Patient Participation Group
Minutes of Meeting Of Steering Group for PPG
Tuesday 14 August 2012
Attendees:;; JR; SS; AEB; DH; PWVT, JW,:DG:
Apologies: ; PM; PW
DG was chair for the meeting
The minutes from the meeting of the 17 July 2012 were ratified
Matters Arising:
Dr Thomas updated the group – The practice has received National recognition thru the NHS Innovation Challenge – as a practice we are relatively unique as the majority of our appointments are managed via the telephone. This enables requests for visits (usually for more complex or elderly patients) to be dealt with earlier as they can be assessed upon request rather than waiting to end of morning surgery; thus reducing risk of patients being unable to wait and going to hospital. There can be significant delays in ambulances taking them to hospital therefore the later in the day an ambulance is requested the more chance that the patient is admitted for an overnight stay as too late to send the home following hospital treatment/assessment.
Telephone consultation allows the clinician to assess the patients needs “the right care at the right time by the right person”. It enables the Gp to co-ordinate care much sooner, involving crisis response or re-ablement team at earliest opportunity. Dr Thomas circulated some data from the PCT regarding trend analysis for attendances at A&E. Whereas most practices within the locality of Bury are showing an increase in attendances, Redbank is showing a reduction. This is one of the reasons why the practice allocates a 15 minute appointment slot per consultation as this allows the practice to deal with the whole patient.
The group felt it important that we get this message out to patients.
DG felt that more should be done with regard to arrangements within the waiting area for patients who need wheelchair access. The impression is that they are ushered into corners out of the way rather than identifying spaces which could accommodate their needs. SS asked if there was any way we could mark out an area on the floor to be reserved for wheelchairs? Explained that the building management would not sanction this and other members of the group felt that this was again segregating them. AEB agreed to look at the reception waiting area layout to see if we could reposition furniture to accommodate the wheelchair users more appropriately.
Patient Survey – feedback from JR
observations on the patient survey proposals as compared with the 2010-2011 GP Patient Survey.
Firstly it seems to me it would be better if we utilised the questionnaire which gave options for response and room for the patient to give reasons for their answer. This gives a better understanding of what the patient actually means.
Comparison with the GP Patient Survey shows that our proposed survey covers 6 of the 8 questions in the GP Patient Survey, namely:-
1. Able to get appointment with GP more than 2 days hence.
2. Ability to see preferred GP.
3. Easer of getting through to Practice on telephone.
4. Satisfaction with surgery opening hours.
5. Satisfaction with overall care received at surgery.
6. Had discussion in past 12 months with doctor or nursed about how best to deal with health problem.
Therefore we can make a direct comparison with the GP Patient Survey on all but 2 questions plus some explanation of the answers given and then we also have a further 12 questions for our own understanding. This should give us a start at developing an evidence base for any decisions which might eventually be made and put our own patients squarely at the centre of that which we are seeking to achieve.
This will put us wholly in accord with the NHS Commissioning Board June, 2012 document ‘Securing excellence in commissioning primary care’ where at 1.11 on page 5 there are given 9 features of the NHS Commissioning Board culture, especially relevant to us in this instance are:-
A commitment to putting patients. clinicians and carers at the heart of decision making.
An objective culture, using evidence to involve the full range of its activities.
Additionally the Operating Framework for the NHS in England 2012/13 in the overview on page 7 at 1.2 states ‘To improve services for patients, there will be four key themes for all NHS organisations during 2012/13. The first is pertinent to us in that it states ‘Putting patients at the centre of decision making in preparing for an outcomes approach to service delivery, whilst improving dignity and service to patients and meeting essential standards of care.’
Dr T. said that one thing that came up repeatedly in surveys as a priority is patient access and suggested that the group may like to take a look at a web site www.patient-access .org.uk
DH raised some concerns with regard to patients having sufficient time to complete the survey. AB advised the group that we have close to 100 members including virtual and those without internet access and it is proposed that once the survey is finalised an electronic copy could be emailed to those members for whom we have email addresses to ask them to complete and hard copies sent to the few who do not. Thus involving the wider PPG we could also draft a letter to them to invite and encourage their participation.
