GRANVILLE HOUSE MEDICAL CENTRE

PRACTICE ANNUAL REPORT

2015/2016

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CONTENTS

1. Practice Mission Statement

2. Background

3. Practice Staff

4. Practice Population

5. Audit and Monitoring

6. Compliments/Complaints

7. Significant Events

8. Other Services

9. The Quality and Outcomes Framework (QOF)

10. Aspirations for the forthcoming year

11. Important Changes – Practice Telephone Number

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PRACTICE MISSION STATEMENT

The practice aims to treat patients with respect and with due regard to their age, sex, religious persuasion, sexual orientation, racial origin, cultural and linguistic background and any disability that they may have. Patients will be involved with their care and treatment and the support choices available to them. Your privacy, dignity and independence will be respected at all times. If you have family members acting on your behalf we will ensure that they can represent your view and are involved in the decisions about your care, treatment and support.

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1. Background

Granville House is a long established practice working from a purpose built surgery covering the areas of Adlington, Anderton, Heath Charnock and Rivington. We also have some patients in Chorley, Horwich and Blackrod. Since the practice area was changed in 2005, we no-longer take new patients from these areas. Unfortunately, if patients move from within the new boundary we will no longer be able to keep them on and they must register with an alternative practice. In April 2013, the practice registered with the Care Quality Commission (CQC) and is working to ensure that the standards we have worked to, continue to be high. The practice has also registered with the Information Commissioners Office since 2002.

2. Practice Staff General Practitioners The practice has 3 full time partners:

Dr Daniel McAllister

Dr James Edwards

Dr Anne Brickwood Dr Telleck joined the practice in September 2015 and works 3 days a week as a salaried doctor. We also have Dr Hardman who was previously one of our registrars and now works on a Wednesday. We have been a training practice for well over 10 years, with both Dr McAllister & Dr Brickwood being GP Trainers. They have seen many GP registrars become fully qualified GP’s. In fact one of our current partners was a GP registrar here. Registrars During the past year, our GP registrars have been:

Dr Tom Clarke is still in his registrar year and is due to finish in August

Dr Sarah Rowbern is still in her registrar year and is due to finish in August

Dr Nabiha Baqai was previously a registrar here and left us in August 2015 We also have other GP trainees (ST2s) who come to the practice 2 ½ days a week for a period of six months. Dr Edwards and Dr Telleck undertake training for 3rd year medical students. We usually have 2 students for 3 days a week for a month at a time over a 6 month period each year.

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Nursing Staff The practice has 3 nursing staff: We have Marie Vickers, Nurse Practitioner/Nurse Manager who specialises in Diabetes and is also responsible for the practice nurses:

Sister Alison Draper, who specialises on COPD and Asthma

Sister Alison Morris, who sees patients who are at risk of diabetes, carries out new patient health checks, immunisations, cervical screening, ear syringing, injections and BP checks

Staff In addition to our clinical staff, the practice also has 12 members of staff which are led by the Practice Manager, Mrs Linda Kershaw and Mrs Audrey Smith, Assistant Practice Manager. We have designated teams who deal with the following:

Medicines Management Team - Prescriptions

Secretarial Team – Referrals

Reception Team - Appointments

Administrative Team – Registration/Data Input As a practice we are lucky to have a very low turnover of practice staff, however in the past 12 months one longstanding member of staff retired and a new member was recruited. As well as staff directly employed by the practice, we also have a number of attached staff who is employed by the local Chorley and South Ribble Clinical Commissioning Group (CCG). These include:

Physiotherapist

Phlebotomist

Podiatrist

Midwife

Health Visitor

District Nurses

3. Practice Population The prevalence of ethnicity at the practice is low and a breakdown of the practice population for age and gender is listed below. This also shows the number of patients who have registered for the Virtual Patient Reference Group (VPRG).

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White Mixed/ multiple ethnic groups

British Irish Gypsy or Irish traveller

Other white

White &black Caribbean

White &black African

White &Asian

Other mixed

Practice 3414 13 4 39 7 2 4 5

VPRG 80 0 0 1 0 0 0 0

Asian/Asian British

Indian Pakistani Bangladeshi Chinese Other Asian

Practice 8 1 4 7 4

PRG 4 0 0 0 0

Black/African/Caribbean/Black British Other

African Caribbean Other Black Arab Any other (no ethnicity recorded)

Practice 0 0 0 0 4854

VPRG 0 0 0 0 0

The list size at the beginning of the year (1st April 2015) was 8278 and at the end of the year (31st March 2016) was 8233. This is an average of 2058 patients per partner. During the year the practice had 66 births and 83 deaths.

