Patient Participation Group

• Date: 24 August 2023
• Location: Station Medical Centre

Present

• Chair – Mr Terry Smissons
• GP Partner -Dr Andy Hargraves
• Ceri Chaplin (CC) –Managing Business Partner
• Lucy Jones (LJ)-PCN and IT Manager (HMG)
• Marcia Martin (MM) -Quality and HR manager (HMG

MM welcomed everyone to the meeting and gave some updates to the Quality Team. Bryony Reid will be replacing MM as Quality Manager in mid-September. MM will remain as HR Manager. Liz Morris replaces Melanie Evans as our Patient and Liaison Manager (PALs). Both will be introduced at the next meeting in November

The chair then started the meeting.

The chair reviewed the minutes and raised the following actions points

• GP Numbers. CC gave an update on the current status of GP recruitment. Whilst both Dr Chataway and Dr Turnbull are retiring this year they are staying on with HMG as retainer GPs. We have recruited three newly qualified GPs and a further experienced retainer GP.
• We discussed the recall system for patients requiring regular blood results. HMG has a team of staff who recall patients for chronic disease checks.
• Cancellation of appointments is an issue, as often patients then have a further wait to be seen. HMG to look at this. Action CC
• The screens in reception have been highered as requested.

New Business 

Improving Access

CC gave an update on the measures been taken and planned to improve the access for patients to medical services

• As part of a national incentive scheme, HMG have a plan to support improved access for patients
• HMG are currently looking at improving the online question form for patients, to give more in depth information, to improve the triaging for GPs.
• Looking to bring triage times down from 5 days to 24 hours.
• HMG have already upgraded the phone system and patients are making use of the ring back feature.

Comments from patients

• Can HMG improve its communications to patients to let them know in advance of changes? Action needed

Digital Access

LJ gave an update on prospective access for patients

Patients will be able see their prospective medical records online from the 4th October 2023 via the NHS app

• Patients from 13yrs old can access
• Proxy access will be available as appropriate
• LJ is investigating community IT hubs for those persons who do not have IT access or smartphones
• LJ plans to produce some communications in regards to abbreviations and acronyms -Action LJ
• LJ would like to send a questionnaire out to patients to understand how we can further support patients with digital access- Action LJ

Patient Survey

The chair reviewed the patient survey results. He noted the following

• HMG scored lower on markers of patients accessing the survey, but that we have already heard from CC about the plans to approve access
• HMG scored average and above from patients following their care from clinicians.
• It was noted that only 191/538 surveys were returned this was 36%

Questions from Patients

• Are there any plans to close Credenhill surgery? CC replied no plans at present. If HMG decided to close the surgery, they would consult patients and the local health board.
• Taking own stool samples to the lab? MM replied, Patients have been asked to take stool samples to the lab for a couple of years, we think this is an infection control issue, but will investigate further. Action
• Does HMG have to have a PPG? MM replied, HMG and previous surgeries all had PPGs. We value the opinions of patients, their support and viewpoints. It is not mandatory for surgeries, but seen as good practice.
• Does HMG consider the wellbeing of its staff? MM replied we have just carried out a staff survey and will perhaps report on this at our next PPG.
• There were queries about the 111 service. CC replied explaining how the 111 service should work and how it refers back to HMG, but depending on the time of calling it might refer back to the out of hours service.
• How can patients ask questions? MM replied that whilst patients can refer questions and queries to the PPG chair for this meeting, part of the PALs officer role is to support patients and this involves questions and queries.
• Bobblestock door is very heavy for patients? CC will investigate this.
• The chair brought up an issue of a receptionist advising a patient to go to A&E – CC said that it was against policy for a receptionist to advise a patient to go to A*E unless it was over the phone and it was a medical emergency then they might ask them to call 999.

• Date: 26 April 2023
• Location: Station Medical Centre

Present From HMG

• Ceri Chaplin (Managing Partner)
• Dr Sarah Morgan-Jones (GP partner)
• Marcia Martin (Quality and HR Manager)
• Melanie Evans (PALS Officer)

Patient Present

• T S (Chairperson)
• C B (Vice – Chairperson)
• J P
• H P
• C P
• C H
• J G
• H B
• L M
• G S
• M G

Apologies received

• S T
• L T
• D J
• L T
• N C
• S E
• D K
• S B
• S M

MM opened the meeting by thanking the patients for attending and introduced the HMG staff members and partners present.

