Cardiovascular Disease Directed Enhanced Service: views and experiences of General Practices

Annex A: Survey and interview questions

Survey questions

Cardiovascular Disease Directed Enhanced Service (DES) - Gathering experiences of practices

The Scottish Government General Practice policy team wish to gather the views and experiences of your practice on your participation in the Cardiovascular Disease Directed Enhanced Service (CVD DES), through your completion of a survey. Your answers will enable us to better understand how the service is working and to find out about any improvements that we can make to it. They will also contribute to the monitoring and evaluation of the overall CVD risk factor prevention programme. Please ask the most appropriate individual in your practice to complete the form and submit one return per practice. The survey should not take more than 30 minutes to complete.

The privacy notice sent with this form sets out why we need information from you, how we use it and what we do to protect the information you provide.

If you have any questions about the survey, please contact XXX

Practice Details

1. Name of Health Board?

2. Name of GP Practice?

Training and support available

3. Have you and/or others within your practice attended training to help you implement the DES? (Yes/No)

4. If Yes, please tick all that apply:

National online training

Your own practice training

Training offered by your Health Board

Other

5. Have all relevant staff within your practice made aware of the DES programme and its purpose? (Yes/No/Unsure)

6. Have you made any links with charities or other support organisations to help you implement and/or deliver the DES? (Yes/No)

7. If Yes, please list the organisations below

8. Have you made use of the Right Decision Service CVD Pathways? (Yes/No)

9. If Yes, what has been your experience of using these?

Straightforward to use

Some initial challenges but now straightforward

Continue to present challenges

Have given up using them

10. If no, what was the main reason for this?

Unaware of these pathways

Perceived not to be useful

Insufficient time

Local options available

Other

11. Have you made use of the ASSIGN Score? (Yes/No)

12. If Yes, what has been your experience of using this?

Straightforward to use

Some initial challenges but now straightforward

Continues to present challenges

Have given up using this

13. If No, what was the main reason for this?

Unaware of the tool

Not perceived to be useful

Lack of time

Local alternative available

Other

14. Have you made use of the ESCRO tool? (Yes/No)

15. If Yes, what has been your experience of using this?

Straightforward to use

Some initial challenges but now straightforward

Continues to present challenges

Have given up using it

16. If No, what was the main reason for this?

Unaware of the ESCRO tool

Not perceived to be useful

Lack of time

Local alternative available

Other

Inviting patients

17. What method(s) did you use to invite patients for checks. Please tick all that apply:

Letters

Emails

Phone calls

Texts

Inviting those booking appointments for other purposes

Opportunistic during consultations for other issues

Other

18. Have you used any consultation methods that differ from your standard approach to conduct CVD checks?

Organising a community event outwith the practice

Having a CVD drop-in clinic within the practice

Offering appointments outside usual practice hours

Other

19. Are you stratifying your patients list and/or targeting invitations (within your cap allowance to reach the cohort in your practice catchment who could be classed as living with deprivation or who have repeatedly failed to engage with offers of healthcare? (Yes/No)

20. If Yes, how did you go about this? (Please tick all that apply)

Used ESCRO tool to stratify practice cohort list and ordered invites accordingly

Used own stratification tool to look at practice cohort list and ordered invites accordingly

Used practice staff knowledge of practice cohort to order invitation list

Other

21. If No, what criteria did you use choose who to invite from your practice cohort of eligible patients? Please tick all that apply:

Age of patient

Address of patient

Date of patient's last contact with the practice

Patient's health status

Opportunistic approach

Other

22. Where you tried to target particular patient groups, what proportion of these individuals would you estimate have taken up the offer of an appointment?

More than 75%

50 to 75%

25 to 49%

fewer than 25%

Impact on practice

23. How straightforward or complicated do you find it to code the outcomes of a consultation?

Extremely straightforward

Somewhat straightforward

Neutral

Somewhat complicated

Extremely complicated

24. Has the implementation and delivery of this programme had any impact on your practice workload?

Increased workload greatly

Small increase in workload

No difference

Reduced workload

25. Do you think you will change your engagement with patients in future as a result of this intervention? (Yes/No)

26. If Yes, please specify what change(s) you think you will make

Other feedback

27. Is there any other feedback you would like to share with us?

28. Would you be willing to take part in an interview with a researcher working on behalf of Scottish Government to discuss your experience in more detail? (Yes/No)

29. If you are willing to be contacted, please add your contact email address

Interview questions

Reasons for signing up to the programme

1. Can I begin by asking the main reasons why your practice signed up to the programme in the first place?

Programme focus and patient selection

2. What were the key determinants you used to select the patients to be contacted about the programme from the pool of eligible patients?

3. Were there any particular constraints you had to factor in?

Patient engagement

4. In terms of your approach to engaging with patients, did you encounter any particular issues or challenges? Is there anything that you have changed about your approach so far?

5. (If not covered above) Did you use any innovative engagement methods, such as group consultations, outreach including community appt days etc? In particular, have you tried anything specific in trying to get engagement from those living in the most deprived aeras covered by your practice?

6. (If not covered above) Have you been working with any external partners, and in particular third sector partners, around patient engagement, sharing messages about the programme and/or any sort of referral system?

7. Overall, have levels of engagement, and the profile of those engaging, been aligned with what you were expecting?

Patient selection and engagement going forward

8. Noting the focus of the programme (i.e. that it is targeted toward those in areas of highest deprivation and those who may not engage with primary health care and are sometimes considered as ‘missing’), based on your experience to date, is there anything you would change in terms of the patients you target/prioritise?

9. Based on your experience to date, is there anything you would change in terms of how you go about engaging with patients?

Resources and workload

10. How well does the package of resources available – in terms of support, software and the per patient payment for example – match with the delivery of the programme?

11. If not covered above) Has your practice brought in any additional resources to support the delivery of the programme?

If yes, what type and approximately how much? Has it been covered - in whole or in part - by the payments made?

If no, how have you managed the additional workload?

12. (If not covered above) Have you had to redirect resources away from other areas of work in order to deliver the programme?

Overall reflections

13. Overall, and acknowledging that it is early days, do you think your practice made the right decision in signing up for the programme?

14. Based on your experience so far, what is your sense of how the programme is progressing in terms of outcomes?

15. Are there any changes that the Scottish Government could make to the practical arrangements that could make the programme easier for you to deliver?

16. Are there any changes that the Scottish Government could make to the focus of the programme, including the desired outcomes, which you think would make the programme/approach more effective?

17. In terms of any of the changes you’ve highlighted, would your practice’s continued involvement in the programme potentially be dependent on any or all of those changes being made?

18. Is there anything else we haven’t covered that you would like to feed back to the Scottish Government?