Minutes for the Patient Experience Group.
Meeting: 17th February 2011, 5.30pm
Chair: Dr Andrew Henderson
Attendees:
Louise Dey, JB, LS, SM, JM, MM, SR, GG
Apologies:
AM
1. Minutes from the August 2010 Meeting.
Accepted
2. Matters Arising
Copies of the minutes from patient group meetings are now available to view on the practice website – Only the initials of patients attending the meetings are included, not full names.
Group remain happy with the change of telephone options.
JB had heard concerns regarding waiting times for well woman clinics – LD to investigate
(Addition: LD checked the next day – Appointments available 22nd February at Cove and 1st March at Kincorth which seems reasonable).
We aim to have our appointments on computer for the GPs 8 weeks in advance, although this can drop to 6 weeks during peak holiday periods. To assist patients who wish to book a review appointment further in advance than this we now have a “recall column”. When a patient comes out from seeing a GP and asks for an appointment in say 12 weeks time, the receptionist takes a note of the patient’s name, contact telephone number and who they wish to see and records this in the column on the date they are due back. When we add that week of the timetable on, reception phones the patient and books the appointment. We hope this will save patients having to repeatedly phone back to see if that week is available to book.
The practice sometimes blocks appointments from being booked if we are awaiting confirmation that a GP is going off on annual or study leave – This reduces the number of patients we have to contact to reschedule.
The practice has applied again for an improvement grant for a handrail at Cove. If approved, the practice would still need to find half the money (£2500) and approval from the partners would be needed. One member suggested adding a plea to the Cove Chronicle for any local tradesmen who may be willing to help – LD to action.
Flu campaign is coming to an end – It has been another successful year.
Positive feedback regarding being able to order prescriptions via the website. JB had a query regarding GPs checking the prescriptions they do – LD to investigate as a separate matter.
Anonymous feedback can be submitted to the practice via its website. However, this is much harder to investigate than if the patient supplies their name and it can be followed up.
3. Staff Update
Our new partners – Dr Anna MacFarlane and Dr Catherine Mitchell – have now been with us for 6 months and have settled in well. In addition, Dr Samantha Whiteside has returned from maternity leave.
Dr Sam Wheelan (Female) is with us as a locum for 4 sessions (2 days) a week for the next few months.
One of our Practice Nurses, Deborah Foreman, is leaving next month to go on maternity leave – We have a locum nurse, Lynne Jenkins, covering for her.
Comment was made on the growing numbers of female doctors in the practice. LD explained that it evens out as we have less males but they work more sessions as most female doctors only work part time.
JB felt it would be useful for patients to know which areas GP has specific interests in. LD to arrange for this information to be added to the website, posters in reception and put into the Cove Chronicle.
Photos in practice booklet were fed back as being very useful.
4. Q&A Session – Any queries relating to how general practice fits in with/works with other areas of the NHS
LD confirmed there is no charge made to the practice if it phones for an ambulance for one of its patients.
AH explained how referrals are done from the practice to hospital. The GP dictates the letter and the secretary types this up. Included in the referral letter are details of a patient’s key past medical history and their current repeat medication – this is extracted automatically from their clinical record. The referral is checked by the GP and sent electronically to the hospital. A copy is saved electronically in their record held at the practice. The practice is not sure how the hospital deals with them at their end although are aware they have a new PMS (patient management system) system being introduced this week. Private referrals are done in exactly the same way.
When a patient is seen at a hospital clinic, the doctor dictates a letter which is then sent in paper form to the practice. There can be a time delay between the date of appointment and the letter being received by the practice. The practice then scans this into the patients record and it is actioned by the GP electronically.
Hopefully in future more information will be transferred from the hospital electronically. There is currently a trial with discharge letters from 3 departments which are typed and emailed to the practice in a very quick time frame – If successful this could be rolled out to other departments other than replying on patients to bring in handwritten discharge letters.
There is some duplication of work for patients being seen at the hospital if it is something which the practice needs to have recorded for their contract – eg. BP monitoring. The practice does try to gleam information from hospital letters to populate their contract screens to avoid unnecessary duplication. The Clinic Co-ordinator should also check records to see if patients are being treated elsewhere but with such large numbers involved, some duplication is inevitable – better to get something done twice than not at all!
Information is also shared with the out of hours service. The practice sends alerts to them for patients who are likely to be in contact – eg. Those on palliative care register with up to date medical information including medications. GMEDs can also access patients’s Emergency Care Summaries with permission from the patient. Each morning we are emailed contact sheets for patients seen by their service whilst the practice has been closed.
Although patients are registered with a specific GP on their medical record/card, they are free to consult with any GP. It is good to stay with the same GP throughout a period of illness. This can be difficult, however, with 2 sites and part time working.
5. Ideas for ways to reduce DNAs (people who book appointments but who do not attend or cancel)
Each month the practice has a large number of patients who book appointments for both the Doctors and Nurses who then fail to attend or cancel their appointments. This is frustrating for everyone, especially those who are looking for appointments.
The practice advertises its DNA rate on posters in the reception areas. It has also highlighted the issue in the past in both the practice newsletter and Cove Chronicle. It trialled phoning patients the day before for nurse appointments to offer a reminder but this did not have much impact on DNA rates and was very labour intensive.
Discussion was made about the possibility of texting reminders to patients. The practice does not yet have mobile phone numbers for the majority of its patients and those it does have are often out of date. This is definitely something it wishes to pursue in the future so currently asks patients to fill in update forms when they present at reception to capture mobile phone numbers.
A query was raised if the practice follows up with patients who do not attend – We currently wait until a patient misses 3 appointments and then send them a warning letter. Concern was expressed by AH about tackling DNA’ers at their next appointment for fear of breaking down the rapport of the consultation. This is something that the practice could consider trialling in future to see if it had any impact of a clinician raising the matter with them.
It would be hard to overbook appointments as the practice won’t know where the DNAs will occur and patients could be left waiting for long periods. DNA time is used by clinicians for doing administration work.
Another suggestion was to be more explicit with patients regarding what these DNAs are costing in terms of clinician’s time and ultimately costing the NHS.
6. Ideas for ways to improve patient confidentiality at the Cove front desk
This is a very open area and the practice is aware there are concerns about confidentiality. There is a poster saying that if patients want to discuss something private to let the receptionist know and they will take them to a separate room.
JB suggested patients could be asked to write down their telephone numbers instead of reading them out to the receptionist – If they are happy to convey this information verbally that is fine.
Discussion was made of the pros and cons of the glass front at Kincorth reception.
It was suggested that the receptionists use a lower tone to speak to patients and that they do not phone patients from the front desk. Nurses to also be reminded about keeping their voices down.
Discussion regarding whether better use could be made of music in reception – could a screen be used? Could practice notices be put on a tape and played at regular intervals?
7. AOCB
a) Parking on the road down to the car park seems dangerous – LD to enquire with the council re double yellow lines and a zebra crossing.
b) JB enquired if practice wishes to rotate members of patient group – Practice will consider doing this if more new members come on board. Members who have been in the group for a long time should not feel obliged to continue but are welcome to do so if they wish.
Next Meeting: August 2011 – Actual date to be confirmed nearer the time