Action and Minutes from the previous meeting held on 18 January 2023

• Volunteers – this is ongoing as they will need the support of the Reception Supervisors in this role and they do not currently have the capacity to support volunteers.
• Acronyms list – this is in progress.
• New routine appointment system – ME and CC ran through the new phone options that will go live shortly.  Dr Laird is currently working on a list of what is classed as ‘urgent’ and what is ‘routine’.  All online routine appointment requests are triaged within 5 working days.  
• The bank holiday period has also put pressure on the appointment system and it can currently be up to 3 weeks for an appointment.  We have had the junior doctors strike so clinics cancelled, visiting Nursing home visits are increasing our duty list, there is a backlog at the hospital and it’s a case of capacity versus demand.  
• We are currently 5 full time GP’s down but the good news is 4 new GP’s should be joining the practice later this year, 1 full time and 3 part time.  
• The Mythbusting document has been posted on Facebook and Your Herefordshire.  
• MG has approached Local parish magazines regarding putting an article in them about HMG – we are yet to receive responses.
• There was a suggestion from the group to invite the Hereford Times to a PPG meeting. CC explained the Hereford Times and Your Herefordshire have visited us before.  The HMG take a deliberate view not to respond to articles by them.  
• All patient records will be online by the end of October so patients will be able to view their records and see future appointments.

New Business 

Election of new Chairperson

TS was proposed by MM and seconded by JG and is now the new Chairperson of the PPG.  At this point TM took over the Chair from MM who thanked him for taking on this important role.TM introduced himself to the room and gave a brief history of his previous work life and Committee experience.  He mentioned items of a ‘sensitive nature’ may be discussed and to keep this in confidence, if appropriate.

Election of new Vice Chairperson

CB was elected as the Vice Chairperson.

DJ a founder member of the PPG, who has previously worked at the CCG (Clinical Commissioning Group) will be the patient representative at our monthly Quality Meeting going forward.  She will report back to the PPG.  The Quality meeting is where were review any complaints, learning events and near misses.

New PALS Officer – Melanie Evans

Melanie introduced herself to the group, she joined HMG in February 2023. and gave an overview on her new role as Patient Advice and Liaison Service Officer.   ME explained that the role was there to support patients via complaints and patient feedback and said we also have Compliments too.

New Booking System

The committee shared some of their experiences booking an appointment and CC and S M-J explained the thinking around the new system.  The new system gives everyone a fair chance of getting an appointment unlike before when people had to ring the surgery and wait for their call to be answered.  We receive around 1000 requests a week via the new method, these are reviewed by a receptionist.  About 20% are administrative queries, any urgent requests are sent to the GP triaging on the day or Staff Lead GP to check over.  The rest are added to the triaging list and we aim to respond to these within 5 working days.  S M-J explained in a Triage session a GP triages 90 online request forms, working with a receptionist who then send a text link out to the patient to book an appointment with a GP or a Nurse Practitioner.  The GP assesses if any pre appointment tests are required, directs to a specialist GP if appropriate and if the patient want to see a male or female GP depending on the request.  The new system was put in place after an extensive audit as previously some appointments were being wasted.

CC explained to the Committee about patient access and the GP contract and funding we receive. Last year the practice had to achieve 35 objectives but this year it is just the following targets

• Hit targets for flu injections
• Ca target relating to FIT test
• Access
• Learning Disability checks

You will see much for in the media about ‘access’ to GP’s in the next year.

HP brought up a query about blood tests. SM-J said she would look into this.  Patients currently have a medication review a year after starting but aiming to move this annual review to the month of their birth.

It was brought up to fill in paper forms instead of online forms as this does not suit everyone and CC said we could look at this as an option.

The current wait time for a physiotherapy appointment if referred today is 9 months.  This service is provided to us by Wye Valley NHS Trust.  We will be raising this waiting time with them. 

Refugees at The Three Counties Hotel – update

The practice have received a lot of feedback via the HMG Facebook place. CC explained it was a central government decision for the refugees to come here.  The local surgery at Belmont was unable to register all the refugees so it was decided it was easier for them all to be registered at HMG than be split between two surgeries.  It is mandatory for every refugee to have a Health Assessment and these are being done at the South Wye Surgery.  Following this, the refugees have to go through the same process as everyone else to get an appointment at HMG. They have no preferential access.

