PPG Minutes 18th July 2024

 

1. Present

John Morphy Godber (chair), Paul Matthews, Paddy Jelen, Allison Mann, Elaine Hooper (by Teams);

By invitation: Emma Wilson,  Dr. Gavin Cattigan.

Apologies: Marion Pitt.

 

2. Previous Minutes and Actions

Gavin had spoken with pharmacy staff to confirm the process for repeat prescriptions, saying that patients should be handed a renewal slip to tick the medications they need, without having to speak to them in the public area. Paddy asked about patients who could not attend the surgery, now they cannot order prescriptions by phone. Gavin said that all local pharmacies should have a list of “vulnerable” patients whose medication needs could be confirmed when they are delivered, or the pharmacy could order medications on their behalf. There has been some confusion with one local pharmacy, but this has been resolved following a meeting last week. 

John had contacted the ICB [Integrated Care Board) specifically to ask about provision of Covid jabs by pharmacies in Stamford and also why Stamford people are not able to use the Pain Clinic, which is operated from Stamford Hospital. He had had a holding response, but is still awaiting specific answers.

 

3. Questions to the Practice

3.1. St Mary’s Radio
Emma reported that the reception staff would reduce the volume and change the stations to provide a more relaxing atmosphere.

3.2. Website References to Cancer and Co-Morbidities
Gavin said that there are links to national organisations such as MacMillan, but that there should be more references to local provision. 
All patients with long term (chronic) conditions have an annual review connected to their birth date; often things like double appointments would be provided.
John commented that it may be useful to refer to this on the website to reassure patients. Gavin said an “FAQ” document was in preparation to help answer common questions.
It was suggested that Mindspace would be a good local organisation to link to. Emma said that the Social Prescriber gathers information about local services and groups and advises patients who, for example get diagnosed with cancer. Two members reported that they had had no support about their cancer diagnoses, so maybe things were not working as they should.
Gavin confirmed that more information about local provision would be added to the website, though no time commitment was identified.
Gavin encouraged members to review the website and report any thoughts on links that could usefully be added. 

Action 1:

All. John asked members to send suggestions to him, so he could compile a coherent response to the practice and asked all members to keep looking at the website even if they have no personal need. 

3.3. Health Screening for Men

Paddy had asked if there was provision for routine screening for any conditions affecting men, such as prostate problems and blood pressure. 
Gavin said that everybody between the ages of 40 and 74 is entitled to an NHS screening for blood pressure, diabetes, cholesterol and height/weight, relating to possible cardio-vascular threats, if such issues have not already been identified.

He said that doctors are discouraged from doing random PSA tests for prostate cancer, as they are very likely to give lots of false positive results. However, last year the Lincolnshire ICB had asked GPs to conduct such tests, which did, indeed, give many people false alarms. He advised that people should look for symptoms before getting tested. He said a patient could request a PSA check if desired.
Members reported that they or people they know have not been offered health checks on a five yearly basis. Gavin undertook to check to see if there had been any hiccups in the system maybe following covid.

Action 2: Gavin to check on provision of routine health checks. 
 

3.4. NHS and Systmonline Apps
Paddy reported that her prescription data on systmonline did not appear in the NHS app. She had been told the two do not communicate. Gavin said that although the surgery had no control over the apps, they could include guidance in the proposed FAQ document showing patients what to expect when using the apps. 

Action 3: Gavin to confirm that guidance will be added to the FAQ about prescription apps.

3.5. How to Help Patients to know “Best Way to Book Appointments” 

Gavin explained that the choices are:

  • Phone call;
  • Come to surgery;
  • Use Systmonline app.

All appointments including “same day” and “up to two weeks in advance” are released at 8 a.m. which generates the rush response from patients anxious to get an appointment. Some surgeries are trying a triage system, where requests are assessed and then, if appropriate, an appointment can be offered. 

People who need to get some advice or have a dialogue can use the Anima process which is not for appointments as such.
Appointments resulting from blood tests, should be arranged by a clinician, so the patient does not need to take any action. 
John said he would contact the other PPG chairs to see if there are any other possible ways of improving access.

Action 4: John to speak with other Lakeside PPG chairs.

On the question of patients missing appointments, Emma said that the surgery does publicise the numbers of no-shows and provides easy ways, through pressing option 1 on the phone, or the Systmonline app, for people to quickly cancel appointments. In addition, nurses and other clinicians do try to call patients who have missed an appointment to try to find out the reason. Paul said that some people in the veterans’ group were discouraged by having to wait a long time on the telephone only to learn that all available appointments had been taken. He said it could often be a simple case that there are too few clinicians to cope with numbers of requests. It is important to educate patients to avoid routinely asking to see a GP if another clinician would be better and not to make multiple appointments, in the hope of attending one and then failing to cancel others, which were then not needed. 

John said that the PPG could help with raising awareness and education once we have established more communication links with patients. He encouraged everyone to promote the PPG to any groups they belong to (as Paul had done with the veterans) and to make people aware of our new email list. 

Action 5: All to look at what groups/networks they could promote the email list to.
Paul suggested we may try to get a councillor involved with the PPG. 

Action 6: John said he would contact Richard Cleaver.

3.6. Anima

There had been some occasions where Anima had offered incorrect or inappropriate advice. 

Gavin said people could let the surgery know where they had been badly advised through Anima, for example, if the process they had followed had led to a wrong outcome. He said it would be possible to ask the developer to make changes to the process and pathways, if there were detailed information on what had gone wrong. 