JW asked for some clarification on the telephone access process – Dr T. explained the patients can have the urgency of their request assessed by gp and dealt with perhaps before a routine call etc. Following the telephone consultation the patient if they need to be seen would either be given an appointment with their GP, the nurse practitioner, the practice nurse or may be booked to have some investigations prior to being seen either within the practice or at hospital.
The trifold brochure which was presented by DG at the last meeting was discussed and it was agreed that there appeared to be adequate information on it – just needs finessing.
JR circulated a newsletter for patients from another practice which he was in his possession and discussed the format in comparison to the Redbank newsletter. AEB to look at.
The logistics of the reception desk was discussed and the group was informed that this had now reverted to Sun Suite and this was working much better – whilst still maintaining the additional opening hours 8.00am to 8.00pm Monday thru Friday and 8.00am to 12.00 noon Saturday and Sunday.
DH raised the electronic prescription service and said she felt this was an area which we needed to develop closer links with the pharmacies. She was also concerned that the message on the repeat form stating that this was the last issue was confusing – AB and Dr T said this was really a reminder to the GP that if they wanted the patient to have further issues of the medication it would need re-authorising. If the GP needed to contact the patient this would be done directly.
DG gave an update on patient cabinet – he has been elected to represent Radcliffe along with one other, there are two representatives from each township. He stressed that this was the locality he was representing and not just this practice. He said it had become apparent from the meetings of the Cabinet, which feeds directly back to the CCG board the amount of influence the patients will have on future commissioning etc. It is crucial for Radcliffe Township that we have a strong voice as we have been in the past and still are quite isolated and this is recognised. DG attended the West Sector locality meeting 7 August 2012 to be introduced to the Practice Managers and clinicians from other practices and explain his role to them as a point of contact and integration and the need to influence services, use of resource. The terms of reference for the group intimate that this is going to be a very powerful forum.
NHS Confederation – Dr T was one of four GPs involved with the development of the CCG Board. As part of this he was included in the NW Leadership training course at Bolton where he came into contact with Gordon Best NW Healthcare support person to the NHS Confederation body – to provide guidance and informational support for the 3rd sector, mental healthcare trust and primary care trust.
Mike Farrar previous chief executive of NW region was seconded to deliver the New GP Contract 8 years ago recognised the need to incorporate the needs of primary care , asked gps to Support Gordon with regard to integrated nursing, external recognition of achievement etc.
Group of 30 GPs from all over UK, described as the leading edge group – to look at how primary care can deliver things differently. Mike Farrar has influence at a high level. Approximately 5 years ago Dr T put forward a proposal for developing an integrated Primary Care Team. Unfortunately we were not chosen as a pilot – but these have been shown to be very effective in delivering care especially to the elderly. With people from Social Services, Pennine Trust a Social Care package model has been developed.
Mike Burrows has been seconded to the National Commissioning Board as a primary care strategist to see how primary care can be developed differently – with the involvement of social care funding.
JR involved with the assurance framework
DG has seen information from Trafford re Health and Social care.
JW – expressed the opinion that the centralised treatment room service was not very effective and in her opinion was very poor. This was agreed by other members of the group.
The GP Points (NHS Choices) does not really reflect the actual clinical care that patients receive. The practice that patients do sometimes have to wait to be seen – the practice has very high prevalence of chronic diseases compared to national targets reaching the 90th centile or above. The practice issues ¼ of a million prescription items per annum. The practice is quite unusual in offering a personal list system – and compared to a practice with a similar disease profile has better outcomes; lower out of hours attendances, greater continuity of care. This allows shared decision making between the patient and the gp improving compliance and dialogue with regard to surgical procedure.
AQA (Advanced Quality Alliance) Shared Decision Making support the definite shift to patient choice.
The date of the next meeting is Tuesday 18 September 2012 @ 6.30pm.
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