Patient Participation Group (PPG) Meeting

Patient Participation Group (PPG) Meeting

Held Strensall Health Care Centre: Monday 1st June 2015, 6.00pm

Present:

Dr Lesley Welch, GP Partner

Joanne Rowe, Practice Manager

Lesley Barker, Branch Manager, Stamford Bridge and Dunnington

Ellie Skingle, Team Leader, Strensall and Huntington

Emily Broadbent, PA to Practice Manager

Mrs Janet Webb

Mr John Yates

Mrs Sian Wiseman (PPG Chair)

Mr David Garbutt

Mrs Mary Masefield

Mr Chris Milner

Mr John Knox

Mr Paul Woolley

1)  WELCOME AND INTRODUCTION

Joanne Rowe, Practice Manager, opened the meeting, welcomed the attendees and brief re-introductions to the practice staff were made. Joanne explained that the members of the PPG Team had met with Sian Wiseman (PPG Chair) the previous week in order to discuss the ongoing development of the PPG and ways to strengthen relationships between the practice and its patients.

Mrs Wiseman explained the reasoning behind the ‘Standard Terms of Reference’, suggesting this would be a way of ensuring the PPG remains a flexible, informal collaborative communication system. It was explained that the PPG should be a ‘voice’ for patients, with the more members attending the better.

It was felt a basic meeting structure would be useful to ensure the meetings are as productive, beneficial and focused on outcomes that the PPG have been instrumental in achieving.

Some members of the group apologised for non-attendance at previous meetings. Dr Welch explained that whilst it is great to have regular members attending each time, patients should not feel obliged to attend and that anyone who can attend is more than welcome.

2)  AGREE STANDARD TERMS OF REFERENCE FOR 2015/16

Joanne gave a brief outline of the Standard Terms of Reference – these were agreed by all.

3)  PATIENT FEEDBACK

Members of the group were given a few minutes to read some examples of recent patient feedback provided – in future, these will be circulated ahead of the meeting.

Missed appointments:

The first item discussed was ‘missed appointments’. It was thought there could be various reasons for patients missing appointments, for example, simply forgetting (particularly if appointments are booked in advance) or feeling better since the appointment was booked. Whilst some patients do cancel their appointment if this is the case, some do not. Some patients who genuinely forget about their appointment do call the practice to apologise once they have realised.

Agreed that the onus on ensuring they attend an appointment should lie with the patient, however, an automated messaging service (for reminders) was thought to be a useful tool in reducing the number of DNAs (missed appointments). This is currently being looked into by the practice.

Question was raised whether the Doctors gently query why a patient has missed an appointment but it was explained that this information is not immediately accessible within patient records and would be time consuming to search for.

Agreed a good starting project for the PPG would be looking at DNA rates and a way of publicising these to the patient population. Agreed that this information should be communicated to patients via a number of mediums, for example, the surgery noticeboards, and also within local community newsletters.

General consensus that the practice as a whole needs to be targeted as whilst the number of ‘repeat offenders’ is small, other patients missing just one or two appointments can have a huge impact.

Agreed for members of the PPG to take joint responsibility of regularly updating the noticeboards in their respective locations, with Mrs Wiseman putting together the information to ensure continuity across the practice. Information/collateral will be delivered to each surgery for collection by the following individuals;

Strensall: Paul Woolley

Stamford Bridge: Queried whether Mr & Mrs De La Warr might like to take this on?

Huntington: David Garbutt/John Knox

Dunnington: Lesley Barker to approach Mrs P (Dunnington patient) regarding this

It was agreed that the noticeboards need to be more communicative and updated more regularly. Further volunteers would be most welcome.

Appointment difficulties:

The practice had been asked to put this item on the agenda for the evening and some examples had been provided.

Unfortunately, the patient who tabled the examples was unable to attend the meeting and so the group determined that it was difficult to discuss the specific examples without the full details/context being explained. The group did decide that practice/general examples (from sources such as the ‘Friends and Family Test’ and practice Suggestion Boxes) could definitely be discussed.

Dr Welch explained that when patients express a desire to see a particular Doctor, they need to appreciate that there could be a longer wait for an appointment than if they were willing to see any Doctor at any site.

Appointment timekeeping was discussed and it was agreed that flexibility in this is needed by all patients, accepting delays happen and Doctors cannot dictate when a patient should leave/end their appointment. Unfortunately the check-in system the practice uses is not intuitive enough to display accurate waiting times as this can be impacted by a number of factors.

Dr Welch explained that occasionally delays can occur when the Doctor is asked to see another patient by a member of the nursing team and there can also be other elements going on ‘behind the scenes’ – it however, was agreed that the practice could be more proactive in letting patients know if there is a delay. This was discussed at the Reception Team Meeting held this week and when staff agreed that they will be more proactive in letting patients know as situations/delays develop.

Example 2 (Achilles tendon):

One of the examples of lack of appointments causing an issue was in relation to a patient with an Achilles tendon problem. With the information available to the group, the PPG agreed that the correct route for this particular patient was in fact A&E, however, it was also agreed that it should not be assumed that patients are aware of the correct route to take/clinician to see as the messaging within the media discourages the public from attending A&E unless absolutely necessary.

Query was raised as to when nurse appointments will be bookable online. It was explained that the reason this has not happened already is that it is a very complex matter. Different nurse groups provide different types of appointments with differing lengths of time. This is unlikely to change in the short-medium term.

