Question 1: Please provide one example of what The Old Exchange Surgery has done well

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The Old Exchange

St Ives
Action Plan for 2012-2013

After consultation with the Patient Reference Group (PRG), it was agreed that the following three questions should be raised:

Question 1:

Please provide one example of what The Old Exchange Surgery has done well
Question 2:

Please provide one example of what the Old Exchange could do better
Question 3:

How likely are you to recommend The Old Exchange Surgery to a family member, colleague or friend? (1 = unlikely and 10 = very likely)

These questions are similar to those be asking at Hinchingbrooke Hospital and other medical establishments. It was agreed that the responses would help to benchmark The Old Exchange for the future.

Objective	Activity to achieve objective	By when?
Clinical
To continue to provide the high quality of care already offered and that all our patients continue to be respected as individuals.	n/a	Ongoing
Appoint Registrar in order to offer more doctors appointments	Registrar to be appointed once Dr Somers Heslam has completed GP trainer programme	31 Mar 2013
Be more proactive in supporting patients (including counselling services and the understanding of complementary therapies)	Systems to be reviewed at internal Clinicians’ meetings	30 June 2012
	Outcomes of review to be implemented	30 Sept 2012
Appointments/Administration
Improve communication with patients when appointments are running late	Receptionist staff to be trained to keep patients informed	30 April 2013
	New electronic Clinical System will provide self booking-in screen at front desk which will inform the patient how many patients are waiting in front of them.	31 July 2012
First appointments of the morning/afternoon to start on time	Clinicians to be informed at internal Clinicians’ Meeting and this to be implemented and monitored thereafter	30 April 2012
Review system for providing telephone consults – can they be allocated in one hour time slots?	To be discussed at Clinicians’ Meeting and any outcome implemented thereafter	31 May 2012
Improve current telephone system so that calls are handled more quickly and efficiently for both patients and staff.	New up-to-date telephone system has been identified and will be installed (after consultation with the Patient Group and Admin Staff)	30 June 2012
Telephone ansaphone message to be switched on and off on time.	This should be rectified with installation of new telephone system. The new system has an automated system to do this so there is no risk of human error.	30 June 2012
The front desk to be permanently manned.	Rotas and admin activities to be reviewed to ensure that front desk can be permanently manned.	30 June 2012
	Computer at front desk has already been upgraded so that more non confidential activities can take place at the front desk.	Completed
	Minor building work will take place to sound proof the front desk from the waiting room so as to protect privacy (e.g. when receiving a confidential telephone call)	30 April 2012
Reception staff to provide customer service at a consistently high level	Formal feedback regarding results of the patient survey will be provided at the next Admin Meeting.	30 April 2012
	In-house customer service training to be arranged which will cover both face-to-face interactions as well as via the telephone.	30 June 2012
Provide tools for reception staff to work more effectively and efficiently	Electronic clinical system (for patients’ medical records) to be updated. Go live date for new system is scheduled for 9 July 2012	9 July 2012
	New Clinical System will provide self booking-in screen at front desk which will help to free up Receptionists’ time.	9 July 2012

Objective	Activity to achieve objective	By when?
Dispensary
Reduce prescription errors	Installation of new Clinical System has a full dispensing module which includes barcode checking system which does not allow for human error.	9 July 2012
	An annual audit will be conducted for the period April 2012 to March 2013 to determine if the incidence of prescription errors has reduced.	April 2013
General
Music played in waiting room to be changed i.e. not a radio station.	To be discussed at internal staff meeting and outcome implemented.	30 June 2012
Waiting room to be revamped	Awaiting outcome of insurance investigation into confirmed subsidence of part of the building. When Insurance Company has agreed to the remedial work required we will co-ordinate revamping the waiting room at the same time e.g. redecorating and new flooring.	31 March 2013
Improve availability and range of magazines in the waiting room	Ask patients to bring in their recently read magazines. Include this in the next Practice Newsletter.	30 June 2012
Flowers/plants in waiting room	Flower/plant arrangements are currently being trialled in the waiting room. Allergies have been taken into consideration.	Ongoing
Wheelchair Access	Plans have been drawn up to improve the current wheelchair access. Awaiting Insurance Company’s feedback re remedial works for subsidence before progressing this.	31 March 2013
Improve layout of Waiting Room for Wheelchairs	Review current seating layout so that wheelchairs can be accommodated easily between chairs.	30 June 2012

Question 3:

How likely are you to recommend The Old Exchange Surgery to a family member, colleague or friend? (1 = unlikely and 10 = very likely)
Just over 62.3% rated a 10 i.e. very likely to recommend

Less than 1% of responders rated a 3 i.e. not so likely to recommend

We will repeat this question in the next annual patient survey with the aim to improve on the number of patients likely to recommend us. Of course, our ideal target would be 100%. A more realistic target will be 70% of patients to provide a rating of 10 i.e. very likely to recommend.
Actions currently unable to be implemented

Comment	Reason for being unable to implement
Request to extend opening hours	Due to insufficient interest from patients and because of lack of resource (personnel and finances), the Practice has been unable to offer extended hours. This situation is reviewed annually and patients will be informed should this change.
Do not close at lunchtime	We close at lunchtime because morning staff need to handover to the afternoon staff; the duty doctor needs to carry out home visits; and for staff meetings to take place.
Do not have afternoon closures	Afternoon closures are arranged by other NHS Departments so that all NHS staff can attend critical meetings about NHS reforms, the Care Quality Commission etc. The Practice advertises closures as far in advance as possible but it is difficult to 'catch all'. We will review our communication systems to see if these can be improved.
Request to have more than one month’s supply of medication	We are not permitted to provide more than one month's supply of medication due to safety reasons and the potential to waste medication. Please be aware that unused and wasted drugs cost the NHS at least £100 million a year. If a patient is going away on holiday or for business reasons, it may be possible to provide more than one month's supply of medication. This is considered on a case-by-case basis.
Reduce turnaround time for repeat prescriptions from 48 hours to 24 hours.	The accepted turnaround time for prescription requests within the NHS is 48 hours (within working hours). The Practice can turn these around in less than this time if it's an emergency. The 48 turnaround period reduces the risk of errors and provides the doctor time to fully review patient notes for a number of reasons e.g. to ascertain whether or not the patient should continue on the medication, does the patient need a review? etc.
On site car parking for all patients	Unfortunately we are constrained by the physical site of the Practice. The only way we could offer car parking facilities for all patients would be to relocate.

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