PPG Minutes - January 2023

1) Attendance:

James Boye, Batia Beverley-Willes , Andrew McQueen, Bernhard Ehreich, Shkar, Malcolm Alexander
Staff: Sherry Oriola
Speaker: Dr Tom McLeod
Apologies: Sue Shepherd, Jeff Silkin,

2) Action Points from meeting held on December 5, 2022:

a) Survey of Allerton patients concerning face to face appointments.

First survey completed and actions taken to improve the number of face-to-face appointments. Second Face to Face survey went out to patients on: 11.01.23. Dr Tom to report back to PPG.

b) Using community pharmacies: Patients are being encouraged to seek advice from pharmacies for minor ailments. More information/poster to be put up in waiting room on the Community Pharmacy Service.

Action: Sue Shepherd.

c) Chronic Illness – agreed it is in patients’ and the clinical team’s best interests for patients with severe chronic health problems to see with the same doctor whenever possible. This approach reduces the time it takes for the patient to explain the problem at each appointment and makes for a better experience for all.

Action: Sue Shepherd to provide a definition of severe chronic illness

d) Duty Doctors are available in mornings and afternoons 8am to 6.30pm to provide urgent care. Details of the Duty Doctor service are on notice boards in reception and on the website. Duty Doctor will ring patients back within 2 hours and provide either advice by phone, face to face, home visit or referral.

e) Agreed to invite staff to attend each PPG meeting to discuss their roles in Practice. Dr Tom to talk about face-to-face appointments in January.

f) Phone system - can phone system be accessible in other languages? Not possible, but LanguageLine is available and is used by the team.

g) Toenail cutting service –could a free toenail cutting service be run at the surgery at no cost to patients? A request has been put into the NHS for the establishment and funding of toenail cutting services across City and Hackney. Action 1: Details of the Hoxton Health toenail cutting service, (costs £15plus), will be placed in the Allerton waiting room.

Action 2: Malcolm to raise funding issue with NHS leads for Hackney and suggest local funding for this service.

h) Upgrade to surgery – A grant application for improvements to the surgery has been submitted and Sue will report on outcome at the next meeting.

i) Vaccination Plan – the flu vaccination service is active in the surgery now.

j) Covid vaccination: Patient’s eligible for Covid vaccinations can receive their vaccine from St Leonard’s or a local pharmacy by calling 119. Allerton has proactively vaccinated vulnerable people in care homes locally.

k) Access to Medical Records – records are available directly from the Practice or by using the NHS App. Posters in the waiting room describe how to access medical records online.

l) Blood test results - Need to ensure that when blood and other samples are taken for pathology tests that the results get back to the surgery, as on some occasions samples go missing, which can result in delayed diagnosis.

Actions: Sue to explain steps to be taken.

m) Picture Board of Staff – This has been put up in the waiting room. New staff will be added when appointed

n) Computer for patient use in waiting room – The computer is now ready to use. Training sessions for patients to be organised by Sue.

o) Timing of Meetings – Make sure that the timing of meetings is appropriate to the greatest number of patients, and if necessary have alternate meetings at different times.

3) Dr Tom McLeod addressed the PPG Meeting

Dr Tom said that there is a national push from NHSE to improve access to primary care and described his experience of providing care by phone instead of face to face, which he said was sometimes like working in a call centre.

He acknowledged that some patients are happy with,and some prefer telephone consultations. He said that the Allerton plan is to go back to seeing 50 % of patients face to face each day and this will require a focus on the appointment’s system in Allerton and will require better engagement with patients.

Dr McLeod said that the first survey of patients showed that 70% of patients wanted more face to face appointments and 30% were happy with telephone appointments. (How many responses?). As a result the number of face to face appointments was increased from 25 % to 50 % for each GP.

The templates used by reception staff to designate patients to Duty doctors and non-duty doctors have been updated, and patients under 5yrs old are being prioritised, as are appointments allocated by 111.
In the second survey 50% of patients had not noticed any changes to services despite the increase in face to face appointments.

25% of patients who responded said it was harder to get a face to face appointments and 25% said that face to face appointments are easier to get.

Other data provided by Dr McLeod suggested that:

1) It may easier now to see the same GP if the patient has a chronic condition. That is consistent with provision of better continuity of care.
2) 75% of patients are seen within 7 working days requesting and appointment with a doctor.
3) 33% of patients found it more difficult to book a GP appt.
4) Patients need more information about how to book an appropriate appointment, e.g. by using info graphs (visual representation of information or data).
5) More face-to-face appointments available, but some patients found them more difficult to book.
6) The Practice needs more doctors – there are currently 3 salaried GPs and another GP will be appointed shortly.

Recommendation to the Practice:

i) That the duty doctor (locums) should see patients face-to- face because these patients have more urgent needs and diagnosis will be enhanced through face-to-face appointments (calls for the duty doctor should be made at 8am or 2pm.

ii) Information should be made available about the days and times that each doctor works so that patients can choose the doctor of their choice when that doctor is available, e.g. by seeing monthly rotas.

iii) If some patients can book GP appointments through the Website or Patient Access, does this give some patients priority over other patients. Could this be harmful to some patients because of delays.

Question: Why can’t patients phone the surgery at 8am and book an appointment for other days? 8am appts are focussed on urgent appointments.

Recommendation: Enable patients to book appointments several days ahead if they call in at 8am and they will not potentially suffer harm due to delayed diagnosis.

Question E-Consult: When using e-consult why are patients often advised to call 999.Note (e-consult doctors are not from Allerton). Is the system too risk averse?

4) Information about Clinical Staff Attached to the Practice

Recommendation: Give patients more information about the role of PCN clinical staff, e.g. the role of the pharmacist in carrying out medication reviews. Information is on website.

5) Other Issues Raised at the Meeting:

Telephone lines are too busy.
Need better communication with patients
After hours hub: appointments to see a doctor are available after hours at Statham Grove on Wednesday, Thursday and Friday.
Need to provide a means of weighing patient who use wheelchairs
One of the clocks was not working

6) Items to be carried over to the next meeting:

PPG priorities for practice improvement

Funding bids of practice improvement

Staff training re patient privacy

Staff training re religion and culture

Publicising the work of the PPG

7) Dates of future meetings:

21st March at 3pm and 9th May at 6pm

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