Minutes for Patient Reference Group 19.8.13

Staff attendees –Dr I Minshall, Grace Marshall (PRG Secretary)

Lee Jones sent his apologies.

7 patient representatives attended.

5 patient representatives sent their apologies.

Previous Item / Item / Actions to be taken / Responsibility
N/A / Dr Minshall explained the change over of registrars at the surgery. Dr Morris and Dr Wilkins have moved on and 2 new registrars will be working with us for 4 months – Dr Helen Owen and Dr Claire Wilson. / No action required. / N/A
The telephone triage system was discussed further. Several PRG members who have used this service compared their experiences.
One member said that their call was requested first thing in the morning and not returned until 3.30pm that day. Another member said that their call was returned promptly, even when requested in the evening. / The effect the triage system has on reducing routine pre-bookable appointment availability was discussed briefly. It was agreed that with the move to the new building more doctors would be able to run clinics, for example Dr Davies could run additional Thursday morning clinics as suggested by Dr Minshall. / No action required. / N/A
The differences between name badges was discussed. Some members of staff have only their first name on the badge (i.e. ‘Grace’) and some have their full name (i.e. ‘Lee Jones’). / Not discussed at PRG meeting.
NVS staff discussed this and agreed all are happy with the current name badges. / No action required. / N/A
Lee Jones explained that a member of staff had recorded a new message in line with the ‘go-live’ date for the new 111 number (to replace NHS Direct and Out Of Hours services in Western Cheshire) however due to the problems with this service the new message was removed. When the 111 service has been sorted and due to be re-introduced the message will change to the new recording, so there is no current time frame for when this will be done.
There is an alternative phone number 01244 564319 which patients can use to contact the surgery.
The reason for changing the telephone system initially was discussed. The idea was to improve telephone waiting times and patient access to the surgery.
At the end of the NEG contract the surgery will be returning to a regular 01244 number, as there is a considerable up-front charge for cancelling the contract. / Not discussed at PRG meeting.
Members were reminded about the alternative 01244 number, which is charged the same as any other landline 01244 number.
The morality and legality of the telephone number was discussed. Members agreed that there is still an issue with regards to the telephone number.
Member had a query on how the 0844 number is paid for. As LJ not in attendance, after the meeting he advised that the contract is paid for monthly. The current cancellation fee for the NEG contract is in the tens of thousands of pounds, however in the future this could decrease.
A member commented that if the contract for the 0844 number with NEG had not been made, the surgery would receive a new number after the move into the new building anyway. / Message to be altered on 111 launch date.
Alternative phone number to be available for use.
Sign in surgery to be looked into advising patients of cost.
No further action.
No further action. / NHS / NVS
N/A
NVS
N/A
N/A
Patients are now using both the 08443 number and the 01244 564319 number. / The access on the old telephone number and the new telephone number was discussed. The old appointments line 01244 318431 still works, however there is no message to advise that you have rung NVS. The 01244 564319 number comes through the same as the 0844 number with the message to advise you have rung NVS. / Possibility of adding a message to the 318431 number to advise patients ringing that they are through to NVS. / NVS
Wash Your Hands campaign posters are on show in the surgery next to hand sanitizers and in the toilet.
A suggestions box has been fixed to the wall next to the entrance to the surgery for any patient suggestions. / If members have any other feedback, ideas, concerns or issues please advise a member of staff. / Ongoing. / PRG
The Spring newsletter is now available in the surgery for patients to view and take away with them. It is to be published on the website as well in future. The possibility of posting out the newsletter to patients who do not have access to the internet to view it was discussed.
It was suggested that a publication date could be added to the newsletter. Another suggestion was that CAN could send in small pieces of art to be included in the newsletter, for example flowers with their Latin names and uses etc.
Another suggestion that was emailed in was discussed with regards to adding a list of the doctors with their first names or listed as male or female. This suggestion had previously been refused by the doctors. This led into a discussion on the equality/fairness of name badges (see previous item re name badges).
A PRG member offered further information on self help information and phone applications that could be added to the newsletter.
It was suggested that the appointment DNA rates could be shown as a monthly comparison as compared to a quarterly figure. / The Summer newsletter has been published and is available on the surgery website. It is also available as a printed copy in surgery. A member queried if the newsletter could be distributed via email to all patients whose emails are recorded by the surgery
Another suggestion for the newsletter is that it is printed on pale yellow paper for partially sighted patients.
