PPG: Meeting Minutes 10th November 2022

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Name	Organisation/Representative	Initials
Sheila Pitt	PPG Co-Chair	BP
Breda Pooke	PPG Co-Chair	SP
Fay Godby	PPG Member	FG
Neville Hudson	PPG Member	NH
David Bay	PPG Member	DB
Ann Bay	PPG Member	AB
Brian White	PPG Member	BW
Andrew Walsh	BMC Lead Pharmacist	AW
Karen Wilshaw	BMC Nurse Lead	KW
Daniel O’Connell	BMC Practice Manager	DOC
Kelly Evans	Invicta Health CIC	KE

Agenda Items

Welcome

• BP and SP welcomed attendees and outlined the agenda items and topics for discussion. 

BMC Updates

Staffing

New staff

• Sam, Practice Nurse with specialism in Chronic Disease has been recruited.  Will see respiratory and diabetic patients after period of training.  
• Admin for workflow and coding due to commence on 30.11.22.  
• Leanne Earl has returned to practice and will work in the palliative team. 
• Dr Joy (specialist in elderly care) has signed a 3-month locum agreement with the surgery. 

Vacancies

• Vacancy in reception remains.  Position was recruited to but offer was later declined. 

Staff changes 

• Nurse Hutton has reduced her hours. 

Current staff 

• Long term locum bookings remain consistent. 

Operations

Patient Management

Chronic diseases, respiratory, diabetes (including pre-diabetic) is entirely managed by the nurses. 

Capacity

• At clinical capacity and more clinicians are working at the surgery than pre-Covid times. 
• Nurse appointments can be booked 12 weeks in advance (longest booking time in Thanet).
• GP appointments bookable 2 weeks in advance and only available ‘open’ on to book on Friday’s. Used to be bookable 6 weeks in advance but caused issues with cancelling appointments should the clinician be unable to work. 
• Action: missed appointments to be displayed in surgery.

Christmas Opening Times

Surgery will be closed on 26th & 27th December, and 2nd January 2023.  Information has been added to the Birchington Parish magazine submission which will include alternative places for treatment when surgery is closed. 

Quality & Assurance

Training

• No training plans until 2023.  Staff are to settle into their roles with their current training. 
• SP and BP will attend next reception training date (PLT) to share telephone audit feedback and discuss any system issues. 

Complaints

• Drop in patient complaints noted. Lucy (Reception Manager) and Clare (admin manager) now managing complaints.  
• 4 complaints currently under management. Themes: miscommunication from locum GP with admin which involved a palliative patient; access for patients. 
• Average open to close complaint time is 2 weeks.  
• Note: palliative care is different from end of life care (EOLC). Palliative: condition will not improve and will cause death.  EOLC: deterioration and only symptomatic relief. Palliative was a term used when a patient was given a cancer diagnosis. 

Other Updates

• New check-in screen has been shared on media platforms and will be included in January Birchington Parish magazine.  Note: the Parish magazine will switch to monthly publications.  PPG to lead and manage future submissions. 
• DOC to provide feedback on dashboard. 
   

Patient Survey

• 508 responses received to date.  Majority of responders are in 65-84 age bracket. Lack of response via the Parish magazine. Lack of response from younger ages groups as not a regular user of the service. 
• XXX critical comments received – Themes: not enough doctors, appointment, and want face-to-face appointments. 
• XXX complimentary comments receive – Themes: staff are hard working and seeing positive changes made at the surgery. 
• Additional responses received (at reception) to be counted.  Negative comments will be reviewed and will form the work plan. Results will be shared in the Parish magazine.  

 

Work plan

• Patient information leaflet on Palliative and EOLC “When the time comes”.   Aim is for BMC to be the ‘Gold Standard’ in palliative care.  This will be explored when nursing staff have commenced their roles with BMC. A further palliative patient education session will occur in the new year.  
• Palliative: explanation of social support available and how to access them, understanding what ‘palliative’ means and the patients condition, and expectation of surgery support. 
• EOLC: pain management information, signposting, expectation, surgery support for patients, family and carers, and what to do when death occurs. 

 

Family and Friends Feedback

• 272 patients (91%) were satisfied.  
• SP and BP recently met with potential new provider to obtain patient ‘real-time’ feedback. New system is independent.  System sends a text message to patient. Comments can be anonymous and staff can be named. This may cause confidentiality issues and breach GDPR/information governance. SP and DP to visit a surgery (1 of 2 GP surgeries who use this system in Brighton) where this be being used. All members agreed for a pilot. 
• Note: FFT provide data to practice which is used to inform the ICB (formerly known at CCG). Possible new provider is to give information to other patients/new users. 
   

Education sessions

• Positive feedback from patients who attended the sessions.
• Will repeat sessions already held (and after planned sessions for December 22 and January 23) before planning new topics for sessions.
• “A Day In The Life Of” to feature in future Parish magazine submissions.

Any Other Business

Other comments 

• Chemists (Paydens) is not open on Saturday’s. Opening times of pharmacies is out of the control of the surgery. 
• Website is only used by 1/3rd of people.  BMC address to be added to the Parish magazine. Interest by PPG members for a session on navigating the web and how to access the BMC webpage. Action: Can either form part of patient education session or a separate session held at the local library.  
• Reception desk is very high which causes accessibility issues for wheelchair users or vertically challenged visitors. The reception redesign will form part of the landlord request. 

Does BMC support the Armed Forces Covenant?  Have veterans been identified and, if so, how?

• Guidance circulated on Armed Forces practice accreditation and veteran friendly service.  Review of impact on staff, GP or centralised lead for the service, associated administration). Registration form updated to reflect and new codes added to the system.
• Veterans may be offered an a different pathway when accessing services. 
• Toolkit and guidance will be reviewed.  Update to provided at next PPG meeting. 

Timeframe of surgery receiving change in medication (from consultation) to action

• Letter is received via workflow (electronically) and coded. Average of 72 hours to turnaround (change the medication on the system). 
• Delay noted when receiving letter from hospital outpatient clinics to practice workflow.  
• Hospital stay/ED visits are sent to practice workflow at point of discharge. 
• Action: Explanation of process to be included in an education session. 

Auto renewals of prescriptions

• Paydens no longer auto-renew repeat medications. This is due to a new protocol initiated by Paydens. In future, paper repeat prescriptions will be forwarded to the surgery. Risk noted for housebound patients and inability to get a repeat prescription request (especially for those who do not use online ordering via the NHS app or BMC webpage).  

Car park

• Barrier for staff parking has been refused by the landlord.
• Gates will be locked going forward due to the antisocial behaviour of youths (drug dealing).

Patient Notes

• Paper medical records digitisation is delayed further due to packing issues.  Now moved to January 2023. 
• Note: paper records will be destroyed but patients can request to keep them (form). 

Date of Next Meeting

• 12th January 2023
• 9th March 2023