The Mill Medical Practice - gr · PDF fileNBSurvey, to enable the ... The Mill Medical...

The Mill Medical Practice

The Mill Medical Practice

Catteshall Mill

Catteshall Road

Godalming

Surrey, GU7 1JW

Practice Manager: Robin Forward

T: 01483 239903

Local Patient Participation

Report March 2014

The Mill Medical Practice Local Patient Participation Report 2014 |2

Executive Summary The following report outlines requirements for a Local Patient Participation Report to satisfy the Patient Participation Direct Enhanced Service 2013 – 2014 requirements as directed by the; 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 2013, and continue on from results in March 2013 Local Patient Participation Report.

The Mill Medical Practice Catteshall Mill Catteshall Road Godalming Surrey, GU7 1JW

Practice Manager:

Robin Forward

Number of full time doctors (FTE) 8.50

Number of patients 15463

The practice has seven partners, three female and four male doctors. Four partners are full-time partners and three part-time. In addition the practice employs four part-time Salaried GPs and two part-time GP registrars.

Patient Participation Direct Enhanced Service Methodology:

The practice engaged with NETbuilder to provide their comprehensive managed survey solution, NBSurvey, to enable the collection of views from patients in multiple locations across various demographic groups. This enabled us to canvas our patients’ opinions via an input channel most suited to them, from physical paper and in-practice touch screen kiosks, through to virtual online surveys.

Patient Reference Group Summary:

The practice has a ‘virtual’ Patient Reference Group. This means that patients are invited and encouraged to give their feedback via surveys on various aspects of the practice in a number of ways; by completing a paper format of the survey, by accessing surveys from the practice website, completing a survey whilst they are in the practice using the ‘kiosk’, or if they have previously given their email address. The practice also has a registered charity “Friends of the Mill” (FOTM) which meets twice a year. We are hoping to combine these two groups to form a more cohesive Patient Reference Group. From October 2013 we started a strong campaign to recruit new members. We began at our annual Flu Clinic handed out flyers to our patients. Flyers we are handed out by individual GPs in their clinics as well as left at reception for patients to pick up. We had our first meeting on the 27th November 2013 with our current FOTM committee and prospective new members to discuss the way forward. Our second meeting on the 19th February


2014, we discussed our financial year end accounts, renewing our subscription to Go Godalming and preparation for our AGM in April 2014. The current number of PRG members is 63. This has reduced from 68 last year. This has been determined by the emails no longer in use and have bounced back to my in box. Recruitment is on-going. Use of the kiosk, paper surveys and the web portal have been used, and will continue to be used to collect feedback from patients about their experience.

Results Summary

Item Total

Number of Surveys 5

Number of Responses 558

Number of Input Channels 3

Summary Outcomes & Action Plan – PPDES Year 3 Results

Following feedback from members of our virtual group our main target this year was Customer Service and Patient Confidentiality. Patient confidentiality was chosen due to the new National initiatives regarding Summary Care records and Care.data which many of our patients may be aware of. We believe it is vital we provide high quality customer service at the practice and therefore wanted to get feedback from the patients to see if there were any areas we could improve on. We have also recently updated our website and wanted to know if our patients were using it and what options were they using. Action Plans: Following feedback from patients we have considered opening a second window at reception to improve privacy at the desk. This would then provide a better service for those who are concerned about confidentiality. Patients have the option to opt out of any shared data. The National Care.data has been put on hold so patients do not need to be concerned. Our practice website holds important information for patients and we are hoping they will use it more often. We will be actively promoting the use of our website and access on line appointment booking.


Contents

Executive Summary 2

Patient Participation Direct Enhanced Service Methodology: 2

Patient Reference Group Summary: 2

Results Summary 3

Summary Outcomes & Action Plan – PPDES Year 3 Results 3

Contents 4

About The Practice 6

The Partners 6

Salaried GPs 6

The Practice Staff 6

Practice Nurses 6

District Nurses and Community Matron 6

Midwives 6

Health Visitors 6

Opening Hours 7

Nurse appointments 7

Home Visits 7

When the Surgery is closed 7

For general health advice only, please visit www.nhsdirect.nhs.uk 7

Local Survey Methodology 8

The NBSurvey Methodology 8

Input Channel Evaluation Criteria 12

Patient Reference Group 14

PRG Membership 14

Member Profiles 14

PRG Recruitment & Representation 14

Results, Outcomes & Findings 15

Summary Information 15


Survey results by Input Channel 15

Summary of Demographics Survey 15

Survey Results 15

Discussions & Action Plans 19

Outcomes & Action Plan – PPDES Year 3 Results 19

Summary of the PPDES 2013/14 20


About The Practice The practice was established in 1968 original based in Godalming High Street, now resides at Catteshall Mill, in Catteshall Road. The practice is a large multi-disciplinary primary care team and prides in providing high quality care and services to our patients in Godalming.

