Patient Participation Group Quarterly Meeting

17th July 2013

6pm – 8pm

In attendance:

Dr Geoff Hamp (GP Partner)

Sister Sue Morse, Treatment Lead

Maria Kay (Practice Manager)

Jacqui Balston (Assistant Practice Manager)

Emily Dewey (Administrator)

Patient Participation Forum Members Present:

Angela Evans

Graham Hustings

Gerry Needham

Sally Parkinson

Janet White

Steve Jones

Agenda:

  1. Action Points from Patient Participation Group Meeting on 11 March 2013 – taking action points forward
  2. Areas of interest for next survey
  3. Developing patient priorities – what do you think is important?
  4. Issues including themes from complaints
  5. Planned practice changes
  6. National GP patient survey issues
  1. Update regarding CQC (impending visit, statutory right of visit, Lead from forum)
  2. Clinical Commissioning Group (CCG) – “the big ask” questionnaire
  3. New Vaccinations
  4. Carers
  5. Extended Hours
  6. New members to PPG – how to sign up and virtual group
  7. Frequency of Meetings
  8. Questions

Maria Kay first introduced herself as returning practice manager to the practice and thanked and welcomed everybody in attendance.

  1. Taking action points forward from last PPG Meeting
  • Getting appointments online – it was discussed that with the introduction of the new computer system, this is something the surgery was actively looking into introducing in the coming months.
  • Confidential area for patients at the front desk – only 3% of patients whom took the patient survey had used the confidential area. It was discussed that this area wasn’t satisfactorily advertised to patients. There needed to be signage on the front desk as well as above the check in screen. It was agreed however that a sign should be made for the door itself and that this should be more noticeable for patients.

It was also highlighted that the front desk receptionist should potentially be able to notice when a patient may be uncomfortable talking in the main area and should offer this service when appropriate.

  • Information given out at the practice – previous points were discussed, such as placement of the newsletter in other local areas such as post office, etc. The difficulty of this was discussed as leaflets would most probably be taken down again. The need for the handbook to be regularly updated was highlighted.
  • Receptionist Introduction – under discussion was the potential for GP secretary’s to introduce themselves either by name, or “Dr X’s secretary” upon answering the phone as patients often have to ask “Am I speaking to …?”

The need for the picture board was also discussed, patients were advised that this was outstanding, but due to vast changes within the practice, this had to be put on hold as processing times are lengthy. This will however be actioned as soon as possible.

  • Rating of Information – engagement of Doctors –it was discussed that the practice had been under a big transition recently with changes of partners and staff. It was agreed that a list of doctors should be placed in the practice newsletter, as well as a statement informing patients of the availability of Dr Wells to all patients.

The advertisement of retirement of Doctors was conversed; MK advised that this was previously the responsibility of the Health Authority; however this has now passed to the surgeries themselves. At present, this has been communicated via posters in the waiting room, however it was agreed that maybe this could be stated on the bottom of prescriptions, in order to better inform patients who may not attend the surgery regularly. The PPG were reassured that the surgery would only seek suitably qualified doctors in replacement for those who have left.

  • Female and Male GP availability – The PPG were advised that if patients wished to see a female doctor (for a female related problem ) or male doctor (for a male related problem) rather than the doctor they were registered with, it was agreed that we would accommodate this.
  • Getting an appointment within 48 hours – it was highlighted that this was a priority for the surgery. It was agreed across the patient board that this had improved and was generally very good. The patients explained that they were very fortunate to have such an accommodating surgery.

Patients who were Friends of the Practice members mentioned that they very rarely had patients who were critical of the practice.

One point of feedback mentioned was the need for things to “settle down” within the practice. It was discussed that this was unfortunate due to unforeseeable circumstances, for example changes in GP partners.

  • Extended Hours – these were listed as follows, and on display for patients’ perusal:
  • Dr Anna Popova – Tuesday before AM surgery
  • Dr Ravi Sastry – Tuesday before AM surgery
  • Dr Julian Strauss – Tuesday before AM surgery
  • Dr Geoff Hamp – Tuesday after PM surgery
  • Dr Geoff Ottley – Tuesday after PM surgery
  • Dr Emma Richards – Thursday after PM surgery
  • Dr Hannah Wells – Tuesday after PM surgery

The potential for inclusion of this in the next practice newsletter was discussed.

