PUTNEYMEAD GROUP MEDICAL PRACTICE

PATIENT GROUP – STEERING GROUP MEETING NOTES TUESDAY 4TH DECEMBER 2012

Attendees from PracticeSteering Group Attendees

DK Doug KershawBQ Bibi QureshiJD Judith DysonVD Vicky Diamond

JL Jak LinsellSR Sue RolfeTHTony Howells

Putney Society Members’ Meeting 22nd November 2012 (Meeting notes are attached at the end of this summary)

  • 75 people attended.
  • Approx 50% of the attendees were from the Putney Society.
  • 56 of the 75 there filled in a survey about where they heard about this meeting. 50% heard it through the Putney Society bulletin. 50% were advised from Doug Kershaw’s MJOG text.
  • SR: Typical demographic of a Putney Society meeting, 40+ year olds
  • BQ: Although there were a few ‘new’ people
  • TH: And some people even came who reside outside of West Wandsworth
  • TH: Nevertheless, slight disappointment at the numbers attending considering the changes within the NHS will affect ALL people of all ages.
  • Generally positive feedback from the meeting itself, with talk of a possible repeat in six months.
  • TH: Nevertheless, cannot see where patient involvement comes in and still the question remains, what are these regular patient involvement meetings for?
  • VD: Questions/feedback/complaints re appointments etc but these patients are not submitting this information to the patient group.
  • VD: Many acronyms used by speakers, which many of the attendance would not have understood.
  • SR: The speakers did very well overall however, especially with the questions fired at them.
  • DK: Could people be asked to send their questions in advance so the speakers could at least prepare a little?
  • VD + DK: Could be led like a Putney Society ‘Question Time’?

Update on the Putneymead Appointments System

  • DK: Beverly Toney (Practice Manager) has changed the appointment templates again.
  • DK: The rolling embargoes (where appointments would only be opened on a set time or on the same day) became too complex so they have been taken away, with the week now opening on Monday and with all that week’s appointments now open apart from six appointments per doctor per day. This should then reserve some capacity for same day requests.
  • DK: Specific doctor requests (e.g. “I want to see Dr Kirkland this afternoon”) are unrealistic. Management advise that to see a particular doctor there can be a two week wait. Reception will of course offer the next available appointment with that doctor, but also advise on which other doctors are available sooner, if not that same day.
  • TH: Where would ‘Continuity of Care’ (i.e. seeing the same doctor) be part of this new system?
  • DK: We have a ‘Team’ system, whereby every patient has a group of doctors assigned to them rather than one. For instance, previously Balmuir patients will be in a team of Balmuir doctors plus a couple of new GPs who have joined the surgery post-merge.
  • Therefore, if the requested doctor was unavailable, reception would then look to offer a doctor in the same team, then on the same floor, then if the patient is still not happy, offer to book with any doctor in the building.
  • JD: Reception have to know how to explain this system in the simplest way to patients over the phone and be able to provide alternatives.
  • VD: Reception could also inform patients of a doctor’s availability so patients can understand more. For instance, if receptionists explain Dr Perry is only in surgery once a week, patients will understand that an appointment with him is going to be harder to book.
  • SR: What happens when somebody wants to discuss an issue but not with the reception team (due to comfort, depth of problem etc)?
  • DK: We have our ‘Cap Doc’* system where a telephone call can be made to the patient by that day’s designated Cap Doc. Reception do not need to be told the reason as to why. The other alternative is to request to speak to management who will be able to offer/explain alternatives.
  • DK: Reception has also been advised that should telephone discussion become heated, they are welcome to press the manual record button. There is a recording disclaimer message prior to every call being answered. Then if there is a following complaint, management can listen to exactly what was said and then determine an appropriate outcome.

* ‘Cap Doc’ stands for Capacity Doctor. Two doctors in the morning (9am-1pm) and two doctors in the afternoon (1pm8pm) are tasked with telephone appointments once all the other doctors are booked up for that day. These telephone calls are for people who require medical assistance on the day but who are unable to see or speak to another doctor due to capacity. Capacity Doctors are able to invite patients in who need to be seen as a matter of urgency. As such they are similar to an On-Call doctor, dealing with emergencies, attending home visits and signing urgent prescriptions. In summary, their presence means patients are still able to communicate with a practice GP when no other appointments are available.

Choose and Book* Referral System

*Choose and Book is the referral system by which patients have a choice as to which hospital they are treated at, albeit within restrictions such as whether the chosen hospital provide certain services.

  • DK: The practice has redone the Choose and Book method and organised training so practice staff will be able to complete the whole process right through to booking an appointment for the patient.
  • DK: This will help avoid patients having to return to the surgery two days later in order to collect the paperwork and book their own appointment. Hopefully saving time and effort for the patients.
  • DK: The process will be double checked by the admin team to ensure everything goes through and that all the patient needs to do is turn up for their booked appointment.

Continuing problems with Prescriptions

  • DK: In all honesty, we are unable to identify WHY we are continuing to have problems. The pathway is clear and prescriptions should NOT be lost or left unprocessed.
  • DK: There are two types of prescription, routine (which reception can issue) and acute (which has to go to a doctor for viewing).
  • The prescription will then go to the doctors (if not already with them as with acutes) who will sign them.
  • The prescriptions are then collected and taken by trolley to the ground floor where they are filtered into ‘collect from surgery’ and ‘chemist to collect’.
  • The chemist signs for each prescription they have collected.
  • DK: Management are looking into moving the filtering of prescriptions from the ground floor to prevent any being lost amongst the mass of other paperwork.

