The Didcot Health Centre Patient Participation Group
23nd ANNUAL GENERAL MEETING
15th May 2014
Apologies:
Apologies were received from Andrew Jones.
Minutes of the 22nd AGM held on 29th May 2013
The minutes were accepted as a true record of the meeting and signed by Shelagh Garvey (PPG Chair).
Chairman’s report – Shelagh Garvey
This year has been one of challenge, for both practice and patients.
This time last year, the practice was wrestling with the installation of a new IT system, following the previous clinical system supplier’s decision to withdraw from the GP market and all the delays and frustrations that this implied, with almost 50,000 clinical records to be converted to the new database, new touchscreens to be installed and extensive staff training to be undertaken – all at the same time as running the practice and dealing with patients.. The IT system continues to throw up the odd gremlin but the practice has dealt with the disruption and the system is now bedded down.
The changes to the IT system mirrored the wider changes going on in the delivery of health services nationally. The picture changes constantly, as do the acres of press coverage, and the PPG Committee has sought to keep patients up to date through Philip Pells' updates in the newsletter. Special thanks must go to Committee members Philip, Hazel Pells, and Lesley Powell, who have attended numerous meetings on our behalf. We believe that it's critical for patients to know what's going on and to respond to calls for consultation - with the health warning that consultation can be a double edged sword, and even very low response levels will be claimed to show 'whatpatients want', with questions carefully worded to get the answers that fit a specific agenda. Patients do need to know the potential implications of the choices they express and we aim to keep you up to date on what these may be.
In October we said goodbye to Wendy Birch, who was on the PPG Committee for 18 years. As a member of practice staff, Wendy was an invaluable source of information and updates on what was happening in the practice. We hope that Wendy is enjoying her well-earned retirement.
Another change this year has been the move to holding Committee meetings at the practice. We’re grateful to Philip and Hazel for letting us disrupt their home for many years, but enhanced opening hours at the practice mean that we can now hold our meetings there, on Thursday evenings. This has the added bonus of enabling Jackie Mercer to attend meetings, which was difficult for her when we were further away.
Last August Bank Holiday we joined with Woodlands and Oak Tree PPGs to run a joint stall at the Didcot Community Hospital Fete. This was the second year that we had done this and was a valuable opportunity to work together again. The weather was - unusually for a British Bank Holiday - warm and sunny and there was a good turnout. We distributed a leaflet that the OCCG had printed specially for us, at no cost to the practices, informing patients of the various methods by which they can make their views known. We’ve been promised a stall again this year and Woodlands have already expressed interest in working with us again.
The newsletter, which I edit, and which is issued three times a year, in hard copy and by email, with a colour copy on the Health Centre website, continues to be the main avenue through which the PPG Committee informs patients about developments, through Jackie Mercer's Practice Update and Philip's OCCG update. Another regular feature is advice on health issues, through Irene Clark's articles on vaccinations, travel health, etc. I have recently introduced a Healthy Bites section, with snippets of news and links to where further information can be found, which I hope you find useful. We are always grateful for ideas and contributions from patients. The newsletter is time consuming to produce and distribute and if you can help with this, by opting for your copy by email or by helping with delivery, this would be much appreciated, especially as some of our distributors are feeling the march of time and are finding delivery more difficult.
On New Year’s Eve, the practice, having weathered the IT storm, was hit by the double whammy of a Care Quality Commission inspection. These inspections happen at only 48 hours’ notice and, although everyone knew the practice could be inspected at any time after 1st April 2013, it did make it difficult to concentrate on the midnight celebrations. On the day, business needed to continue as normal so that the Inspector could get a ‘feel’ of how the Practice functions on a day to day basis. It’s also a requirement for a patient representative to be involved and I’m grateful to Lesley for making herself available at short notice to represent the PPG. You’ll be pleased to hear that overall the practice ticked all the boxes in relation to the CQC performance requirements.
We conducted another annual Patient Survey, working closely with Dr Barnes. At the end of last year we conducted a recruitment exercise to increase the number of people on the Patient Reference Group, which is email based. Thanks to PPG committee members who carried this out, especially Marnie Fitzgerald, who patrolled the waiting areas relentlessly and whose sign up rate made my efforts look pretty insignificant. In the New Year, Lesley Powell and I had several meetings with Dr Barnes, acting as a Steering Group on behalf of the PPG and PRG, to put together the survey format. All practices are required to conduct a survey, but we agreed that we wanted to have a shorter, more focused survey than in previous years. The Steering Group also suggested that we make a virtue out of a necessity by focusing on issues raised by patients in the previous year's survey. This would make the survey more relevant to both patients and practice by testing out whether the measures put in place by the practice to address patients’ concerns are working. The survey was conducted in early February by email and by face to face interviews conducted in the Health Centre by PPG Committee members - again thanks to all Committee members who participated.
