Rosebank Health Patient Participation Group (Rhppg)

ROSEBANK HEALTH PATIENT PARTICIPATION GROUP (RHPPG)

Minutes of Meeting held on 26th February 2013 at Rosebank Surgery, Stroud Road, Gloucester

Present:
Apologies:
Absent: / JF Chair, TH, NP, JR, JU, WP, JT, CE, SH
MC, WH, HW, MW, RW, ME
1. / Welcome
JF welcomed members to the meeting and accepted the apologies of members unable to attend. It was noted that a new member, WH, has joined the Group but was unable to attend this meeting due to being on holiday.
Members of the Group commented on the content of the notice boards/leaflet holders in the waiting room and how they felt that information required to be communicated to patients needed to be clear, similar to the ‘Breast feeding welcome here’ poster.
2. / Results of Patient Survey
JF thanked members of the Rosebank team involved in producing the survey. JF stated that it is useful to get feedback from patients and having a discussion on key issues.
Questionnaires were handed out to patients at both Stroud Road and Severnvale surgeries and also 600 were posted out with flu invitation letters. The response rate was poor from the questionnaires posted out.
The results of the survey were discussed.
TH asked if it was possible to have a percentage split of the responses between the two surgeries. It was noted that this was not possible as the returns were anonymous.
Question 1. How well do you think the Practice communicates the medical services available to the patients?
This was positive with 57% giving a response of ‘well’ and 69% ‘very well’.
Question 2. What additional services would you like offered?
Access and waiting times are the two main issues from this question.
WP advised what actions the Practice has been taking.
We have formed an Access Working Party comprising of GPs/Nurses, including Triage/Reception/Admin, who meet quarterly looking at the ways we deal with appointments.
We did some work with David Carsons from the Primary Care Foundation. He liaised with JT regarding how many appointments were offered to establish if we offered enough appointments. The national guidelines suggest 5.6 appointments per patient per annum and we meet that level of appointments for Nurses and GPs.
We have nearly 23,000 patients and offer 120,000 appointments per annum, excluding telephone consultations and triage.
It was also suggested by David Carsons that we offer too many ‘same day’ appointments with triage and emergency appointments – this has now been changed and more routine appointments are therefore offered which eases access to the patient’s usual GP.
It was also suggested that we should offer appointments further in advance than the four weeks that was offered. It was decided by the Practice, and implemented, that appointments are offered eight weeks in advance.
TH advised that he had not been able to get an appointment for a week, which he felt was not acceptable.
JF asked if the Practice had a target for the number of days to wait for a non-urgent appointment.
WP advised that ideally it would be three days but there have been staffing and recruitment problems. Recruiting has been difficult; we have recently had two GPs to replace two young GPs who have moved on to further their careers. We have recently advertised for a full time Partner and the response to all these vacancies has been limited. We have also recruited more nursing staff. It is hoped that when these positions are in place, it will help to address the demand.
JU stated that part of the appointment system allowed for GPs to book appointments where appropriate so that if a patient needed to be seen following a consultation, this could be done by the GP.
WP was asked how we measure the need for increasing the GP/Nurse availability. We work on the third available appointment???
JF asked WP if he could report on this at the next meeting. / WP
WP asked the Group if there was anything they wished the Practice to look into regarding access. No further comments were made.
It was noted that there are 1400 patients signed up to the online appointments system. The next step is to add some Nurse appointments, particularly blood test appointments. When this has been introduced, we will promote the online booking system again.
Question 3. At your last appointment, did you understand what the Doctor/Nurse said to you during the consultation?
98% responded ‘yes’
Question 4. Were you given enough information about your diagnosis/treatment?
94% responded ‘yes’
Question 5. Are you aware how the triage service operates?
71% responded ‘yes’
It was confirmed that that patients are aware of triage and that it is explained to them when they are put onto the triage list.
The Group were advised that receptionists ask patients the nature of their problem so that they can signpost the patient in the correct way. It was noted that not all patients are willing to disclose this.
JF asked if receptionists were trained to deal with patients when asking them what the problem is. CE confirmed they are but there have been a number of new staff for which training has to be arranged.
Question 6. Are you aware of the following methods of cancelling appointments?
Via Surgery website - 58% responded ‘yes’
Via dedicated phone line – 62% responded ‘yes’
Via main surgery line – 98% responded ‘yes’
JF asked if the cancellation information is advised to patients. CE advised that the cancellation line and website details are printed on the appointment card.
Discussion took place on the benefits of having a multimedia display boards installed in the waiting rooms. It was noted that this is being investigated but there is a cost in the region of £10,000 (£5,000 per surgery) to have these installed.
TH raised the subject of the touch screen in Severnvale surgery which appears not to be working. TH advised that he had observed a queue of 17 patients waiting to book in.
JT advised that it has not been possible to resolve the problem with that touch screen and it has been switched off. A replacement touch screen similar to the one installed at Rosebank is being investigated. The cost of this is £4,000.
Question 7. Are you aware of the text reminder service?
62% responded ‘yes’.
JT advised that around 170 text reminders are sent each day, which is about 50% of the appointments. Patients continue to be asked for their mobile phone number to enable texts to be sent.
Question 8. Are you aware there is a Rosebank Health website?