Emma advised that patients who ran into problems with Anima could advise the surgery through the website, which is now www.stamfordsurgery.co.uk or by simply mentioning the issue as part of another contact.

 

4. Patient Survey

Gavin said that the survey had been conducted in March and subsequently there has been a national survey with a smaller sample.

The key information was:

  • The surgery received 1800 responses from Stamford in 2024 and only 273 in 2023. This is a 253% increase in number of patient responses. We are not sure what has caused the huge increase, but it is welcome;
  • 20% increase in those patients finding it easy to contact us;
  • 58% of patients would rather contact us by telephone, 19% in person. 11% online, 8% by email and 4% by NHS app;
  • The main reasons for making contact had changed between 2023 and 2024, where urgency had dropped from first  to fourth place. Prescriptions was the largest category; 

When asked if an appointment had been offered the percentage saying “yes” increased from 38% to 59% with more face to face appointments now; 
Overall experience of our service – 25% increase who are  saying Very Good or Good, 8.5% increase saying Neutral.

Dr Cattigan said while the indicators were all positive many fall short of a desired level and there is clearly still a lot to do to get to acceptable levels of patient satisfaction. 
There is an internal plan to address the issues where the surgery believes an impact is possible in the short term.

A new GP partner starts in September and two further potential partners are in the process of deciding whether to join. In the meantime, money for salaries is being used for locums, which is the most expensive way of providing doctors. There are currently two long-term locums, who know the practice well and some newer ones.

More reception staff are being recruited. This is the staffing area with the biggest turnover, partly because, being on the front line, receptionists take the most criticism from some patients.  
The call-back feature on the telephone line, due to come in during October, should reduce the annoyance of hanging on for extended periods. There is also now a “Prescriptions Enquiries Line”, as a result of the survey responses.

Emma said that the line would be in operation for limited hours, but would provide direct contact with dispensary clerks for repeat prescription queries. 

Some videos have been produced to help patients use the Self Check-in stations (which are being relocated nearer the entrance) and also the Health Hub at Sheep Market.

Emma said a “Practice Leaflet” is in preparation with FAQs and help guides, on a whole  range of issues, where patients are  expressing uncertainty on how to get the best out of the surgery.  She agreed to give the PPG an opportunity to review the leaflet, before it is published.

Action 7: Emma to provide the Practice Leaflet to the PPG.

A new, “In Your Community”  display” of local and national events and organisations will be introduced to support patient awareness of support and facilities beyond the surgery. This will be updated regularly.
Texts are going out to patients encouraging them to use the Health Hub for their annual blood tests. 

John asked if he could discuss, with Emma and Caroline Freeman, ways in which the PPG could raise awareness. Emma agreed to this idea. 

Action 8: John to speak with Emma about PPG involvement in patient education. 

Gavin said that each of the five current partners had been linked with the five local care homes.

Ironically because training for new GPs typically runs to  August, there will be newly qualified doctors, who will not be able to get a job because funding to surgeries across the country has been cut so much. So for a time there will be more doctors available for work who will not be taken on in England, unless the funding situation is improved by central government. There is a helpful proposal to move funding from secondary (hospitals) to primary (GPs) care. This should mean more health problems being sorted, without reference to A&E.

Emma will contact John about PPG support for ‘flu’ clinics in October. 

5. PPG Admin

John said he had produced a contact slip for members to use and he would send the electronic file out. 

Action 9: John to send members the PPG contact slips. Elaine had previously asked for something she could hand out in her drop in sessions at St Mary’s.

Members were happy with the slip with the addition of the phrase “Marked for the PPG” where we were offering the option to hand in a letter at the surgery. 

John reported that he had now set up an email group where people could get information from the PPG. The group is on the groups.io platform and is a closed group so people cannot randomly join unless approved. 

It had been suggested that we have a photograph of the PPG but the general feeling was this would not be necessary. 

John also asked members to look at the PPG section of the website and consider producing a very short individual biog, so patients know a little more about who we are.

Action 10: members to see if they would like a short personal summary on the website.

In his summary of recent actions, John confirmed he was pursuing the ICB for answers to various questions. He had also now attended two Zoom meetings of Lakeside PPG chairs, which had shown him that there is a big range and level of activity and participation. His hope is that he will be able to coax chairs into sharing of information and concerns, in order to make a more effective collective voice to Lakeside. 
He asked the committee about holding an open meeting later in the year, as there had been no opportunity for face-to-face communication with patients.

Opinion was divided, with some worries about having a negative session. John said he would speak with Emma to see if anything could be arranged on 24 September, which is our next meeting date. However, two members said they would not be able to attend on 24th. 

Action 11: John to speak with Emma about a possible open meeting.

End of Meeting 

Summary of actions

  • All members to send suggestions to John, so he could compile a coherent response to the practice. All members to keep looking at the website even if they have no personal need.
  • Gavin to check on provision of routine health checks.
  • Gavin to confirm that guidance will be added to the FAQ about prescription apps.
  • John to speak with other Lakeside PPG chairs.
  • All members to look at what groups/networks they could promote the email list to.
  • John to contact Richard Cleaver.
  • Emma to provide the Practice Leaflet to the PPG.
  • John to speak with Emma about PPG involvement in patient education. 
  • John to send members the PPG contact slips. 
  • All members to see if they would like a short personal summary on the website.
  • John to speak with Emma about a possible open meeting.