The Castle Medical Centre

The Castle Medical Centre

PATIENT REFERENCE GROUP

Minutes of the meeting Monday 30th July 2012

Present: Andy Matthews , Jim Price, Gill Othen, Judith Nicholls, Jane Cunningham, Val Millman, Val Mobberley, Gail Helfet, Thuy Hoan Gibb, Keith Rockett, Rhys Williams, Dr Tim Holt, Lesley Aldridge, Kim Dodd, Vanessa Smith, Rachel Spurgeon.

Apologies: Nathan Gould, Barbara Sheppard, Ruth James, Evonne von Heussen, Carol Baker

Chair – Andy Matthews.

FOR ACTION

1. Andy Matthews welcomed everyone.

1. Minutes of meeting of 19.6.12 were agreed. Kim reported that further to a call for volunteers to help demonstrate the use of the automatic check-in service at last meeting, Val Mobberley has assisted with this task, with very positive results.

1. Open issues list (see e-mail circulated by Andy on 12)

Judith raised questions on the remit of the group, pointing out social care issues in groups of patients such as the frail elderly. The PRG is focused on health issues, and from the patients’ perspective.

1. DNA Appointments

Following last meeting, at which a sample policy from another surgery was handed out to aid us in debating this issue, some members thought this was an existing draft for our surgery and those unable to be present had not received it at all. Jane to circulate by e-mail.

It was clarified that as yet no draft policy on DNA for CMC has been decided. To aid the surgery staff with patient views on acceptable actions to be taken, the PRG has been consulted. After this, the surgery will formulate the policy, which will incorporate flexibility allowing for surgery knowledge of individual patient circumstances/conditions. Several PRG member contributions have been received with suggestions, further contributions are welcome and will be collated by Andy.

Several members asked whether we could obtain figures of DNA rates (eg percentage of appointments DNA in our own surgery and any comparisons available.) Management team will try to provide these.

Rhys suggested having more dedicated time to agree recommendations on this issue, possibly at an informal meeting or by forming a sub-group. This debate led into the next item.

1. Interim meetings alternating with formal meetings – after some discussion, it was agreed-

• The present amount of business to be covered requires more time than available in our current meetings (averaging 6 weekly) especially for single topic discussion
• Many PRGs meet only quarterly, but there was general agreement in support of meeting monthly in the short term at least.
• Andy had put forward the idea of having interim meetings (without surgery staff attendance) between full meetings (with surgery staff attendance.) Interim meetings to provide opportunity to discuss issues in more depth, ready for decision taking in the full meetings. Scheduling of interim meetings is possible further in advance than full meetings, due to the constraints of the surgery rota.
• The surgery is in favour of interim meetings and there was unanimous PRG support for this
• The surgery was agreed as the best and most impartial location - available most Mondays and Thursdays
• 7pm was chosen as still being the time likely to enable most members to attend; daytime or lunch meetings exclude many in full time work/study and very early evening difficult for parents of young children.
• Jane and Lesley to liaise on dates.

1. Patient survey- questions for local survey

These are ideally needed by mid- September. Members please to forward suggestions for questions to Jane by date of September meeting (to be announced). Duplicating questions on the National Survey to be avoided (copies previously provided by Lesley) although may complement them.

1. Waiting times when attending surgery appointments.

Appointment slots are 10 minutes long (national guidelines), but if patients have complex medical problems, this time can prove clinically insufficient. Some patients need to book double slots, but this is not always possible to anticipate in advance of consultation. To help manage the situation where a doctor is running late, patients are kept informed and when possible, offered the option to transfer to a different doctor. Reception staff have recently refined best practice here and very conscious of the problem, but a couple of complaints still being received. The automated check-in system now informs patients of delays. Dr Tim Holt felt that although the problem may be minimized, it may be irresolvable at times.

