Congratulations for such a great turnout. PM asked group to spread the word and invite other patients to the group.

Transcription

1 28 th August 2014 PRG Meeting In Attendance: Tracy Lindsay Practice Manager Sarah Kandziorka Receptionist Katie Richardson Health Care Assistant Hudson Lee Care Co-ordinator PRG MEMBERS: KL, KM, DH, MM, KM, FO AND AB Introductions PM introduced group members to the 3 new members attending the PRG meeting today. The group agreed for there names to be shared in the minutes. Congratulations for such a great turnout. PM asked group to spread the word and invite other patients to the group. PM opened the meeting with minutes from the previous PRG meeting in May; only 4 patients were in attendance. In the meeting the action plan which was produced in March for the survey carried out in 2013/2014 was reviewed. New recruit to the team at Lincoln Green PM asked the group if anyone had met the new ANP Vicky Eastwood? 2 members had seen Vicky on more than one occasion and the following comments Were given: I never understood why I or what I was taking all my tablets for, but Vicky took time to explain each one; I have even managed to reduce The amount of tablets I am taking, she is brilliant I never used to go to the doctors I was fed up of seeing a different doctor All the time until 2 months ago when I booked my first appointment with Vicky, she was thorough and had a good understanding of my problem Without me having to repeat everything over and over again. I have Struggled with depression for a long time, I am now taking medication Which enables me to have a relatively normal life, and I am now actively Seeking work, something I never thought I would be able to do again. I meet with Vicky once every 2 months now and hope to eventually start reducing my medication. PM informed group the action was to recruit regular clinicians whether a salaried or regular locum. The practice now also have regular female locum Dr Sara who has now worked for the practice for 6 months plus.

2 Practice to have recruitment drive to recruit salaried female GP Weekend opening Action timescale- 3 months The Practice are awaiting feedback from the CCG on whether we will be supported for weekend opening. The practice to consider whether extended hours currently carried out on a Tuesday and Wednesday could be done on a Saturday morning. PM informed group this would be proposed to ANP or GP. Following on from the meeting both VE and AC agreed they would not Be able to do Saturday mornings or Sundays. PM to enquire whether it would Be viable to employ a locum on these days replacing a session through the Week. Action timescale 1 month Refurbishment of building Group members were appalled at how long the refurbishment work took and the impact it had on service users accessing the building. PM informed group a meeting had been had with Lillian Dalton, estates manager, apologies were offered, communication was a big problem throughout the refurbishment which made it difficult for the practice to inform patients in a timely manner of works been carried out. It was agreed that a public consultation should be arranged prior to any other building works being carried out at the health centre. PM to inform estates of proposal. Patient Information Displays PM informed group it had been agreed am a recent buildings meeting last month that the proposal is to have glass display cabinets which can be used to display patient educational materials, practice campaigns and displays. Time scale when this should happen is not yet known, PM to enquire. Patient Feedback The Accolade of complaints received in practice was reviewed by clinicians and admin staff at the practice Team meeting in July. A total of 6 complaints have been received since January of the complaints were with regards to patient care, 3 complaints received about prescriptions and 1 complaint against reception staff. The practice is satisfied that all complaints were received and acknowledged in a timely manner according to practice policy. PM informed the group a copy of the practice complaints, compliments and concerns policy is available to all patients on request or in the waiting area. Actions taking following the complaint review were as follows. Patients prefer to see same regular GP, therefore the practice now only employs self employed GP s to cover pre planned leave, locum agencies are now only used in emergencies. At present the practice currently has 3 regular self employed GP s in place whilst the recruitment of a 2 nd salaried GP is still under way. A full time ANP