The Walk In Clinic was then discussed with a query whether this can be used for nursing appointments. It was explained that the Walk In Clinic is actually nurse led (with GP supervision) but it is not appropriate for routine chronic conditions and it primarily there for those problems which are urgent for that particular day. The Walk In Clinic has now been up and running for almost 12 months and the general feeling is this has been a success.

Question was raised whether we have a practice policy for those patients with cyclic mental health concerns, for example, depression, and whether we have GPs who are specifically trained in these areas. Dr Welch explained that all GPs are trained to look at patients as a whole when they visit, including their mental health but we do have one or two GPs who are especially interested in mental health. Dr Welch also explained that as a practice, we also have additional mental health professionals working alongside the GPs e.g. counsellors a mental health worker and an addiction worker. These professionals are a specialised resource who patients can see upon referral from their GP.

Mobile phones in the waiting room;

We had previously received feedback about the use of mobile phones within the waiting room and will now introduce signage in each branch asking patients to please respect other patients and please refrain from making/taking telephone calls within the waiting room. The PPG agreed that this is simply a sign of present times and this is often now the case everywhere.

Dunnington reception area;

The layout of the reception area at Dunnington was discussed as it had been raised that this can be confusing with more than one service window. The group was asked whether this need to be changed to make it clearer, however, it was agreed this was not necessary as the first window provides an element of privacy which you would not have if using only the second window.

Patient privacy at Strensall;

Point was raised regarding patient privacy at Strensall and how this had still not been addressed in the reception area. The group agreed that a clear line on the floor and signage asking patients to respect the privacy of other patients whilst waiting to speak to the receptionist would be a good idea. It was explained that within the future development works at Strensall, this concern will be permanently addressed.

4)  POTENTIAL PROJECT FOR THE PPG

Discussed within point three – practice notice boards.

5)  CARERS MEETINGS

The first MyHealth Carers’ Group Meeting took place on Thursday 21st May with six attendees and representation from York Carers’ Centre also. The group is open to all those who care for another person, whether they be a MyHealth patient or not.

Meetings will be held monthly with future meetings taking place on Thursday 18th June and Thursday 16th July, 2pm – 4pm at Huntington Health Care Centre.

Feedback from the first meeting was very positive with attendees being a mixture of ages and the meeting taking an informal, discussion structure and sharing of resources.

The June meeting will see Sian Balsam from HealthWatch attending, with the July meeting being attended by a member of the nursing team to discuss keeping healthy.

All those patients registered as carers have been informed of the meetings and these have also been advertised on our website, social media pages, in local pharmacies and also via York Carers’ Centre.

During the meeting, a long discussion was had about what resources the practice offers for carers and whether we could do more to help.

The Carers’ Forum was discussed and how they look after the social aspect of being a carer but it was agreed that they do in fact need wider publicity as there are few people who are aware of the work they do.

6)  FEEDBACK ON SHERIFF HUTTON COMMUNITY EVENT

Mrs Masefield provided feedback on this event, explaining that it had been ‘fantastic’ and she thanked the practice for being in attendance. There was an excellent turnout at the event with a great atmosphere and some very positive feedback from attendees.

There was a wide range of information provided about all aspects of the community and support available to local residents.

Whilst another Sheriff Hutton event will not be undertaken, the group are happy to help with the setting up of this type of event in other areas of York.

Mrs Masefield has kindly agreed to produce a write up about the event for the next MyHealth newsletter which will come out in the Autumn.

7)  SURGERY NOTICE BOARDS

Discussed as above.

8)  POTENTIAL BUILDING DEVELOPMENT

The potential building development at Strensall has been previously discussed with the group, in particular, regarding the reception/dispensary areas.

The practice is hoping to receive funding in the coming months in order to help with this and also assist with making some changes at Stamford Bridge and Huntington. The funding which is available would need to be used by October 2016 so we should hear whether we will receive this in the next few weeks.

The site at Huntington will hopefully be developed in conjunction with the library and bring the area up to date. Explore (the company behind the library) will be releasing a document into the public domain over the coming weeks, detailing their plans for the next 6 months. Information regarding the development will be included in this and plans shared as and when they are available.

It was questioned whether the practice had received any adverse feedback regarding the Huntington Thursday afternoon closure – aside from one piece of feedback, the practice found this had not been the case. The reason for the Huntington closure was due to demand but it is possible that this could change again in the future.

Parking at Huntington was also discussed as the group felt that this can be difficult when the school is in such close proximity, especially around school drop off and pick up times. The practice has spoken to the school regarding parents’ use of the practice car park and requested that they are discouraged from doing this. The situation will continue to be monitored.

Question was raised regarding the proposed improvement to the Stresnall Reception/waiting area which will result in dispensary likely being position on the floor above, and whether patients will still collect from the reception area? It was explained that whilst the dispensary (and associated staff) would likely be based upstairs, patients would still collect their items from reception as usual. The move of dispensary upstairs would free up more space downstairs for privacy areas etc.

9)  MYHEALTH DUNNINGTON SITE FOR ELVINGTON PATIENTS

The practice has been approached by Elvington practice who were looking to close their Dunnington site (following a public consultation with their patient population). Elvington patients indicated they would prefer to see a GP (from Elvington practice) at the MyHealth Dunnington site if we could provide the space to accommodate them.