A discussion ensued regarding the refugees, they are here from 30 different countries.

David Ponton – Pharmacist for Quality

David gave a talk on the role of the Pharmacy Team at HMG.

The committee thanked David for his overview of this service.

Volunteering

This was covered under Actions from the last meeting.

PPG Questions

Physio appointments – this was covered earlier, our service is sourced from Wye Valley Trust and there is currently a 9 month waiting list from referral.

Staff Welfare and rooms to relax in – The meeting was held in the Staff room which is next to the kitchen.  The staff have access to free tea, coffee, milk and the room has chairs and tables situated in an informal setting.

Whistleblowing Regime in place – Any member of staff can access the NHS England website should they wish to raise any concerns – There is a section ‘Freedom to Speak up’ and they can be emailed, phoned or a letter sent to them.

AOB

CC explained the ICB (Integrated Care Board) had now replaced the CCG (Clinical Commissioning Group)

TS was happy for his email address to be shared with the Committee and then items for the agenda can go through him:-

CP asked what volunteers roles may be.  Helping in reception how to use touch screens and entering car registration details.  We need to be mindful of a Confidentiality Agreement and an Induction process for volunteers.

JP suggested that the screens are difficult to see as they are situated quite low on the wall, presumably for disabled accesss, it was discussed about one screen being raised to eye level height.  This will be looked into. CC/MM

JG asked the situation regarding home visits.  SM-J explained these are done ‘where clinically appropriate and if the patients is ‘ bed bound or acutely unwell.

There was no other business and the meeting closed at 8.25pm.
The next meeting is scheduled to be 26 July 2023.

• Date: 18th January 2023
• Location: Station Medical Centre

• Present From HMG
• Ceri Chaplin (Managing Partner)
• Katie Jones (Operations Manager)
• Dr Cath Laird (GP partner)
• Marcia Martin (Quality and HR manager, and Interim Chair)
• Michael Griffin (Communications Officer)
• Kerry Mills (Advanced nurse Practitioner and PCN Clinical Lead)

• Patient Present
• CB
• AS
• SB
• HH
• JP
• HP
• LM
• CH
• ST
• LT
• SM
• TS

MM opened the meeting by thanking the patients for attending the meeting and introduced the HMG staff members and partners present.

Action and minutes from the previous meeting held 13th October 2022

• Chair- MM said that the group was still looking for a patient Chair, and that we could offer support to that person. Please let Marcia or Michael know if you are interested.
• Volunteers- MM is still exploring this option, some of the barriers are around confidentiality and insurance. Action MM
• There was a request to produce an acronyms list, for better clarity. And TM raised the point about sharing news in local parish newsletters. Action MG            

New Business 

• Communications Officer, MG introduced his role, and welcomed offers of advice and support in regards to comms including the website.
• New Routine Appointment System – KJ and CL gave an update on the new Routine Appointment request system. The system was thought to be more equitable and a fairer system removing the need to keep phoning the surgery back and waiting in a phone queue. LT had tested the system and it worked, although she would have liked to have seen which GP she was booking with.  CC/KJ currently working with the text system provider to look at improvements . Action CC/KJ                                           
• There was also a question about what is a ‘Routine appointment,’  KJ/CL are working on a list that should help with this but generally anything that does not need to be seen today.          Action CC/KJ
• There was also a query about the phone messaging, KJ will review to make the messaging clearer. Action KJ
• Myth Busting – MM had previously shared this document and the feedback from the PPG was discussed anonymously. Overall comments included

1. It was too long
2. It needed pictures
3. It needed to focus more on the positives
4. HMG needed to market itself more.

• PPG questions –had not been received – MG will look into this technical error. Patients shared some individual stories that the management team will follow up individually. One patient thanked the script team as the system was working well, and the group thanked the Staff for their work sorting out the appointment system.

AOB

• CC discussed the issues that had prevented the full access of patient’s records online. This included confidentiality and safeguarding issues. There is no national rollout date planned at present 

The meeting ended at 19.30
The next planned meeting is the 26th April 2023.