The Partners

Dr. Ailsa Borthwick MA MB BChir DA 1982 (Cambridge) Dr. Felicity Overington MB BS DRCOG MRCGP 1988 (London) Dr. Anthony Cerullo State Exam 1990 (Pisa) Dr. Steven E D Simons MB BS DA DFFP MRCGP 1989 (London) Dr. Klaus Green MA MB BChir DRCOG MRCGP 1992 (Cambridge) Dr. Leslie J F Campbell MB BChir DRCOG MRCGP 1990 (Cambridge) Dr. Suzanne Clark MB ChB MRCP DRCOG MRCGP DFFP 1997 (Liverpool)

Salaried GPs

The Practice employs four fully trained part-time GPs for some additional surgery sessions per week. Dr. Sarah Taylor-Smith BM DRCOG MRCGP 1997 (Southampton) Dr. Helen Carr MB BS MRCGP DFFP DCCH DRCOG MSc 1991 (London) Dr Georgina Dalton MB BS MRCGP DCH DRCOG (London) Dr Ann Summersgill MB BChir MRCP MRCGP DRCOG DFFP (Cambridge)

The Practice Staff

Practice Nurses

The Treatment Room is manned by our five Practice Nurses and three Treatment Room assistants, who carry out blood tests, travel immunisations, dressings, ear syringing etc. as well as running various clinics. Penny Randall RGN Melisa Yeardley RGN Linda Smith RGN Alison Tucker RGN Jenny Boyden RGN Sandra Greener Jacqueline Sherrington

District Nurses and Community Matron

The district nurses are based at the surgery and visit patients at home when necessary.

Midwives

The midwives provide care and advice during pregnancy and after childbirth.

Health Visitors

The health visitors provide care and advice to parents after childbirth and monitor the development of the child to ensure it is healthy.


Opening Hours

Monday – Friday 8:00 – 18:30 Saturday and Sunday CLOSED The Surgery is closed every Monday at lunchtime between 13:00 and 14:00. The practice appointment system provides more availability for 'on the day' appointments and a smaller number of pre-bookable appointments for those who need to book ahead. Appointments can be made either on the telephone or via the internet. To access appointments via the internet please ask reception for details. For an on-the-day appointment, please telephone the surgery preferably in the morning. Pre-bookable appointments are opened up each weekday two weeks in advance. These appointments can be made at any time. Please be aware our phones lines are exceptionally busy first thing in the morning but will be answered as soon as possible. We encourage patients to see their usual or registered GP wherever possible. However, our part time GPs are able to see those patients whose usual GP is not available. We will provide up-to-date information about individual GPs' current surgery times on our website and from our reception desk. Please note that these times may change from time to time. We have EMIS access, giving on-line patient access and an automated facility on our telephone system to enable patients to book, cancel or check appointments on the phone. Both these facilities are available to patients out of hours.

Nurse appointments

These can be pre-booked in person or on the telephone and there is very limited availability on the day for urgent appointments only.

Home Visits

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

When the Surgery is closed

Out-of-hours cover is now the responsibility of the NHS 111 service. ”Out of hours” means urgent calls outside of normal surgery hours i.e. weekdays 6.30pm to 8.00am the following morning and from 6.30pm Friday to 8.00am Monday morning. Please restrict out-of-hours calls to genuine urgent problems that cannot wait until the next working day. If you need to be seen by a doctor, this may be either at your own home or at the nearest Primary Care Centre. For urgent medical advice or treatment telephone NHS 111 on 111. For general health advice only, please visit www.nhsdirect.nhs.uk


Local Survey Methodology

The practice engaged with NETbuilder to provide their comprehensive managed survey solution, NBSurvey, to enable the collection of views from patients in multiple locations across various demographic groups. This enabled us to canvas our patients’ opinions via an input channel most suited to them, from physical paper 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 to the investigational design and measures, for example measuring how effective it is for patients to get an appointment using a short survey (The Access Survey). Additionally, this encourages 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 on the production of practice surveys and collaborating with the practice to analyse the results and agree realistic change opportunities.