A publication date has now been added to the Summer and all future newsletters. Flower art was discussed prior to the meeting by PRG member Sandra and Grace.
Not discussed in PRG meeting.
NVS staff discussed this and information on doctors full names and genders is available on the surgery website and in the practice leaflet.
PRG member not present at meeting for discussion.
Information and phone applications suggested by PRG member have been taken into consideration and used in the newsletter.
Not discussed in PRG meeting.
DNA rates are now shown in the current and future newsletters as monthly comparisons.
The Autumn newsletter is due for publication early September. / Email distribution to be looked into further for future newsletters.
Use of pale yellow paper instead of white to be looked into for future newsletters.
Art to be considered for use in future newsletters.
No further action.
Any information patients would like to be taken into consideration for inclusion in the newsletter please advise Grace.
No further action.
Newsletter to be published. / GM / NVS
GM / NVS
GM / PRG
N/A
GM / PRG
N/A
GM / NVS
Lee Jones explained that the DNA statistics are still being monitored and reported in exact figures, not percentages, as the percentages did not provide a ‘wow’ factor. The DNA rate is slowly dropping.
Some receptionists do remind patients regarding their appointment DNA rate if it flags up when they book appointments.
Grace explained that receptionists do not do this (ask for cancellation reasons) for reasons of confidentiality.
This was discussed further with consideration to sending out a standard letter to recurring ‘DNA’ patients to remind them of missed appointments.
It was also suggested that the DNA statistics could be compared with other surgeries. / Current DNA figures discussed briefly. The rate is still slowly dropping,
Not discussed in PRG meeting.
Not discussed in PRG meeting.
Not discussed in PRG meeting.
LJ queried this with 3 other practices, only 1 was happy to share this data and the other 2 do not publish or share their figures. NVS are not able to make a comparison with this information.
It was discussed that possibly patients DNA appointments that are booked far in advance as reviews, however it was agreed that it is the fault of the patient if they do not attend appointments. / DNA statistics to continue to be reported on.
No further action.
No further action.
No further action.
No further action.
No further action. / LJ
N/A
N/A
N/A
N/A
N/A
N/A / Text reminders were discussed. If the surgery has more mobile numbers this could be used to prevent further DNAs as patients will be automatically reminded.
An issue with the text reminders was raised, as patients are not receiving the reminders at timely intervals – i.e. when the appointment is booked and then no reminder until 10 minutes before the appointment.
Grace discussed this with LJ after the meeting. It is a known problem and we will be raising it with EMIS at the next service users meeting.
It was suggested that the proposed ‘strikes’ system (where a letter is sent to patients who repeatedly do not attend appointments) could be helped by using text reminders. It was agreed that letters would be more appropriate than texts as more formal and less easy to ignore. / Staff to try to collect more mobile numbers for patients so reminder texts can be sent.
To be raised with EMIS Web at the next service user meeting to be addressed.
‘Strikes’ system implementation to be looked into further by staff. / NVS
NVS / EMIS
NVS
N/A / A member suggested an automated telephone reminder system as used by some hospitals. The patient would receive a phone call stating the time and date of the appointment (after security questions answered) and patient could advise then to cancel the appointment if they can’t attend. This may work better than text reminders as patient has to actually respond to the message. / To be looked into further. / NVS
The late policy has now been introduced. Patients who are more than 15 minutes late for their appointment must reschedule, or if it is deemed medically urgent the clinician will be consulted.
It was suggested that the late policy be displayed in clinicians rooms to remind patients not to be late for their appointments. / The late policy is in place, members have no complaints.
Not discussed at PRG meeting.
The late policy is now displayed in clinicians rooms. / To be continued by staff.
No further action. / NVS
N/A
The patient questionnaire has now ended and the results are available on the website. The problems highlighted were the telephone system and routine appointment availability, as discussed in other items. / Not discussed in PRG meeting. / No further action until next years questionnaire. / N/A
Appointment availability was discussed at length. The current average wait time for a doctor of your choice is 3 to 4 weeks. To try and ensure that urgent medical concerns are seen to promptly, the triage system was introduced, and this has caused the wait time for routine appointments to increase.
There are currently 2 partners, 3 salaried GPs and 2 registrars seeing patients, and currently there are not enough rooms to cater for more appointments.
The ‘one appointment, one problem’ issue was discussed. Patients will multiple or complex problems can lead to timing issues from clinicians. / Appointment availability was briefly discussed. The main query was why there are so few appointments for patients to see doctors. This is caused in part by the triage system, as this has caused the loss of at least one clinical session every day. However this increases access for patients who have urgent medical concerns or problems. One reason suggested by a member is that doctors are using more time for administration that clinical time.