Other Issues

  • SR: Sue is still chasing up the Resuscitation Course run by the London Ambulance Service
  • The Open Forum will be held at 7pm on Monday 10th December in the Disraeli Room.
  • The next steering meeting will follow the Open Forum. Tuesday 8th January at 11am.

Actions

  • Beverly Toney to update the suggestions log.
  • Re feedback from other patients regarding practice services, can suggestions coming in from the Putneymead website be sent to the email address? And also for members to take a look at patient feedback on the NHS choices website.
  • JL to establish agreement with pharmacies so forum posters can be displayed in windowsJL 10/12/12

Putney Society Members’ Meeting 22 November 2012 at St Mary’s Church, Putney

Changes to your health care and services in Wandsworth, and what YOU can do about it'

Chair: Jeremy Ambache – ex LiNK, Healthwatch, Chartfield patient rep

Speakers:

Dr Houda Al-Sharifi – Director of Public Health Wandsworth

Dr Peter Ilves – Danebury Surgery, Chair of West Wandsworth Local Commissioning Group

Mike O’Bryan – patient representative on West Wandsworth Commissioning Group, Heathbridge Practice

Jeremy Ambache explained to us that Healthwatch will take over from LiNK in April 2013.

Healthwatch will comprise of a network of groups who use health and social care services, with the aim of giving patients and users a voice locally and nationally. There is Healthwatch England, which works at the national level, and then there are local Healthwatch groups. There will be one Healthwatch for every local authority area, and they will take the experiences of local people and use them to help shape local services. Healthwatch England will make sure that people who use health and social care services are able to have their voice heard by the Secretary of State, the Care Quality Commission (CQC), the NHS Commissioning Board, and every local authority in England. More information on

Jeremy told us that there is the Wandsworth Clinical Commissioning Group (WCCG). The WCCG covers 46 medical practices, is lead by Dr Nicola Jones and works with NHS Wandsworth, Wandsworth Council, and patient groups. The public can attend meetings and ask questions of the speakers. GPs will work together to manage their budgets and to influence all the wider commissioning decisions within the new Wandsworth Clinical Commissioning Group. These commissioning decisions will be both ‘clinically led’ and worked out in partnership with patients / patient groups.

Dr Houda Al-Sharifi explained that the Joint Strategic Needs Assessment (JSNA) is a snapshot of the population in the Borough and the health and well-being of its people. There is a gap in life expectancy between the most and least affluent areas of more than 7 years, with coronary heart disease being the greatest single cause. Childhood obesity is a major concern, with teenage pregnancy rates, sexually transmitted diseases, alcohol related hospital admissions all having risen. Wandsworth has higher than expected rates of mortality from circulatory disease and cancer, as well as a high rate of excess winter deaths, and the mortality rate from winter falls is also high. There is concern that carers may have unmet health and support needs, and there is a drive to enable the over 75’s to maintain their independence. The full document is available on

Dr Peter Ilves talked to us about health care services being patient focused, outcome driven, principled and collaborative. He outlined the Better Services, Better Value (BSBV) review in South West London. This will be formally consulted on in 2013 and will include: prioritizing clinical quality, less Hospital with A and E provision, more care out of hospital and savings that have to be made over 5 years.

(Primary care refers to services provided by GP practices, dental practices, community pharmacies and high street optometrists. Secondary care is defined as a service provided by medical specialists who generally do not have first contact with patients)

Peter talked about Personal and Community Resilience. At present we, the patients, are very Primary and Secondary care dependent. The hope and plan is that, as time goes on, we will become more involved with Integrated Health Care and will end up with Community networks of support, with Primary and Integrated Care working closely together. The need for Secondary care (both acute and non-acute) will be reduced by the other systems in place having kicked in earlier, in a more preventative way.

Wandsworth CCG and Health and Wellbeing Board are committing to delivertruly integrated health and social care through the Planning All CareTogether programme.

(There are many Groups and organisations involved, but, as Convenor of the Community Panel of the Putney Society, I have decided that we will have to host another meeting in 6 months time. By then we should have a better idea of how things are going, and can then get to grips with all the different groups, what they do, and how they affect us. As well as learning their names and acronyms!)

Mike O’Bryan explained how the GP Practice Patient Consultative Groups work (PPCG) with the Local Commissioning Group (LCG). There are 9 practices in Putney and Roehampton working to produce consistent long term plans. It’s really important that patients get involved and join the Patient Groups at their doctor’s surgeries. If you don’t get involved and voice your concerns, then it’s going to be impossible for patient’s ideas and concerns to be taken on board, changed or improved. Mike collates the information gathered from the different PCG’s (Patient Consultative Groups) and takes it up the ladder to the Clinical Commissioning Group (CCG).

There are Clinical Reference Groups (CRG’s) which focus on different areas, such as sexual health, substance misuse, children’s services, diabetes, sickle cell, mental health etc.

There were a wide variety of questions about care of the elderly, worries about privatisation of the health service, Sure Start, the effects of poverty, the Maternity Unit at St George’s (Trudi Kemp from St Georges explained how their maternity unit was originally set up to take 3000 births a year, and is now up to 5000. They just can’t take more patients, hence having to send pregnant women to other hospitals), the Out of Hours (Harmoni) service, data sharing between Hospital and GPs, Drugs and alcohol services, developing community resilience, high rates of Cancer … and much more!

One thing we forgot to mention : 111 is the new three-digit telephone service that'sbeing introduced to improve access to NHS urgent care services. Patients can use this number when they need medical help or advice and it's not urgent enough to call 999. NHS 111 operates 24/7, 365 days per year and is free to use from a landline and a mobile.

VLD 24/11/2012