We had a good outcome of patients participating in our survey. Hopefully more patients will join our PRG and the practice will continue to promote it.

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 prioritise 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.

In year 1 of the PP DES we conducted a patient priority survey; this gave us a good idea of three areas of priority that patients wished to look at.

Seeing a Doctor Seeing a Nurse Access Practice Information

In year 2 of the PP DES we ran the following surveys;

Access

Surgery telephone

Patient priorities

Seeing a Doctor or a Nurse

Patient participation Group In year 3 of the PP DES we ran the following surveys;

Access

Surgery telephone

Patient participation Group

Seeing a Doctor or a Nurse

Customer Service & Confidentiality Survey

Design & Build Surveys

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

The practice will collaborate with the PRG to agree the questions in each survey, to the areas mentioned above.


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.

We used the Input Channel Evaluation Criteria to help us decide which channels to use for The Mill Medical Practice:

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

Paper: available in the surgery as an alternative to the kiosk or to be completed on behalf of others if required. The GPs can also target patients from all demographics in the consulting room

Web Site: open to all practice patients

Paper input has proved popular with patients who like to take the survey home and complete it there and return it at their convenience. In year 2 & 3 we continued to use the following input channels;

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

Paper: available in the surgery as an alternative to the kiosk or to be completed on behalf of others if required. The GPs can also target patients from all demographics in the consulting room

Web Site: open to all practice patients

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 promoting include but is not limited to:

Encouragement slip given by the doctor

Noticeboard Posters

Leaflets

News Letters

We will continue to use all these methods to promote the surveys and participation in the PRG. We put up notice boards, website and a competition was set up for the admin team to promote the survey and encourage patients to complete.


Encouragement from all Practice Staff & PRG

Surgery Website

Capture Patient Experience

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

Data from paper forms is inputted onto the NETbuilder Paper Survey links by practice staff. This allows patients to use an additional input method especially where they do not use technology in everyday life and maybe wouldn’t otherwise complete the survey. It does however take up time within the surgery to do this so we also encourage patients to use the other input channels as much as possible. We will continue to encourage the use of the Kiosk and website, though many patients find it easier to complete the paper survey. This was not as onerous as thought to be.

Produce & Distribute Reports

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

The results of the surveys were emailed to the Patient Group and feedback was requested. Copies of the surveys were also made available in the Reception area prior to the Practice Meeting. The results will be published on our website and displayed on the Notice board together with this completed report.

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.

Having a virtual PRG which can be contacted via e-mail, post or telephone will make this process much easier than having regular meetings which have not proved popular with our patients in the past. We will discuss this at our PHCT meeting as this affects all members of staff. I will also arrange another meeting with the PRG once we have an action plan in place.


Input Channel Evaluation Criteria

Input Channels should be thoroughly evaluated for their suitability for use by patient 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

Excellent for tracking feedback for

specific treatments (e.g. specialised

clinics)

Limited to patients with internet

access


to use technology

Limited to patients with email

accounts

Agree Action Plan Detailed action plans are created at the end of year 1 (2011/2012), end of year 2 (2012/2013) and end of year 3 (2013/2014) of the PP DES.

An agreed action plan between the PRG & Surgery was created after the year 1 result (2011/2012) according to the outcome of the analysis from the results. Further action plans were created following the year 2 results (2012/2013) and year 3 results (2013/2014). Details of the year 3 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.


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 from patients registered at The Mill Medical Practice.

Nationality PRG Profile

White 100%

Mixed 0%

Asian or Asian British 0%

Other 0%

Age Group PRG Profile

18-30 years 3.85%

31-40 years 23.08%

41-50 years 23.08%

51-65 years 23.08%

65- over 26.92%

Gender PRG Profile

Male 34.62%

Female 65.38%

Employment PRG Profile

Employed 53.85%

Unemployed 3.85%

Permanently sick or disabled

15.38%

Fully retired 23.08%

Other 3.85%

PRG Recruitment & Representation

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

The practice website

Display Screen in waiting room

Posters on full view in reception and waiting areas

Leaflets available on reception desk

Leaflets in consulting rooms for GP’s to recruit individuals

Current members recruitment drive The current number of PRG Members is 63. Recruitment is on-going using all the methods described above. Note: Feedback is not solely reliant on the PRG, surveys are also completed by other Patients from the Practice via the surgery kiosk and web portals etc.