73% responded ‘yes’
Question 9. Have you visited the Rosebank Health website?
59% responded ‘no’
Question 10. Do you know the following facilities are available on the Rosebank Health website?
10a. Ordering repeat prescriptions – 72% responded ‘yes’
10b. Booking online appointments – 53% responded ‘no’.
It was noted that some patients have had difficulty registering and JT has assisted many of them to register successfully. As noted above, there are currently 1400 patients registered for the online booking system.
10c. Cancelling appointments – 58% responded ‘yes’.
10d. Subscribe to Practice Newsletter – 67% responded ‘no’.
10e. Change personal contact details – 54% responded ‘no’.
10f. Links to patient health information – 62% responded ‘no’.
JR asked what we are going to do with this survey information.
The Group was advised that we will be putting together an action plan from the results and implement where feasible.
JF suggested that a summary is put in the Newsletter advising of the proposed actions and advise patients how important it is to participate in future surveys.
3. / Process of accepting new patients
JF asked what was the process for accepting new patients. CE advised that patients usually come to reception and they are asked where they live to check that they are within the Practice boundary. They are given a registration form to complete, they are required to provide two forms of ID – utility bill giving their current address and a photo ID. On completion, they are given a welcome pack with a letter, card giving details of their registered GP and a Practice leaflet.
JU stated that the principle of registration is geographical – the Practice has boundaries and we do not close our list to patients.
TH stated that with the growth of population with Kingsway and Huntsgrove, the surgery at Severnvale is being pushed to breaking point. JU responded that the building at Severnvale is at saturation point and there is no further room for development. A surgery is at the planning stage for Kingsway/Huntsgrove but no land has yet been identified.
TH advised that there is a designated site at Kingsway but JU stated that the PCT is clear that the surgery is for Kingsway and Huntsgrove and should be in a position between the two developments which could cater for current list size and for expansion in the future.
4. / Update from the Practice
Care Quality Commission (CQC)
It was reported that the Practice has successfully registered with CQC. JU advised that it required a full time member of staff working for nine months to achieve this and all staff are required to read all the protocols and receive training as appropriate.
Research
JU advised that the Practice is involved in research and has carried out a six month study called DUTY (diagnosis on urinary tract infections in children) which raised the profile of the Practice and the condition.
The Practice is on the South West Primary Care Research Network and JU advised that there are a number of projects which he could become involved in for the Practice but research needs to be balanced with day to day work.
It was suggested that the Practice’s involvement in research could be mentioned in the Newsletter.
Repeat Dispensing
JU advised that the Practice produces 386,000 prescriptions a year, with up to four items on each prescription. We have a prescribing team of three members and support from the PCT.
Repeat dispensing, which requires patient consent, means that we can issue up to six months of prescriptions which go to the Pharmacy. This would greatly reduce the number of prescriptions that have to be produced and would save the patient having to come to the surgery to request and collect prescriptions. Patients’ medication has to be well controlled to be considered for repeat dispensing. We want safe, efficient, cost effective prescribing. JU advised that not all GPs are engaged in repeat dispensing but this is developing.
JR asked about patients’ compliance with medication and how diabetics are recalled. JT advised that these patients are written to asking them to make an appointment for an annual review and they also have tests every 6 months.
5. / Healthwatch
JF advised of the reorganisation within patient representation that the government has put in place. Healthwatch replaces Local Involvement Networks (LINks).
The aim of Healthwatch is to give communities a voice to influence and challenge how health and social care services are provided within their locality. Gloucestershire Rural Community Council is responsible for Healthwatch in Gloucestershire. There is also an advocacy department to assist with patient complaints.
6. / Any Other Business
6.1 Commissioning
TH advised that Richard Graham, MP, had a discussion with him about commissioning being taken over by doctors from PCTs. JF stated that clinicians have the information to run the Clinical Commissioning Group (CCG), and the CCG make decisions about how we change and improve the service. The process of handover to the CCG has taken place over a number of years.
JU advised that Dr Roberts has a life time of experience in this work. He is currently Chairman of Gloucestershire Locality Commissioning Forum.
6.2 ‘Dying Well’
Ricarda Witcombe was unable to attend the meeting this evening but has forwarded feedback on the Dying Well conference that was held in November. It was agreed to circulate this to the Group for information. / SH
6.3 Benefits Agency Surgery
NP advised that the Benefits Agency Surgeries are going well and that a lot of patients find this very helpful. NP asked if feedback could be obtained from GPs.
It was suggested that NP write about the service for the Newsletter and forward to SH. / SH
NP
JF advised NP that the Health Access Centre also appreciate the work that is being done.
6.3 NHS 111 Service
JF advised of the new service which is taking over from NHS Direct and covers everything other than the 999 service. In the long term the plan is to be able to make appointments for patients. The ‘soft launch’ of the system commenced last weekend.
JU advised that he was working at the Out of Hours service last Saturday and the NHS 111 service was very poor with patients waiting a long time for response. JU advised that he had contacted the Commissioner about this and it was being investigated.
7. / Date of Next Meeting
To be agreed.
Meeting closed at 8.55pm
Signed: ………………………………………………….. (Chair)
Date: ………………………………………………………..