MINUTES OF PATIENT PARTICIPATION GROUP
MEETING THURSDAY 27TH JUNE 2019
Lesley Holt - Practice Manager
Jane Baines – Assistant Practice Manager
AM – patient
KM – Patient
SM – Patient
JH – Patient
Lesley announced that Friday 28th June 2019 will be Dr Edge’s last working day. He will retire officially on the 13th July 2019. Dr Douglas will be taking over as partner and from the beginning of August and Dr Deborah Spreckley will be joining the practice as our new salaried GP and she will be working Wednesday, Thursday and Friday.
We have a lot of ongoing issues with staff in that we have 2 clinical staff that have been, and still are on long-term sick leave. Our ANP Janice has been off for the last 3 months but is coming back to work on Tuesday 2nd July on a phased return.
Our HCA, Collette has been off for the last 3 months also and we are unsure when she will be back. However we have employed on a temporary basis Bharti to cover the phlebotomy clinics as well as ECG’s, B12 injections and smoking cessation.
We have had 1 full time receptionist leave which has left reception short-staffed. However we are interviewing next week for a full-time reception manager which will then help relieve the pressure.
From August 2019 we will be having another new F2 doctor for whom Dr Youssef will be their trainer. Dr Douglas is going to be doing a trainers course so that he will eventually take over from Dr Stagg as the ST3 trainer.
Lesley passed around a copy of a standard patient survey form and asked for suggestions of what could be done different to improve the services for patients. This next survey will be carried out over a period of 3 months and forms will be handed out not just by reception but GP’s and nurses also. The responses will be collated 2 weeks after the end of this period and with the help of the PPG at a future meeting decide a way forward to try and improve the patient services. This could be a change to the telephone system to improve communication. We have a 2 year time scale to try and make changes from a patient led perspective. Members of the PPG suggested that there be 2 equal sized boxes at the bottom of the page to for patients to give suggestions of things they feel would make a difference to patients. It was suggested that the survey form be dated stamped when handed out to enable correlation with issues.
Some members of the PPG thought that telephone triage and skype could be a way forward. However the current telephone system is rather old and outdated and does not have enough lines to support this. Skype is not used at this practice at the moment although there are some practices in Tameside that do. It has been reported that the majority of patients utilising this service are in the 60+ age range.
Lesley asked if any members were aware of the APP, if they had downloaded or used it. KM said he had tried accessing it but said it was very difficult to get on and not user friendly. This is being rolled out gradually to all GP practices and patients will only be able to use all features once their GP practice is connected. Patient access and the NHS app works the same in that patients can book and manage appointments order repeat prescriptions and view their medical records. This is an ongoing project and hopefully things will improve with time.
On-Line Patient Access
All our computers have now been upgraded and we now come under the ICFT for updates and any IT issues we encounter. Recently we had to turn off our on line prescription request due to a critical incident, which had to be investigated before turning back on. There was a loop hole no-one was aware of where a patient was ordering medication on a daily basis, which was being signed off by a GP thinking the request had gone via reception first. All 600+ patients who used on line prescribing had their records reviewed. There were only 7 patients who required a GP review before the on-line prescribing could be turned back on for them. The rest of the patients are now able to order online again. Now everything goes via reception first and they add a note for the GP to review before signing off their prescriptions. The GP’s sign around 300-400+ electronic prescriptions on a daily basis, this number does not include paper prescriptions that need signing.
Lesley feels that the format of the newsletter needs an upgrade. She would like more input from the PPG members so that it is more patient centred and be more campaign based. If anyone has suggestions or thinks of any after the meeting then they should email Lesley with details.
KM suggested that any standard information, ie appointments information, medication etc, things that don’t tend to change regularly, be put into a small standard leaflet that can be picked up in reception. Then future newsletters to be done on a quarterly basis and to look at specific informative campaigns. Lesley said that we are in the process of putting up new boards in the main reception area covering general practice information and she is going to be organising more to cover specific topics.
