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Patient Participation Group

A Patient Participation Group was formed by the practice in 2011; and regular meetings are held where all members of the group are invited into the practice. The meetings give the practice feedback and ideas from the perspective of patients. The minutes from the meetings are available to view on the website. Should you wish to pass on any ideas or suggestions directly to the members of our Patient Participation Group please contact our receptionists for email contact details. The member will then bring the issue to the next meeting for discussion.

If you have time to attend 4 meetings a year (lasting approximately 1 hour) would you consider becoming a member of our Patient Participation Group?

This group is formed to discuss the services offered by the practice and to decide upon an area each year for change/improvement. An action plan is then formed to carry out the actions agreed upon. Should this appeal to you please leave your contact details and email address with reception.

Should you wish to pass on any ideas or suggestions directly to the members of our Patient Participation Group please use the email contacts shown in the document below. The member will then bring the issue to the next meeting for discussion

Please share your ideas and suggestions with PPG Members- Email Contact Details

Carterknowle and Dore Medical Practice
Patient Participation Group Meeting
Monday 11th February 2019 at 12 noon


Dr Kenny introduced himself and explained that there had been a change of roles within the partnership and that he would be taking over the Patient Participation Group for the foreseeable future. He has been a partner since 2012 having worked in 2 previous surgeries; one in Sheffield and one in Rotherham. He is also the Trainer/Educational Lead for the practice.

The members introduced themselves. PM – this is 3rd meeting he has attended. GB – this is his 2nd meeting. PG – has attended several meetings. ID – has been a member of 4 years. MH – has attended several meetings.

  • GB asked what is expected of being a member of the PPG. Dr Kenny explained it is to share ideas and a link between patients and the practice.

Matters Arising

  • PG said that he is still unable to access the Coalition for Collaborative Care website.  Dr Kenny brought the relevant website up on his computer. PG is to check his security settings on his own computer. Dr Kenny advised that PG could attend the surgery and use one of the practice computers if he is still having problems accessing the website.
  • PM queried where the minutes of the PPG meetings is on our website as he had been unable to find them.  Dr Kenny demonstrated where to find them: > Have your say > Patient Participation Group

  • PM also mentioned about the noticeboards at both sites and the possibility of having one for the PPG. Also introducing borders and coloured card/arrows and making them less cluttered.

Nicola explained that the noticeboards are changed on a regular basis by our Healthcare Assistants to keep them current. There is a lot of information to go onto the boards as there are lots of subjects that need covering.

Patient Survey

Nicola explained the patient survey is now live on the practice website and available in the waiting room at both sites. Over 10,000 text messages were sent to patients inviting them to complete the survey. We have already had more than 350 responses which is more than the total responses from the 2018 survey.

  • PG asked what we hoped to get from the patient survey. Dr Kenny explained that the survey is used to plan for the future and it is important for patients to be able to give the practice feedback.
  • PM asked if we could put PPG information on the screens in the waiting rooms. Dr Kenny agreed we could look at this. He also asked about Care Navigation Software for patients to be able to complete on line. Dr Kenny explained about a trial that Carterknowle did 2 years ago where patients completed a care navigation questionnaire which was then printed by the surgery. Although it was useful it was not ideal for patients with special needs.


Online Access

Nicola informed the group that we are trying to build up the numbers of patients with online access.  And that it is not just for requesting repeat prescriptions.  It can be used for making appointments and eventually access to patients own medical records.

  • PG asked when patients would be able to have access to their notes.  Dr Kenny explained that it is definitely on the cards but is a very complex area. One problem is patients may see upsetting information about themselves they may have forgotten about. The practice does not want to create more anxiety for their patients.

We are getting requests for on line access from patients. The subject is on the practice meeting every month.  There is no doubt that online access to records will come.

Dr Kenny explained that a patient recently had looked at their blood results. Two components of the results were slightly different but were of no concern and were in the normal limit. However, seeing the variance in the result did cause the patient anxiety.

  • PG asked about the possibility of being able to ask a question online. Dr Kenny explained that it would be difficult to manage the workload - we could get hundreds of questions.


The practice always looks at rolling out new systems gradually once they are tried and tested and we have the correct protocols in place.

  • There was a suggestion of having a FAQs page on the practice website. Dr Kenny advised this would be put on the practice meeting agenda.
  • PM asked about how appointments are released at the practice. Dr Kenny advised that the system we use is the universal way practices operate appointment systems to aid workflow.  It has previously been found that if patients book too far ahead practices tend to get more Did Not Attends (DNAs) – although Carterknowle do not get too many DNAs.  If we explain the appointment system in detail it could be open to abuse by some patients. However, we acknowledge there should be a degree of transparency regarding appointments. This could be covered on the monthly Roundup produced by the PPG. Dr Kenny advised that this could be put onto the next practice meeting. We need to look at patient friendly and safe procedures that do not compromise doctors’ time.

The practice contacts patients who do not attend appointments and has a protocol in place for regular patients who do not attend.

Dr Kenny explained that as members are probably aware there is a capacity issue with the lack of trained GPs in the country. Carterknowle is involved in training Physician Associates who have a biomedical degree and then do 2 years of shadowing training in general practice under supervision.

  • GB asked if there was a Nurse Practitioner at Dore Surgery. Dr Kenny said we originally had two nurse practitioners so we did have one at Dore but when one left we were unable to recruit a new one and the practice felt there was a greater need at Carterknowle for the nurse practitioner.