4. Audit and Monitoring Appointments The practice offered over 28,000 doctor appointments and over 11,000 nurse appointments and in addition to this we also offered a daily telephone consultation service and home visits

0

100

200

300

400

500

600

700

00-09 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80-89 90-99 100+

Males 414 443 408 410 573 655 550 407 160 18 1

Females 390 421 411 468 619 603 576 466 215 59 2

Co

un

t

Practice Population

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for those unable to attend the surgery themselves. There are approximately 7 home visits made each day. The practice also audits and monitors various activity for e.g. DNA (did not attend) rates for missed appointments for the doctors and nurses, attendances at accident and emergency, out of hours service, urgent and routine referrals, immunisations etc. DNA (Did Not Attend) The DNA rate recorded during the year showed that there were 973 patients who missed their doctor/nurse appointment, in some cases several times. As a result of this, there were 1235 missed appointments; the majority of these were for the Asthma/COPD clinics. Accident and Emergency attendances There were 2285 patient visits recorded in the last 12 months. Overall the practice has a significantly low attendance, compared with practices in the Chorley and South Ribble area. This information has been extracted from the CCGs database.

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Out of Hours/ 111 Service The out of hour’s service was contacted 1322 times by patients during the year. Referrals There were 2386 routine referrals made to secondary care during the year and 271 urgent referrals made for patients to be seen within 2 weeks. The practice has seen an increase in the number of referrals made, compared to the same time period for 1st April 2014 – 31st March 2015. Immunisations/Vaccinations - Pneumococcal There were 187 patients who received the pneumococcal vaccination during the year. Shingles The practice contacted patients who were eligible for the vaccine by letter to offer them the vaccine. The following age groups were contacted:

Age Number Identified Number Vaccinated

70 262 66

78/79 102 45

There were 8 patients who declined to have the vaccination. Seasonal Influenza The practice identified the following numbers in an ‘at risk group’

Age Number Identified Number Vaccinated

6m – 2 3 2

2-5 11 8

5-16 93 49

16-65 942 421

65 and over 1956 1368

There were 693 patients who declined to have the vaccination. Of these, 347 were over the age of 65 and 346 were under the age of 65. There were 45 patients identified as having the vaccination through their pharmacist. Of these, 17 were over 65 and 28 were under the age of 65.

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There were 32 patients identified as having the vaccination through other health providers. Of these, 8 were over 65 and 24 were under the age of 65. Cervical Smears The practice carried out 391 cervical smears during the time period. Prescription Requests The practice receives on average 1486 repeat prescription requests each month through the practice website. In addition to this, we also receive requests via Patient Facing Services (formerly Patient Access), fax and paper requests. There were also over 140,000 items prescribed using the Electronic Prescribing Service (EPS). Practice Website Visits On average the practice website is visited 11,000 times each month. We are constantly updating the information held on the website and this is an invaluable source of information. GP Patient Survey – Results The GP Patient Survey is an independent survey run by Ipsos MORI on behalf of NHS England. The survey is sent out to over a million people across the UK. The results show how people feel about their GP practice. Below is a selection of responses that were received for our practice.

Questions asked Practice Average

Local CCG Average

National Average

Find the receptionist at the surgery helpful 94% 88% 87%

Usually get to see or speak to their preferred GP 67% 64% 59%

Were able to get an appointment to see or speak to someone the last time they tried

94% 87% 85%

Say the last GP they saw or spoke to was good at listening to them

98% 91% 89%

Had confidence and trust in the last GP they saw or spoke to

100% 97% 95%

*Would recommend this surgery to someone new to the area

98% 81% 78%

* THIS SCORE WAS THE HIGHEST SCORE IN THE BOLTON, CHORLEY, PRESTON AND WIGAN AREAS.

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To view the full survey for our practice, please visit the following website at https://gp-patient.co.uk/about Friends and Family Test (FFT) The Friends and Family Test (FFT) is a simple way to provide feedback about the practice and the service we provide. The feedback can be provided in written form or by completing the questionnaire online via the practice website. Any feedback given is reviewed and where possible any issues raised are addressed and improved upon. The feedback can be viewed on the practice website. The question asked was: How likely are you to recommend our GP practice to friends and family if they needed similar care or treatment? The table below shows the responses that have been received over the 12 month period.