Not discussed in PRG meeting. / More appointments to be made available after the move to the new development.
If PRG members have any suggestions as to how availability can be improved please advise Grace for discussion at next meeting.
Solutions to be looked into further. / NVS
NVS / PRG
Appointment booking methods were discussed. A statistic that the PRG would be interested in seeing would be how many are booked online and how many are booked through reception.
The system through which home visit requests are triaged was explained by Grace.
A PRG member explained a dissatisfactory experience from the Out of Hours service. / Not discussed in PRG meeting.
Not discussed in PRG meeting.
Not discussed in PRG meeting. / Staff to look into gathering this information.
No further action.
No further action. / NVS
N/A
N/A
Students sitting in with doctors on their clinics was discussed. A PRG member advised that they have previously not been informed that there is a student sitting in for the appointment when they would have preferred to see the doctor alone. / Members advised that the login screen does not always work or show messages. It was suggested that a physical notice next to the login screen could be added in addition to messages on the screen and receptionists advising patients. / Staff to ensure that warnings are added when students are sitting in. Physical notices to be looked into further. / NVS
Other issues patients have with the appointments were discussed. Some doctors have issues with regards to timings of appointments and running late. In some surgeries reception staff advise patients that there may be a long wait time in surgery. / Grace advised that there is really no way of knowing when appointments are booked in advance if the clinician will be running late. This is an unavoidable problem and the only thing staff can do is advise patients of the wait time verbally and through login screen. / Staff to continue advising patients of long wait times on the day. / NVS
There was a query from a PRG member as to where EMIS Access prescription ordering messages go to, particularly regarding prescriptions being sent to certain pharmacies, as sometimes these requests are not being carried out. / Not discussed in PRG meeting.
Investigation from staff show that the messages are passed through correctly however they are very small and can be missed. Staff have been reminded to be vigilant. / No further action.
Members to advise if any further issues arise. / N/A
N/A / Members queried what Electronic Prescribing (EPS) actually is and how it affects patients. Grace explained that EPS is a change in the way that staff deal with prescriptions and should not overly affect patients. The only change that patients will be able to see is that during a consultation instead of printing a prescription and handing it to patient to take to pharmacy, the prescription will go electronically straight through to pharmacy of patient’s choice. If patients do not want their prescription going directly via EPS the doctor can still print out a prescription as normal. / NVS staff and pharmacies to continue using EPS.
If members have any issues please advise a member of staff or discuss at next meeting, / NVS
PRG
N/A / PRG member queried if the surgery is part of the new sharing of GP records scheme. LJ advised that this is currently a trial period and is due to go live on a widespread basis in the next few months. / Please see information as sent via email. Members to advise GM / LJ of their opinions as soon as possible. / PRG
N/A / Grace explained that the surgery will be going to the Chester University Fresher’s fair in September to encourage new students to register as patients with us. Members had no suggestions as to how we could do this.
After the meeting a PRG member advised that we could use business cards as these are small enough to put into pockets or purses without being discarded. Fridge magnets would also work as these could be on display to the whole household if student is living in shared accomodation. / GM and LJ to go to Chester University Fresher’s week fair.
Business cards to be looked into. / GM / LJ / NVS
GM / LJ
N/A / The flu vaccinations were discussed. The two dates for the clinics are Saturday 5th October and Saturday 19th October 8.30am to 11.30am.
These dates will be added into the Autumn newsletter and patients can use this as a point of contact for information. A PRG member offered to hand out the newsletter after publication to ensure that the message is spread around. / Flu clinic dates to be included in the Autumn newsletter
Offer of assistance will be considered, and other ways of advertising discussed. / GM
NVS
N/A / Thedate for the next meeting is:
Monday 2nd December at 6pm
Held at NorthgateVillage Surgery. / Members to advise if they will not be able to attend this meeting. / PRG

If you have any queries on the content of these minutes or wish for a revision of the details, please advise Grace or another member of staff beforeMonday 30th September.

Refreshments and snacks will be provided for the meeting.

Updates on new development as discussed in the meeting:

Due to the volume and nature of the discussion of the new development this is now displayed in new format as below.

Discussed 19th August
Dr Minshall provided an update on the new development. The current scheduled completion date is August 2014. The current delay is with regards to contractual issues between the partners and the CCG.