Arbury Road Surgery

Arbury Road Surgery

Patient Participation Group (PPG) Meeting Minutes

29th November 2012

Those present

Patients:

6 patients

Welcome and Introductions

We welcomed a new membertoday.

Feedback From Previous Meeting

The display boards promoting the PPG that Claire was allocated to do haven’t been done because she, and all other admin staff, have found their workload to be very heavy and as a result the display board couldn’t be considered a priority at the moment. The offer was thrown to the group to come up with any wording or visual ideas for the display to make the process of producing it easier for Claire.

It was asked if the self check in screen could be programmed to have an advert for the PPG showing when people go to use it. Claire will look into this.

On of the group members have volunteered to be the new representative for our PPG at the Cam Health meetings. Another member also said his Daughter-in-law would be keen to be a second representative.

CamHealth

Cam Health was explained briefly to our new member. There are 9 practices all included in the Cam Health group. Cam Health are responsible for community clinics, such as Diabetic Clinics, Dietary Clinics etc, where patients are referred to instead of to Addenbrooke’s. This is to take the pressure off the hospital. There is a budget that is divided between all of the practices within Cam Health who refer patients to the clinics. The spend per patient is much less when they are sent to a community clinic than when they are sent to Addenbrooke’s. Practices have to pay more per hospital referral and still pay even if the patient does not attend their appointment. Also, community Diabetic Clinics are better for the Diabetic Nurses in respect of being able to give continuity of care.

The question was raised “would we use private consultants within community clinics?” This would be very unlikely. Also “Is there a choice in place of referral?” Not often,this can cause discharge problems. You must be referred to somewhere within your county because if patients need further care afterwards, for instance physiotherapy, then hospitals will arrange this locally to them. Referrals into another county’s system could be a logistical nightmare.

Patient Questionnaire

We have almost finished our yearly patient questionnaire that we hand out to patients in order to gain feedback on the practices performance. We ensure that each full time GP has 50 questionnaires filled out and returned, those on reduced hours have 40 and part time GP’s have 30 filled out and returned to us. There will be a total of 250 questionnaires when they are all complete but patients can opt out of filling them in and not all GP’s work every day, so the length of time it takes to ensure we collect enough questionnaires is a little unpredictable.

Overall results

Claire collated the information we have so far and the results are looking good. We have had very positive comments on the GP’s, Nurses and Receptionists saying that they are competent and caring and that communication skills are good. A majority of people are very satisfied with the practice. Between 80% and 90% of people rated the GP’s consultations skills as either ‘good’, ‘very good’ or ‘excellent’.

There were some negative comments about the phone lines always being busy, patients can’t always see their own GP. Occasionally peoples experiences with GP’s and Receptionists aren’t always good, but only 2.5% of people stated this.This will be looked at and discussed by management. Any issues with people’s experiences with any member of staff with be closely looked at acted upon.

Patient suggestions

Some suggestions were that we open on weekends but over all people were very satisfied with our opening times. To be open at weekends would be expensive in respect of paying wages.

It was asked if we could have Phlebotomist appointments available on line. Unfortunately this isn’t possible becauseReceptionists need to establish exactly what the nature of the blood test is so the correct amount of time can be booked for the appointment. Also for some Phlebotomist appointments certain advice needs to be given to the patient that can’t be done online.

Another question was could we have INR testing in the surgery, unfortunately this wouldn’t be cost effective. We would need to train up a member of staff to do this and buy the machinery and equipment which would work out to be quite expensive. Instead Addenbrooke’s come to the surgery 3 times a day to collect blood samples and they give results back promptly so it makes it easier to send all samples off for testing.

Patient support volunteers

One new question that was added to the questionnaire was asking people who have a long term life changing illness (such as diabetes or COPD) if they would like to volunteer to offer support for other newly diagnosed patients with the same condition. We had 2 people volunteer. It was discussed amongst the group that maybe it should have been more specific in the nature of the support they would be asked to give. Also that it should have been re-phrased so that the word volunteer is taken out as this can put pressure on people as they don’t know how much they would have to commit to.