TOTALS

Online Paper Total

Extremely Likely 12 53 65

Likely 51 5 56

Neither Likely or Unlikely

23 1 24

Extremely Unlikely 12 0 12

Don’t Know 5 0 5

SPAM 13 0 13

TOTAL 109 59 168

Of the total responses received, 65% were received online and 35% were received by paper. Please see the practice website for all comments made on the Friends and Family Test.

5. Compliments/Complaints The practice received 3 compliments during the year. Compliments July 2015 A comment was posted on the NHS Choices website from a patient who said “This is the best GP surgery ever; I can always get an appointment when needed. Staff at all levels are lovely and the GP’s are great. I am always treated with respect, things are explained to me and I get the treatment I need. We would love to move house, but won’t because we don’t want to change our doctor’s ever!” July 2015

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“We would love to move house but won’t because we don’t want to change our doctors ever!” November 2015 A comment was posted on the NHS Choices website from a patient who said “I have been registered with this wonderful team at Granville House for 54 years. I and my family have only praise for all departments of the practice. Thank you each and every one of you for all the kindness and care you have given us over the years”. All the above comments are in addition to any comments that were received via the Friends & Family Test (FFT) and the Patient Participation Group survey (PPG). Complaints The practice received 5 written complaints during the year. Where possible, patients were contacted to discuss and resolve their specific complaint. In some cases this was not possible as some were posted anonymously on the NHS Choices website. Where this happened, a comment was posted on the website inviting the patient to contact the practice manager, but no response was received. July 2015 A complaint was received regarding a consultation with a doctor. The patient complained that the locum doctor they had seen had made assumptions about their presenting condition based on a previous diagnosis. An example of factual evidence was given which the doctor should have been aware of regarding their condition. The doctor concerned wrote to the patient apologising and thanked them for bringing the evidence to their attention. The doctor did offer to meet the patient again to discuss the matter further. July 2015 A complaint was received regarding a consultation with a doctor. The patient complained that the doctor was still dealing with a query regarding a previous patient whilst consulting with their family member at the same time. The doctor concerned wrote to the patient apologising for their actions and the distraction of taking a phone call during the consultation. November 2015 A complaint was made about a referral to secondary care. The patient complained that they had not been referred appropriate. After a full investigation involving the hospital consultants, they confirmed that the practice had taken the correct course of action. The patient was written to with an explanation.

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January 2016 A complaint was received about releasing medical information. As this is a private matter, we cannot make any comments. March 2016 A comment was posted on the NHS Choices website from a patient who said “I’m not well and I needed to see a doctor, unfortunately I have to work, could I get through? No, I started to ring at 8 in the morning over 130 calls later could I get through No!!!!! So I went in before I dropped the kids off from school could I get an appointment No one appointment left at 4 well I have to work I can’t pre book when I need to it’s appalling this service we recently moved to this practice and all I can say is what a mistake utterly disgusting and this isn’t the first time this has happened either!! The practice responded to the above stating the following: “we are sorry that we could not accommodate your appointment request. The practice policy is that if a patient rings before 10.30 am, we will offer them an appointment, however; the choice invariably becomes more limited the later in the morning we receive your call. You could always register for Patient Access which gives you the same ability to book appointments online as they become available at 8.00 am. These are only a brief summary of the actual complaints as we do not wish to divulge any information that will identify any patient. The above compliments and complaints are in addition to any that are received through the Friends and Family Test (FFT) and the Virtual Patient Reference Group (VPRG).

6. Significant Events The practice is always striving to improve its performance and one of the ways of doing this is through regular significant event meetings, which the whole of the practice team discuss specific events. These can be either positive or negative and have shown that there are ways to improve our working practice.