PPG Newsletter

  • ID explained that she has taken over the newsletter. This is a monthly “Roundup” and covers one subject only. She feels that historically a newsletter was compiled but was not seen by many people. Two Roundups have been produced covering the upgrade to the premises and covering the patient survey. These are in the waiting rooms at both sites. Future topics will be: explaining how triaging works, preparing for a consultation, joining the patient participation group and out of hours access to medical care.
  • ID will continue producing the Roundup and email to Nicola on a monthly basis. ID stated that she will do this for approximately a year but would then like to hand it over to another member.
  • ID suggested that when the details of the next meeting are emailed out that the email requests that a reply is sent agreeing to continue being a member of the PPG.
  • ID asked about the future of joint consultations e.g. diabetes. This is planned for the future through The Quadrant Model.


Dr Kenny explained about neighbourhood working and that NHS England want practices to engage with this more in the future. Currently we are working with Sloan and Woodseats Medical Centres which gives a total of 50,000 patients.  Carterknowle is committed to this way of working already and will continue to do this.


Any Other Business

  • PG – flu clinics – PG asked if we could look at the time slots for flu vaccine clinics.  The word on the street is negative for this season’s flu clinics due to long patient queues. We used 1 hour time slots and there was a suggestion of using 10 to 15 minute time slots for future flu clinics. Nicola advised that this would be fed back to the management team.

Dr Kenny explained that we do the clinics on a Saturday so as not to interfere with other appointments for patients.

  • PG said he has previously volunteered his services to the trainees. Dr Kenny advised that this is more likely to be for the Early Years trainees and that we would pass on his name to Dr Rihal who oversees this at the practice.
  • PM said that he joined the PPG to help lonely elderly patients. He has set up a group and he wondered how he could advertise this.  Nicola advised that if the information could be sent to her she would ensure it is put on our practice website and she would also forward to our Healthcare Assistants and also to Joanna Glaves who works at Age Concern.
  • PM asked if the date of the next meeting can be sent out earlier than usual. Dr Kenny suggested that we could look into using Doodle Diary.

Nicola advised that the next meeting would be at the beginning of May.   


Next meeting –  the next meeting will be in May 2019


Carterknowle and Dore Medical Practice
Patient Participation Group Meeting
Monday 5th November 2018 at 2pm

The practice had received apologies as above ahead of the meeting.
Dr Hilton opened the meeting and thanked everyone for attending.

Matters Arising

The group went through the minutes of the last meeting and the following queries were raised:

  • Page 1 – PG mentioned that he had rung the surgery today and had tried for 45 minutes to get through. Dr Hilton explained that Monday mornings are very busy with telephone calls after the weekend which could explain the reason.
  • Page 2 – Agreed.
  • Page 3 – PG reported he had had problems getting on the website with regards to Coalition working which was in the minutes from July. Dr Hilton advised we would raise this with Dr Hart at Sloan Medical Centre who is leading on this initiative.
  • Page 4 – Agreed.

Patient Survey 

Dr Hilton explained about the problems of getting the patient survey out to patients due to Information Governance and General Data Protection Regulations and needing consent from patients. 

  • NC brought some example questions to the meeting for feedback from members. After discussion around some of the questions it was decided, due to time constraints, to email the example questions to members of the PPG and ask for feedback.
  • Also we need to look up the percentage of responses we had from last year’s questionnaire.
  • PM asked, what is the role of the members of the PPG? The practice sees members as a link between the practice and its patients.
  • AH explained that we have taken information from previous surveys and acted upon it. E.g. installation of a lift which has been mentioned in several patient questionnaire responses previously. This has now been installed whilst we have undertaken major works.
  • The PPG needs to be a positive thing rather than an arena for raising gripes. Some practices have very active patient groups whilst other practices are struggling to get members. Carterknowle seem to fall in the middle of these groups.
  • SH commented that he regularly tells people he is a member of our PPG and he wants to continue to engage with patients.
  • PM said that he joined the PPG to help lonely elderly people but he does not feel much has happened along these lines. He also fed back about the notice boards and the group discussed how to make these as eye catching and effective as possible.
  • There was a discussion about having a PPG noticeboard at each site. Dr Hilton agreed to look into this and suggest the PPG looked for volunteers to ensure they are kept current.

On Line Access 

Dr Hilton explained where the practice is with on line access and that we are looking at patients being able to access their own records and also about sending message regarding certain results. Dr Lees and Dr Rawlings are leading on this.
Dr Hilton explained the system of releasing appointments over in a staggered way to ensure there is always a spread of available appointments. He felt it was more important for patients to know how to access the available appointments rather than knowing the technical issues that sit behind their release. 
The practice is aspiring to increase on line access and that over the next 6 months patients will see some changes. 

  • ID suggested that one of the newsletters could be used to explain the appointment system to patients. She feels that text reminders for appointments are a good idea and texts for results are a good idea too.

Carterknowle Refurbishment

NC updated with regards to the refurbishment. Lift, decorating, noticeboards, electric doors, new seating and new reception desk.

  • All members agreed the surgery improvements had enhanced the building.

PPG Newsletter

  • ID said that she and NC and had had a good meeting to discuss a newsletter. ID had suggested that the newsletter would be kept to A5 size and cover one topic a month.
  • Suggested topics : Renovations, access and coalition, BMR, working with practices.
  • ID will email NC the contents of each newsletter at the beginning of the month so that the newsletter can be sent out and displayed by the middle of each month.
  • Suggestions for the Newsletter title include
    • Patient News
    • Patient Bulletin
    • Patient Roundup
    • Patient Newspage 

Any Other Business

Questions from PG

  • Flu Vaccinations – due to time constraints this will be put onto the next PPG meeting
  • How to contact a specific doctor – this has been covered in discussions today.
  • Texts re contacting the practice regarding test results – PG wonders if it is possible for text messages to be sent out nearer to the time when patients can ring into the surgery so they do not worry in the meantime. It was agreed we ensure messages are not worrying for patients.
  • SH asked if it would be possible for patients be informed at the time of the blood test that they may get a text.

