New Hayesbank Surgery, 23rd November 2016
Apologies: Caron Browning, Mrs Blunt, Mrs Jenkins, Mrs Peters, Mrs Sims, Mrs Pope, Mrs Knight & Mrs Tapp
Attended: Miss Simcox, Mr Mitchell, Mr Bridle, Mrs Shilling, Mrs Whorwell, Mr Hooper, Mr & Mrs Vaughan, Mrs Short, Mrs Andrews, Mrs Marshall, Mrs Hatton, Mrs Martin, Mr Cowley & Mrs Power.
1. Matters arising from the meeting on 13th July 2016
a) Live it well Centre: The Shaw Trust have taken over Live It Well. It is now called Live Well Kent. The café has been moved to the same site, but Mrs Shilling feels that there was no communication and all at the meeting were unsure what is happening. Mark will look into this and feedback to the group.
b) Outpatient Appointments: Unfortunately Jackie Tapp was unable to attend as she was unwell. Mr Bridle and Mrs Shilling have both visited the department and were very impressed with the people who worked there and the pace with which they dealt with enquiries. They put up with a lot of abuse, but are limited what options they are able to offer patients.
The main reason for hospital appointments being cancelled is either that they have no consultant to cover the clinic or no funding to host the clinic. There does seem to be problems with some department to department referrals with in the hospitals.
Patients are given the first available appointment slot, which may mean travelling to a hospital which is not the closest to them. If a patient changes an appointment date or time this counts as a cancellation.
Dr Sharp added that though GP’s at hayesbank do liaise with consultants on individual cases, they have no particular sway with the hospital on how they run their systems. This sparked some conversation within the group on how we influence this issue. The ideas ranged included:
· New Hayesbank PPG writing to EKHUFT to voice their concerns
· Collecting information on the issues via patients surveys.
· Making a freedom of information act request to the trust regarding the number of appointments cancelled in the last year and how quickly they were re-booked.
· Forming patient groups at specialty level to work with EKHUFT to create a patient charter.
It was agreed that we would conduct our own survey. See point e. No decision was made by the group to pursue any other approach at present.
c) Telephone System: The practice has experienced major problems with BT and this has led to a significant delay in the new SIP phone lines being installed. However, we now have a date in mid-December agreed to install the new SIP lines. This will significantly increase the number of telephone lines for patients and doctors. It will also enable the practice to use additional software to aid our reception staff when dealing with patient enquiries.
A member of the group fed back that a friend was told that the GP will only let the phone ring twice before hanging up. Mark clarified that the receptionist was trying to explain that the GP will try and call them on two occasions. Mark will let the receptionists know what happened in this instance as it is a good learning point, and shows how a message can be mis-understood if precise language is not used.
d) Carers Week: It had been discussed that we should hold a carers week once the new extension had been completed. It was agreed that we should progress with this in the New Year. What the group would like to achieve from the event is:
· Educate patients regarding What is a carer?
· Identify Carers and add them to the practices carer register.
· Ensure we identify Young Carers.
· Promote what support is available.
· Ask them what support they need.
It was agreed that liaising with carers support may be a good way in ensuring we get the best out of the event. Mark will do this.
e) Patient Survey/Questionnaire: It was agreed that the next New Hayesbank survey should focus on what primary and secondary care services are required locally. Mark will e-mail the group and ask for volunteers to be on the focus group.
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2. Update by Dr James Sharp:
Building Work: The build is going well and we are waiting for a final sign off. The new fire system has been commissioned. There are some bits of work that still need to be completed. The signage for the new building will be going up soon.
We are still looking for the best setup for chairs in the new waiting room and also the best system to ensure patients queue away from the reception counter.
Staff: Dr Sharp informed the group that unfortunately our nurse Lisa Hagger has decided to have a change in career direction and will now be working as an Asthma nurse in the Ashford and Canterbury CCG area. We will miss her, but have been very fortunate to have Holly an experienced local district nurse join the team.
Lisa Green our receptionist and Dementia care navigator has also used the knowledge she gained at the practice and joined the Admiral nursing admin support team.
Lois Cavallaro has joined the practice as Caron’s new PA. Lois has lots of experience in primary care and has also used the EMIS clinical system, so will be invaluable during our changeover.
Our HCA’s Vicky and Sian have both been successful in the first round of a local scheme to fund and train HCA’s to become practice nurses. They will both be attending interviews in the New Year and if successful will have their training fully funded whilst still being paid. This may mean that we will need to recruit two new HCA’s in the New Year, but we wish them the best as this an unbelievable opportunity for them.
Cataract Service: We will start the new cataract service in January and will be the only provider in the Ashford area. We have a pool of 25 staff working in the eye clinic. And once this service has established itself we will also be starting a Wet AMD service.
