GRANVILLE HOUSE MEDICAL CENTRE

PRACTICE ANNUAL REPORT

2016/2017

1

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

2

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.

3

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 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 Adeel Arain was a registrar and has now completed his training. He is currently working at the practice as a locum whilst Dr Telleck is on maternity leave

Dr Akram Alzamani has completed her training and is due to finish in August 2017

Dr Charlotte Fisher is still in her registrar year and joined us in February 2017

Dr Othman Al-Helli is still in his registrar year and left us in June 2017

Dr Natasha Sharma was previously a registrar here and left us in February 2017

Dr Elena Ivan was previously a registrar here and left us in August 2016

Dr Emma Stringer was previously a registrar here and left us in August 2016 We also have other GP trainees (ST2s) who come to the practice 2 ½ days a week for a period of six months.

4

Dr Edwards and Dr Telleck undertake training for 3rd year medical students. 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 Rachel Olewicz, 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 The practice appointed Mr Jon Wilson in April 2017 as the Practice Business Manager following the retirement of Mrs Linda Kershaw. In addition to our clinical staff, the practice also has 12 members of staff which are led by the Practice Business Manager, Mr Jon Wilson 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. The practice has also recruited an apprentice. 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

5

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).

White Other Ethnic Groups

British Irish Gypsy or Irish traveller

Other white

Polish Turkish Arab

Practice 3936 11 1 16 20 2 0

VPRG 80 0 0 1 0 0 0

Asian/Asian British

Indian Pakistani Bangladeshi Chinese Other Asian

Practice 8 1 4 8 4

PRG 4 0 0 0 0

Black/African/Caribbean/Black British Other

White & Black Caribbean

Caribbean Other Black Any other (no ethnicity recorded)

Practice 9 0 0 4197

VPRG 0 0 0 0

The list size at the beginning of the year (1st April 2016) was 8233 and at the end of the year (31st March 2017) was 8217. This is an average of 2052 patients per partner. During the year the practice had 86 births and 92 deaths.

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 392 433 405 420 534 657 518 456 161 27 1

Females 396 428 380 475 583 628 550 493 221 54 1

Co

un

t

Practice Population

6

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 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 721 patients who missed their doctor/nurse appointment, in some cases several times. As a result of this, there were 942 missed appointments; the majority of these were for appointments with the practice nurses. Accident and Emergency attendances There were 2178 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.

7

Out of Hours/ 111 Service The out of hour’s service were contacted by 623 patients during the year. Referrals There were 2061 routine referrals made to secondary care during the year and 180 urgent referrals made for patients to be seen within 2 weeks. The practice has seen a decrease in the number of referrals made, compared to the same time period for 1st April 2016 – 31st March 2017. Immunisations/Vaccinations - Pneumococcal There were 186 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, 70, 78 and 79. Of the patients identified, 91 patients were vaccinated.

Age Number Vaccinated

70-72 114

78-79 58

Seasonal Influenza There were 1777 patients who received the Seasonal Influenza vaccination during the year at the practice (see below).

Age 0-9

10-19

20-29

30-39

40-49

50-59

60-69

70-79

80-89

90-99

100+

Gender

Female 0 7 44 65 54 82 217 319 176 46 3

Male 2 6 8 8 37 64 187 295 130 25 2

There were 169 patients identified as having the vaccination through their pharmacist (see table below).

Age 0-9

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

Gender

Female 0 0 4 3 6 3 23 32 10 0 0

Male 0 1 1 1 5 8 27 34 11 0 0

8

There were 383 patients who declined to have the vaccination (see below).