Dr Hilton said that we have a practice meeting tomorrow and contacting patients with regards to text message results is on the agenda.

  • PM commented on the buttons for the electric doors and that they seem to be in the wrong place. NC explained that the door company have fitted them in the correct place. PM was positive about the fact we have done some notices to ensure patients are able to enter and exit the building easily.
  • ID thanked the practice for getting minutes of the last meeting and the agenda emailed out prior to the meeting today.

Next meeting – the next meeting will be in February 2019

Carterknowle and Dore Medical Practice
Patient Participation Group Meeting
Tuesday 31 July 2018 at 5pm

The practice had received apologies as above ahead of the meeting.
Dr Hilton opened the meeting and welcomed new members- GB

Matters Arising
The minutes were agreed from the previous meeting.

Patient Survey

Dr Hilton explained about the problems of getting the patient survey out to patients due to Information Governance and General Data Protection Regulations and needing to get consent from patients.
GB suggested that we obtain consent when new patient register with the practice. Dr Hilton advised that this was already in hand.

  • SC brought up that there is a problem getting through on the telephone at lunchtimes and there is no message advising the times of closure. Dr Hilton explained about lunchtimes at the practice as it is time for the receptionists to have a break and also to catch up with work in the practice.
    Sue asked why staff couldn’t have staggered lunches. Dr Hilton and NC explained that there have been recruitment issues with staff but that we were now almost fully staffed but that it takes time to train new staff in the practices procedures.

GB commented on the fact that there is now a message on the telephone system which tells people where they are in the queue. He thinks this is very positive move.

  • GB was unaware that there was a problem recruiting admin staff. Aware about GP recruitment issues. Dr Hilton explained about the difficulties of recruiting admin staff and GPs and that it is an ongoing issue in general practice partly due to the need to change and adapt in practices.
  • GB raised the issue of waiting for an appointment for 2 weeks and that if patients could wait 2 weeks surely they didn’t need to see a doctor. Dr Hilton explained the appointment system; we have on the day appointments, 3 day prebookable and further ahead bookable ones. There is an on call GP every day to deal with queries and home visit requests. All GPs work in the Sloan hub which provides evening and weekend appointments. ID said if she wants to see a specific doctor is happy to wait to see them.
  • Dr Hilton talked about modern general practice and continuity of care. Where possible it is better to keep to the same GP for the same problem but this is not always possible. A few years ago a patient would be seen about 2/3 times a year whereas now it is 5/6 times a year. So general practices have the same number of patients but the workload is heavier.

Refurbishment of Carterknowle Road

NC updated everyone on the refurbishment.

  • 6/8 weeks until the work is finished.
  • New seating for the waiting room to do
  • Repainting of the waiting room to do
  • Automatic front doors to do
  • Clinical Rooms not quite ready
  • Paint colour schemes are in line with the patient survey – blues and greens.
  • Rooms will be numbered
  • Car parking area to do
  • New reception desk to do
  • Low part of the reception desk for wheelchair users
  • Staff name badges to do
  • The lift is now up and running
  • The practice website is updated regularly with photographs of the progress.

SC asked if as well as numbering the rooms if there will be signs to say which room is where. Dr Hilton confirmed this would be the case.


Dr Hilton advised the group that even though it was July we were already looking at our flu campaign for this year and that we would be holding the usual clinics during the weekend and some Saturday mornings.

PPG Newsletter

NC acknowledged that LH is no longer doing the newsletter and that we are looking for someone else to take over. ID suggested that a monthly short bulletin may be better. ID andNC to meet up and discuss.

Dr Ollie Hart

Dr Hilton explained that we are working with Sloan and Woodseats Medical Centres and explained about Dr Harts work with a pilot on a person centred approach to long term conditions.
More information is available on the website :
SC commented that she felt the project was a good idea.
ID also commented that she felt the project was a good idea.
LH asked if there had been any feedback about Age UK. Dr Hilton said he had referred 2 or 3 patients to them and the feedback had been positive.

Any Other Business

  • ID mentioned about the marking of spaces in Dore car park and that this had been brought up a year ago. Dr Hilton expressed concern that if we act on one patients comments we could be sending a message out.
    Dr Hilton said it would be better to focus on positive things eg the fact that several patients have commented on the installation of a lift and that through the refurbishment of the surgery one has now been installed.
  • ID asked if would be possible for Dr Hilton to hold a meeting for patients to attend and a PPG member to chair it focussing on one particular subject eg the NHS. Dr Hilton said it can be difficult to predict uptake and it would have to be kept to no personal opinions.
  • SC asked why there were no posters about the PPG in both surgeries. ID and LH both said there was a poster in Dore waiting room. NCexplained that due to the refurbishment at Carterknowle there were no posters and leaflets in the waiting room but there would be once the works had been completed.
  • LH said she would be leaving the PPG group as she was moving out of the practice area. Dr Hilton thanked her for her work for the PPG. Also advised that should could stay on the practice list depending on where she was moving to and about out of area registration.
  • SC asked why the practice was not undertaking post natal checks anymore. Dr Hilton advised that this was not his area of expertise so would have to find out and that items like this need to be brought up through other channels.

Next meeting – date to be confirmed but likely to be end of October

Carterknowle and Dore Medical Practice

Minutes of Patient Participation Group discussion
on Monday 12th February 2018

We would like to start by thanking the PPG members for their comments on the alternative format discussion group email. This was very much appreciated and all comments have been noted.

