Trinity Court Patient Participation Group (PPG)

Minutes of meeting Wednesday 22nd November 2017

1. Present:

Dr Coleman, Bob Malloy (Chair), Shirley Coleman, Liz Wise, Margaret Tweed, Ian Henderson, Sue Band, Angela Millard, Jon Moll.

2. Apologies:

Fiona McConville, Maggie Langford, Elaine Kemp

3. South Warwickshire GP Federation

Practice Manager Jon Moll explained that the GP Federation brings together 34 practices in South Warwickshire. It provides a vehicle for surgeries to bid jointly for funding, for example for the recent Over 75’s project.

There are six elected Directors of the Federation three of whom are GPs and three are practice managers. There are two full time staff based at Waterside surgery in Leamington.

The Federation aims to work in partnership to support general practice and to improve the skills of the workforce. GP surgeries are independent practices and do their own purchasing but have made considerable savings by bulk purchase of flu vaccine for example. A common IT platform allows the Federation to support GPs in record keeping and funding claims.

There is a GP shortage which will probably worsen, and the Federation can help with recruitment and training of e.g. physician associates and pharmacists. The Federation can also provide support with HR and produce standard staff contracts for example. The GP Federation is supporting the sharing of good practice and is training reception staff to release the burden on GPs.

Questions: Jon was asked if there was duplication between the CCG and the GP Federation and explained that the CCG is the purchaser/commissioner and the Federation is the supplier. The Federation can bid to the CCG and then sub-contract to the surgeries.

4. CCG Feedback

i. Phlebotomy at Warwick Hospital and Stratford Hospital

Bob Malloy explained that he had been to a presentation on a new phlebotomy booking system at Stratford and Warwick Hospitals which will be in place by January. Patients will be able to make appointments on line although some appointments will be reserved for ‘walk ins’.

Warwick phlebotomy will be open 8 am till 5 pm and Stratford 8 am till 3.30 pm. Seven more phlebotomists will be recruited. There will be plinths with computer screens at clinics, so patients can book at the hospital, and in some cases clinics will have slots reserved and can make the appointments for their patients.

The improved service at Warwick and Stratford is not expected to affect existing arrangements for blood tests at Trinity Court or Claverdon.

ii. GP Extended Hours.

Jon gave details of the government’s aim to make access to appointments for patients easier and more convenient. Funding worth £1.7 million is available cross South Warwickshire for the Extended Access initiative which will mean appointments available for an extra 1.5 hours in the evenings and on Saturdays and Sundays. It is expected that ‘on the day’ as well as routine appointments will be available and are likely to be delivered through a small number of hubs rather than at every practice.

Appointments could be with a GP, nurse, or pharmacist and the extended service should start in October 2018. The CCG appear to be planning to put the contract for extended hours out to tender so there could be bids to deliver this from private providers such as Care UK as well as from GPs. If this does go out to tender the GP Federation will be bidding on behalf of South Warwickshire GPs.

Jon was asked about the effect this will have on the current Out of Hours service based at Warwick Hospital, and he understands this will continue. Discussion focussed on the merits of the extended hours service being delivered by current GP surgeries or by private external organisations.

It was stressed that whoever provides the service, it must give value for money. A clear preference was expressed for the extended hours service to be delivered by the existing GP practices and the following statement was agreed to represent the view of the PPG:

‘Patients feel that the real value of the extended hours initiative will be if it is provided by and integrated with the existing GP services’.

5. Surgery News

Dr. Proctor who does six sessions a week is going on maternity leave. Dr. O’Connor will start in the new year doing seven sessions a week. The surgery is finding it hard to recruit GPs. The practice will be interviewing for an apprentice admin/receptionist.

It was mentioned that there appear to be difficulties at Arden Surgery because of retirements and the problems in recruiting.

6. Patient Feedback

Ian Henderson explained that the separate PPG at Claverdon had been looking at ‘Did Not Attend’, (DNA) rates. Patients had heard that some GPs operated a ‘three strikes and out’ rule where appointments would not be offered after three failures to arrive, but it was felt this was probably not true and probably not legal. It was thought that DNAs had to be dealt with on a case by case basis and sometimes it would be appropriate for the GP to contact patients who do not attend.

Claverdon patients want to do a project on DNAs and to encourage patients to use the surgery more appropriately, for example by booking a phone call rather than a face to face appointment. Jon agreed with the need to study DNA rates and understand the reasons behind them.

Ian explained that Claverdon started a PPG before Trinity Court and they would prefer their own PPG meeting locally. Jon explained that many GPs have satellite surgeries and it is usual to have only one PPG. Patients can also be communicated with by newsletter.

Ian raised the issue of two week waits to get an appointment for a blood test at Claverdon, and Jon said he would investigate this. Ian asked if it is possible to email the surgery as he got messages saying, ‘this email is for administrative purposes only’. Dr Coleman was under the impression that emails did get through. Dr. Coleman explained that there are issues with the e-referral system at present.

Ian asked about the protocol of consultants writing to GPs after hospital appointments. Should the patient always get a copy? Practice appears to vary at present with some patients getting a copy from the consultant and others not. He had an example of a letter to the surgery not being actioned, but he was able to raise this as he had received his own copy. Dr. Coleman advised that patients can always ask the surgery for a copy of a hospital letter if they do not receive one direct.

Dr. Coleman was asked how long patients should have to wait to hear about a hospital appointment and replied that it should be within two weeks for cancer investigations, but it will vary for other conditions.

The EMIS system was discussed and it was noted that patients can see more information on the app. at other surgeries than here. Ian said there was an example of another patient’s information showing on the app. Ian aid that there were inconsistencies in the receipt of text messages about appointments and Jon said he would look into this.

8. Date and Time of Next Meetings.

Next meeting 28th February 6.30 p.m.

Following meeting13th June 6.30 p.m.

1