Minutes of the Church Lane Surgery Patients’ Participation Group Meeting held on Monday 6 November 2017

Those present: Richard Borthwick, Jane Hiscock, Brian Hooper, Ken Chapman, Jill and Dennis Lawton, Clifford Butler, Jenny Bostock (Director of Nursing - Invicta Health) and Sophie Williams (Clinical Support Manager).

1.Apologies:Penny Snoad, Pip Metcalfe and Dr Alan Tollins.

2.Minutes of the Last Meeting on 4 September 2017: At para. 4.1 BH said the words “he had received etc.”are incorrect and should be replaced by “he had heard of 2 appointment letters from the surgery etc.”. Agreed by all.

3.Matters Arising from the Last Minutes:

Appointments - RB thought there was no progress on online bookings, and SW said there had been some delays due to book-on-the-day appointments but JB said it was now improving. She added “one of the issues we have been experiencing is Locums cancelling at short notice and this whole situation impacts upon other clinics”. CB wanted to know if there were now dedicated locums and JB confirmed that some are regular sessional GPs who have been working with the practice for over a year, also the surgery is now selective in their choice of locums attending to ensure good quality GPs. SW confirmed that locums are not being paid for non-attendance. She said routine appointment patients have had their appointments re-booked if locums did not attend and any patients with urgent appointments booked are ‘squeezed in’ or moved to another clinician where possible . BH asked “how soon after this cancellation did the patient get another appointment?”. She said routine appointments are about 2 weeks but it depended upon the patient’s health issues, and they could be phoned and asked if they wished to be seen by another doctor. JB said they look at the whole picture of what the patients’ needs are. SW added the Martello practise can be an alternative option in these unpredictable cases.

3.1 Staff and Other Matters – JB announced that a new Nurse Practitioner had started 2 weeks ago. (One NP has been on sick leave for the past year), the Practise Manager – Julia Young who was recently recruited on a 6 month contract has resigned but her replacement sourced via an agency is due to start work on this Wednesday Sean Hart. CB asked about numbers of patients registered, SW said 4,600 at Martello and 6,742 at Church Lane plus a`weighted’ list making the total 7,500. DL said the proposed house building in NR would mean another 1,000 houses. BH asked about complaints made and how they were dealt with as he made a complaint after the last PPG meeting to the Practise Manager but had not received a response. SW said they hold `listings’ and JB added they are both the written and verbal.

4.At the Last Meeting: BH & JH were tasked to draw up a poster displaying the issues with DNAs (Did Not Attends) and BH showed members the poster. Members appeared to like this but KC suggested an appointment score bar be included but BHsaid the draft displayed a figure and cost of DNAs so was not necessary. JB took the draft away with her for future printing and display.

4.1. CB asked whether patients were triaged to determine the level of treatment prior to appointment/treatment. SW confirmed this basically was the case depending upon the health issue presented.BH raised the issue of reception still without medical knowledge so they could miss something, SW said theirs were trained to signpost (areas of concern). DL asked if any specific medical conditions were flagged up on computer screens. JB confirmed this and said palliative care and vulnerable patients were covered by this action. When there was a situation where no appointments were available SW said the reception staff would “open up a conversation with the patient” regarding the need for urgency. She added that staff now have the right attitude. She confirmed there was a private room available for such a conversation and that there was a male member of the staff available if needed.

4.2 Continuing with the Bullet Point Suggestions in the Agenda,

BH explained his suggestion of situating a ticket m/c in the surgery was to alleviate the problem for patients having to stand outside waiting to be let in at 8a.m. SW said there had never been a problem with the order of entry, just that patients had complained that the bench inside the lobby had been removed, due to health and safety reasons (faulty). This was when patient queuing had been allowed in early due to poor weather conditions. So now the policy was to open at the contracted normal time. The suggestion of earlier opening was discussed and the majority thought the problem would still exist albeit at an earlier time.

JB said there had been 45 appointments available that morning and 36 were still free to book so no-one queueing was without an appointment that day. SW said a `huddle’ meeting was conducted each day in order to assess the clinical workload and ensure all staff were aware of the daily issues. JB added that Christmastime would be a busy time for the surgery due to seasonal illnesses and the four day closure

JB said Invicta were looking into the possibilities of providing a n improved telephone service, using a`Section96’ request and had asked for additional funding from the CCG. Although it had been approved in principal but we were waiting to see if this was feasable. JH asked her whether there were any other known competitors in the running when Invicta’s contract ends on 31 March 2018. She did not know of any in the South east region but nationally there were other similar agencies doing the same job as Invicta. JB said as suggested appointment cards could carry a message re. DNAs but a phone back system to report available vacant appointments to patients was not possible. JB agreed a poster showing all the various services available/or not at the surgery was a good idea and she would provide the PPG with the list to enable them to draft a poster. JH asked if a `Family Tree’ chart showing staff would be possible. JB said yes with some exceptions (some staff may not agree to be photographed).

5.Secretary’s Attendance at the Health Summit on 18 Oct 2017: JH said the meeting was to discuss the future plans for a `Hub’ on Romney Marsh. She said it was made clear that a temporary Hub was to be located at the RM Day Centre in Rolfe Lane hopefully in January 2018 and the future site possibilities were discussed for a permanent more comprehensive facility in the next few years. The CCG want to look at all the issues and options available to them. JB said the Hub would allow the freeing up of GP surgeries by allowing doctors to refer patients to the Hub when there is no capacity at a particular the surgery.

6. A.O.B.

JH asked if there had been a response back from the CQC following their recent inspection. JB said not yet but she would circulate the responses from patients, to PPG members. SW said that Martello was inspected in May and they were given a `good’ rating and a 3-5year time review. Invicta have been with Martello for 2 years now but there are no quick fixes. They have been with Church Lane for just over 1 year. In 2015 Church Lane was given a `good’ rating. CB asked about blood tests and JB confirmed Church Lane has a phlebotomist for 4 days a week but they are trying to recruit another. Comments were made by several members about the state of the PPG display boards in the waiting room. JB noted this and will respond in due course.

7. Next Meeting on 8 January 2018 - will be an Annual General Meeting and will include an election for the posts of Chairman and Secretary to the PPG, JL said there had been a constitution in the past so JH asked JB if she could provide it together with a form possibly titled “Disclosure of Confidential Material” or similar which had been in use before her time, so that all members can sign up to it. JH asked JB about the planned `Open Day’ agreed by Dr Alan Tollins, JB said she will investigate this.

NOTE: Next meetings are booked for: 8th Jan and 5th Mar.

Jane Hiscock (Secretary of the Church Lane Patients’ ParticipationGroup)