PATIENT REFERENCE GROUP (PRG) MEETING MINUTES

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1 PATIENT REFERENCE GROUP (PRG) MEETING MINUTES Wednesday 30 th January 2013 Present Mary Askew. Laraine Bingham, Terence Coward, Brian Donoghue, Pamela Finn, Sean Hall, Andrew Hogg, Teresa Moss, Carol Palfrey, Philip Rawlings, Roy Seeman, Robin Simmonds, Michael Simms, Val Tompkins, Kathleen Warnes Guest Speaker Rebecca Champion, Engagement Officer North Norfolk CCG Staff Linda Horne: Lynsey Wayte: Helen High: Lynda Wilson: Practice Manager Assistant Practice Manager Medical Secretary (minutes) General Assistant (minutes) Apologies: William Burgess, Elisabeth Dewhurst Presentation from Rebecca Champion, Engagement Manager North Norfolk CCG (Clinical Commissioning Group): Linda welcomed Rebecca Champion who gave the group a very interesting PowerPoint presentation and details are attached to these minutes. Rebecca explained how the CCG will replace the existing Primary Care Trusts and how the CCG will become legal from Throughout the presentation the group were able to ask questions and Rebecca was keen for any feedback from the group. With regards to the map displaying the GP practices and hospitals in the area, the group felt that the colours of the balloons should be changed to make it easier to differentiate between different services. Kelling Hospital was not labelled and the number of GP practices shown in North Walsham was incorrect. Outstanding action: Helen to forward these points to Rebecca Champion

2 - 2 - Presentation from Rebecca Champion, Engagement Manager North Norfolk CCG (contd): A discussion took place regarding how the 5 GPs were appointed to the Executive Team and Rebecca pointed out that 2 lay members also form part of the governing body. Rebecca also explained to the group that the 5 GPs represent all the GPs in North Norfolk and that they would be able to voice their opinions and concerns to the elected 5 members. Jackie Schneider is a registered nurse who is part of the governing body of the CCG and it was felt that it would be helpful to invite her to a future meeting to discuss her role within the CCG. Outstanding action: Linda to invite Jackie Schneider to a future meeting Miss Palfrey asked Rebecca if this was a national group and she advised that there are 5 CCG groups in Norfolk. Mrs Bingham had concerns about a voluntary organisation that she is involved with and a local physio service that has been withdrawn. She had contacted the chief executive of the CCG but had not received a response and was concerned that lines of communication from health users with ideas and suggestions are not getting through. Rebecca apologised and will investigate this matter but it was felt that the group needed to be clear about what routes to follow should they wish to raise an issue. If patients wish to contact the CCG, they can do this on their website: and clicking on the contact us tab. A discussion took place about the CCG and social services, mental health, palliative care and hospices. This issue of funding was also discussed and Rebecca explained that the CCG will not have more funding. The issue of services being put out to tender was discussed and although initially there were some reservations, Rebecca explained that research has been done into this and as long as patients were happy with the level of service given, in some cases this worked very well. For example some audiological services are now available on the high street and patients can access these services easier rather than having to travel to the Norfolk & Norwich Hospital. Linda explained that these types of services do have to meet very high standards of criteria before they can be authorised. A discussion took place regarding voluntary workers and how they may come to be more relied upon in the future.

3 - 3 - Review of Previous Minutes and Matters Arising: The previous minutes were agreed. Linda advised that the next issue of the newsletter is coming out on Mr Hogg was thanked for his article. A member of the PRG was asked to volunteer to write an article for the next newsletter and Mrs Finn has kindly agreed to do this. Partnership Update: Linda advised the group that following a recent doctors meeting, the doctors are looking to appoint a new partner, to work 3 days a week. We have already had good interest in this position and hope to be holding interviews in February, although they may not be able to start for some time as some doctors may have to give up to 6 months notice if they are already a partner elsewhere. Linda explained that we cannot specify that we would like a male doctor. Dr Maggio is a male locum doctor who will be working on a temporary basis with us and will work on a Friday. Mrs Warnes asked how home visits are triaged and Linda explained that the doctors discuss these each morning and the most appropriate clinician will attend. CQC (Care & Quality Commission) Update: Linda confirmed that we have been registered and accepted by the CQC, so that we can still continue to practice from However there is some quite extensive building work that will need to be carried out to ensure we meet the necessary requirements, including all of the clinical rooms. This work will start fairly soon and be completed by Linda explained that we have also just appointed an apprentice to help with the extra work involved with the CQC process. Patient Participation Action Plan Update: Linda updated the group on the action plan that had been made with reference to the last patient survey and the 4 key areas that the PRG felt should be focused on. These were Patients arriving late for appointments Access and review the waiting room and entrance area to the medical centre Trial of a GP telephone triage system for patients Staff training in customer care