3 Ms Vicky Eastwood commenced in February this year, Vicky has acquired a majority of patients who regularly visited Dr Cohen, this has alleviated the pressure a little for Dr Cohen and freed up more appointments to see him too. Patients have complained re prescriptions not been ready, the practice have implemented the strict rule of prescription requests now only taken in person, by post, by fax or in the prescription box in the practice, no telephone requests are taken unless the patient is housebound. The practice can then have a paper trail of all requests made other than verbal; also patient safety is no longer compromised. A complaint made against reception staff with regards to attitude and communication. This was addressed with admin staff; PM is currently investigating this complaint. Postcards Excellent feedback on postcards, good service and good care all round. Several patients left telephone numbers, these patients were contacted, and the response was overwhelming. Patients have seen a definite improvement of our service and continue to support us to develop our practice to suit the future and present needs of our patients. Admin and Clinical team to encourage patients to fill out the cards, feedback is important. Virtual Network Group Members offered possible solutions to a common problem of how to attract younger members to their group. Suggestions included the developing of an on-line questionnaire. In response to a query about how a viable group can be established Helen Butters said that she can offer tips on how to recruit, Pm to contact Helen for support on recruiting more patients and creating our Virtual Network Group. University of Leeds On-line learning resource for patient and public involvement Dr Eileen McDonach, Research Fellow Academic Unit of Psychiatry and Behavioural Sciences at Leeds Institute of Health Sciences is able to offer members information about a Gateway for Patient and Public Involvement Learning (GPPIL) project and has invited members to take part in a focus group to discuss ideas about how to develop the resource. Contact details are to be forwarded once received from LSE CCG.

4 Date: 13 th January :20 PRG Meeting In Attendance: Tracy Lindsay Practice Manager, Melissa Canavan Practice Nurse PRG MEMBERS: AB, LB, PH, KH,SH,YH Existing Members: KL,JL,JO,FO,WL,PA,KM, Introductions PM introduced group members with a round table introduction Congratulations for such a great turnout. PM asked group to spread the word and invite other patients to the group. PM offered apologies to group re last PRG meeting in October 2014 this was due to room allocation and lack off communication off actual date. Suggestions were welcomed from the group on ways off communicating further PRG dates to encourage a wider audience from the local community. The group offered the following suggestions:- Clearer notices in the waiting area although there are 2 notices up in the waiting area has observed by the PM on leaving the meeting, the posters are not clearly visible nor eye catching. Leaflet drops Newsletters Word of mouth Encouragement from clinicians, i.e., GP and PNs Slip on repeat prescriptions Attractive advertising, i.e. the posters etc need to sound exciting and liberating, make pts want to join Directory off information folder made available for patients in the waiting area, it was noted by the group, if other patients see patients looking at the folder they will be tempted to look too. The discussion on practice advertising and education of patients was a very productive topic. Patients discussed historically medical conditions were managed with the help of family and friends, PN agreed and said there is a loss of community spirit and people simply just don t talk anymore. Patients discussed a case which involved there granddaughter, whom had diabetes diagnosed several years ago. The first thing the patient did to support her granddaughter was find out what the condition was and what it meant, they did this a family. The family were able to make informed choices

5 on what foods and lifestyle advice they could offer to help. Patient was very satisfied because off this her granddaughter leads a very healthy active life! Melissa informed the group off previous workshops which were held in The workshop was designed to educate patients on there Diabetes. Patients took from the workshops valuable educational information on there condition, evaluations on the day gave us the answers we needed! A majority off patients simply do not understand there Long Term Condition (LTC) Diabetes. Working with this feedback helped the surgery to understand that patients need to understand the implications and the impact there lifestyles are having on there LTC. Shocking patient into reality seemed to be the answer. The practice however are continuously responsible to educate the patients as deemed clinically appropriate on how to manage there condition with the support off there GP surgery. The group were made aware off additional services the practice offer above and beyond normal services, this information is also available on the practice website or NHS choices which is regularly updated by Melissa. The following services offered to patients are as follows: Health Trainer includes lifestyle advice, weight management, access to local gyms and swimming baths at reduced rate or for Free, 45 min one to one appointments. Contraception drop in clinic Available Thursdays Citizens Advice Beaureu Tuesdays only appts are to be booked via the CAB office LTC Workshops held monthly dates TBA using advertising methods suggested at beginning of meeting. It was discussed that other services were being designed but we are planning to design new services with the support off the PRG or even better would be for the PRG to design the service to suit there needs with the support off the practice. The group suggested following on from a discussion on access and demand, additional service the practice could consider and promote is a full day session for sick note reviews. Sick note reviews tend to take up 20% off calls on a daily basis. Patients whom require a sick note can then effectively plan there appts. To discuss further with clinical team. 20 min appt for assessment and education on support available to encourage patients back into work. PM congratulated the group on such a productive idea; this would certainly be worth developing! PM to discuss pros and cons with the clinical team and come back to the group. The group discussed plans the practice have with regards to employing a pharmacist to do prescribing medication reviews, the practice are not quite clear on this so no information to offer on this at present, the group agree this could also be a good idea. Barriers preventing us from offering other services and increasing our capacity is simply down to room space and availability. The group were informed that at present the practice are struggling with room space and availability, this issue is currently being addressed with The Practice Group going forward. Likely hood is we could obtain additional space within the building but this would come at a large cost, this may possibly not be affordable. The Group were then informed on recent reductions in payments made to GP practices per patient. The group were informed that a