Judith felt a surgery notice, explaining reasons delays can unavoidably arise, would be appropriate.Gill suggested further communication may help patients better understand this situation; this topic could be included in the Newsletter. This led on to an additional item

1. Newsletter

Having volunteered to write a newsletter item on (7) above, Gill was asked if she would be willing to act as co-ordinator for the PRG input to the quarterly Newsletter, and was also willing to accept this role. The surgery will contribute one A4 side and the PRG the same, and liaise in the final draft stage to avoid duplication. Another issue for newsletter inclusion is the recent e-mail cancellation facility.

1. Patient Transport

Kim explained some patients of CMC do have real difficulties getting to both surgery and hospital appointments. The surgery would welcome any help available from the PRG. Insurance issues were raised as a query. To be followed up.

1. Receptionist Presentation

Kim introduced Rachel and Vanessa, who had come to help us understand their demanding role.

Val Mobberley, who has been volunteering at the surgery, had first-hand information on the work pressures reception staff experience, and expressed her appreciation of their professional and polite contact with patients, which was unanimously endorsed by the group. Gail commented on the high quality of service, which has developed over the years she has been a patient at the practice.

Vanessa explained the wide range of tasks carried out by the reception staff (see handout).

5 reception staff are usually on duty in the mornings (1 dealing with admin work, 2 with phone lines, and 2 with reception desk and phone lines), 3 in the afternoons and 2 in evening surgery. About 1,000 appointments are booked weekly, 300 approx on Mondays alone. 200 prescription requests may be generated in 2-3 hours. Recent improvements in task allocation amongst receptionists have reduced phone answering wait times and this has been commented on by some patients.

Rachel, who joined the CMC reception staff most recently, found the demands of reception work at a busy surgery far exceeded her expectations both in volume and variety, coming from a different work environment.

Both the automated check-in and the internet appointment booking systems can ease receptionists’ workloads and the PRG can promote them.

Reception staff would welcome a visit from PRG members to explain the group’s function.

1. Telephone system update

The surgery has now identified a preferred provider and a preferred installer. Hardware and software programmes have been selected. The pricing structure is being finalised on 31.7.12, and the installation date should be late Sept/early Oct, with the new system starting in operation on 31/10/12.

The surgery is hoping to work with the PRG on message choices and there was general agreement from the group that consultation will be welcomed. A separate meeting may be needed to consider the choices available. Feedback from the PRG on patients’ views on the new system post-installation, will be welcomed.

1. N.H.S. Choices website

Kim made the PRG aware of this site - all surgeries are obliged to have a website entry. Comments can be posted and practices rated.

1. Draft plans of alterations

Kim provided a copy of the draft plans.Andy to circulate amongst members and Kim asked for a co-ordinated response. It has been necessary to take action on one item urgently (provision of aircon upstairs) to ensure patient and staff comfort.

The former playroom off the main downstairs waiting room is now out of use, preparatory to becoming part of Boots Pharmacy on 3/8/12.

1. Flu Clinics - input of PRG

The PRG can spread awareness of its role and gain more patients’ views, through representatives at surgery flu clinics. Dates to be finalised by mid-August; clinics held mainly Friday pms and Saturday ams for 3 weeks approx. About 3,000 will attend, a further 300 are seen in the community. This is an opportunity to raise the profile of the PRG and gain feedback from a vulnerable patient group. Volunteer names to Jane please.

Any other business

The South Warwickshire Patient Group of the CCG was attended by Andy and Jane on 11/7/12. A list of areas of particular concern and form for suggestions of priority projects has since been circulated to members. Jane has drafted one response proposing that a review be carried out on existing services for very ill, frail and terminal patients aiming to improve choice and enable more patients to choose home care if wanted. The deadline for submissions is 2/8/12.

Judith requested a copy of the clinical guidelines referred to on a wall poster in the waiting room. The surgery management staff could confirm that the budget payment for hospital care, although referring specifically to South Warwickshire Foundation Trust, will actually cover all our surgery’s hospital referrals.

Keith and others commented favourably on the high profile given to the NHS at the opening ceremony of the Olympic Games last week.

Next meeting – a proposed date for an interim meeting in late August to be circulated and a date in September for the next full meeting to be arranged a.s.a.p.

Andy thanked everyone for their attendance and contributions at this very busy meeting.

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