Home Community Pharmacy Patient Questionnaire (CPPQ)
The Department of Health and PSNC have now agreed the requirements to fulfil paragraph 26 (2) (a) (iii) of Schedule 1 to the National Health Service (Pharmaceutical Services) Regulations 2005 - the requirement to conduct an annual community pharmacy patient questionnaire (formerly referred to as the Patient Satisfaction Questionnaire).
The questionnaire will allow patients to provide valuable feedback to community pharmacies on the services they provide. The requirement applies from the contractual year 2007/08.
The requirement applies in Wales from the financial year 2008/09.
What do pharmacy contractors have to do?
The Clinical Governance specification of the Essential Services requires pharmacy contractors to conduct an annual patient survey.
The following guidance has been issued by the Department of Health and PSNC.
1) Pharmacists must undertake a patient satisfaction survey (as set out in Annex A) annually.
2) Contractors may add additional questions if they wish, provided they are related to healthcare service provision. The point at which extra questions can be added is highlighted in the questionnaire.
3) The minimum number of returned surveys for analysis required each year is proportional to dispensing volume, as outlined in the table below:
4) The questionnaire must be free from adverts.
5) The questionnaire shall be accompanied by, an explanation as to what it is for, how to complete it, options for it to be returned and what will be done with the responses provided.
6) There must be at least two choices as to how questionnaires can be returned. This may include as one option either to return it to a location other than the pharmacy or replying electronically.
7) The survey shall be distributed from the premises to which it refers.
8) Surveys shall be distributed only to persons who have received NHS services from the pharmacy.
9) Surveys shall be distributed in a way which reasonably reflects the pharmacy's business profile. For example:
|
Average monthly script volume (Items) |
Minimum number of returned surveys |
|
0-2000 |
50 |
|
2001-4000 |
75 |
|
4001-6000 |
100 |
|
6001-8000 |
125 |
|
8001-upwards |
150 |
-
It is unacceptable to survey all patients who have received an MUR but none who have received an enhanced service.
-
Distribution should be even over the opening hours of the pharmacy, including weekends and extended hours where applicable
-
Where the pharmacy delivers a significant number of prescriptions to patients' homes, consideration needs to be given to ensure a suitable distribution of surveys to these patients.
10) Responses should be analysed and strengths and areas for improvement identified
These requirements are also laid out in the document below:
Community Pharmacy Patient Questionnaire requirements (PDF format)
The Questionnaire
Community Pharmacy Patient Questionnaire (Annex A) (PDF format)
Community Pharmacy Patient Questionnaire (Annex A) (Microsoft Word format)
Large print version - Community Pharmacy Patient Questionnaire (Annex A) (Microsoft Word format)
Welsh version - Community Pharmacy Patient Questionnaire (Annex A) (PDF format)
The questionnaire needs to be accompanied by an explanation to the patient as to what it is for, how to complete it, options for it to be returned and what will be done with the responses provided. This information may be provided verbally, but it would generally be beneficial to provide this in writing to the patient. Suggested wording, which may be personalised by pharmacy contractors is provided below:
Explanatory wording for CPPQ (PDF format)
Explanatory wording for CPPQ (Microsoft Word format)
Analysing the results
To assist pharmacy contractors with the basic collation of the raw data from the questionnaire, PSNC has produced a worksheet which you can download by clicking on the links below.
CPPQ Worksheet (PDF format)
CPPQ Worksheet (Microsoft Word format)
What do you do with the questionnaire results?
The survey results should be used to inform consideration of how contractors can develop their pharmacy service. It is sensible to discuss the results with the whole pharmacy team.
The clinical governance service specification stated that contractors should share with their PCT the area where the survey identified the greatest potential for improvement and the action being taken to improve performance, along with the areas in which the pharmacy is performing strongly. This requirement has not yet been written into regulations and the associated guidance. If contractors do wish to share this information, a template letter is provided below:
Template PCT letter (Microsoft Word format)
Using the questionnaire results to inform your CPD
The Centre for Pharmacy Postgraduate Education (CPPE) have written a brief guide to using the outcomes of the survey to inform pharmacists' Continuing Professional Development (CPD). The guide was printed in the April 2007 edition of PSNC Community Pharmacy news.
To download a PDF copy of the guide click here.
Where can I help with conducting the questionnaire?
A number of organisations are offering packages of support that include provision of questionnaires and the collation of results. Those that PSNC is aware of are listed below:
Patient Dynamics
CFEP UK Surveys
CRT
Webstar Health
Research House
intelliPharm
The Informacist.com
A listing above should not be interpreted as PSNC endorsement of the service provider.
The NPA has published a toolkit to help its members to implement the CPPQ. This is can be downloaded by clicking here.
Frequently Asked Questions
Do we have to participate in the survey?
Yes - it is part of the clinical governance requirements of the contractual framework. The results of the survey will help contractors to develop the service they provide to their patients.
When should I do the survey?
You will need to complete the survey by the end of March 2008 and by the end of March in subsequent years. Do not underestimate how long it will take to obtain the necessary number of returned questionnaires - leave yourself a cushion of at least two months before the deadline. We recommend you make plans for running the survey as soon as possible.