We had the biggest response ever this year, with 298 respondents. A summary of the main results is included in the latest newsletter, with the full results on the HC website. We were pleased to see that there is significant awareness of telephone triage and that the majority of those who had experienced it were positive about it. There was also strong awareness of the new 111 telephone number although nearly one in five respondents said their first port of call for an urgent, but non-emergency, situation would be A & E, so there is still work to do. There were high levels of satisfaction with clinical care received but access to GPs remains a problem for some. We were encouraged by the enthusiasm for using technology, e.g. text appointment reminders by text and the facility for booking appointments online, if these measures could be available.
We are grateful to all patients who completed the survey – very few refused to do so - and to the practice for facilitating it. Special thanks to Dr Barnes for his unfailing cheerfulness and enthusiasm for the survey, for being open to suggestions and new ideas, and for the amount of his own personal time spent on the survey and the development of an Action Plan.
As always, many thanks to fellow Committee members for all their hard work. Thanks to Philip for yet another year as Secretary and for his prompt Committee Minutes. Thanks also to Andrew as Treasurer, and to Rhonda for sourcing a last minute replacement banner for the Hospital Fete when the previous one went walkabout (nothing to do with us!). We are grateful to Jackie Mercer for providing photocopying facilities and covering the costs of paper, staples and cartridges – this comes from funds specifically allocated to practices for patient support and not from direct patient care. Thanks also to Monica for ongoing advice and support to me over the last year, and thanks to practice staff, especially Gill, Jackie's assistant, for putting up with constant interruptions and pleas for help when the newsletter is being copied at the practice. Thanks also to my friend Jenny for her help at the Hospital Fete and help with photocopying.
Treasurer’s report – Andrew Jones
There is £59.12 in the account and £2.50 petty cash, no change from last year except for the interest of 6 pence paid 1st June 2013. There has been no expenditure as the Practice covers all printing costs and members of the committee pay for any minor postage costs.
Election of the Committee and Officers for 2013/14:
The 2013/14 committee stood down and Dr Jackie Mercer temporarily took the chair while a new committee was elected. Jackie read out the list of last year’s committee who were willing to stand again and their election was agreed.
Chairman:
Shelagh Garvey was nominated by Marnie Fitzgerald and seconded by Monica Pocock.
Secretary:
Philip Pells was nominated by Rhonda Leighton and seconded by Leslie Powell.
Treasurer:
Andrew Jones was nominated by Stewart Watson and seconded by Leslie Powell.
There were no other nominations for any of these posts and all were elected unanimously.
Shelagh Garvey took the chair.
The PPG Committee now includes the following:
Shirley AndersonHazel Pells
Marnie FitzgeraldPhilip Pells (secretary)
Shelagh Garvey(Chair)Monica Pocock
Andrew Jones (treasurer)Lesley Powell
Rhonda LeightonStewart Watson
Jackie Mercer (Practice Manager) will be kept informed of all committee proceedings and will attend meetings as and when she is able to.
Any other business
The date for the next committee meeting was to be decided.
Notes taken from the AGM talk given by Dr.David Ebbs on the subject of:
Telephone Triage and the Appointments System
General Practice appears frequently in the news over the topic of access with weekend access being the hot potato at the moment.
The Didcot Health Centre (DHC) reviews the appointment system regularly to try and make it as flexible as possible. There is such a wide variety of appointment needs with some being for months ahead, some being regularly spaced all the way down to urgent, that day, appointments. It’s not possible to meet everyone’s needs. In some smaller practices doctors are able to deal with more than half of callers over the telephone. However, with nearly 17,000 patients registered with DHC it is logistically impossible for doctors to triage all calls.
Most illnesses are self-limiting, i.e. go away in a few days. On an average day each doctor has about 60 “contacts” with patients and the practice is working at near full capacity. Anw appointments system has been set up starting in June. There will be 2 duty doctors on every day to deal with urgent cases.
The meeting was opened to the floor.
QI do not like being triaged by a receptionist and would prefer to be triaged by a doctor.
AOne problem is that people are demanding to be seen for what might be a minor problem that will go away in a few days. Conversely medicine has become more complex and so takes up more time per patient.
Managing expectations is difficult as the person answering the phone has to deal with a multiplicity of attitudes and expectations in the patient.
There is a hot line for people who are chronically sick and occasionally have urgent problems.
QWhat about none-attending patients?
AWe don’t have many now.
QPeople are suspicious of age related treatment, i.e. no scans for those over 55.
AIt is true that some scans are of little use for those above a certain age. Most hospital patients are old – on average about 80. In the practice they do find that those under 5 and over 80 do need to be seen on the day.
QShould the public use pharmacies more?
AIf a receptionist suggests that patients go to a pharmacy the patients object. The same objections occur if a doctor suggests going to a pharmacy. However, pharmacies are a good source of advice.
Nurse practitioners are widely experienced but are not trained to the same level as doctors. It’s up to the patient to decide if a NP will satisfy them.