Locally there is £407,000 worth of extra dosh available to the 46 Wandsworth GP practices this year and the same again next. All they have to do is demonstrate that they have got some basic building blocks of patient engagement in place and they can collect £1.10 per patient. Serious money in a time of resource restraint. Astonishing then that only 19 out of the 44 practices we surveyed have bothered to do the necessary for themselves and their patients. Perhaps the Daily Mail is right about what GPs are earning and this was too little reward to bother with? Why did the majority of practice not Pass GO and collect their share of the money for the Patient Participation Directed Enhanced Service (PP DES) for Year 1? Money aside, this is worrying for patient engagement in the practices of the emerging CCG – which is supposed to be a “Pathfinder” after all.
What we looked for in our survey last week
We checked the practices twice last week for the four things GP practices should have done or set up to comply with the PP DES:
1) existence of a patient reference/participation group, which could be a virtual group;
2) existence of a functioning and accessible practice website;
3) posting of patient survey report on the practice website; and
4) ability to access patient survey report through the website.
All the principal four tasks we looked at should have all been completed by 31st March, according to the DES guidance published by NHS Employers and the BMA’s General Practitioners Committee a year ago.
Short of the mark
In this day and age in the NHS, one surely would reasonably expect every GP practice to have at least a basic, up to date and accessible website. So why don’t all Wandsworth practices meet this basic standard? Twelve didn’t.
For 18 practices there was no evidence of a patient participation group. Of course there may be some PPGs in practices which lack a website, but this is something that would require more investigation than was possible in this survey. At any rate, just having a patient reference group is not sufficient for PP DES compliance.
Only 19 out of 44 practices surveyed had actually posted a completed patient survey on their website. Surely this should have at least been 26 practices who also had a patient group which was mentioned on their website? Several sites had evidence that they had completed a survey and even discussed it with patients (all as required by the DES) but then had failed to post it on the website. This means non-compliance. Why did this happen in seven practices?
That leaves just 19 of 44 practices which, in our view, are compliant with the Year 1 requirements of this DES and are entitled to their payment. This is a disappointingly low figure. Some of the reports we dipped into were excellent and clearly a lot of work had gone into them.
It wasn’t just the mega-practices who performed well – in fact, some of them didn’t comply, certainly when compared to several small and medium sized organisations who met all the requirements and did so clearly and efficiently. We recommend that the information in the patient surveys should be collated and disseminated as “top line messages” by the PPI Team at Wandsworth PCT working with LINk/Local HealthWatch to the Wandsworth CCG and the Health and Wellbeing Board as well as the general public in the borough.
Step forward the deserving 19 and take a bow
Since we believe in rewarding success, we thought it worth listing the compliant practices in Wandsworth.
- Balham Park Surgery
- Battersea Rise Group Practice
- Bedford Hill Family Practice
- Danebury Avenue
- Greyswood Practice
- Heathbridge Practice
- Lavender Hill Group Practice
- Mayfield Practice Roehampton
- Mittal “Open Door” Practice, Boundaries Road
- Putneymead Group Practice
- Roehampton Surgery
- Southfields Group Practice
- Streatham Park Surgery
- The Triangle Surgery
- Thurleigh Road Practice
- Waterfall House
- Tudor Lodge Health Centre
Detailed Findings for the 43 Practices
|Practice-specific website accessible||33/44||One practice’s URL did not exist according to BT so unable to access website and assess compliance|
|Evidence of a patient reference/participation group||26/44||2 were said to be “virtual groups” which is allowable under the PP DES|
|Patient survey report completed and posted on website||19/44||Several practices reported their patient group had discussed the survey, but it was not posted on the website as the PP DES requires|
|Compliant with the Year 1 PP DES||19/44||This reflects the four factors used in this survey|
|Not compliant with the Year 1 PP DES||25/44||One practice could not assessed for above reason|
You can read the full report here.
What happens to the money?
So what will happen to the £814,000 which local practices could earn from the Patient Participation DES over its two years of life?
Certainly for Year 1 payments, we look to Wandsworth LINk working closely with the Wandsworth Borough Team (what’s left of the PCT) to make sure that practices are not just “tick boxed” through this DES and handed public money they have not earned. Requirements must not be ignored and deadlines must be honoured. It must all be transparent and open to scrutiny.
We have always advocated more data being made available to users and this is an opportunity to demonstrate that the data can be used to reward achievement and more than that, avoid a fudged outcome where guess what? everyone passes GO and collects their dosh even if they have done nothing on their way round the board. By putting our survey results in the public domain, we hope we have helped to prevent any chance of that happening.
Now that this report is in the public domain, we hope lots of people will send it on and start asking questions, and not just locally, about what is happening to the £1.10 per patient multiplied by all the registered patients in England – not a small sum.
The Moore Adamson Craig Partnership supports user and public participation, trains lay representatives and develops responsive health, care and education organisations. We are ready to work with and support all those who want to make sense and a success of the new structures of patient and public engagement within the new arrangements for health and social care commissioning and providing. Feel free to contact us to discuss the opportunities.