Northgate Village Surgery Patient Participation Group Meeting

MINUTES

Northgate Village Surgery Patient Participation Group Meeting

10th March 2015

Attendees

Ken Sylvester, Ken Holding, Margaret Nixon, Angela Gatt, Sue Butcher, Ann Fradley

NVS Staff – Lee Jones (Chairperson), Grace Marshall (Secretary)

Debbie Smith Western Cheshire Clinical Commissioning Group (CCG)

Apologies

Wendy Bell, Jess Hitchcock, David Jones, June Moore, Brenda Southward, Gail Ashton

Debbie Smith Western Cheshire CCG

Debbie was invited to attend today’s meeting by Margaret Nixon. She explained the role of the CCG is to buy in secondary healthcare services, i.e. hospital services. Debbie’s role at the CCG is engagement management, which is to encourage patients to engage with the NHS to have their say and improve services. There are a total of 36 PPGs in Western Cheshire and Debbie supports these groups any way that she can, including holding PPG Chair Meetings and Workshops. PPGs are funded by NHS England, however the CCG can support PPGs.

The next Chairs Meeting and Workshop is on 20th April. The Workshop is open to all and will run from 2pm to 4pm.

Debbie explained the importance for PPGs to feel they make a positive difference, as they are a bridge between patients and the practice and have the ability to change services for the better.

A good PPG will have energised, enthused members and can make improvements to people’s lives. A PPG needs to try to get a good representation of the practice population as this can mean different topics for discussion (i.e. children’s services), can have interested professionals (i.e. GPs) and members should know their role/function within the group. It was discussed that there is currently no way for patients to feed information and feedback to PPG members to thereby provide a good representation of the practice population, and it was agreed that this could be improved by making the PPG more publicly visible to ensure patient concerns are reflected.

Debbie discussed various methods of raising the profile of the PPG with the group. The methods currently in place are a notice board in the waiting room, information on the surgery twitter page, information in the practice newsletter and possible members being suggested by GPs. It was agreed that in the new building the PPG can look to advertise themselves and improve further.

Lee said that in the Fountains Health building all 4 GP practices can work together for health events, and hope to hold an open day/evening between all 4 PPGs.

Open evenings and health events organised by the PPG were suggested, with each member having an assigned role – i.e. designing leaflets. Open evenings could be a good way to attract patients of a working age, and events will increase public awareness.

Debbie stressed the importance of members knowing what they want to achieve and get out of the PPG.

When the surgery moves to the new premises on Delamere Street, each patient will receive a letter informing them of the move date and other information. It was agreed that a note or even a separate page would be added to the letter to inform patients about the PPG and encourage them to join. These letters will be sent to PPG members before sending out to all patients to get opinions & feedback from the group. Debbie mentioned that the cost of the postage could be covered in part by the engagement budget the CCG has, however this will be discussed further between Debbie and Lee.

Approval of Previous Minutes

Margaret had issues with the previous minutes – on the first page the bus station is referred to as a bus stop. Grace apologised for this typing error and agreed to alter the minutes accordingly. The concessionary parking charge in the minutes was £1 for the first two hours. Lee confirmed that this is still the case.

Ken H queried about the parking charges for blue badge holders, as currently in other car parks in the city it is free. Lee said that unfortunately charges have not yet been confirmed, however he is attending a meeting 11/3/15 with the council and developers and will try to get confirmation to pass back to members.

The change in time of the meetings was briefly discussed. This was changed from 6pm to 3pm initially, and then 4pm. This was to try to encourage more members to attend, however Lee advised it is trial & error to see what times work best.

The rest of the minutes of the previous meeting (1/12/14) were approved.

Northgate Development (Fountains Health) Update

The current move date has not been set, however it should be at the end of April. Lee should know more after the meeting on 11/3/15. The two major issues with the building are a slight leak in -1 level car park, and the fire alarm not being connected between the building and the car park. There are currently over 200 ‘snags’ (small issues with the building, i.e. a missing plug socket), however the developer will have 12 months to fix these, and all 4 practices hope to move in as soon as the major issues are fixed.

The council have confirmed that the building will be well served by buses.

The group will be able to visit the site after PC (practical completion) has been reached. Invites will be sent out to all PPG members for this visit.

The practice identity was discussed at length, and it was agreed that it is important to keep that identity when we move.

The Co-operative pharmacy was briefly discussed. The pharmacy wanted to move into the building on 2nd February however they won’t be able to open until the PC date has been reached.

The traffic aspect of the car park/new road system was discussed. The car park entrance for patients will be traffic light controlled, and staff and residents will have a separate car park entrance. As this is a council car park the surgery has not had much input, however Dr Minshall has gone into lengthy discussions with the council regarding parking charges as mentioned in previous minutes. Some members are concerned on how the new road layout will work. The surgery has no more information on this yet, as it is a council car park and is not controlled by the surgery.

As with all new buildings there will be teething problems; however it is hoped that once these are worked out everything should run fine.

Matters Arising from Previous Minutes

1.  Mission Statement

All members are very happy with the mission statement.

