Community Pharmacy Patient Questionnaire (CPPQ)
Community Pharmacy Patient Questionnaire (CPPQ)
All pharmacies are required to conduct an annual community pharmacy patient questionnaire (sometimes referred to as the Patient Satisfaction Questionnaire). The questionnaire allows patients to provide valuable feedback to community pharmacies on the services they provide.
What do pharmacy contractors have to do?
The requirements are set out in the Approved Particulars:
1) Pharmacists must undertake a patient satisfaction survey (see below) annually.
2) If contractors add additional questions, they must be 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:
|Average monthly script volume (Items)||Minimum number of returned surveys|
4) The questionnaire must be free from adverts.
5) The questionnaire must be accompanied by:
a) an explanation as to what it is for;
b) instructions on how to complete it;
c) options for it to be returned;
d) a description of what will be done with the responses provided.
6) There must be at least two choices as to how questionnaires can be returned. For example:
a) return it to the pharmacy;
b) return it to a location other than the pharmacy;
c) reply electronically.
7) The survey must be distributed from the premises to which it refers.
8) Surveys must be distributed only to persons who have received NHS services from the pharmacy.
9) Surveys must be distributed in a way which reasonably reflects the pharmacy’s business profile. For example:
a) it is unacceptable to survey all patients who have received an MUR, but none who have received an Enhanced service;
b) surveys should be distributed evenly over the opening hours of the pharmacy, including weekends and extended hours where applicable;
c) 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) The pharmacy must summarise the demographic information provided and collate the responses to the nine mandatory survey questions. Responses should be analysed and strengths and areas for improvement identified.
11) Where practicable action should be taken to address issues raised by respondents, in a manner that is proportionate to the issue raised.
12) The pharmacy must publish the results of the survey. This report should identify the areas where the pharmacy is performing most strongly and the areas for improvement together with a description of the action taken or planned.
13) The results must be published via one or more of the following options:
a) in the pharmacy, as a leaflet or poster;
b) on the pharmacy’s website;
c) on the pharmacy’s NHS Choices profile (if and when this functionality is available).
Community Pharmacy Patient Questionnaire (Annex A) (Microsoft Word)
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 (Microsoft Word)
See the FAQ below for guidance on use of the CPPQ where the majority of prescriptions are delivered/posted to patients.
Optional Information Governance question
In 2010/11, Level 3 requirements were added to the NHS Information Governance arrangements (requirement 212 and 214) which require pharmacies to check that patients understand their consent choices and feel that their wishes are respected and to check that patients trust the pharmacy to hold information securely. Evidence of meeting these requirements could be achieved by adding questions to the annual CPPQ; suggested wording is outlined below:
1. After you receive services or advice from us, we may retain some of your health information so that we’re best placed to help when you next visit the pharmacy. We always ensure this information is safely stored and kept absolutely confidential. Are you happy with our procedures or do you have any concerns? Yes/No
2a. In certain circumstances, the pharmacy may need to ask your consent to share your data with another healthcare professional to support your care. We will never pass on your health information without your express permission. Has the pharmacy ever asked for your consent like this? Yes/No
2b. If yes, do you feel your wishes were respected? Yes/No
Analysing the results
To assist pharmacy contractors with the basic collation of the raw data from the questionnaire and analysis of the results, PSNC has produced a worksheet and a template report for publication which you can download by clicking on the links below.
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 approved particulars which are effective from 1 July 2012 require that the questionnaire is analysed, and the results published. For surveys completed on or after that date, the pharmacy must summarise the demographic information provided and collate the responses to the nine mandatory survey questions. Responses should be analysed and strengths and areas for improvement identified.
Where practicable action should be taken to address issues raised by respondents, in a manner that is proportionate to the issue raised.
The pharmacy must publish the results of the survey. The report should identify the areas where the pharmacy is performing most strongly and the areas for improvement together with a description of the action taken or planned. The CPPQ worksheet above, will assist in the production of the report.
The results must be published via one or more of the following options:
a) in the pharmacy, as a leaflet or poster
b) on the pharmacy’s website (if it has one)
c) on the pharmacy’s NHS Choices profile (if and when this functionality is available)
Where can I get help with conducting the questionnaire?
A number of organisations offer packages of support that include provision of questionnaires and the collation of results. Those that PSNC is aware of are listed below:
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. Click here to visit the NPA website.
Q. Most of my patients receive their medicines through a delivery service, and do not visit the pharmacy so most of the questions are irrelevant. Do I have to undertake a survey?
A. Yes, the requirements to carry out the patient survey applies to all NHS pharmacies. However, PSNC believe that different questions would provide much better feedback if the pharmacy is a ‘distance selling pharmacy’ (a mail order or internet pharmacy) or if the business profile is largely carried out remotely. A template is available here, which can be used as a substitute for Annex A – but only if your local NHS England team consents to its use.
Q. Do we have to participate in the survey?
A. 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.
Q. When should I do the survey?
A. You will need to complete the survey by the end of March each year. 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.
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.
Q. Do we have to use the national template survey as published by the Department of Health & PSNC?
A. 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.
Q. Do I need to amend the template questionnaire before I use it?
A. Yes – you will need to add your pharmacy name and address where indicated.
Q. Can I amend the formatting of the nationally agreed questionnaire, including adding my pharmacy logo?
A. 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.
Q. Can we add additional questions to the questionnaire for our own interest?
A. 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.
Q. After Q.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?
A. This could include questions on the following topics:
– Essential, Advanced or locally commissioned 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 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.
Q, Which member of the pharmacy team should collect the data?
A. 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.
Q. Will the local NHS England team or DH provide the questionnaire forms?
A. No. 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.
Q. Which patients should we give the questionnaire to?
A. 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.
Q. Can patient comments be identified back to them if they make serious allegations?
A. 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.
Q. Are the questionnaires available in different languages?
A. Commercial survey providers have a range of languages available.
Q. Can we help patients to fill in the questionnaire?
A. 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.
Q. Can surveys be completed by a patient representative on behalf of a patient?
A. 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.
The Friends and Family Test and community pharmacy
The NHS Friends and Family Test (FFT) aims to provide a simple way to obtain feedback from patients about NHS services. Patients are asked the following question:
“How likely are you to recommend our Service to friends and family if they needed similar care or treatment?” (Extremely likely; Likely; Neither likely nor unlikely; Unlikely; Extremely unlikely; Don’t know)
with a follow up question, which is usually:
‘What is the main reason for the answer you have chosen?’ (free text response)
The Government has decided that the FFT will be used across all NHS funded services, including in primary care, where GP practices will implement the FFT from December 2014. The target for implementation across all NHS funded services is by the end of March 2015.
PSNC has had initial discussions with NHS England about how the FFT could be incorporated within the CPCF, but the approach to introduction of the FFT to community pharmacy is still being considered by NHS England and further information will be published in due course; for the time being, community pharmacy contractors need take no action relating to the FFT.