Enter and view: Portcullis Surgery

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Summary of report content

Healthwatch Shropshire gather information on people’s experiences of health and social care services and there are times when it is appropriate for Healthwatch Shropshire to see and hear for themselves how services are being delivered: these visits are called ‘Enter and View’, they are not inspections. Healthwatch Shropshire visited Portcullis Surgery on the 19/06/2014. The summary of findings highlighted areas in relation to patient feedback, staff feedback and observation. These findings informed that two of the six patients Healthwatch Shropshire spoke to had been asked about their communication needs when they registered at the practice. None of the patients they spoke to said they had a communication need. Staff had received some initial training on the AIS. Staff said they had not changed their ways of communicating with patients since the introduction of the AIS as they have always been sensitive to people’s needs and adapted the way they communicate with them. Staff are encouraged to identify if any existing patients have any communication needs. The alerts on the electronic screen calling people to their appointment were quiet and patients told us they were difficult to hear. There is a hearing loop in reception but there did not appear to be any training for staff on its use. The staff they spoke to were not sure if it was working and which parts of the practice it covered. There is a privacy booth in reception, which can be used if people find it difficult to hear what is said. The surgery uses the EMIS computer programme, which flags the communication needs of patients. Healthwatch Shropshire saw some staff come into the waiting room to call people for their appointment. Healthwatch Shropshire saw one poster referring to AIS on display in the waiting room. There is a page on the website labelled AIS but it is difficult to find and it might not be clear to patients that it is about communication needs. The PPG had not been involved in the introduction of AIS or been asked to review information sent out to patients to check if it is easy to understand. The fire alarm does not have a flashing light for people with a hearing loss and it was unclear how often a fire drill is carried out. The new patient pack includes a request for patients to make the practice aware of their communication needs. The nurse’s leaflet has been rewritten for people who need a more visual format and larger font. Carers are not specifically asked about their communication needs but were asked in the same way as all other patients if they were registered at the practice. Patients with a learning disability are offered annual health checks and given longer appointments. At the time of our visit the practice had not produced any patient information in easy read. The repeat prescription form has small font and many patients prefer to ring up to ask for medication. There is a call bell in the accessible toilet but it may be difficult to reach for people with limited mobility. The toilet seat in the accessible toilet was a little unsteady. The recommendations within the report state further training for staff on the AIS. Involving the PPG in raising awareness of the AIS with patients. Revisiting the AIS page on the website to make it more obvious to patients and make it clearer to them what it is about. Increasing the volume on the electronic screen to make it easier to hear. Testing the hearing loop to ensure if and where it works and training staff in its use. Telling patients with a hearing loss about the hearing loop. Undertaking a review of the fire procedure and how often fire drills are held. Reviewing the style and size of the font on the repeat prescription form. Consider providing practice information in easy read format for all patients especially those with a learning disability. Reviewing the location of the call bell in the accessible toilet. Ensuring the toilet seat in the accessible toilet is secure. Ensuring that the communication needs of all existing patients (who won't receive the new patient pack) and carers (who may not be registered with the practice) are collected.

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General details

Report title 
Enter and view: Portcullis Surgery
Local Healthwatch 
Healthwatch Shropshire
Date of publication 
Thursday, 2 August, 2018
Date evidence capture began 
Thursday, 19 July, 2018
Date evidence capture finished 
Thursday, 19 July, 2018
Type of report 
Enter and view
Key themes 
Booking appointments
Building and facilities
Cleanliness hygiene and infection control
Communication between staff and patients
Continuity of care
Health promotion
Information providing
Public involvement
Quality of care
Quality of regulation
Quality of staffing
Quality of treatment
Staff levels
Healthwatch reference number 

Methodology and approach

Was the work undertaken at the request of another organisation? 
What type of organisation requested the work 
Primary research method used 
Structured interview
How was the information collected? 
Visit to provider
If an Enter and View methodology was applied, was the visit announced or unannounced? 

Details of health and care services included in the report

Primary care services 
GP practice

Details of people who shared their views

Number of people who shared their views 
Not known
Age group 
Not known
Not known
Not known
Sexual orientation 
Not known
Does the information include public's views? 
Does the information include carer's, friend's or relative's views? 
Does the information include staff's views? 
Does the information include other people's views? 
What was the main sentiment of the people who shared their views? 

Outcomes and impact

Were recommendations made by local Healthwatch in the report? 
Does the information contain a response from a provider? 
Yes action has been taken or promised
Is there evidence of impact in the report? 
Is there evidence of impact external to the report? 
What type of impact was determined? 
Implied Impact

Network Impact
Relationships that exist locally, regionally, nationally have benefited from the work undertaken in the report
Implied Impact
Where it is implied that change may occur in the future as a result of Healthwatch work. This can be implied in a provider  response, press release or other source. Implied impact can become tangible impact once change has occurred.
Tangible Impact
There is evidence of change that can be directly attributed to Healthwatch work undertaken in the report.