The idea of the support group is that patients who have been newly diagnosed with life changing illnesses can speak to someone who has had first hand experience and who can give advice and offer support. GP’s may not have long enough in a consultation to explain in enough detail about diagnoses and not all patients have access to the internet to research into their diagnosis by themselves. There aren’t always support groups dedicated to certain illnesses so having an in-house support group would offer some peace of mind to people. It would mean that they have someone to speak to in the time between being diagnosed and their next appointment with the Nurse or Doctor at any given clinic.

It was thought at first that the initial contact would be by telephone. However this idea is still in its infancy so it’s open to suggestions. The question was raised of would people be trusting enough to speak to strangers about their problems? Would phone contact be appropriate or would a meeting at a neutral venue be best? This would take much more organising. Guidelines would have to be put in place for those who have volunteered and we would have to ensure that is mutually consensual between patient and volunteer before one can contact the other.

Appointments

Having seen the patients comments about appointments the question was raised as to whether evening appointments are exclusively for those who work or if elderly people are booked into those times as well. Although we can appreciate that people who work find it difficult to take time off to attend appointments and therefore find evening appointments very useful we cannot be seen to discriminate against age or any other reason when it comes to allocating appointments in order to keep the evening appointment slots free. This point has been discussed before and could always be raised again with management but there are other factors to consider, for instance it may be that some elderly people rely on a relative who works during the day to bring them to their appointments.

If someone wants to see their GP but they are duty doctor that day can they be squeezed into cancelled slots? The answer is actually no, any appointments for the duty doctor are reserved especially for emergencies.

Patients were going to receive text message appointment reminders, has this happened yet? Yes the text messages are going out to all patients who consent to text alerts. All new patients are being asked to fill in a consent form so it’s easy to capture new patient’s details for this, however it’s our existingpatient’s details we need to try and collect. It was suggested we have some of the consent forms in the waiting room with some pens and a box to put the completed forms into, and although this is a good idea there is the issue of making sure that all the information given is correct, and if someone is filling it in on someone else’s behalf we have to make sure we have a signature. This is protocol that has to be carried out at reception when the forms are filled in. Also we would have to make sure the deposit box for the forms is secure for confidential reasons, we would have to get one made.

Chesterton Medical Centre Musculo-skeletal Physiotherapy Service

Dr Karttunen gave a talk on our community physiotherapy service to explain a little more about how it works. In 2009 there was a government push to reduce hospital waiting times. The Department of Orthopaedics had the worst waiting list of all the services. It only used to be GP’s who would diagnose joint problems and refer patients to Addenbrooke’s but GP’s quite often don’t specialise in joint problems so they were sending people to hospital who didn’t really need to be there. This meant that the conversion rates for Orthopaedics were very low, i.e. out of the number of patients actually referred to Orthopaedics very few were actually admitted to surgery for treatment.

Now any joint or muscle issue is sent to the “Core Phyiso Services”, Physio Direct, based at Chesterton Medical Centre, where they are then assessed further. Either the GP can refer the patient direct to the physiotherapy services or the patient can bypass the GP and go straight there themselves. There is a form that can be filled in or patients can call them and they will be triaged over the phone.

Once the patient has been seen the physiotherapist will send a report or discharge summary to their GP to keep them updated. If the diagnosis is unclear then reassessment over the phone by the MSK clinic is needed. If they diagnose the patient with any problems needing further treatment then the GP makes a referral to the MSK Clinic, which is also at Chesterton Medical Centre but based on another floor. The MSK clinic actually deals with all referrals within the Addenbrooke’s catchment area, whereas Physio Direct only deal with the local catchment area. Luckily for the residents in this area they both happen to be in the same building.

The MSK clinic has access to MRI scans so that by the time you need to see a consultant you will have has all necessary tests and analysis done for a quick diagnosis and treatment. Since this scheme has been in place the conversion rate mentioned in earlier has increased from 30% to 80%.

Any Other Business

Susie Howe, the lady who runs the Nuffield Road Patient Participation Group for Cam Health, is happy to come and talk to us about what other Patient Participation Group’s do and to give us some insight into the possibilities of whatour group can achieve.

Date and Time of the Next Meeting

Monday 18th February, 7.30pm at Arbury Road Surgery.