Age 0-9

10-19

20-29

30-39

40-49

50-59

60-69

70-79

80-89

90-99

100+

Gender

Female 1 5 6 6 18 24 44 60 23 10 0

Male 0 1 3 4 14 32 52 43 14 3 0

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 417 cervical smears during the time period. Prescription Requests The practice receives on average 1504 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 150,000 items prescribed using the Electronic Prescribing Service (EPS). Practice Website Visits On average the practice website is visited 14,000 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 90% 88% 87%

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

92% 85% 85%

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

99% 89% 89%

Stated the last GP they saw or spoke to was good at giving them enough time

97% 87% 87%

Stated the last GP they saw or spoke to was good at 99% 85% 85%

9

To view the full survey for our practice, please visit the following website at https://gp-patient.co.uk/ 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 9 14 23

Likely 33 1 34

Neither Likely or Unlikely

2 0 2

Unlikely 2 0 2

Extremely Unlikely 4 2 6

Don’t Know 18 3 21

TOTAL 68 20 88

Of the total responses received, 77% were received online and 23% were received by paper. Please see the practice website for all comments made on the Friends and Family Test.

treating them with care and concern

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

100% 95% 95%

Stated that the last appointment they got was convenient

94% 92% 92%

*Would recommend this surgery to someone new to the area

97% 81% 78%

10

5. Compliments/Complaints Compliments July 2016 A comment was posted on the NHS Choices website from a patient who said “Always good care from all staff and doctors. Have had various issues and have never felt I was totally cared for. A great overall experience”. October 2016 A comment was posted on the NHS Choices website from a patient who said “Very good! Great doctors treat people well, I am very happy that I can use the services of the clinic” Complaints The practice received 4 written complaints and 2 verbal. Verbal August 2016 A complaint was received from a patient who felt their medication dose had been altered incorrectly by a doctor. The patient’s blood tests were reviewed and it was confirmed that at that time, changes to the medication were correct. The patient was contacted and informed of the outcome, which they understood. September 2016 A complaint had been received from a patient who was upset that they had had a consultation with a doctor and though that they had been referred to one speciality, but ended up being seen elsewhere. Upon discussion with the doctor who had carried out the consultation, it was assumed that the patient was aware that this would be happening as this had been discussed earlier with another doctor that they had seen. The patient was contacted and an explanation offered and an apology given, which they accepted.

11

Written October 2016 A complaint was received regarding travel vaccinations that were listed as being free on the NHS website, but upon contacting the practice, they were advised that the practice was not currently offering the service. The practice wrote to the patient explaining that the practice would not have been able to offer travel vaccination services as there was not a suitably qualified member of staff at that time. It would have been inappropriate for the practice to offer a service and be delivered by someone unqualified to do so. The practice apologised to the patient if they felt that they had been let down, but there are times when due to adverse circumstances, the practice is unable to fulfil all its patient’s wishes. November 2016 A complaint had been received from a patient who had received a letter from the practice which had been delayed in being sent via the Royal Mail. The matter was brought to the attention of the Royal Mail and they were contacted for an explanation as to what may have happened. They offered their apologies and fully appreciated the importance of delivering all mail on time and apologised that the item of mail took longer than expected to be delivered. They thanked us for making them aware of this and assured us that they take letting customers down seriously and will use the information to make further improvements. March 2017 A complaint was received from a patient regarding a consultation with a doctor. The patient complained that they were not being treated with concern and respect and that they were not being listened to. They felt that their long term condition was being ignored and not being dealt with appropriately. The doctor wrote to the patient and offered their sincere apologies regarding that they felt that they had not been dealt with appropriately or that their expectations had not been met. The patient was also offered an appointment at the practice to discuss the matter, which they accepted. March 2017 A complaint was received from a patient regarding an appointment they had with the practice nurse, but had waited a long time to be seen. The patient informed the receptionist that they were unable to wait any longer and had to leave. A further appointment had to be made for the patient to attend.

12

The practice nurse contacted the patient and offered their apologies regarding this matter. A letter was also sent to the patient informing them that if they wished to discuss the matter further, the practice would be happy to do so.

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 The practice offers 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 Named 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 84 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 740 patients who have subscribed to receive this.

13

SMS Text Messaging The practice uses the SMS Text Messaging Service. This service allows the practice 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 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 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

14

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:

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 2016/17 the practice achieved 538 points out of 545 points available.

15

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

To use the SMS text messaging system

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 set up a face-to-face Patient Participation Group

To make changes to the practice website for easier navigation