Pelton and Fellrose Medical Group

PELTON AND FELLROSE MEDICAL GROUP

PATIENT REFERENCE GROUP MEETING

THURSDAY 25 May 2017

MINUTES

Present: WE

Apologies: MC

Matters arising from previous minutes

Wellbeing for Life Service

YF queried whether Caroline Cranston from the Wellbeing for Life programme had contacted Ouston Gym. The practice had not received any update on this from Caroline and are to chase this up with her when she attends for her clinic this afternoon. It was discussed how the Wellbeing for Life clinics are now up and running within the practice.

Lewis Kirkbride, Healthier & Wealthier Development Officer, Citizens Advice Bureau

Lewis Kirkbride from the Citizens Advice Service visited the practice to provide further details about the type of service in which they provide. This service is specifically for GP practices and is funded by Public Health. It was discussed how applications for benefits are on the rise and this may mean more patients attending the practice for advice. It was also discussed how the service can also refer on to other services including Wellbeing for Life/Fire Services etc.

Lewis explained that patients can be referred to the service with the follow type of issues:

- Non medical issues

- Benefit applications/enquiries

- Debt

- Housing issues (including landlord problems etc.)

- Issues paying bills

Referring a patient to the service can be done by either clinical or non-clinical staff at the practice, following the below process:

- Contact the Citizens Advice Service’s Practitioners’ Hotline (This hotline is

available Monday to Friday between 9am and 5pm or there is a voicemail service for calls out of

hours). This should be done with the patient in attendance wherever possible

- Provide the patients name, phone number and a brief description of their issues

- Agree a time with the service to call the patient back at a time convenient to the patient. This is

usually the same day and, by the service calling the patient, the phone call comes at no cost to the

patient.

Lewis explained that patients can also self-refer using the public telephone number of 0300 323 1001 (this number is only available to 1pm Monday to Friday to allow time for the service to call back patients referred via the hotline). Lewis did explain, however, that this number is best used only by patients who have been under the service before.

It was queried how the referral process would work for a patient who had problems using a phone/did not have access to a phone. Lewis explained that a face to face appointment could be arranged for these patients via the practice staff. The Citizens Advice Bureau would then also work with other organisations to create a network of support around the patient. There are centres in Chester-le-Street, Durham and Consett which are usually open around three days a week and are run mostly by volunteers.

The service can help anybody who is applying for benefits and can work through, with the patient, the forms they need to complete. They can also send through to patients typed information to help them in their applications.

It was queried whether Welfare Rights was still situated in Spennymoor. Lewis explained that it was but that this service would only become involved if the case were complex and the patient needed a caseworker. They would normally support patients who are going through an appeal or tribunal process. The Citizens Advice Bureau would help in the early stages and then pass on to Welfare Rights if necessary.

Lewis discussed how this particular service has not yet had a public campaign and that they are mainly targeting GP practices at the moment. It was explained that the service currently would not be able to answer the thousands of phone calls they would receive if it were to be campaigned. However, it is hoped that there will be a public campaign at some point in the future. Lewis explained that the Citizens Advice Bureau do offer other services which are currently advertised to the public.

Lewis explained how there is to be a change to universal credits from October and this may lead to an increase in patients attending the practice. The DWP and HMRC do not normally issue any information regarding any changes to patients until the changes have been made so this means patients are often unaware and can be left without any income. The hope is that through signposting patients to the service, this can reduce the amount of GP appointments being used for these issues and the patient can access the support quickly.

The practice is currently referring patients and Dr Turner feels this has helped reduce consultation times within the practice.

SH queried whether a member of staff from the service would be able to attend an upcoming CCG meeting or Healthwatch meeting. Lewis is to look in to this but explained that he would be happy for patients to also mention the service themselves at these meetings.

Food Banks

It was queried whether the Citizens Advice Bureau can issue food bank vouchers. Lewis explained that they can issue a virtual voucher over the telephone and call ahead to the food bank. They can also provide support and advice to the patient at the point of contact. The practice does not provide vouchers but the Health Visitors and Social Workers have access to these, along with some community centres.

Review Action Plan 2017

Patient Reference Group Promotional Days

CR explained that no further dates have been agreed as yet for further PFG promotional days but that the practice is looking to hold more of these in the future.

Hunt Groups

It was discussed how a ‘Hunt Group’ is set up within the practice so that other members of the practice team, other than the reception staff, answer phone calls during peak times. This has seen a reduction in the waiting time for phone calls to be answered and also a reduction in patient complaints regarding this issue.

An admin ‘Hunt Group’ has also been set up so that there is a dedicated phone line for patients to call to arrange any long term condition appointments (i.e. diabetic/asthma reviews). This also appears to be working well.

