ROSEBANK HEALTH PATIENT PARTICIPATION GROUP (RHPPG)

Minutes of Meeting held on 10th October 2013 at Rosebank Surgery, Stroud Road, Gloucester

Present:
Apologies:
Absent: / John Ford (JF) (Chair), Wendy Hubbard (WH), Nasreen Patel (NP), Hilary James (HJ), Jane Russell (JR), Dr M Roberts (MR),Wyndham Parry (WP), Jon Tremeer (JT), Cheryl Ellis (CE),
Trefor Hughes (TH), Ricarda Witcombe (RW), Hazel Walker (HW), Maria Wells (MW)
Michael Cawley (MC), Martin Easey (ME)
Action
1. / Welcome/Introduction
JF welcomed HJ to the Group and welcomed all members to the meeting. MR was attending as the Practice Partner representative on this occasion.
JF informed the meeting that member RW, who had been previously keen to hold events for services and support for people at the end of life or suffering bereavement, was moving away from Gloucester and had resigned from the group.
2. / Minutes from Previous Meeting
The Minutes from the meeting held on 5th June 2013 were summarised by JF and the following items were further discussed
  1. Waiting Times for appointments – WP confirmed that GP recruitment was still a problem for the Practice and locum GPs are still being used until appointments are made
  2. “DNAs”(Did Not Attend) patients – JT provided information on th number of text reminders that are being sent to try to reduce the number of DNAs.
  3. Siting of the BP machine at Severnvale – WP confirmed that this was still outstanding due to the lack of suitable space but hope a resolution would be forthcoming soon.
  4. Reception staffing levels – CE explained that staffing levels within Reception had been increased particularly at peak times
  5. JT explained that the “on-line” appointments system is being promoted via the Practice website and via leaflets at Reception desks. In addition all invite letters for flu vaccinations included a reference to this facility.
  6. Test results – CE confirmed that the system had been revised and there had been improvements as a result. JB confirmed that she had seen an improvement recently
  7. Auto messaging– change of message reflecting current surgery times,completed

3. / 2013 Survey Results
JT explained that the goal this year had been to increase the number of participants, set questions that could be consistent year on year so that meaningful comparisons could be made. JT also explained that the survey had been hosted on the website, it had proved quick and easy to undertake and there were paper versions distributed in both Rosebank and Severnvale Surgeries. This approach had enabled a wide range of patients to participate giving meaningful representation.
JT then presented the results of the survey to the meeting which is attached to these minutes. Points of note:
  1. There were 792 surveys completed with 200-300 completed on paper.
  2. The helpfulness of Reception Staff showed very positive results
  3. The easiness for patients to get through on the telephone is still showing problems. MR informed the meeting that some patients abuse the on-line booking system by block booking and limiting the ability of patients to do this was discussed. - see Actions Arising below
  4. Getting to speak to a doctor received generally good result, it was noted that, as with other surgeries, there is a high proportion of part-time doctors which has an adverse effect on their availability to respond to patients.
  5. The ability to see a GP urgently on the same day – the response was not very good however CE and WP explained the principle of the Triage system whereby requests for same day appointments are assessed by a Nurse Practitioner or a GP. What is perceived as “urgent” by the patient is not always the case in practice and MR gave some examples but also felt that the Duty Doctor system helped to overcome some of the urgent requests. It was emphasised that Triage was an efficient way of dealing with demand but was often seen as a barrier by patients - see Actions Arising below.
  6. Booking appointments ahead of time and at the patients “usual surgery” with their “usual doctor” was seen to be very important to patients – CE explained that the appointment system was now routinely set to eight weeks ahead and doctors are polarised to one surgery making it easier for patients. . JT went through the benefits and limitations of the “on-line” appointment booking system and how this is developing - see Actions Arising below.
  7. The speed in which a patient can be seen by their usual GP showed to be 5 or more days – WP explained to the meeting that the current shortage of doctors, the high number of part-time doctors and the fact that patients wanted to be seen when it is convenient to them rather than when the doctor is available will have all impacted on the results to this question. WP provided a snapshot of data showing the waiting time to see individual doctors. MR also emphasised that in the interest of continuity of care patients are actively encouraged to see the same doctor. It was further noted that recruitment of doctors was also crucial to this - see Actions Arising below.
  8. Waiting time to the start of a consultation – It was noted that this varied from doctor to doctor and from day to day, nevertheless there were some doctors who do not always start on time which then has an impact throughout the day - see Actions Arising below.
  9. Recommending the surgery to someone moving to the area – WP felt that the response was a little disappointing with 67% being positive. The meeting agreed that expectations effect the perception of the service provided and publicity/press had an influence on those expectations which can be unreasonable.
JF thanked JT for analysing the survey results and presenting the data.
4. / Actions arising from 2013 Survey
  1. Survey – It was agreed by the meeting that it would be beneficial to have the same or similar survey for 2014 so that comparable data can be used to monitor improvements or otherwise.
  1. Telephone Access – JT/WP will discuss with the telephone system provider whether there are better ways to use the current system or whether a new system should be considered. CE will review Reception staffing levels and monitor demand. The Practice will further promote the use of on-line appointment booking to reduce the volume of telephone calls however JT will also look at restricting the number of advance appointments that can be made.
  1. Changing staff roles at peak times to improve service to patients to be reviewed.
  1. Consideration to be given to technological enhancements wherever possible to improve the patient experience.
  1. Make more use of the automated booking in systems within reception with having a member of staff directing patients to the machine.
  1. Publicise what the Triage system is for and what the patients can expect.
  1. The Practice to continue to recruit doctors to fill current vacancies.
  1. Doctors to be encouraged to start surgeries on time.
/ JT
CE
JT
WP
CCE/WP
JT
CE/JT
WP/MR
WP
5. / Medical Provision for Kingsway/Hunts Grove
JF circulated TH’s note to the meeting which was discussed. MR explained that Rosebank was still the preferred provider for a new facility for the Kingsway and Hunts Grove area nevertheless there were still difficulties in finding a suitable site at a suitable price. The Practice was dealing with the increases in patient numbers as well as it can,given the pressures on room availability and clinician time. MR explained that a new facility will be very beneficial in respect of space from which to work however this will not automatically solve all of the problems. There has to be a balance between income and expenditure and additional clinicians can only be employed as patient numbers also increase.
Obtaining the help of local politicians was discussed and MR felt that this may be helpful if there is no progress in the near future. MR also outlined the changes to the NHS organisation that has subsequently contributed to delays. The Practice will further update the Group when there are any significant developments.
4. / Any Other Business
Problems with prescription requests were discussed in particular when adding an additional item that is not shown on the “Repeat Order Slip”. CE explained the current system. It was noted that patients are not informed if an item is not being issued before they come to collect the prescription. CE undertook to review how this may be communicated to the patient without causing unnecessary additional work and not to breach patient confidentiality. / CE
5. / Date of Next Meeting
It was agreed that the next meeting be held on 9th January 2014 at 7.00pm at Severnvale Surgery.
The meeting closed at 8.45pm
Signed: ………………………………………………….. (Chair)
Date: ………………………………………………………..