Meeting Minutes - 2nd August 2022

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Attended by 21 patients, Sherry Oriola and Sue Shepherd – Practice Manager

This was the largest ever Allerton PPG meeting.

1) We met Sherry the new Reception Supervisor who introduced herself and welcomed a positive and productive relationship with Allerton patients and their PPG. She agreed that some improvements were necessary in the reception area including improved lighting.

2) PPG members expressed concern that it was becoming very difficult to see regular doctors with whom some patients have formed a positive and trusted relationship over many years. It was also stated by some members that even if you phone the practice, you would be lucky to get a face-to-face appointment with a GP. Members also asked why they were being referred to pharmacists and other practitioners instead of a GP. 

3) Concern was expressed regarding the phone queuing system which some patients regarded us slow and inefficient.

4) Sue replied that a survey is being carried out by Dr Tom McLeod into the appointments system to find patient’s preferences. This will be sent out using the texting system and also available in hard copy. Questions in the survey will include patients views and preferences regarding face to face and E-consult. Most patients appear to prefer face to face appointment with GPs because they feel more focussed on the patients needs.

5) Sue said the practice is short of doctors and it is therefore difficult for patients to see the doctor of their choice. They are therefore trying to diversify the team by employing new staff in liaison with other GP practices (Primary Care Network). These include pharmacists, practice nurses, health care assistants and physiotherapists. There is also an ‘advanced nurse practitioner’ whose role is to support patients managing long term conditions and who also leads on screening and immunisation programmes.

6) Sue added that patients with serious chronic conditions would be able to see the same GP whenever possible.

7) The practice has 6000 patients.

8) The doctors currently employed at the practice are:

• Dr Leela Jayapal – Lead GP
• Dr Tom McLeod – Lead GP
• Dr Ruth Hallgarten
• Dr Yasmin Kathrada long term sessional GP

Three work in the morning and two in the afternoon.

9) Patient Comments

A) “We need more face-to-face appointments”.

B) When I have a health problem, I have no problem seeing the first available doctors. Its too much to expect to be seen by the same preferred doctor every time.

C) Half my family work in the NHS so I am aware of the pressures. But I requested an appointment with a female doctor and an appointment was made for me to see a male doctor, which was not appropriate or satisfactory. I should have been notified in advance that the practice had arranged for me to see a male locum doctor. 

D) A patient spoke about her teenage daughter who saw a GP at the practice regarding bruising, but the GPs did not appear to know the girls medical history and the consultation seemed inappropriate. There were also concerns in this case about self-medication and urgent action was needed to make sure that the young woman was safe and receiving the right care and support. The matter was referred to Sherry Oriola. 

E) A patient said that she had called the reception and asked for the Doctor on Duty - who should be able to speak to the patient within two hours in urgent situations. She was told that the Doctor on Duty was not in and referred back to another doctor who was not able to provide the necessary service. She described this as a waste of her time. 

F) Jeff mentioned that his 99 year old mother is a patient at the practice. He expressed concern that it was difficult to always get access to the doctors. He said we should accept that the triaging service helps with this problem. It involves consultations with other health care professionals who would have access to the full medical history. He said that the new system needs to be consistent and needs to be regularly reviewed to see if the services – including pharmacy – is effective.

G) Batya described the situation for a member of her family who has autism and needs to see the same doctor each time to ensure continuity of care and a trusting relationship.

H) Batya also referred to her own situation. She is in a wheelchair and it is difficult for her to see the receptionist face to face. She said that a mirror would be helpful so that staff can see patient sitting below the desk level.

Note: changes were made the following day to the reception area to allow direct eye contact between patients in wheelchairs and staff.

I) “The pharmacy system works really well and is very good.”

J) A patient who is a pensioner raised a concern that he has to pay £30 to have his toenails cut through Hoxton Health. Surprise was expressed that pensioners should have to pay for this service (see below). 

Note: patients get a free toenail cutting service if their GP surgery has purchased the service from Hoxton Health
Action: can this been done by staff at the Allerton Practice or can Allerton purchase the service?

10) Sue recommended that a formal complaint be made regarding the report that a patient had requested to see a female doctor, but was allocated a male doctor instead. A complaint should also be raised regarding the failure of the  Doctor on Duty to respond within two hours as required.