7. Other Services The practice offers a wide range of services and information that can be accessed through the practice website. The website is maintained and is updated on a regular basis. Weekend Opening In November 2015, the practice introduced weekend opening for patients who find it difficult to attend a doctor’s appointment during the week. These are a mixture of pre-bookable and book on the day. For further information, please visit the practice website at www.granvillehousemc.co.uk

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Names GP – Patients over 75 As part of a government initiative, each patient over the age of 75 has to be allocated a named GP. The named GP will be responsible for co-ordinating the patients overall care and wellbeing in conjunction with the other GP’s and nurses who work at Granville House along with other health and social care professionals. Each month patients who reach the age of 75 that month are written to and advised who their named GP is. Virtual Patient Reference Group The practice conducts an annual patient survey to help us understand how the services that we provide can be improved. The practice has 85 registered members of the Virtual Patient Reference Group (VPRG) who are consulted either by email or letter regarding what the content of the questionnaire should include, prior to this being published on the practice website for all registered patients to complete. A full report can be found on the practice website at www.granvillehousemc.co.uk Practice Newsletter The practice produces a quarterly newsletter and we have 642 patients who have subscribed to receive this. SMS Text Messaging We have recently started using a patient text messaging service. The new service will allow us to keep our patients informed about their appointments at Granville House Medical Centre. You will receive confirmation of your booked appointment and a reminder will be sent 48 hrs prior to your appointment. PLEASE ENSURE THAT WE HOLD A CORRECT MOBILE NUMBER. We hope the new service will reduce the amount of telephone calls made to the surgery. Messages sent from Granville House Medical Centre will show on your phone as from NHS-No Reply.

Health & Social Care Information Centre (HSCIC) NHS England has comissioned a program of work to gather information to improve the quality of care for all. The role of the Health & Social Care Information Centre (HSCIC) is to ensure that high quality information is used appropriately for this purpose. Family history, vaccinations, diagnoses, referrals, all NHS prescriptions along with personal identifiers such as date of birth, postcode, NHS number and gender are extracted from our system. This information is then used to analyse patient care, improve healthcare, advance customer services and increase accountability. The information collected from our records

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will be linked to information from hospital records. Once the information has been linked together, the details that identify you, such as your date of birth and postcode, will be removed and replaced by a reference number. This data may then be sent on to other accredited third parties. You can choose to opt out of this should you wish. You can find further information about this on the following website – www.nhs.uk/caredata Summary Care Records Summary Care Records are a summary of clinical information deemed useful in the event of emergency care. This information is made available to other health care professionals and includes allergies, adverse reactions and medication. You can opt out of sharing this information should you wish. Further information about this can be found on the following website www.nhscarerecords.nhs.uk Patient Access We have been offering patient’s the ability to book appointments through Patient Access for some time now. In addition to the above, you can also do the following:

Order repeat prescriptions

View your medical record

Update your contact details

Send secure messages Also from 8.00 am each morning you will have access to all of the available appointments avoiding the need to phone the surgery during our busiest time. If you want to know more about Patient Access please look on our website www.granvillehousemc.co.uk and follow the links provided. GP2GP

Granville House Medical Centre utilises an electronic system for transferring patient records to and from other GP surgeries, called GP2GP. GP2GP enables patients' electronic health records to be transferred directly and securely between GP practices. It improves patient care as GPs will usually have full and detailed medical records available to them for a new patient's first consultation.

8. The Quality and Outcomes Framework (QOF)

The Quality and Outcomes Framework (QOF) is the annual reward and incentive programme

detailing GP practice achievement results. The QOF is split into the following two domains:

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Clinical Domain

Public Health Domain Within each domain are individual indicators which set out the target, intervention or measurement to be recorded within a specified time period.

QOF is a voluntary process for all surgeries in England and was introduced as part of the GP

contract in 2004. QOF awards surgeries achievement points for:

Managing some of the most common chronic diseases, e.g. asthma, diabetes Implementing preventative measures, e.g. regular blood pressure checks

The extra services offered such as child health care and maternity services

The quality and productivity of the service, including the avoidance of emergency admissions to hospital

Compliance with the minimum time a GP should spend with each patient at each appointment

Achievement In 2015/16 the practice achieved 539 points out of 545 points available.

9. Aspirations for the forthcoming year The practice will continue:

To use the SMS text messaging system

To improve on identifying patients next of kin/carer contacts by asking them to fill out a form

To provide a stable workforce

To work closely with the Chorley & South Ribble Clinical Commissioning Group (CCG) in providing new services that become available in areas such as mental health

To provide access to weekend surgeries

To reduce prescriptions for Cephalosporin’s and Quinolones 10. IMPORTANT CHANGES – PRACTICE TELEPHONE NUMBER

The practice will be having a new telephone system installed and from the 20th September 2016 the main telephone number to contact the surgery will be 01257 514100.