Refurbishment to Carterknowle Surgery

  • Carterknowle practice will be undergoing a programme of refurbishment starting in March and aimed to finish in October 2018. The refurbishment will include the installation of a lift to allow patients with mobility difficulties easier access to the first floor; along with a widened ramp at the front entrance, automatic front doors and a new reception desk with a lowered section for wheelchair users. The waiting areas, both upstairs and downstairs will be refurbished along with public corridor areas. Additionally the refurbishment project will create three extra consultation rooms on the ground floor.
  • We understand from patient feedback through Friends and Family surveys that patients feel the practice would benefit from upgraded waiting room seating along with the installation of a lift.

In response to the questions below:

What would be the preferred communication channels in order to ensure our patient group are aware of these changes?

Feedback on the proposed plans and the impact/improvements these will have on our patients?

  • A member suggested adding the renovation plans on the surgery website and the patient survey.

One member suggested the following ideas:

  • They asked if the extra consultation rooms resulted in the reduction in the size of the waiting area. The waiting area will be reduced in size due to the two extra consulting rooms and the installation of a lift. We have therefore allowed for the seating to be in rows rather than the current seating plan.
  • They recommended an informative display in the waiting area to raise awareness of patients who use the facility. To obtain feedback they suggest a proactive approach with the receptionists asking patients for their views. This is something the practice is looking into doing once the renovations are complete. The practice now has the use of several tablets. These were used during our flu campaign to collect information from patients.

Patient Questionnaire

  • The practice are aiming to release the 2018 patient survey in coming weeks and have put together the following ideas in order to gain patient feedback-

a) Ask patients for their help and ideas in relation to our refurbishment project – including colour schemes, if they currently struggle to access the building with the current format, do they think installing a lift would be utilised well by patients, seating types

b) Ask patients for their input into the telephone system- do they prefer to hear the voice of practice staff such as GPs guiding them through the telephone system? Do they think by staggering timings for incoming calls in order to manage the flow better and reduce call waiting times is a good idea i.e. call after 11 for routine appointment bookings?

c) Social Media- patient opinion on whether the practice should have a more prominent social media presence

d) Friends and Family survey- would patients recommend our practice to their friends and family

e) Ask patients for updated contact data- emails addresses and mobile telephone numbers.

In response to the question below:

Please can we ask members to share ideas on additional items that we can include in the annual survey?

One member responded as follows:

  • Regarding the refurbishment, introduce shades of yellow (or another brighter colour, not magnolia) due to lack of natural light to the waiting area.
  • Quality of feedback is enhanced by introducing a scoring system, for example, ranking importance in numerical order. For instance, improved privacy at the front desk might be of less concern for Carterknowle patients due to its size and layout etc.
  • Consider the questions based on which surgery a patient visits given the nature of the questions.
  • Numbered rooms instead of GP names on the doors would be impersonal.

Another member responded as follows:

  • With the increase in clinical rooms, there does need to be a telephone monitoring system in place to automatically monitor the service levels.
  • A suggestion to ask patients how long they have to wait to obtain appointments?
  • Ask patients what they think of the quality of care they have received during their appointment.

PPG Newsletter

  • The practice would like to thank the PPG for all their hard work in creating the bi-annual PPG newsletter; this is been a welcome addition to our patient communication channels appreciated by our patients.
  • We are looking for a different member (s) to become involved and look towards putting together the next addition for release.
  • We are currently awaiting offers to help with our PPG newsletter.

Practice Website

In recent months the practice website has undergone a transformation and now includes a new format that is hopefully easier to navigate along with updated information on a variety of health and practice issues.

Please can we ask for you to look around the new format and provide feedback and suggest further improvements?

We aim in coming months to include a few photographs of the surrounding area including some of both practices; please could we ask you have any photographs of the local area that could be included on our website home screen?

  • Nothing to report on the transformation of the practice website.


The practice has a Twitter account and is now regularly posting health related information along with practice updates.

Please share with us ideas on how we can increase our social media followers?

  • A member suggested that the use of social media may not reflect the age profile of our patients.

Date of next PPG meeting to be confirmed

Date of next Sheffield Patient Participation Group Network – 22nd March 2018 – 6-8pm at The Circle, Rockingham Lane, Sheffield 1

Carterknowle and Dore Medical Practice
Patient Participation Group Meeting
Tuesday 3rd October 2017 at 5.00 pm


Dr Hilton opened the meeting.
A new member of the group attended and was welcomed.
The minutes were agreed and minor amendments made from the previous meeting.

Matters Arising

Patient Self-Help Groups

To be discussed further at next meeting.

Email Correspondence

Members had received one or two emails but this had tapered off.

Joanna Glaves – Age UK

  • Joanna Glaves attended the meeting to discuss the developments in the People Keeping Well Campaign. She explained that this was hopefully going to be an integrated service to include voluntary organisations as well as well as Age UK. It was suggested that a noticeboard could be put up in both Carterknowle and Dore Reception to signpost patients to the services on offer.
  • There are two strands to this service:
  • Social Prescribing: This is prescribed by the GP for patients who they feel would benefit from this service to include social activities as well as practical advice on benefits, etc.
  • Patients who are well, they may have retired and these patients need to be targeted before they become socially isolated.
  • Joanna would like to hear from PPG members if they have any ideas about activities that they think will be helpful. She has left her email address is, telephone no: 07951435664
  • There are a lot of groups available at the moment but these are difficult to promote in Dore as they do not have a ‘hub’, e.g. a Church hall or community centre. It is hoped that people in the community, e.g. hairdressers will be able to forward people’s details to Age UK.
  • Joanna intends to do a Newsletter approximately once every three months which hopefully will be delivered by Dore to Dore so everyone in the community should receive a copy. This Newsletter will outline all the activities and events that are available in Dore & Totley.
  • Joanna pointed out that there was a lack of activities for men and this needs to be addressed.
  • Joanne is to chair a Forum at regular intervals to discuss which activities are a success and which activities aren’t working.
  • ‘Budding up’ was also discussed whereby neighbours could help neighbours if they have hospital appointments or budding up with the Community Transport Service


  • A member asked for any suggestions for the next Newsletter
  • Joanna (from Age UK) is going to do a paragraph on Age UK and the Keeping People Well Campaign.
  • Stockpiling repeat prescriptions. Dr. Hilton to ask one of the in-house Pharmacists to do a paragraph on stocking piling prescriptions.
  • One member suggested less content and larger print to make it easier to read. They also suggested that we make it ‘jazzier’.

