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PATIENT PARTICIPATION GROUP MEETING 26 NOVEMBER 2014 Present: Patients Brian Lightoller David Ward Bob Radford Simone McAllister Hannah Alonso Whittaker Liz O’Sullivan Jo Winskell Sylvia Long Val Loomes Eric Richards Brian MacLaren Gordon Yonge Tony Kirk Pam Coling Mary Wallace Jackie Holloway Present: Staff Dr Sodipe Dr Prathap Gill Howes Lindsay Alger Janet Frankland Sue Morgan WELCOME Dr Sodipe welcomed everyone to the practice and hoped it would be a productive meeting. Everyone introduced themselves. SURGERY TEAM Janet, our lead receptionist, advised that there is a team of 11 receptionists and 2 prescribing clerks who all deal with queries, faxes, A&E forms, post, scanning, booking appointments, answering the phones and trying to assist patients and the clinicians alike. It is a very varied role. Queries they cannot solve there and then are forwarded to the doctors for their advice. Janet advised the phones still do not seem to be working properly. Patients say they have called, but the phones are not ringing. Gill, Practice Manager, advised she helps to ensure the smooth running of the practice, dealing with all staff and patient queries, and together with her assistant, Sue, - IT, claims, CQC, QOF. Lindsay Alger, Nurse Practitioner, advised that Nurse Practitioners came into being when there were problems of recruiting more medical staff especially in poorer areas. It was decided that perhaps the nurses could do more and received advanced training and so the role developed. It started in the USA and it proved to be a very satisfactory solution. Nurse Practitioner is not a recognized qualification and many can call themselves it without the correct training. Lindsay however has qualified by doing a 3 years course at Southbank University and is now an Advanced Nurse Practitioner. She advised that she sees patients with minor ailments and illnesses. She had previously been a practice nurse for 18 years with a diploma in Long Term Conditions. Her role has been tweaked at the surgery in order to try to provide the best possible service to our patients. She usually has an open surgery and sees problems on the day. She works closely with the Duty Doctor when required. She does not do steroid injections, fit coils, sign sick or death certificates. However, she can prescribe medication and refer to the hospitals. She is a member of the MDU. Dr Sodipe advised that the partners have total confidence in Lindsay, she is highly skilled and that they chose well in appointing her and that she has been well received as a member of our clinical team by most of our patients. TOPICS SUGGESTED BY THE GROUP Receptionists – were complimented Continuity Care once discharged from hospital Is the NHS ‘dying’ on its feet as suggested in the media? Our telephone provider When results come in could they be emailed to patient? Could we have a triage nurse here? No shows – wastage of appointments – should these be publicised? The group should meet once a quarter TELEPHONE SYSTEM We changed our provider in March this year having sought advice from other practices and our IT Department and thought we would be addressing a lot of the problems encountered by our patients on the old system. Unfortunately this is not the case. The main issue appears to be the length of time waiting. Although some patients thought it had improved. We have already had the telephone company back to amend problems, but we obviously need them to return again. Among the changes that we need to make are amendments to the message and why everyone appears to be 4th in the queue. Two members of our group – Hannah Alonso Whittaker and Simone McAllister have offered help with sorting the phone system as this is their area of expertise. ONLINE APPOINTMENTS We offer online booking of appointments as an alternative to telephoning the surgery. However, it was pointed out that there only ever seem to be appointments for 2 female doctors and it can only be booked 2 weeks in advance. We will speak with our software company to change this. Are we providing enough online appointments? The patients felt if they knew the patient/doctor ratio they would understand the problem. However, it is not possible to increase the number of doctors so patients need to be educated about self-help and speaking with their pharmacists. Some appointments are unnecessary. Could we consider a triage nurse? We need to encourage more self help and consult local community pharmacists for minor illnesses. The group felt that perhaps the triage system could have worked as we probably never heard from the patients that were happy with it just the ones who complained. SERVICES How can we improve our services to our patients? We could offer more information on the telephones and the Jayex board. A newsletter advising patients of the services would be welcomed. We could improve the online booking and also the online prescription requests. A lot of medication is wasted as the pharmacist asks for all the medications whereas they may not all be needed. We could be more proactive in asking patients for their email addresses. Some of the group felt that the online system was not user friendly, however it is not something that we can change since it is not our software. BROMLEY HEALTHWATCH This is a group who describe themselves as consumer champions and will be coming to the surgery during the next few weeks to explore the patient and public experience of health and social care services. They will be listening and observing how the surgery operates. CARE QUALITY COMMISSION INTELLIGENCE MONITORING (CQCIM) CQC statistics show Addington Road Surgery to have had an under average response for patients requesting and able to see the same doctor (doctor of their choice). The group felt that if they were asked the question whether they always saw the doctor of their choice they were likely to have answered ‘no’, but they were happy to see any doctor with an acute problem, but wanted to see the same doctor/doctor of their choice where the problem was ongoing. It was highlighted that more part-time doctors made it difficult to have doctor continuity. The overall feeling was that the ability to see a doctor had improved, especially with the duty doctor system where you would be seen for urgent or emergency health issues. Although it was not always possible to see the doctor of your choice, patients felt if they were prepared to wait then they would be able to. NHS Dr Sodipe explained that the nature of the practice has changed. More hospital work is being performed in surgeries now. In fact, 90% of NHS work is done in primary care but inexplicably receives only 10% of the NHS budget. A&E URGENT CARE CENTRES Some of the group were unaware of the Minor Injury Unit at Beckenham and UCCs and felt we should advertise these services either on the surgery website, Jayex board or the notice boards around the reception area, although some admitted that they did not, in fact, read the notice boards or website. Perhaps a regular newsletter. We would try this as a pilot study and would request feedback from the group. THANK YOU Unfortunately, time ran out to discuss anything further. Dr Sodipe thanked everyone for attending and for all their comments.