KM also suggested a topic for the next newsletter regarding medication and to explain the processes that take place once medication is requested. Explain about overusage, reasons for requesting meds early and that there is ongoing monitoring in place.
Lesley handed out a breakdown for the PPG members of what is involved for practices for the next 12 months. We have 3 mandated projects around prescribing that we have to do. These are Prescribing Project, Practice clinical focus project and a Patient Practice Experience. We have a pharmacist from the Medicines management team who works in practice 1 day a week who will be helping with these projects. She will do the majority of the work involved and will get help from other members of the team once an action plan has been devised.
Primary Care Quality Scheme.
The practice has been working on a couple of projects improving the prevalence of our hypertensive patients as part of the primary care quality scheme. Lesley showed posters to the PPG members showing the results of the work carried out on these projects. We wanted to increase the hypertension prevalence by 1% ensuring that patients were added to the register once diagnosis was made. Because of this work we actually increased prevalence by 1.6%. Another project we undertook was looking at how we dealt with incoming correspondence to try and relieve some of the pressure off GP’s by only sending them what they needed to deal with. We now have robust systems in place which eases the paper workload on GP’s. This also includes having a robust system to deal with any DNA’s.
JH enquired if anyone reviewed all the A&E attendances as to whether they were appropriate. Lesley said that we have dealt with these many ways in the past and whatever we did made no difference as the patients did not change. There was a discussion about the fact there are not enough resources available for patients with mental health problems. For those who weren’t aware the walk in centre has now relocated from Ashton Primary Care Centre to Tameside Hospital.
Lesley spoke about elemental prescribing and said that we are attempting to get all clinicians within the practice using this resource. Elemental prescribing can be accessed via a template in EMIS and patients can be referred direct to Be Well Tameside, healthy minds and all social prescribing services. This is done electronically and is reviewed by these services quickly therefore enabling the patient to get help in a timely manner. The GP’s have said that when they use this service they do not get any feedback as to the outcome of the referral.
This ties in with the new Primary Care Network. Lesley explained what the PCN (primary care network) was. Every patient is part of a PCN based on a locality footprint, ie ashton. This has been mandated by the government to procure services for this network to include extended hours and out of hours services. Dr Jha is the clinical lead for this network and all practices in Ashton have engaged with this (8 practice in total) . There is talk about including lay members at some point but this further down the line. The network will cover 58,000 patients accumulatively, our practice being the second largest within the group. This is supposed to go live on the 1st July but things are still in the very early stages, still setting up and recruiting.
Lesley informed the PPG members that CQC inspections are performed differently now. Any practice that had a good or excellent report will now get a telephone inspection. This is done by a conference call where they will ask a series of questions, of which we are made aware of prior to call. Dependent upon the outcome of this conference call we will either get another telephone inspection 12 months later or a physcial inspection.
JH informed us she is involved in a Chaplaincy in community project. She spoke at a conference in Birmingham in January and has done a write up, has spoken with the CCG and presented at a conference in Stalybridge to try and engage practices. There are 2 practices interested in trialling an Integrated Chaplaincy in Practice service.
She has also been working with pennine care on a wellness spirit, offering spiritual support. She has run 2 courses so far, is planning another in the near future and has also been elected onto the governing body.
She is keen to provide support for young people at Tameside 6th form college on Mental health issues. If GP’s see patients that attend there they could direct them to this service if they feel it necessary, once the service is up and running.
The following was agreed.
- Amend patient survey to have 2 boxes at the bottom for suggestions to make improvements that would make a difference to patients.
- Forms to be date stamped on day of giving to patients.
- Topic for the next newsletter regarding medication and to explain the processes that take place once medication is requested. Explain about over usage, reasons for requesting meds early and that there is ongoing monitoring in place.
Next PPG meeting – once patient survey complete – Date to be emailed out. Start time 11.00 am