Any other business

  • A member said there had been a mix-up with the Flu Clinics, patients had had text messages asking them to attend the wrong Surgery.
  • Self Help Groups to be discussed at the next meeting.
  • The banner for 'Getting Older – Living Well' needs to be bigger and bolder.

Date of next meeting to be confirmed.

Carterknowle and Dore Medical Practice
Patient Participation Group Meeting
Tuesday 27th June 2017 at 5.30 pm


The practice had received apologies as above ahead of the meeting.

Dr Hilton opened the meeting.
Emma mentioned that we had a new member for the PPG and they were hoping to attend the next meeting.
The minutes were agreed and minor amendments made from the previous meeting.

Matters Arising

PPG Newsletter – 3rd Issue

Further discussion has been postponed until the next PPG meeting

Patient Self-Help Groups

To be discussed further at next meeting.

PPG What’s New/Community Boards

These are now in place at both surgeries and are full of useful information. One member mentioned the recent social event at Millhouses Bowling Club and how successful it had been with over 100 people attending- they felt this was very positive and aimed at people of all ages and abilities.

Email Correspondence

Update postponed until the next meeting.
No new emails/ correspondence was received by members.

Steering Group

  • A member gave a quick update of the last meeting of the steering group. They emphasised that the group was open to suggestions but that the main things that needed to be considered were on the possible agenda list.
  • Preferred name for group – One member suggested ‘Getting Older – Living Well’ which was well received by the group and felt to have the right balance and not too flippant. ‘Getting on with Getting on’ was also suggested.
  • Frequency of meetings – These are to be monthly, it was suggested the waiting room at Dore Road surgery, on the 4th Thursday of each month. The suggested time was 1.30 to 3 pm but Emma said from a practice point of view it would be better 12.30 to 2 pm so this has been changed accordingly.
  • One member brought in a booklet from Age Concern called ‘Life Book’ which is a very helpful booklet for a person to record relevant information i.e. pin numbers, insurance details, funeral wishes, which is really useful information for relatives/friends sorting someone’s estate.
  • A member will look into obtaining copies of the leaflet for the group.
  • It was agreed that a PPG member would get in touch with Age Concern to see if we can get a supply of the Life Book to put in the waiting room
    Possible agenda items:
  • The group looked at the proposal for the patient discussion group and also the possible agenda items. There are a good few contacts if interested in doing tasks about the agenda items. There are really good topic suggestions for future meetings and Dr Hilton felt a maximum of 2 should be discussed at each meeting there being enough for 3 or 4 meetings
    Dr Hilton thanked those involved and felt this was a really good piece of work and would be great once we can roll out to patients. Agenda items for the first meeting along with a date to be agreed at the next meeting.
    The date of the next steering group meeting to be arranged.

Good Things Foundation – Neighbourhood Project on Digital Inclusion Projects

  • Emma updated the meeting that the CCG had secured funding for a pilot scheme for 2 neighbourhoods in Sheffield to work with the Good Thigs Foundation project. South Sheffield Health Group neighbourhood (including Carterknowle) was lucky to be one of these. The aim is to reduce social isolation and increase people’s confidence in accessing resources via the internet.
  • Dr Hilton mentioned that we are currently working with Age UK Sheffield, Dore & Totley and that it was hoped we could get their representative to come and talk to us at possibly the meeting after next.


  • There was a lengthy discussion regarding DNAs and how we could reduce these.
  • Currently we have a system whereby if a patient DNAs on the first occasion nothing is done, on the second they get a DNA letter advising that if it happens again they may be removed from the list, and on the third occasion, with approval of the partners, the patient is written to and asked to register elsewhere. There are obviously circumstances where this does not happen i.e. if the patient is vulnerable or there are extenuating circumstances.
  • It was queried whether it was a certain groups of patients who were DNAing i.e. age, repeat offenders, vulnerable people. It was suggested that perhaps time could be spent on reminding vulnerable patients or their carers the day before their appointment but as mentioned previously if there is a mobile number on their records they do receive an SMS the day prior to the appointment.
  • Chesterfield Royal Hospital have started adding in the cost of failing to attend an imaging appointment which is approximately £110 to their DNA letters. It was queried by the group how much a GP or nurse appointment would cost the practice and Emma is going to look into this. It was felt initially that we would prefer to send DNA letters with the emphasis on the impact it has on other patients trying to book appointments rather than the cost.
  • It was discussed whether there could be an easier quicker way to cancel an appointment and the difficulties sometimes encountered when ringing the surgery. It was queried whether the practice could have a mobile number where patients could text to cancel but it was pointed out that this could be used by patients to ring the surgery and the risk would be the phone would not be answered; it would have to be very clear that it was for this purpose only and no one would respond to text messages. Sloan Medical Practice are piloting a scheme re texting; Emma will ask regarding feedback.
  • Emma mentioned the Saturday catch up clinics, we have just had our third Saturday clinic, and the fact that they were booked up but only 50% of patients attended. These were 30 minute appointments with the nurse or HCA supported clerical staff; the time wasted was considerable. Patients who didn’t attend were contacted and they had either forgotten or had other family commitments even though if a mobile number is on the records they would have received an SMS reminder the previous day.
  • It was discussed whether there could be more clarification as to what everyone does i.e. the Nurse Practitioner, Nurses and HCAs. It was commented that this information is already available via the website, the telephone message which is on a loop and posters within surgery.
  • Dr Hilton mentioned that we are currently trialling a new triage system which will hopefully improve our efficiency at dealing with calls and that staff are currently having training. We are moving towards greater care navigation which will involve referring to the most appropriate person within the practice and organisations outside the practice i.e. Age Concern. It was discussed that currently anyone registered can book an online appointment with a GP, Nurse Practitioner or Nurse even if inappropriate; it was suggested that these appointments would be better to go through triage.
  • Dr Hilton said that initially the aim was to tackle same day demand for appointments with a view to triaging online bookings at a later stage but that this was the way forward.
  • Emma to look at the cost of GP/Nurse appointments and also to try and get figures/date to try and identify is specific group that DNA. To feedback at next meeting.