We were asked if we would be offering laser surgery. To do this we would have to demonstrate that there is a need in the area. At present we have no plans to pursue this service, but if a local need arose we would consider it.
Prescriptions: The new prescription system is working well. We are using a smaller dedicated team and are making the process more paper light. We are looking to utilize the EPS system for electronic prescriptions as this is much faster for the practice and improves turnaround time for patients. It also offers a better audit trail and reduces the need to hunt for prescriptions. The prescribing clerks are also doing a lot of the admin work that the GP’s used to do, which in turn frees up the GP’s time.
We appreciate that our patients need an easy to use online ordering system if we are going to increase the number of electronic prescription request we receive. We hope that a combination of our move to EMIS and the IPLATO system that we will discuss later will enable this.
3. Request for Urgent Medication: We have a large number of patients who request medication on an urgent basis and want their request turned around the same day. This puts a lot of pressure on the system and GP’s. We have actively tried to identify patients doing this on a regular basis to educate them into using the system correctly. However, there has been limited success and we continue to get a lot of request for medication on the same day.
Dr Sharp explained that the practice would like to limit the number of medications that we would be willing to do as an urgent on the day request.
Some in the group felt that it is for the GP’s to decide where the line is drawn as they understand the clinical significance of what conditions can be safely managed if a few doses of medication are missed. And they would support whatever the GP’s decided. Others were concerned that it may be patients with mental health issues that are making these requests and that they should be given more leeway. Another view was that if a patient had asked for a medication that was not on the practice list then the duty doctor could call them to discuss, rather than the receptionist refusing the request.
The group felt that a limited list would be a good idea, but it may be best to have the caveat that the patient could speak to a GP if they needed medication that was not on the practices approved list. It was agreed that any change should be advertised through the newsletter and on the website.
4. Appointment System – Winter Pressure: Mark explained that to cope with the increase in acute illness throughout the winter months the appointment system would be tweaked to include more telephone triage slots for the GP partners. This would mean a reduction in routine bookable slots for GP partners, but the numbers would be managed as carefully as possible to maintain a healthy balance. The patients group felt that the new appointment system has worked well since its introduction in April.
5. Patient Survey: Covered in point 3e.
6. CQC Visit: We have not yet had a date agreed for our CQC visit, but we do know that they will want to speak to members of the CCG. We will let the group know more once we have our visit date.
The hospital has had their CQC re-visit and the results should be published in December.
7. EMIS: All other practices in the CCG will soon be using the clinical system EMIS Web. It has been agreed that New Hayesbank will be switching over to this system at the end of April 2017. We have had good reviews on the system and patients should see no reduction in online services available to them.
The biggest hurdle will be that for almost a week during the changeover we will not have access to a clinical computer system. The team that will be installing the new system have done this many times and will ensure that the practice can still run effectively during this period. We will let the PPG and patients know more as 2017 progresses.
8. IPLATO: This system allows the practice to send SMS text messages to patients to remind them of their appointments and also provide health promotion information. It is hoped that patients not attending for appointments will be reduced once the system is in use.
The system also allows patients to use an app to order prescriptions online. We have been informed that the system should be setup within the practice by January 2017.
9. Friends and Family Feedback: Mark feedback all of the recent comments and reviews for both friends and family. No specific actions were agreed from the comments that were discussed. Mark said that often anonymous comments make it very hard to investigate the comments fully as we are unable to establish all of the facts without knowing who to go back to. Mr Bridle agreed that posting comments on a website may not always be the best way to go about affecting change, but we need to ensure we do listen to the views the people put forward.
10. There were no new comments on NHS choices.
11. PPG and future direction: The PPG agrees that the group needs to be active and have a voice. They are by no means a passive group, but more could be done to champion carefully selected initiatives. Everyone was encouraged to come forward with any idea[s, suggestions or agenda items they may have for the future.
12. Any Other Business:
Online Services: We have had serious problems with our online patient services site. We have escalated this to the highest levels with our system provider and are looking to have a solution in place very soon. We are aware of the importance of this service to our patients and are doing all we can to resolve the issue.
Accessible Information Standards: The practice tries to identify when patients require assistance with communication. This could range from hearing or sight impairment to dyslexia or illiteracy. AS well as having posters in the waiting room and information on the practice website the practice also encourages all staff to identify patients who could require assistance. This information can then be highlighted on the patient’s record to ensure we continue to meet their needs going forward. The group felt we need to continue to do so.
APPG: Mr Bridle said that he is no able to represent our group at the Ashford area PPG or North Network meetings. He was thanked for all of his work with these groups. Dr Sharp and Mark both hope that another member of the group will come forward to represent the practice at the Ashford PPG
13. Date of next meeting: Wednesday 22nd February 2017