4 - 4- Patient Participation Action Plan Update (contd): Patients arriving late for appointments The phone greeting had been changed to advise patients to allow time to park and check in for their appointment. Additionally we have just started writing to patients who do not attend (DNA) appointments advising them of the services we provide that may help them to remember in future. These services are the SMS message system, online booking and cancelling of appointments and telephone consultations. A copy of this letter is attached to the minutes. PRG COMMENTS: Mrs Finn advised that she had registered with the SMS text reminder service but had not been receiving a reminder the day before her appointment. Lynsey will investigate this as she has also received other feedback that the service is not working as it should. Mr Simms expressed his concern about missed appointments and how these are funded. Linda explained that this comes from the practice s funding and a discussion then took place about whether patients should be charged for missing appointments. Linda advised that the text advising service is free as it is provided by the NHS service. Outstanding action: Lynsey to investigate the text appointment reminder service is working correctly Access and review the waiting room and entrance area to the medical centre: Following our assessment from the CQC some of the areas we had already highlighted for improvement have been confirmed as requiring work. As previously stated some of the forthcoming building work will address these issues and we are currently in discussions with the architect. The reception desk will be moderated to accommodate dealing with patients in a wheelchair and the carpet in the waiting room and entrance area is likely to be replaced. We have installed a television screen in the waiting room displaying information. This has helped to replace the posters that were in the waiting room and makes things look much tidier.

5 - 5 - Patient Participation Action Plan Update (contd): Access and review the waiting room and entrance area to the medical centre (contd): PRG COMMENTS: The group were pleased with the screen but had concerns about the size of some fonts and the colour combinations used. In general patients had made favourable comments to the reception staff about the display. Outstanding action: Lynsey to investigate if the print on screen can be made larger, darker and to review the use of coloured print on coloured backgrounds. Trial of a GP telephone triage system for patients: The doctors had discussed telephone triage and had decided that telephone consultations would be useful especially for discussing patient results. The telephone consultations had received positive feedback from both the patients and the doctors. The duty doctor also had 2 emergency telephone appointments and these where useful for conditions such as diarrhoea and vomiting but not so useful for triaging more complex cases. Linda advised the group that we have received very positive feedback from our standard telephone consultation appointments with a doctor. PRG COMMENTS: Mr Donoghue asked about the new 111 service which has replaced NHS Direct. Linda advised that any general health questions can be answered by this service and that if patients contact the surgery out of hours they will be redirected to the 111 service. This is a national service which is being rolled out across the country. Staff training in customer care: Linda advised the group that the dispensing, administration and reception staff have received training in customer care and we have met all the necessary targets required. This was either face to face training or by completing NVQ Level 2 (or 3) in customer service.

6 - 6 - Patient Survey and New Action Plan: Linda gave a PowerPoint presentation to the group giving full details of the patient survey and a copy is attached to the minutes. Each of the demographics and results were carefully reviewed and discussed by the group. The group were pleased with the results in all areas and that the survey had been completed by a good representation of the patient demography. The full report and action plan will be published on the practice website by the end of March. New Action Plan: Linda asked the group what they felt our action points should be for this year or whether we should continue to enhance the previously raised points. A discussion then took place regarding the CQC and the extra work that this would involve and it was felt that we should not be too ambitious in taking on anything that we could not complete to a high standard. After some discussion it was felt that the following areas should be focused on: Patients failing to attend surgery appointments: how this can be reduced Promoting the use of patient addresses: to optimise patient contact and help reduce postage costs Promoting the use of patient mobile telephone numbers: in order that patients can receive text message appointment confirmations Promote the use of online services for patients: which includes booking appointments Any Other Business: 1. A discussion took place regarding patients phoning into the surgery with serious conditions that require prompt medical attention. Linda explained that when patients telephone to make an emergency appointment with a doctor that the receptionists are trained to be aware of symptoms that may be serious, such as chest pain. Lynsey advised that there are certain medical conditions that the reception staff follow a template for and that this has worked very well in ensuring that patients receive the correct and prompt treatment. The practice will call 999 on behalf of the patient if necessary.

7 - 7 - Any Other Business (contd): 2. Mr Coward asked if the surgery follow up with the patient to check that an ambulance has arrived at their home. Linda explained that unfortunately we do not have the resources to follow up everything and Lynsey advised that once a call has been logged with the ambulance service, they do contact us and advise us if they are not able to attend within the agreed timescale. 3. A discussion took place regarding what constitutes a carer and carers in general. Patients using online services can complete a questionnaire to notify us that they are a carer. We can then make them aware of any relevant services that may be of benefit, including an appointment with the carer support worker if required. This received some very positive feedback from the group who had found it very helpful. At our recent staff training day, all the staff were updated regarding the carers service and help that may be available to carers. 4. A discussion took place regarding the next patient survey and it was felt that this should include questions regarding the online prescription service. Outstanding action: Linda to ensure that next patient survey includes questions about online prescription service 5. It was suggested that when patients register with us or update us with their address that there should be an option for them to advise if they would like to receive a copy of the newsletter by . Outstanding action: Lynsey to add a tick box to patient registration form or when patient provides address to ask if patient would like to receive a copy of newsletter by 6. Mr Hogg asked how the newsletter is distributed and was advised that it is available to collect from the surgery, is displayed on the website and can also be ed to patients who request it. 7. Mr Coward had concerns as to whether the practice meets all the necessary health and safety requirements and Linda confirmed that we do. A discussion took place about the fire risk upstairs as there is only one exit downstairs. Mr Hogg has been involved with the fire industry for many years and also shared his concerns. Linda advised that although the practice does meet the required regulations and professional advice had been sought on more than one occasion, the groups comments were welcomed and Linda and Lynsey will investigate this further. Outstanding action: Linda and Lynsey to investigate fire safety Date of Next Meeting: The next meeting will be held on Tuesday 30th April at 10.30am (please see attached update)

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