2.  Patient Satisfaction Questionnaire Results

The surgery patient satisfaction questionnaire has previously been run annually. Last year it was run for one month and it was agreed that there was not enough feedback received in this time, so the surgery is now running the questionnaire continuously, from October 2014. Members were shown two charts and a list of notable patient comments.
Debbie commented that the high numbers of ‘likely’ or ‘extremely likely’ to recommend the practice to a friend or family member was positive. Lee and Debbie explained the ‘friends and family test’ is a question which we are required to ask all patients and report the results. This was started in December 2014. Grace added the ‘friends and family test’ question to the bottom of the existing patient satisfaction questionnaire. The website also has a ‘friends and family test’ questions open to all – even members of the public who are not registered patients. It was agreed that confusion between practices would be something to be aware of when moving.
Margaret brought the Mori questionnaire results sheet to the meeting and noted that the recommendation rate from this has gone down. Debbie explained that Mori is a company who send a questionnaire on behalf of NHS England to a random selection of 850 patients twice a year.
Routine appointment availability was discussed. Grace explained that patients were asked to rate their satisfaction out of 5 and this was the information shown. Lee explained that routine appointment availability is currently poor with the wait time for named GPs being between 3 to 5 weeks in some cases. The triage system is used to try and counter this to ensure that patients can get urgent access to GPs when needed.
Dr Davies is now holding less clinics as he is at Sutton Beeches Rehabilitation Unit in Ellesmere Port two days a week, so his appointment availability is affected by this. Dr Crasta is now working four days a week instead of 2 so there is more availability with him, as well as with Dr Banks and Dr Cooley as they are able to run clinics at the surgery instead of visiting Sutton Beeches. Lee explained the role of the GPs with regards to Sutton Beeches and why they visit there.
Patient comments from the questionnaire were discussed, in particular the front of house reception staff. The main issue identified was the reception staff ask for the reason for the appointment, and should this be the case. Lee explained that the information the patient provides will be added to the triage list for the duty doctor to see to get the most of the triage system. Some issues can be dealt with by reception staff, i.e. needing repeat medication, however patients may not be aware of this and will ask to speak to the doctor when it is not necessary. It was suggested that the phrasing reception staff use when asking patients for an outline of their problem could be changed.
It was also discussed that appointment wait times have increased, as 3 years ago when Dr McClure was with the practice appointment wait times were only a few days instead of a few weeks. Debbie confirmed that this is a massive national issue, due to a phenomenal demand for appointments. The surgery’s list size has only increased by approximately 300 patients in the last 3 years, so it is the demand from patients which has increased. This is why the triage system is used and pharmacy first has been introduced to encourage patients to try other services before going to a GP.
Debbie told the group about an experience she had when shadowing a practice, where a patient came into the surgery and asked for an appointment on that day. The GP was out on visits and not available at that time, which the receptionist explained. It transpired that the patient wanted to see a GP as they had a sore throat and were just passing the surgery and thought they would pop in to see a GP.
Lee provided another example of a patient walking in to see a GP and the GP was not available. The patient then walked out and stated that they would go to a walk in centre or A+E instead.
The demand on GP services was discussed, with a question as to what the surgery can do differently to manage it best. The group agreed that the triage system does work very well, and patients get called back very promptly – at most the wait time is a couple of hours. It was discussed that the group spearheaded the change to triage every day, as when the group first started triage was only being tested on one day a week. Extended Hours and Out of Hours services were discussed. There is information on the surgery newsletter to inform patients of these services. Debbie explained that the CCG aims to provide 24 hour access to health care services.
The data charts for the questionnaire results will be published on our website as part of the PPG Report, and the questionnaire will continue to run so that there will be more data for comparison in the future.

The group discussed targets for action in the next 12 months from the results of the questionnaire.
Ken S suggested that the length of time patients have to wait to see a named GP was too long, as sometimes it is best to see the same GP for continuity of care, especially with ongoing conditions. This will be a target area for improvement.
The group discussed ways to reduce unnecessary appointment usage, for example a medication review could be done by any GP or even a nurse in some cases. It was agreed that patients need to take control of their care, and this could be through self help or other services such as Pharmacy First. The group agreed that an action to be taken in the next 12 months would be to promote self help.
Another area discussed was online booking through Patient Access. Lee explained that this service would be expanding at the end of the month to allow patients to access their entire medical record online. This links in with increasing self help as patients should be more aware of their medical conditions. Some members were unsure on how this would work from a confidentiality point of view. This extended online access is at the patient’s choice, and the patient would have to apply at the surgery for this. The group agreed that an action to be taken is to improve the access patients have online and to make this easier to do.

The final comment discussed was regarding a hook in the patient toilet. This has been suggested every year in the questionnaire and a hook was attached in the toilet on Friday 6/3/15.

3.  PPG Awareness

This was discussed earlier in the meeting – see Debbie Smith Western Cheshire CCG section.

New Business

1.  Group viability & recruiting new members

This was not discussed as the member who wished to discuss this was unable to attend today’s meeting. This can be discussed further at the next meeting.

2.  Feedback from GP Access Survey from Healthwatch Cheshire West

Members were shown patient comments from a Healthwatch questionnaire. Debbie explained that only the comments have been shared, as Healthwatch are still processing the rest of the results.

3.  PPG Chairs Meeting – minutes & report from Margaret/Angela

Margaret reported on the PPG Chairs Meeting as unfortunately Angela had had to leave the meeting early. The areas which were discussed were the amount of money a practice gets for having a PPG, podiatry referrals and personal health budgets.
The practice previously received £1.20 per patient from NHS England, however this has now been reduced to £0.36 per patient. Lee explained that PPGs were previously an enhanced service, but now the funds per patient will be funnelled into the overall GMS fund.
Podiatry referrals currently have a 40 week waiting time, with 6,000+ patients on their books. This has caused low morale within the team. Suggestions to try to improve the service include charging for the first assessment and for Age UK to educate carers. Podiatry services will be moving to 3rd floor of Fountains Health. Debbie explained that podiatry are trying to ensure proper access for those who need it for assessment and support. The service wants to talk to PPGs to discuss possible options for improvement.
Personal health budgets for patients with long term conditions were discussed at a high level. Patients would manage their own budgets and choose care packages etc.