Results, Outcomes & Findings

Summary Information

Item Total

Number of Surveys 5

Number of Responses 558

Number of Input Channels 3

Survey results by Input Channel

Input Channels

Survey Kiosk Paper Website Total

Customer Service & Confidentiality 116 345 13 474

Patient Participation Group 2 0 0 2

Access 23 0 6 29

Seeing a Doctor or Nurse 18 0 2 20

Surgery Telephone 30 0 3 33

Total 189 345 24 558

Summary of Demographics Survey

Our Practice took the strategic decision not to solely rely on our Patient Reference Group for feedback to our surveys and wanted to capture the views of as many of our patients as possible. To support this decision we invested in a touchscreen kiosk and web portal technology. The intention was to encourage patients visiting the practice to provide us with “in the moment” feedback about the service they had just received. The web portals enable us to reach-out to patients who are unable to visit the surgery. In addition, our committee members came into the surgery over a two week period to hand out paper surveys and encourage recruitment onto our PRG. We believe that this strategy will provide the practice with feedback from a representative demographic of our patient population. Survey Results

Detailed reports for each survey can be posted on The Mill Medical Practice Website www.themillmedicalpractice.co.uk All results were discussed with the PRG and relevant practice staffs, 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.

http://www.themillmedicalpractice.co.uk/


Customer Service and Confidentiality

When asked whether other patients could overhear what they were saying to the receptionist 46.62% said ‘yes, but I don’t mind’, 10.55% said ‘yes and I’m not happy about it’, 36.71% said they ‘didn’t notice’ and 6.12% said ‘other patients can’t hear’

69.2% of patients said the last time they requested an appointment they were able to see or speak to someone on the same day or next working day

6.33% of patients said they are normally seen on time for their appointment, however a total of 61.81% patients said they were seen within 15 minutes of their appointment time

76.58% of patients said they are ok with having to wait and don’t have to wait too long

95.78% of patients said they were ‘satisfied’ or ‘very satisfied’ with the care they receive at the surgery

When the patients were asked what they had use the website for they answered: Check opening times - 19.82% Request or cancel appointment - 17.12% Update their details - 3.06% Order a repeat prescription - 7.93% Haven’t used the website - 52.07%

When the 52.07% of people were asked why they had never used the Website they said: Don’t have computer access - 17.66% Prefer to phone the surgery - 36.47% Prefer to visit the surgery - 6.27% Didn’t know about the website - 16.81% Another reason - 22.79%

66.88% of patients said they felt OK about anonymous data relating to their medical history being shared with other organizations for research purposes and to plan and improve healthcare services

26.58% said they wouldn’t want to share anonymous data about their medical history

51.27% of patients said they were aware that patients of 16 years and over have confidential medical records that cannot be accessed by their parents, 17.51% were not aware and 31.22% said it wasn’t relevant to them

38.61% of patients surveyed said they were aware that carers must have pre-authorised permission to access confidential medical records for a person in their care, 21.31% were not aware and 40.08% said it wasn’t relevant to them

Access

78.26% of patients normally book an appointment by phone

52.17% of patient prefer to book appointments by phone

The patients that have tried to contact the surgery by phone rated the service as ‘good’ or ‘excellent’ in the following areas;

Getting test results – 57.14% Getting through – 36.36% Speaking to a doctor – 33.33% Speaking to a nurse – 22.22%


52.17% of patients were able to get an appointment to see a doctor on the same day or within 2 working days. 65.22% of those that couldn’t get an appointment on the same day or within 2 working days said there were no appointments left

91.30% of patients have tried to book ahead to see doctor, 52.38% of those patients were able to book an appointment for more than two days in advance

Seeing a doctor or nurse

75% of patients said they saw a doctor the day they came to the surgery and 25% saw a nurse

The doctors were rated as ‘satisfactory’ or ‘good’ in the following areas:

Asking about symptoms – 92.31%

Explaining test and treatments – 69.23%

Giving enough time – 100%

Involving patients in decisions about their care – 84.61%

Listening – 100%

Treating patients with care and concern – 91.67%

75% of patients said that they had ‘confidence’ or ‘confidence to some extent’ in the doctor

they saw

83.33% of patients said they would be happy to see the same doctor again

When seeing a doctor, patients gave their reasons for having a consultation as:

