Boundary House Medial Centre
Patient Participation Group
Annual Meeting held on: 26 March 2014
Time: 6.30 p.m. to 7.45 p.m.
Venue: Boundary House Medical Centre, Library
Chair: Dr. Paul L. Jackson
Minutes: Geraldine Featherstone
Attendees: Brian Rains
Frank Hancock
Michael Stephen
Norah Kilroy
Rosalind Bryan
Audrey Smith
Sue Leigh
Frank Tomlin
Boundary House Medial Centre
Patient Participation Group
Annual Meeting held on: 26 March 2014
Time: 6.30 p.m. to 7.45 p.m.
Venue: Boundary House Medical Centre, Library
Chair: Dr. Paul L. Jackson
1.Welcome
Dr. Jackson (PLJ) welcomed the participants to the meeting and detailed the agenda for this meeting of the Patient Participation Group (PPG).
PLJ gave the group a short overview and update on the work of the Practice and the current demands and funding issues faced.
Enquires were made regarding:
Funding and how funding was obtained/managed. PLJ detailed funding streams were in the main demographically based with input through Quality of Frameworks (QoFs) funding if specific health improvement targets were met. Funds were then used to provide services to patient, provide medical/admin staff, facilities and building upkeep. It was noted that whilst more funding per capita was static workforce and facilities expenses had risen.
PLJ confirmed demand had increased and patient contact would increase further due to more preventative work taking place and would impact on demand without funding rising to reflect this. Although this work would be a benefit in the long term regarding population health, it was recognised that it would also contribute to a larger elderly population, therefore demand would be long term.
2.Practice Update
•These are challenging times for Primary care nationally
•Demand is increasing, funding is decreasing
•Appointment demand is unsustainable
•Clinical staff changes in the near future
•Clinicians retiring – Dr Berry and Dr Webb. Dr Moley part-time
•Dr Goga has joined as a new partner
•We will be recruiting new staff in due course
PLJ updated the group on the personnel changes which would be taking place in the Practice in the coming year. Dr. Webb was due to retire in May 2014, Dr. Berry in October. It was noted that Dr. Moley was now working on a part-time basis and Dr. Goga was a new full time entry to the Practice. PLJ noted that these changes presented an opportunity for the Practice Team to look to new and innovative ways to present a service to the community both in staff recruitment and service provision.
3.Facts and Figures
•Boundary House has 9340 patients
•Consistently performs well on QoF
•PMS contract for extra services eg phlebotomy is at risk.
•Yet demand is soaring…
•December 2013 – 3887 phonecalls for clinical appointments. Approx 200 calls per day every day or 20 calls per hour every hour……
Discussion was held regarding
Contract changes and funding to services such as phlebotomy, which could potentially be centralised within neighbouring Practices but was not a set up which would be actively sought by BH.
Telephone activity was further detailed.
4.Progress from Last Year’s PPG Action Plan
1-Completed and introduced 17th June 2013 – produces excellent data
2. Improve Website
-Online appointment booking and kept up to date
3. Appointment reminder texts
-Now live with a new clinical IT system interface – good feedback
4. Investigation results by text
-Not live as yet due to confidentiality issues
5. Evening PPG meetings
-Successfully implemented
4.1 The group noted that there had been a positive outcome with regards to the comments and suggestions made regarding telephone accessibility with the Practice and a new computerised telephone system was now in operation. It was noted that this presented a very different way of working for the Practice and presented patients with more immediate access to staff. Also, as the system could be audited it presented the opportunity to provide data which could be acted upon to further improve services.
4.2 The website now provided the opportunity to book appointments online and was also seen as a method to provide patients with up to date information on the Practice.
4.3 Text messaging was now available for those patients who had provided mobile telephone numbers to confirm appointment bookings. It was viewed as a positive step.
4.4 PLJ confirmed that the Practice now had the IT system interface which would allow result information to be forwarded to patients by text, however further thought was required regarding issues of confidentiality and the practical application of non contact with a doctor when results were received by patients.