You do not need to conduct the survey over a single period, although you will probably find it helps with planning to schedule a period - or several periods - of survey activity. The length of time to schedule is also up to you. Overall, the survey may take several weeks to run.
Will we get paid any money for completing the survey?
The funding for this is included in the global sum for essential services. You will need to bear the direct cost of running the survey - whether you decide to ‘do it yourself' or whether you take up support from a survey organisation.
Do we have to use the national template survey as published by the Department of Health & PSNC?
Yes - this has been agreed nationally between PSNC and the Department of Health. The use of a national set of questions will allow you to compare your results with similar pharmacies (the survey companies who are providing support to contractors will provide benchmark data with the individual results for each pharmacy). The questions in the national template survey have been piloted in pharmacies; the contractors involved in the testing found that they produced useful results.
Do I need to amend the template questionnaire before I use it?
Yes - you will need to add your pharmacy name and address where indicated.
Can I amend the formatting of the nationally agreed questionnaire, including adding my pharmacy logo?
Yes - but it is probably wise to ensure that any changes to the formatting do not make the questionnaire excessively long, as this may reduce the likelihood of patients filling it in.
Can we add additional questions to the questionnaire for our own interest?
You can add your own questions to the standard set published provided they are related to the provision of healthcare services (see below). Constructing questionnaires is not as straightforward as it seems; you may want to seek assistance from a specialist survey company in drafting any additional questions. Bear in mind that there is likely to be an additional cost to analysing additional questions, if you are outsourcing analysis to a survey organisation.
After Qu.10 the template states that additional questions relating to healthcare service provision can be inserted if required. What topics could be included in this section?
This could include questions on the following topics:
- essential, advanced or enhanced services
- the location of the pharmacy
- access to the pharmacy
- customer service
- services related to Pharmaceutical Services such as prescription collection and/or delivery services
We do recommend that only a small number of additional questions be added to prevent the questionnaire becoming too burdensome for patients to complete. We suggest that no more than five be included.
Which member of the pharmacy team should collect the data?
Many contractors may find it efficient to ask counter assistants to approach patients, however the optimum skill mix will of course vary from one pharmacy to another.
Will the PCO or DH provide the questionnaire forms?
The template is available to download above. The pharmacy can print out versions of this form or use a commercial survey provider who will do this for you as part of their service.
Which patients should we give the questionnaire to?
Select patients in such a way as to reflect the whole spectrum of the patient profile of the pharmacy, i.e. don't just give them out to specific groups of patients, or to people accessing a particular service. You should aim to distribute them evenly over the opening hours of the pharmacy; you might find it easiest to ask every third customer if they would participate.
Do not be tempted to cherry pick patients you think will give you a good score! The evidence actually tends to show this does not have the desired effect. Seeking the views of a wide range of patients will produce a balanced view that will be of most use to pharmacy contractors.
Can patient comments be identified back to them if they make serious allegations?
No, unless the patient chooses to enter their details on the questionnaire - it would be most unusual for them to do so. The survey should be considered anonymous rather than confidential.
Can I publish my own results and use them in advertising material?
If you wish to do this then that is fine as long as you comply with professional guidelines. You should however consider whether this would in effect result in the publication of commercially sensitive information relating to your business.
Are the questionnaires available in different languages?
Commercial survey providers have a range of languages available.
Can we help patients to fill in the questionnaire?
Where possible patients should complete questionnaires themselves, but limited assistance for those with poor eyesight or explaining general concepts is acceptable. Staff need to give impartial guidance to patients should they ask for help with the questionnaire.
Can surveys be completed by a patient representative on behalf of a patient?
Surveys completed by a carer or other patient representative are acceptable, except where the pharmacist reasonably believes that the response was submitted without the patient's consent.
When I have completed my Community Pharmacy Patient Questionnaire, do I need to send anything to the PCT?
When the new contract was agreed, it was intended that the pharmacy would share with the PCT the area where the survey identified the greatest potential for improvement and the action being taken to improve performance, along with the areas in which the pharmacy is performing strongly.
The regulations require the pharmacy to undertake the CPPQ in ‘an approved manner', but no further regulations or directions have been issued. Therefore, when the pharmacy has undertaken the CPPQ including analysing the results and determining the changes needed, there is no contractual requirement to share this with the PCT.
The NHS Primary Care Contracting monitoring toolkit, which was agreed with PSNC includes the following: 'It is good practice that contractors should share with their PCT the area where the survey identified the greatest potential for improvement and the action being taken to improve performance, along with the areas in which the pharmacy is performing strongly. Pharmacies will be aware of the commercial sensitivity of some of the information that will be collated and may decide not to share this with the PCT'.
DOWNLOADS: Some documents are available in PDF format, you will require Adobe Acrobat Reader 5.0 or later for viewing which can be downloaded from the Adobe Website
DOWNLOADS: Some documents are available in ‘Microsoft Word’ format. If you do not have Microsoft Word, you can read these forms by downloading the free 'Word Viewer'. This program can be downloaded at the Microsoft website