6 massive reduction of upto 35 per patient will be lost over the next 4 years. (The PRG group did not offer any discussion on this although the meeting at this stage was becoming rather rushed due to time restrictions on the meeting.) To be discussed further at next meeting, this can then lead the discussion on ideas of what services could be offered within our community that the practice could benefit from? New Recruits to the team at Lincoln Green Dr Sara Khoshneviszadeh - Commenced employment on a part time basis as a salaried GP. Dr Sara currently works Tuesdays and Wednesdays, going forward Dr Sara will eventually only be working with us on Wednesday. Hudson Lee Care Co/Coordinator also covering HCA duties Commenced employment in August 2014, Hudson was employed too manage what the practice have identified has at risk/vulnerable patients. The Group were informed what we call an at risk or vulnerable patient and how they were identified. The patients were identified using a clinical tool designed by our local commissioning group LSE CCG. The tool is designed to identify patients by calculating a risk score based on patient access. Patient access is defined has patients being seen by a GP, practice nurse, community nurse, secondary care hospital appt etc A+ E attendances, OOH services etc. Also the risk score is calculated based on the patients current Health. The risk scores were calculated and a list of identified patients who were identified as high risk was produced for the practice. The practice also has increased this list from 2% upto 3% patients continue to be identified and put on the list. The aim is to then offer the patients the following advice and support: Inform patient off named accountable GP Book patient in for a care plan using the care plan template on the clinical system, the care plan takes on average 30 minutes depending on complexity off the patients. Patient s clinical needs, independent daily living assessments and preferred place off care discussions and reviews by the clinician. Patients are then contacted by the care coordinator within 3 months off initial care plan; social needs are identified and coordinated accordingly. Patients are regularly reviewed according to needs and high risk. Patients are also given same day access, this gives patients the option to access a clinician on the day when required, and this aim is to prevent unnecessary hospital admissions. Patients have the right to see or speak to a clinician on the day. It was identified during the meeting that 2 patients had experience of the care plans, one was the patient and the second was a patient carer whom was aware there parent had a care plan in place. It was identified that same day access was attempted for a patient on a care plan; group was informed this patient was not able to gain access on the day. It was also identified that on this occasion it may have been because patient attempted access and was told nothing available, no attempt would have been made by the patient to contest this. (Not certain whether pt was actually assessed on the day PM to clarify) PM to address this issue with admin staff, all patients should be retrieved and checked for updates on records i.e. At risk patients, palliative patients,

7 safeguarding patients the list can be exhaustive. Reception staff must had the decision to the on call clinician when patients are on the at risk register contact the surgery. Weekend opening The group suggested at previous meetings weekend opening, we now offer weekend access. The group were informed and asked if they were aware of the new extended hours available on Saturdays? None of the PRG members were aware, PM informed the group this commenced on the 16 th December 2014 and to date 2 sessions on a Saturday had been operated, the group were informed the phone lines are also open between the hours off This service will continue until further notice depending on demand for the additional access, the group were informed the last session on the 3 rd January was not busy has expected although it was busier than the first session in December. These details are not yet available on the practice website but will be made available by Friday 16 th Jan at the latest. Group members enquired whether a payment was received for this additional access. The additional access is funded although does not cover all the costs of extra staff, the practice were keen to offer the additional access has patients requested this according to the last survey carried out in Patient Feedback Friends and Family Test, no time in meeting to discuss, to discuss at next meeting in February. Postcards PM asked the group if they had noticed or been offered a feedback postcard to fill out when visiting the practice, disappointingly no one at the meeting had, although it was noted that they had noticed things around the waiting area which may resemble a postcard but never actually had one. PM to communicate with admin team to emphasise importance off handing these out also clinicians to encourage patients to fill in the the FFT feedback and postcards. Virtual Network Group Bulk text messages were sent out to patients advising of online services available; on the text message the practice put the practice address lg.reception@nhs.net Patients were advised to the admin team for further information. On receiving the s back to the practice we are able to collate patients addresses. The practice envisages a VRG covering at least 50% of the practice population, considering the fact nearly every household has a valid address. This will be an effective way of communicating our service to patients and receiving views and opinions back to the surgery.

