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Haughton Thornley Medical Centres - GP services for Hyde and Denton

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Guardian Article - Patients need access and understanding of their electronic health records Royal College of General Practitioners
 

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10,000 survey monkey questionnaires completed providing us with an aggregate insight into what real patients in a practice think when signing up for full access to their GP electronic health records

On 17th December 2017, Haughton Thornley Medical Centres completed the 10,000th survey monkey questionnaire. In 2007, we launched the practice-based web portal www.htmc.co.uk with the help of Glen Griffiths and the patients and staff in the practice. It was clear that patients needed a trusted place to go to where they could find out what was relevant to them and which supported the ongoing conversations that were happening with clinicians in the practice. We started the questionnaire using Survey Monkey on 24th July 2009. Prior to this date, we used to do the questionnaires on paper but did not aggregate them and so could not monitor what the key issues were for the patients as a group. The questionnaires are a key part of the sign up process and is also part of our Quality Improvement strategy as we have responded to needs as required. This is the BIG CONSENT issue and we have travelled around the UK and even to UNESCO to confirm our processes are safe. You can read our Case Study which we published with NHS Improving Quality. In 2011 we published a Press Statement by NHS NW when we reached 1000 patients with full access to their records. Earlier this year in 2017, we published our second Press Statement when 1000 Bangladeshi patients got full access to their records - a proportion considerably better than the rest of the practice population and way ahead of the 1% in England and Wales who have some access to their records. In 2014, Nicola Jeffery-Sykes went on BBC News describing her frustration as a cancer survivor of not being able to do what our patients have been able to do since 2004 when we first started offering patients online access to their GP electronic health records along with Manor House surgery. You can see Ingrid Brindle, patient of ours sitting in her kitchen and tapping away on a computer to see what people can do. You can hear Mary Fitton, practice manager at Manor House Surgery talk about their experience and Dr Brian Fisher talk about his experience too in 2010. Later that year, the Royal College of General Practitioners along with the Royal College of Physicians and the Royal College of Nursing along with 40 other patient groups and a number of other groups published a document for clinicians on guidance to enable Patients to access Electronic Health Records. Dr Richard Fitton went on the radio in 2011 with his patient to describe the benefits. Ingrid Brindle, the Chair of our PPG wrote a blog for the Richmond Group of Charities and also Understanding Patient's Data entitled "How giving patients access to health records can transform care; a patient's perspective". As 2017 draws to a close, it is worth again seeing our Review of 2014 which was a prelude of what was to come. This week a talk was held at the practice with patients from Hyde neighbourhood asking "How can I get an appointment with the doctor, please?" after women from the local Muslim community asked this question. There has been a constancy of purpose throughout this time despite all the challenges the practice and the NHS has had to face. The message has not changed at all in all this time and continues to shine a light on what good looks like.

Most patients have completed the questionnaire when asked to do so by their clinician rather than spontaneously doing it. This is because most patients do not know about the service or what it means until they are asked to do so and generally people do not think about their healthcare needs until they need it. As a practice we have therefore felt it was important for patients and or carers to complete the questionnaire as part of the process of getting full access to their records and also use the practice-based web portal www.htmc.co.uk to gain a better understanding of their healthcare needs. This is why we also direct patients to diabetes care, obesity care, depression care, pregnancy care, common problems you can solve etc to learn more On this day currently, 62% of our patient population (7646 patients) have signed up for full access to their GP electronic health records. (you can see the latest info here as this is constantly changing)

The following table shows figures correct on 17th December 2017 showing how many patients have access to their records according to medication they are on or what condition they suffer with.

Patients with Prediabetes  370/580 63%

Patients with Diabetes (Type 1 and Type 2)

557/873

63%

Patients with Type 1 Diabetes

54/65

83

Patents with Ischaemic Heart Disease

293/476

61%

Patients with Heart Failure 51/94
54%
Patients with Atrial Fibrillation 124/224 55%

Patients with Obesity

318/405

78%

Patients with Rheumatoid Arthritis

55/72

76%

Patients with Asthma

1287/1841

69%

Patients with Low Back Pain

2232/3127

71%

Patients with Chronic Obstructive Pulmonary Disease

239/406

58%

Patients with Depression / Anxiety with Depression

2494/3537

70%

Patients with Attention Deficit Hyperactivity Disorder 10/24 41%

Patients with Cancer confirmed

217/347

62%

Patients with Is a Carer 196/255 76%

Patients with a Deep Venous Thrombosis

78/137

56%

Patients with a Pulmonary Embolus

45/80

56%

Patients with Chronic Kidney Disease

177/372

47%

Patients on anti-coagulation therapy ie warfarinsin-throne

35/73

47%

Patients on Thyroxine

342/509

67%

Patients on Methotrexate

22/29

75%

Patients on Cyclosporin (immunosuppressant)

1/1

100%

Patients who were Pregnant from 10 months ago

83/90

92%

Patients on Learning Disability register

28/63

44%

Patients who have ever had a URTI or viral infection

4697/6790

67%

Bengali patients with access to their records 

1030/1507

68%

Patients on gold standards palliative care framework 42/88 47%
Current patients who have ever Ordered Prescriptions Online 1998/12197 16%

Patients at Haughton Vale Surgery

3229/5572

57%

Patients at Thornley House Medical Centre

4406/6587

66%

Number of patients with access to their GP electronic health records

7646/12197

62%



To mark this day, we decided to publish our combined data to show how people have answered the questions when asked to do so before they are granted full access to their GP electronic health records. The data shows screen shots of what is accessible. You cannot click and download the data or see individual results or comments. The data is shown as is. Some patients may have done the questionnaires on more than one occasion and of course some people previously did the questionnaires on paper. The purpose of the questionnaire is not just for individuals to demonstrate their understanding and also an opportunity to ask questions. As a practice we have found the aggregate data useful to help support the "partnership of trust" and consider what further information we need to provide to support patients who wish to use online services. This is not a single event in time but rather an ongoing relationship with the practice, its clinicians and staff and its patients and carers. Patients register with the GP practice which in turn supports their care needs. 

Click here if you would like to know more about the explicit consent questionnaire, how we do this, see real-life examples of questionnaires being completed in person and also on the phone by real patients and FAQs. This data helps to inform us about our processes and procedures and ensures we continue to responsibly share information in a safe way to deliver great care. 

We hope this encourages others to follow as well as we embark on enabling others to do what we have been doing help people to self care more supported by their own practices and the wider public services. 

We would like to thank all the patients, carers and staff, past and present as well as the system suppliers and others who have helped us to reach this milestone. We could not have done it without you.


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