Wild at Heart

  • Emma brought in some leaflets ‘Wild at Heart’ which is supported by the Wildlife Trusts Sheffield and Rotherham which is a way of getting people over 50 involved in nature-related activities to meet other people and make friends. The activities include nature photography and wildlife gardening but there is an indoor base if the weather is bad.
  • Leaflets will be displayed in the surgery and on the Community Boards within surgery.

Any Other Business

  • A member mentioned that they had printed off a prescription leaflet from our website that had the Sloan MC on and queried why. Emma explained that it was a leaflet for the three surgeries in the neighbourhood, Sloan, Woodseats and Carterknowle & Dore.
  • A member also mentioned that when they recently took their prescription to the chemist they were asked to register with them for electronic prescriptions and were given the impression that there would come a point when transition of prescription will only be electronic. Dr Hilton reassured the meeting that this was certainly not the case and that patients would always be able to collect paper prescriptions although he did emphasise the benefits of electronic prescribing as being timelier, less paper, ability to go to different chemist locations i.e. if on holiday.
  • Following the recent CQC report one member requested an update on one of the action points asking us to consider promoting a private area away from the reception desk if required. Emma advised that at both Dore and Carterknowle there were signs on the reception desk indicating that if privacy was needed there was a room available (the kitchen at both sites)to discuss things or if required to breast feed, a sign is put on the door if appropriate to advise staff members it is being used.
  • One member updated that they had attended the wider neighbourhood PPG meeting and will scan information and their notes and send them to other PPG members – to be discussed for 10 minutes at next meeting.
  • Hepatitis C – A member will send information to be passed onto Dr Hilton.

Date of next meeting to be confirmed.

Carterknowle and Dore Medical Practice
Patient Participation Group Meeting
Friday 17th March 2017

The practice had received apologies as above ahead of the meeting.
Dr Hilton opened the meeting and welcomed new members.

Matters Arising
The minutes were agreed from the previous meeting.
Terms of Reference- a copy was given to all at the meeting.
The issue raised at the previous meeting regarding confidentiality and staff accessing rooms during patient consultations has been discussed with the team.

PPG Email Correspondence
A member updated that she had received a number of emails from patients to be discussed at the meeting-

  • The carpark at Dore was raised as an issue with a suggestion to draw parking bays.
    Emma updated that the practice had noted in increase in vehicles parked in the surgery carpark and around the entrance that were not staff or patients and that these concerns had been addressed and improvements should be seen. The practice will consider the drawing of parking bays.
  • A telephone queueing system was suggested, informing patients of their position in the queue.
    The PPG was involved in the process of moving to a local landline telephone number. To make this move the practice and PPG group chose a type of phone system that connects online and has a number of benefits, however it does not have the capacity to queue patients. The practice has a limited number of lines, once all are in use a patient would receive the engaged tone; this was with the aim of ensuring phone call length and therefore call charges are kept to a minimum for patients.
  • The length of time waiting for calls to be answered was raised.
    The practice does audit the length of time calls take to be answered and uses this information to help plan staffing arrangements to meet the demands, within the constraints of the practice capacity. The practice is also trying to help more patients gain access to the online system for booking/ cancelling appointments and ordering repeat prescriptions- with the aim to reduce call traffic.
  • A suggestion to improve the waiting room seating was received.
    The practice is hoping to make improvements and are awaiting a response from NHS England with regarding to funding to make these improvements. A discussion was had around the standard required for infection control and that seating must be or a certain material therefore making it difficult to have cushions on the seating.
  • The issue of a practice closure for staff training was raised, as a patient was unable to get through to the surgery on the telephone.
    Practice staff are invited monthly to a Sheffield CCG led training event and the practice is able to divert telephones to the GP collaborative and close for this afternoon to allow staff to attend. At Carterknowle and Dore practice we aim to arrange for some of the team to attend the training event and also keep the practice open for booked appointments in order to prevent complete closure of the surgery and disruption for patients. However due to running on less team members we are unable to also operate the telephones on these afternoon. The practice will endeavour to inform patients of closures via the practice website.
  • The issue of receiving a one month supply of medication instead of two was raised.
    Dr Hilton updated the group that the practice is part of a CCG pilot –Prescription Order Line. Whereby trained pharmacist assistants receive the calls and process the prescriptions before a GP signs them. Under this system only one month supply is issued. The aim of this scheme is to improve safety or prescribing and reduce wastage across the city; so far success has been noted and this will be rolled across the city. However the practice does recognise that by enabling the issue of two months prescriptions is more convenient for the patient and has therefore shared this idea with the CCG. It was agreed that the practice should be involved in initiatives like this to save NHS funds that can be spent instead in other areas.
  • A PPG group member informed of the decision to withdraw from the group via email.
  • It was flagged up that the practice website is showing out of date contact information.
    The website has been checked and the telephone contact details are correct. The practice is not responsible for updating other websites that may reference the practice and may have out of date information.