Asking for advice – 25%

Routine check-up – 8.33%

One off problem – 33.33%

Prescription – 8.33%

On-going problem 25%

The nurses were rated as ‘satisfactory’ or ‘ good’ in the following areas:

Asking about symptoms – 100%

Explaining test and treatments – 100%

Giving enough time – 100%

Involving patients in decisions about their care– 100%

Listening – 100%

Treating patients with care and concern – 50%

75% of patients said that they had ‘confidence’ or ‘confidence to some extent’ in the nurse they

saw

50% of patients said they would be happy to see the nurse again

Telephone

The patients that have tried to contact the surgery by phone rated the service as ‘good’ or ‘satisfactory’ in the following areas;

Getting test results – 60% Getting through – 41.18%


Speaking to a doctor – 50% Speaking to a nurse – 66%

35.29% of patients find the surgery answerphone messages useful

76.47% of patients would prefer to be put in a queue when the phone line is busy

Patient Participation Group Survey

2 people completed the Survey and 1 of those people said they would like to join the Virtual Patient Participation Group

1 person was male and 1 person was female and both were under 17 and white

1 person was in Full Time Education and worked 30 hours or more a week and the other person was unemployed

1 person surveyed said they had a longstanding physical condition

1 person surveyed said they were the parent or legal guardian of children aged 16 years or under currently living at home

Both people said they rarely come to the Practice

1 person said they preferred to be contacted by email and the other by post


Discussions & Action Plans

Outcomes & Action Plan – PPDES Year 3 Results

This year we decided to target our survey on Customer Service and Patient Confidentiality. The reason we chose Customer service as our first topic was in relation to feedback from members of our virtual group. We also believe it is vital we provide high quality customer service based practice. Most patients surveyed were able to discuss their condition on the same day. The wait on average is between 5 and 15 minutes after they have checked. Most patients are ok with having to wait. And most importantly the majority of patients are satisfied or very satisfied with the care they receive at our practice. Patient confidentiality was chosen due to the new National initiatives regarding Summary Care records and Care.data. We are aware with the open plan in reception patients may feel their confidentiality is being breached and we wanted to know their opinions. Thirty-six percent didn’t notice whilst nearly fifty percent don’t mind. With regards for anonymous data of medical history being shared, sixty-six percent of our patients were ok as long as it is anonymous. Most patients are aware that children over the age of sixteen have the right to medical record confidentiality. Whereas only thirty-eight percent of patients surveyed knew that carers needed pre- authorisation to access confidential medical records. We have recently updated our website and wanted to know if our patients were using it and what options were they using. Fifty-two percent of our patients surveyed have not used the website. Those who did mostly used it to check our opening times. The main reason they did not use the website was that they preferred to call the practice. Action Plans: As a practice, we are aware that we are a very busy practice and we have a high volume of patients every day. It appears waiting times and being able to see their doctor about recent condition is not a concern at the moment and no action is needed. However, we will revisit these issues later in the year. We have considered opening a second window at reception and moving the touch screen log in to another area in order to provide a second receptionist and privacy for those at the desk. This would then provide a better service for those who are concerned about confidentiality. Patients also have the option to opt out of any shared data. The National Care.data has been put on hold so patients do not need to be concerned. Summary Care records are only shared with other NHS organisations for the benefit to the patient being seen in case they are out of area. Our practice website holds important information for patients and we are hoping they will use it more often. As noted in previous surveys, our phone lines are extremely busy and you may be able to book an appointment or order a repeat prescription from there rather than waiting for a clear phone line. We will be actively promoting the use of our website and access on line appointment booking.


Summary of the PPDES 2013/14

Over the last year we have had a total of 558 patients respond to our surveys and for the most part they have been positive. We very much appreciate the time patients have taken to complete these surveys and find they are a valuable part of providing a better health care service. We also recognise many of our patient’s concerns and value their feedback. Even though our PPG is not a fully established group, the virtual group has been tremendously helpful by contributing as part of our national requirement. The five surveys open for comments covered a variety of issues and we will continue to monitor the areas that need to change. Looking towards next year, we are hoping to get an early start on targeting areas for feedback and/or review. We are also hoping that the establishment of new recruits to the PPG will inspire active participation and new ideas. We would also like to set up regular meetings and fund raising as a way of becoming a bigger part of the community. Most importantly, thank you to all our patients and we hope we can continue to keep the line of communication open and provide a service you deserve.

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