8 Other items Patient SH offered support from her students at the university in promoting our PRG, this offer was greatly and appreciatively received and we look forward to hearing from SH in due course. Date and time of next meeting, it was discussed within the group that a variation of days and times may be more appropriate for some patients. I have considered maybe a Wednesday afternoon late or early? Please come back to me with some suggestions. I hope you agree with me and feel today was very productive, I am confident going forward in 2015 together we can design a service to suit. Times are changing and becoming increasingly demanding therefore with the support of our patients we can manage our service using the 5 core values below effectively safely well led innovative listens P.s see if anybody can remember what the 5 core values above represent was it a. CQC b. CCG c. PCT The next meeting will cover the answer to the above in more detail; I look forward to seeing you all at the next meeting hopefully with even more participants.

9 18 th February 2015 PRG Meeting In Attendance: Tracy Lindsay Practice Manager Sarah Kandziorka Receptionist PRG MEMBERS: KL, AB, LB, KM, Introductions PM introduced group members attending the PRG meeting today. The group agreed for there names to be shared in the minutes. Patient Survey Results, actions and results for Most recent Patient survey results produced by GP patient survey data on the 8 th January % of patients were not able to access their preferred choice of GP via phone or face to face. Practice currently monitoring rota system closely, adjustments will be made where a need is identified. PM encouraged group to consider the results of the survey, Seeing their preferred choice of gp face to face or telephone contact. What could the practice do to improve this result? PM informed the result was historic data from 2014, the result going forward in 2015 may improve considering ANP and GP commenced employment fairly recently, may have not impacted at the time of survey distribution 58% usually wait 15 minutes or less after their appointment time to be seen. 56% feel they wait too long to be seen after their appointment time to be seen. The practice implemented in 2014, 15 minute appointments to reduce waiting times with all clinicians. Admin staff received training and education to identify effectively the need for longer appointments with specific patients, the patient records have reminders on record indicating need for longer times, interpreter requirement, at risk, complex multiple LTC etc Admin staff now book double appts, clinicians stress the importance in consultations were medically possible, one problem one appointment. PM informed group works well although some days we do have patients whom do need the extra time which hasn t been planned. Practice audit appropriate use and booking of appointments on a weekly/monthly basis. On-going audits and monitoring Action on-going review 3 months

10 Recruitment of ANP, salaried GP impact - Practice have implemented new rota for all 3 clinicians which is designed to free up on the day access and provide ample pre bookable appointments. Aim to ensure pts. are able to see preferred choice of GP/ANP in a timely manner, pts. are now actively booking with all 3 clinicians, the demand on Dr Cohen has reduced over time. The practice is now open every other Saturday, dates available at reception. The practice is open there are 16 appointments available on a Saturday. The practice is considering opening Saturdays permanently. Group keen for this to happen. Action Review 1 month Recruitment of support/care worker Hudson Lee - Hudson supports the clinicians and the practice to help improve access whilst managing with the support of his team the identified complex patients. Patients are signposted to Hudson by clinicians for various reasons such as Lifestyle advice/improvement/reviews Education and literature on long term conditions and living with a condition Information on local events/resources/activities Carers identification, assessments Living assessments/appropriate accommodation etc... Independent daily living assessments Welfare Reform education/information Referral to social services Appointment management Motivational interviewing and much much more PM informed the group practice has registered for the general practice improvement programme. The programme will have a massive impact on the running and management of the surgery. PM to provide more information at next PRG meeting. Year of care 1 st clinic held on Tuesday 17 th Feb 2015 for year of care patients, was a success for the first clinic, practice will review at next practice meeting and update group at next PRG meeting. Patient Information Displays 2 display boards now shared and used by Shakespeare and Lincoln green.