Minor Ailment Scheme

Reception staff are now trained with regards to the minor ailment scheme and have been encouraged to promote this to patients.

Minor Surgery

CR explained how Dr Bowron is now undertaking minor surgery clinics. A new minor surgery scheme has also been introduced in to the practice. This scheme is for patients who have any lumps or bumps they would like to be removed (i.e. skin tags/moles etc.). The patient will be given an initial appointment in an assessment slot within a minor surgery clinic (without having to see a GP prior to this). These appointments are of 3 minute duration. The minor surgery GP will then assess the lesion and its suitability for minor surgery. If it is suitable, an appointment will be made at that time for the patient to come back for minor surgery. On occasions when the clinics have not been fully booked, the GP has been performing the minor surgery at that time.

The aim of the new scheme is to reduce the number of normal GP appointments being used for assessment of lumps and bumps. The scheme is advertised within the practice and on the practice website.

PLT Sessions

CR explained that the last PLT session had to be cancelled due to the cyber attack. Members of the Patient Reference Group were asked to the let the practice know if they would be interested in attending a future PLT session.

Seating Plan

The seating plan in the waiting area is currently being reviewed but has been delayed as the surgery is due to receive a surgery pod. This can be used by patients to record blood pressure, height, weight etc. The pod will collect the data and this will then be inputted on to the surgery computer system. The pod is patient friendly and it is hoped it could reduce the demand on nurse appointments.

Jayex Board

It was discussed how enquiries have been made in to purchasing another Jayex board but that there are financial limitations.

Appointments/New Staff

Appointments

BR provided a presentation with regards to the most recent appointment data (please see attached information sheet). She explained how the practice is achieving its GP appointment target figures nearly every week (excluding bank holiday weeks). The DNA policy appears to be working well with a 15% reduction in patients not attending appointments from February to March 2017 compared to the figures from the same period the previous year. The nurse practitioner drop in clinic has also proved to be successful with 200 patients having been seen in these clinics since 27 February 2017. This has caused a reduction in GP telephone triages with a reduction of just under 1000 calls in this time frame. The nurse practitioner drop in clinic continues to be reviewed regularly.

Online Appointments

It was discussed how there has been a slight increase in the availability of online slots. This was altered when reviewing the number of patients registered for online services. There have been some issues with patients booking appointments online with a GP when the reason for the appointment was not appropriate for the GP. Information regarding what is appropriate to be booked with a GP has been added to the website and it is hoped that this will reduce any inappropriate appointments. The surgery continues to also monitor online appointments.

New Staff

· Reception Staff

The practice has a new apprentice in reception called Lily. A new receptionist has also joined the practice called Louise.

· Management

Derek has joined the practice as part of the management team and works three days a week.

· Tier 2 Diabetes Service

The Tier 2 Diabetes Service now sees patients within the practice rather than in a hospital environment. A diabetic specialist nurse attends the practice every second Monday and works alongside our diabetic practice nurse. A GP with special interest in diabetes will also have a clinic in the practice to see more complex patients.

The overall aim is that the practice staff will upskill so that the service can be run using just the practice staff.

· Nurse Practitioner

Sonia, who previously worked at the surgery as a nurse practitioner, is working at the practice each Monday. She sees patients who are due long term condition reviews.

· Registrar

The practice will receive a register on 2 August 2017. The registrar is female and called Dr Clarke and will work within the practice for six months.

· Dr Stratford

Dr Stratford is a career start GP and will work within the practice for two years.

Dr Wheatley

Dr Turner informed the Patient Reference Group that Dr Wheatley is due to retire at the end of February 2018. He is currently working four days a week but may reduce his hours leading up to his retirement. The practice may not recruit a new GP as currently there are extra appointments available due to the registrar and Dr Stratford.

Any Other Business

· Terms of Reference

WE explained that the 2017 version of the terms of reference needs to be updated. This was agreed to be done.

· Minutes

SH queried whether the practice receives the minutes from the North Durham Patient Reference Group and Carers meetings. It was confirmed that the practice does receive these and that they are added to the practice website.

· Meetings

SH enquired whether there could be a notice displayed in reception to advertise meetings outside of the practice for patients to attend. It was agreed this would be beneficial and SH is to create a poster which can be displayed.

SH queried whether any other patient would like to attend the meetings with him as they do suggest each practice has two representatives. It was agreed to put this request in the minutes in case any virtual Patient Reference Group members would like to attend the meetings. It was agreed, however, that information regarding what would be required would be beneficial.

· Citizens Advice Bureau Information Leaflet

There was concern raised that the leaflets in which Lewis has provided to the Patient Reference Group should actually not be given to patients as they have the GP referral line number on. The practice is to ask Lewis about this.

Next Patient Reference Group Meeting – Thursday 28 September 2017