 | 61 |
| More than once a year | 29 | 38 | 67 |
| Annually | 4 | 4 | 8 |
| Less often | 8 | 17 | 25 |
| How did you get to the surgery today? | | | |
| Walking | 31 | 40 | 71 |
| Public transport | 1 | 4 | 5 |
| Taxi | 3 | 1 | 4 |
| Car | 37 | 55 | 92 |
| Other (please specify) | 1 (Cycle) | | 1 |
| Does difficulty parking at the surgery stop you coming by car? | Yes 16 No 44 | Yes 28 No 46 | Yes 44 No 90 |
| Do you have any of the following? | | | |
| A disabled parking permit | 15 | 13 | 28 |
| Young children with you today | 0 | 5 | 5 |
| Problems with mobility | 5 | 10 | 15 |
| Where did you park today? | | | |
| Surgery car park | 25 | 34 | 59 |
| Hospital car park | 9 | 9 | 18 |
| Aldi car park | 4 | 11 | 15 |
| Other (please specify) | 1 (Main Road) | 0 | 1 |
| Did you have difficulty parking at the surgery? | Yes 18 No 31 | Yes 35 No 30 | Yes 53 No 61 |
4. Discussion of survey findings
53% (92) patients travelled to the surgery by car
57% (53) had difficulty parking at the surgery
36% (34) parked in places other than the surgery
25% (44) stated that difficulty parking at the surgery stopped them travelling to the surgery by car
The patient survey results clearly show that patients are having significant problems with parking at the Withernsea surgery. The GP partners and managers have discussed the issue and have proposed the following actions for discussion with the PRG.
· Arrangements to be made for staff to park off site – It has been noted that a significant number of parking spaces are taken up by surgery staff.
· Only doctors to park on site in a designated area. (Staff allowed to park on site only for safety or in the case of disability).
· New signage designating doctors only area.
· Repainting of bay lines
· New signage identifying patient only parking area and pointing out only those with business at the surgery are entitled to park and only for the duration of their business at the surgery. (It has been observed that people with no business at the surgery use the surgery car park and that patients are leaving their cars after their business at the surgery has been completed while they conduct business in areas other than the surgery).
The survey results and proposed actions (outlined above) were disseminated to all PRG members by their preferred medium (email/letter). A meeting was set up for those PRG members who preferred to discuss the issues face to face. Virtual members, who did not wish to attend the meeting, were invited to send in comments and actions they would like discussed by email/telephone/letter.
Outcome of discussions
The results of the survey and the proposed actions were discussed and approved.
The following additional issues were raised by members of the PRG -
· A wheelchair user on the PRG pointed out the difficultly caused, to a disabled passenger in a car, due to the kerb edge affecting one of the disabled bays.
· The lack of a mother and child bay.
· Suggested introduction of a drop off/short stop bay, for those dropping off patients, collecting prescriptions etc.
· Signage on upright posts at the end of the disabled bays, reminding people that they are parking in a disabled bay.
5. Agreed areas for action between PRG and Practice with timeline for completion
· Arrangements to be made for staff to park off site. (Staff allowed to park on site only for safety reasons or in the case of disability). – To be completed by end April 2012
· Only doctors to park on site in a designated area – To be completed by end April 2012
· New signage designating doctors only area – Costings to be researched by Practice Manager. Signage to be erected May 2012
· New signage identifying patient only parking area and pointing out only those with business at the surgery are entitled to park and only for the duration of their business at the surgery. Costings to be researched by Practice Manager – April 2012. Signage to be erected May 2012
· Signage on upright posts at the end of the disabled bays, reminding people that they are parking in a disabled bay. Costings to be researched by Practice Manager – April 2012
· Repeat of patient survey to establish effect of changes above – June 2012 (To be completed prior to next meeting 28th June 2012)
· Review of the layout and designated use of the parking bays in the patient parking area – June 2012 (After completion of repeat patient survey)
· Repainting of bay lines – June/July 2012
6. Publication of actions agreed with timeline
Publication of the actions agreed will be made by the following means –
· Dissemination of completed PRG report to all PRG members by their medium of choice.
· Posting the PRG report on the practice website – www.withernseadoctors.co.uk
· Display on practice notice boards.
· Copies of PRG report to – Withernsea Health Forum; Older Peoples Charter Group; The Shores (Resource centre); ERYLinks; ERYPCT, Local Library.
Thank you for taking the time to read this report. The work we are doing is designed to let you have ‘your say’ in how services given by your surgery can be improved. Any suggestions or comments are appreciated and will be given consideration. New members of the PRG are welcome. If you would like to make your views known, or would like more information about the PRG, please contact Gill Black (Practice Manager).