11) In relation to seeing the right doctor when a patient needs urgent care, Sue said that the sessional doctors (locums) would be better for urgent problems, whilst the permanent GPs would be better for patients with long term problems.

12) Regarding the use of pharmacist instead of GPs, Sue explained that there is a pharmacist attached to the practice who can do expert medication reviews, and there is the Minor Ailments services at local pharmacies. In some cases, the Minor Ailments services can provide free over the counter medications.

13) Purchase of New Equipment for the Surgery

i) Sue said that the following equipment had been bought using funds provided by the CCG:

• Blood Pressure Monitor
• Physiotherapy Couch
• Lights
• Ear wax removal machine

ii) In addition, a bid had been put into NHS England for major upgrading of the practice include more consulting and administration rooms on the first floor and a lift to take disabled patients to the first floor. Malcolm will chase up progress with the bid with Richard Bull from the CCG.

iii) We discussed that air-conditioner system which has been broken for several years, despite the onset of covid, which made the need for good air-conditioning even more vital. Sue said that NHS Property, who provide a maintenance service for the practice, had been asked to repair the air-conditioner. Update on this needed.

iv) Other requests for improvements included a clock for the waiting room.

14) Flu and Covid Vaccine

Sue reported that the flu and covid vaccines will be provided to all patients in designated groups. The surgery will be the vaccine site and practice staff will visit care homes to administer vaccines. Vaccines will be administered in September 2022.

15) Test Results for Patients

Malcolm reported that pathology specimens (blood, urine etc) sometimes go missing. When this happens patients may assume that the results are normal as they have not been contacted by the practice to discuss an abnormal result. Taking no action when the results is abnormal can cause harm to patients. The current system has no way of knowing that a result has gone missing unless the patient asks for the results, or the doctor proactively looks for the results. The responsibility lies with the doctor.

Sue said that it is not practical to release both positive and negative results to patients because this would entail too much work for the practice.

Action 1: discuss with Sue Shepherd why patients can’t routinely receive a copy of their blood test results – either positive or negative – at their request.

Action 2: Malcolm has raised this matter with the local branch of the Integrated Care Partnership and the Pathology Governance Committee

16) Blood Samples

Blood samples can be taken at either the Allerton Practice or John Scott Health Centre. Sue explained that if blood was to be taken at the JS, a form is printed out by the reception team and the patient then either phones or goes online to make an appointment:

17) Picture Board for Staff

It was agreed that a Board would be placed on the wall of the surgery waiting room showing the photos, names and job titles of every member of staff.

Currently the website does not show pictures of any staff members.

18) Computer Training to use the on-line consultation system

Noted that the computer for training has been in the practice waiting room for a long period of time but no action taken to train patients to use on-line consultations.

Action – Sue to report

19) Sue told the meeting that she will retire in 2024.

 

Toenail Cutting

Hoxton Health

If you are unable to cut your toenails for reasons of health or disability we can provide free toenail cutting if you are on pension credit, universal credit, or esa.  This service is funded by North East London CCG for:

• City and Hackney registered patients, over 65s, living alone, at risk of mobility issues or falls
• Over 55 and a carer of someone else

For people aged over 55 and a carer it costs £30 per appointment. They ask everyone to purchase their own footkit from them for £8.50 on their first visit.

Hoxton Health may refer patients to a private chiropodist. St L foot health state that they no longer provide a toenail cutting service.

For patients not on benefits a free service is only provided if the GP practice funds this service.

Toenail Cutting Clinics in GP surgeries

We run monthly clinics in:

• Fountayne Road Practice N16
• Nightingale Practice E5
• Neaman Practice EC1

 

Agenda - Patient Participation Group

August 2022

1) Face to face consultation – current situation
2) Improving telephone consultations
3) Patient feedback – service improvements
4) Covid vaccination plan
5) Bloods and pathology samples
6) Who are the Allerton Staff? – information about GPs, nursing, health care, administration, reception staff, pharmacist, care-coordinator
7) Meeting Sherry new dep practice manager
8) Purchase of new equipment – ear syringe, physio couch, lights and plans for development of practice
9) Broken air conditioners
10) Patient computer training for on-line consultations
11) Dates for future meetings