4.5 Evening PPG meetings – had been achieved and attendance had been positively increased.
5.Practice Survey Results and discussion
The following information, demographics and statistics were presented to the group based on the responses collaged from the survey replies received in March 2014.
How was the survey undertaken ?
•198 replies received
•Approximately 2.1% of our patient population were surveyed
•Post, email and in-practice replies
•Not all were fully completed but all included
•All comments have been included
DISCUSSION :
PLJ expanded on certain items detailed above and discussion was generated.
Opening hours – 90% found rated these as `good.` Surprise as the majority of respondees were employed. Only 1% rated opening hours as `poor` but it was recognised that a low amount of available evening appointments and no weekend appointments were noted as a problem. More publicity of the availability of very early morning appointments was needed.
Telephone Service – The survey results showed the new telephone service was seen as a good improvement but availability of appointments was still an issue. Respondees indicated that they would be happy to speak to staff other than a doctor regarding their medical needs (90%).
The use of the Prescription Line was considered with 48% happy with this provision and 40% not aware of or not using it. The group noted that the Practice currently had a Nurse Prescriber and it was felt more publicity of this and the prescription Line service would be useful.
The availability of Urgent same day appointments – PLJ felt that while 57% were happy with current availability, the figure of 21% dissatisfied with this service could be improved upon.
“Did Not Attend” (DNA) - the group was made aware that there was a number of appointments not made use of as patients who had booked an appointment did not attend without informing the Practice so that appointment would be offer out to other patients. Within this number there was a significant amount of patients who repeatedly behaved in this manner. After discussion the group felt strongly that this situation should be address in a more substantial manner and a plan of action was agreed.
Website and access to Practice information in general was discussed further. It was felt that take up of texting and web use was not as large as could be. The group felt that publicity of such services, a more proactive seeking of mobile telephone numbers by staff and such access being promoted, ingrained into practice and expected of patients should be encouraged.
Availability of patient data – there was discussion around demographic data being used to focus funding of both public and private services. With more private companies being involved in apply for NHS contracts to provide services such as physiotherapy, ultrasound scanning, etc. and how important demographic data was.
Innovative Services. The group noted that a funding bid had been made for a “Federation of General Practitioners” in the Sale area to provide, as a group, extended opening times and services.
6.Action Plan
The group felt the following action plan would be a positive response to the issues consider and would further support the work of the Practice and the services it provides. It was agreed PLJ would progress these issues and bring back to the Practice partners and report back on developments to the group, as well as proposing to get together with those PPG members interested in taking an active part carrying forward the following:
Communication
Felt to be an issue underlying a majority of the concerns discussed. Many actions and information already positively implemented are accessible to those patients who attend or have regular contact with the Practice. The group felt it was necessary to now look at making contact or providing information on services to those patients not in current contact. Methods to be investigated included, local leafleting, bulletins in local papers, contact through correspondence generated by local schools, Sure Start Units, etc. PLJ also noted that the Practice supported patients in both the Manchester and Trafford areas so this would need to be borne in mind when making contact.
DNAs
There was strong feeling within the group that this was a matter which should be addressed in a more stringent manner. Such as making repeated non attendees aware of the impact their actions had both on the Practice and on other patients who may have made use of the appointment time, especially those appointments at premium times (early morning, etc.)
Triaging of patient’s needs
The group were very supportive on further consideration of the role of triage or Nurse Practitioners, given the positive feedback to this received in the survey and triage could be considered as an initial option with it being viable that a choice of Nurse Practitioner or G.P. appointment being offered at time of booking.
7.Any suggestions for further meetings or ideas
The group felt that the outcome of this meeting had been very positive with a number of issues which could be investigated and carried forward. It was felt that the PPG would benefit from meeting again (proposed as Wednesday, 18 June 2014 at 6.30 p.m.) to progress the Action Plan further.