It was unanimously agreed that the extended hour’s service should be primarily for patients who would find it difficult to attend during surgery time, which was not necessarily representative of the population present at the meeting today.

The patients however agreed that they were satisfied with this service.

  1. Areas for interest in next survey

a)Developing Patient Priorities:

Reception Issues

  • Length of time from end of recorded message to answering the phone by reception – this was felt to be worsening. It was suggested that at busy periods it might be advisable to have two receptionists present, one to deal with telephone calls and the other with patients at the desk. Another suggestion of a diversion to another line was also put forward. This was agreed to be looked into.
  • Getting an appointment – it was felt that getting through to reception was a more pressing issue. Getting an appointment was satisfactory, however, the patients themselves mentioned that the group presenting here today was not fully representative of the population of the surgery and that other age groups may find getting an appointment more difficult. The need for a more representative PPG was an outcome thought from this point. Jacqui Balston, (JB) (Assistant Practice Manager) explained the purpose of the virtual PPG and it was explained that this did target a much wider age group.

Clinical Care

  • Access to other services – it was questioned why there was no longer a surgery dietician. It was explained that the dietician was present here many years ago and that GPs can make hospital referrals to dietician services.

b) Issues including themes from complaints:

  • Parking – it was felt this had worsened, as patients whowere not disabled had begun to use the designated disabled bays.
  • Automatic Doors – it was discussed that the main door from the waiting area to the consulting rooms should be more accessible for patients who may use a walking aid or mothers with pushchairs as it is often difficult when approaching from the consulting room side to physically open the door. It was agreed that Maria Kay (MK), Practice Manager, would discuss this with the practice handy-man to consider various options to resolve this, it was mentioned that the Friends of the Practice budget could be considered for this. The importance of the door being there for fire safety and confidentiality purposes was highlighted.
  • It was suggested that patients who make complaints should be invited to join the PPG so that their issues can be discussed and resolved.

c) Planned Practice Changes:

  • Seats to be recovered – a quote from a company in Wimborne has been sought, it was mentioned that the seats would need to be taken away for replacement.
  • Treatment Room Reception Carpet is to be replaced
  • Floor has already been replaced in the Treatment Room clinical area and new bottoms for the chairs, etc have been placed to minimise markings.
  • Times when the surgery is closed – new allocation of protected learning time was introduced and the purpose explained. Details of Basic Life Support and Information Governance training conducted during protected learning time were explained. It was discussed that this should be better advertised further in advance as well as communicated to the local pharmacies.

d) National GP Patient Survey Issues:

MK had spoken to the National Association for Patient Participation (NAPP) to ascertain areas of concerns that patients’ surveys had revealed nationally and the following were found common areas of concerns as a result of patients’ surveys.

  • Getting an appointment
  • Reception
  • Telephone Systems
  • Access
  • Customer Service

A brief history of NAPPwas explained as well as the purpose of the surveys in terms of allowing patients to voice their experiences and contribute to bettering their health care.

At this point, a PPG member kindly pointed out that if there were patients with multiple criticisms of the surgery, there would be a greater attendance at the current meeting.

  • Electronic prescribing – it was explained that this was being set up by Medicines Management. This is something we would consider in the future, but due to multiple changes occurring at presentthis will need some time to be set up in conjunction with local chemists.
  1. Update - CQC

The Care Quality Commission was explained to be an independent regulatory body that inspect services used by the general public for their health care needs.

It was outlined that an inspection for our surgery and other local surgeries was imminent. We will receive 48 hours notice for this and the inspectors will be present for the entire working day and are free to walk around the whole surgery.

MK explained that an acting ‘Lead’ from the PPG was needed on the day of the CQC inspection as it is a good reflection to have a member there to explain their input. Patients interested in taking this on were invited to contact Jacqui Balston.

The results of the CQC inspection will be displayed on the CQC website and the surgery will have one month to rectify any areas that have been outlined as needing improvement.

It was pointed out from a member’s previous experience with the CQC that it is mainly documentation and confidentiality that they will focus on, with the patient’s best interests at heart.