It was agreed that an email response would be sent by the group member.

PPG Newsletter
A member updated that she is now working on the third addition of the newsletter and suggested the following articles-

  • Antibiotic prescribing
  • Repeat prescriptions- how to order
  • BMR –Birthday Medical Condition Review –
  • Ecclesall Forum
  • STP
  • Neighbourhood Update- to include information on collaborative working with volunteer organisations.
  • Self-Help groups led by the PPG

Self-Help Groups- Living Better in Later Life
A  steering group has been set up in order to lead on this project.
The steering group would meet up to discuss next steps in the coming weeks and report back to the group at the next full meeting.

It was suggested that meetings could be held monthly or quarterly. The location was discussed as the practice does not have a large boardroom however the practice waiting room could be utilised but only when practice is closed i.e. lunchtime.

The aim of the groups is to provide a non-exclusive group for patients to come and discuss their concerns and the meetings will each be different topics. Some suggested topics-
•    How to prepare for retirement
•    Pathways relating to end of life care
•    Alterations to your home in later life
•    Dietary support/ Cooking classes
•    Activity/ walking groups

It was suggested that patients could be updated on the groups and topics via-
•    Posters
•    Practice website
•    Practice staff signposting patients
•    PPG newsletter
•    Social media

Community Board
It was agreed that the group would manage a ‘Community Board’ at each practice to include information on local groups and activities and ensure this is kept up to date.
The information must be checked to ensure it is no-for-profit organisations.
It was agreed for reception to accept information and keep in a folder in reception. A member of the PPG will attend each site monthly to check the information and update the display.
POL- Prescription Order Line
The group felt that they have noted an improvement to the system since the launch of the POL pilot. It was agreed that comments could be forwarded to the practice via email and these will then be shared with the POL service.

Patient Survey 2017
The patient survey was available for three weeks at the beginning of March. It was made available in the waiting room at both sites and also on the website. We sent text messages to 8500 patients informing them of the survey.

Many thanks to group members for their help in formulating the questions to be included within the survey.

There was consensus that an annual review would be positive for patients (91%) and the practice will go ahead with the concept that this will be around the month of birth as 60% supported this.

A discussion was had how best the practice could collect email addresses. The survey showed that 41% would use email correspondence and the group felt that using email more information could be sent to patients rather than in a text message. The group felt that using both text messaging and email would be good for patients.

The survey showed that 79% of respondents had a positive experience when using the new Prescription Order Line (POL)- we have shared this with Sheffield CCG who are taking steps to roll this out to more practices. The group agreed that this was positive.

50% were already signed up to Electronic Prescribing (EPS)- however of those not 52% did not take regular medication

70% were not signed up to SystmOnline- the group discussed how we increase this number in order to reduce the build up of call traffic.
-We can text those with mobile numbers to inform them of the online services and how to register
-We can add Information on website on how to register.

43% were aware of the PPG and how to pass on comments- all agreed that this was positive, especially in light of the recent increase in correspondence received from the group.

77% had not used NHS Choices or Health Watch to share their comments about the practice, 48% would access help from the PPG to do share comments online. It was felt that this could be addressed through the self-help groups.

Dr Hilton reported that the inspection team commented on the teamwork and how engaged the practice were during the inspection visit. One area of outstanding practice was recognised- the additional blood delivery to the hospital allowing afternoon appointments; this was recognised to be beneficial for working age patients and families.
The group discussed how a practice could achieve the outstanding rating and agreed that due to small numbers achieving this across the country it must be difficult. It was felt that developing the PPG self-help groups could be an area of outstanding practice.
BMR- Birthday Medical Condition Review
Over the last twelve months the practice has been working towards an annual review around the patient’s month of birth. This year we have invested time in developing the IT supporting this and therefore streamline the system to prevent patients been invited in multiple times throughout the year and instead have one annual review arranged. All agreed that was good for patients- this is supported by the patient survey.
The practice shared with the group the wording for the posters designed for the waiting room at both practices.
PAM –Patient Activation Measure
Dr Hilton introduced the PAM questionnaire to the group and explained that this is used by clinicians in order to tailor healthcare to a patient’s needs. The questionnaire seeks to find out how a patient engages with their own healthcare and whether social prescribing or a clinical model of care may be more suitable to the patient.
The questionnaire is commissioned by Sheffield CCG and we have been approached to ask for patient feedback. The group were each given a copy to look over and provide feedback via email to the practice.

Any Other Business
A recent CCG meeting was attended by a group member- it was reported that there was a consensus of frustration with the achievements that different PPG’s are making. Some members felt frustrated with the progress here however recognised upon reflection that working within the finite resources and time constraints the PPG had supported and influenced a lot of change beneficial to the patients as a whole. The group recognised the lack of funds and investment along with increasing expectation and demands on the system. It was agreed that the focus of addressing social isolation and loneliness in the area was a positive focus for the group.

A member mentioned a recent telephone programme about a machine that could scan patients’ blood for virus via a finger prick blood sample; the aim of the machine is to reduce unnecessary antibiotic prescribing. The practice is not aware of this being used in the Sheffield area.

Physiotherapy referrals were discussed; Dr Hilton informed that the physio team have locations across the city and patients have a choice in this.