  1. Clinical Commissioning Group (CCG) - Update

In its first 100 days since transition from Primary Care Trusts to Clinical Commissioning Groups the following had transpired:

Strategy principles of the CCG were outlined:

  • Services designed around patients
  • Preventing ill health and reducing inequalities#
  • Sustainable healthcare services
  • Care closer to home

Areas of CCG which are now different:

  • Clinical Leadership
  • Involvement with strategy and prioritisation
  • Streamlined CCG Structure

What went well?

  • Transition to CCG
  • Engagement
  • Workforce
  • Communications

What didn’t go well:

  • IT Support
  • Responsibility and accountability
  • Office space/location
  • Engagement and communication
  • Developing Leadership

MK described the rationale of a patient survey instigated by the CCG, ‘The Big Ask’ and the PPG were asked if they would be interested in partaking. Surveys were handed to members for completion.

  1. New Vaccinations

Dr Geoff Hamp (GH) gave an explanation of three new vaccinations being introduced this year.

  • Rotavirus – early protection against Rotavirus gastroenteritis- causing diarrhoea and vomiting, particularly in the under 5 year olds. Vaccination will be aimed at 2 year olds.He explained there were approximately 140,000 cases per year and 10% of these patients are hospitalised. It is hoped this vaccination will minimise admissions to hospital. It is lifetime coverage and will be given at 2 and 3 months.
  • Child Flu - to be initiated in September 2013 – aimed at 2 year olds. Administered via a nasal spray. It was explained that this should not affect the incidence of other flu’s.
  • Shingles – to be initiated in September 2013 – patients who are aged 70 and aged 79 years old on the 1st September will be invited for vaccination. Over the following years there will be a catch up programme for other age groups. It was explained that shingles can be contracted multiple times. At present we are still waiting final confirmatory guidance from the Department of Health. This will be a separate clinic from the Flu Clinic.
  1. Carers
  • The practice is aiming to raise awareness of the support available for carers and promote the concept of patients identifying themselves as carers.
  • It may be that patients do not recognise themselves as carers
  • The importance of identification of carers was explained, as we can provide extra support when accessing services
  • Only a few carers signed up after the ‘Carers week’ promotion
  • It was acknowledged that some people may not see themselves as carers or may not wish to step forward.
  • It was agreed that the use of the notice board was an excellent way of communicating support and courses available to carers.
  1. PPG New Members
  • Patients were referred to the notice ‘How to Sign up to the Virtual PPG’
  • The drafting of a constitution was put to the floor – it was suggested that Ann Jones (Friends of the Practice) should be approached for help with this drafting.
  • At this point the Friends of the Practice were given special thanks and it was pointed out that their valuable time and organisation was very much appreciated by the doctors and staff at the Practice.
  1. Frequency of Meetings
  • The National Association for Patient Participation results were outlined with regard to valid input for both face to face meetings and virtual input.
  • It was agreed that due to frequency of change at the surgery, that face to face quarterly meetings with the PPG would be mutually beneficial
  • It was requested that an RSVP should be put onto the bottom of email invites to the PPG meetings as this would help the practice to estimate attendance at the meetings
  • JB explained the process for survey distribution – which was conducted on a response basis to an email questioning what patients would like to see in the survey. It was explained that various means were used to attempt to attract populations within varying age groups, e.g. via text message.
  • It was decided that an interim Treatment Room survey would be drafted to allow evaluation of that side of the service from a patient perspective.
  1. Questions
  • A concern was raised regarding blood test appointments being filled up so far in advance. The treatment room lead (Sister Sue Morse) explained that fasting blood test slots should now be loosened in terms of their availability by freeing up of Diabetic blood test criteria.
  • Thyroid function test requests were confirmed as being on a recall system by the treatment room reception.
  • The need for a process of identification of PPG members to other patients in the surgery was discussed – concerns with confidentiality were highlighted – it was decided that if a patient was to approach the surgery with a concern – we would explain that their views could be expressed through our PPG and that they could leave their contact details for a member to call them to discuss this.
  • It was pointed out that ample notice was needed before PPG meetings, perhaps with more eye catching promotion in the waiting area.
  • The potential of having a television in the waiting room was suggested to be an excellent method of communicating various items to the patients. Advertisements for the next PPGmeeting will commence early in order to ensure maximal response.

Thanks and appreciation was expressed to all attendees.

The next PPG meeting will be on Wednesday 2nd October – 6 pm