The group suggested a photograph of GPs to be displayed in reception.

Carterknowle and Dore Medical Practice
Patient Participation Group Meeting
Tuesday 22nd November 2016 at 5pm

The practice had received apologies as above ahead of the meeting.
Dr Hilton opened the meeting and welcomed new members.
Dr Hilton introduced the group and explained its history to the new members. A discussion around the positive impacts the group has had-

  • The group help the practice in setting the topic focus and questions for the annual patient’s survey. The next survey is due to be released in March 2017 so it was agreed that this would be the focus of the next meeting.
  • The group have set up a bi-annual newsletter; this is available in the waiting room and on the website. It was suggested that the next copy is printed in a larger text size (size 14).
  • The group have influenced positive changes to the practice such as a tidy up to the outside areas and increasing confidentiality in the waiting rooms by suggesting amendments to the layout.
  • The group helped the practice develop a mission statement that best reflected the practice and its team.
  • The group have set up a ‘What’s New’ board in the waiting room at both practices- this includes current information that is relevant to patients.
  • The group have aided the practice in reaching out to a wider audience by making information available in different languages- the website can now be translated and the mission statement was printed on the ‘What’s New’ board in a variety of languages.
  • The group have set up a leaflet on local groups, clubs and activities that the practice team use, especially for vulnerable patients. The practice offer care planning to vulnerable patients and the clinician takes an holistic approach, looking at clinical and social needs; this leaflet is used to promote social interaction and reduce social isolation.
  • The group also supported the practice with the switch of telephone lines and the associated decisions in order to make this seamless for patients along with improving the existing system.

The group discussed the representativeness of its members and all agreed they would like to recruit more new members to reflect the full population needs.

PPG Meeting Feedback
A member had recently attended a Patient Participation Group meeting at another practice and provided feedback to the group. The group was much larger than ours; however did tend to focus on individual issues rather than the needs of the wider population. All agreed that it was important to focus on the wider group of patients rather. The group was very welcoming. The meetings were held early evening similar to our group meetings.  The group had members that assisted with coffee mornings and baby groups however all recognised that we were limited on space and therefore would struggle to offer these to our patients.

The group discussed ways to interact with patients within the premises constraints. It was suggested that PPG members could offer a meet and greet service and be available in reception to interact with patients.  This would also sit alongside the idea of running small self-help groups on various life issues.
It was recognised that this was not without its difficulties as the group members would need support and guidance of practice staff of how to handle situations where patients are upset regarding their health.

Ecclesall Forum
The group were introduced to the Ecclesall forum. The group meet monthly in the library and consists of local residents, counsellors and the local police officer; the group are largely reactive to local issues however aim to be more proactive. Their focus is improving social isolation and they aim to try and get local people more involved with providers. They have arranged a meeting open to all on 13.12.2016 in order to share ideas develop upon their aims. They have met with the community support workers
This information will be included in the next issue of the newsletter.
It was agreed by all that the group could incorporate these ideas and suggestions; the group will re-visit at the next meeting.
PPG Focus
The group all discussed their individual ideas and aims for the group-

  • It was felt that the group should help the socially isolated.
  • It was felt that the group could offer a meet and greet service in order to gain opinions and suggestions from a wider patient group.
  • It was felt that the group could help inform the general public of wider political changes to primary care. The group should work both ways and also provide a voice for patients with concerns over changes and feed these back to the practice for discussion.
  • It was felt that the group provides a voice for patients and can steer change in the practice.
  • The group has a role in communicating with patients – such as the newsletter.
    Patient Self-Help Groups

We would look at the area further at the next meeting.

Dr Hilton updated the group that the practice had received a very positive response following the CQC inspection. Dr Hilton thanked the group for their support with the preparation and support on the day of the inspection.
Dr Hilton explained that the practice had been recognised for outstanding practice in the area of offering afternoon appointment for blood tests; the practice organise a taxi to transport these bloods to the hospital each evening. The practice had also received constructive ideas for improvement- some already have been implemented in practice.

Dr Hilton updated the group regarding local and national initiatives to streamline and improve service delivery.  NHS England aim to rationalise and centralise services. In Sheffield practices are grouping up with other local practices to form ‘neighbourhood’ groups. Our practice will work with Sloan Practice, Woodseats Practice, Abbey Lane Practice and Veritas Practice. The aim for these smaller groups is to be more responsive to health needs and reactive to change required.
The Neighbourhoods will try to connect with local communities and smaller organisations, such as voluntary sector (i.e. Age UK, Shipshape) and social care (Community Support Workers) that can help with a holistic approach to healthcare.  The aim is to put the public and patients back in control of their healthcare and use these available resources to keep patients well in the community.
The local satellite units were discussed, patients are able to access GP and Nurse led healthcare 6-10pm Monday-Friday and 10-6 Saturday and Sunday. All agreed that this was a helpful service for patients.
A discussion around the rationalisation of resources was had- recently this has cropped up in media articles. Dr Hilton explained that this is due to a financial need and CCGs are now starting to work together to deliver service at scale and share resources more.  
A member is attending a local meeting on healthcare next week and will feedback at the next meeting.

Practice Team
Dr Hilton informed the group that the practice had recruited some new team members-
Dr Adeney is a female GP, she joined the practice three months ago.
Mary Wheeler is our new Healthcare Assistant
We also have two new receptionists- Aliah and Nabeela.

Any Other Business
It was suggested that the chairs in the waiting area at both practices need updating; Emma advised that this is on the practice agenda. The practice is always looking for funding opportunities to support changes and improvements to the practice layout.

The group discussed issued around confidentiality during consultations, a member updated that an acquaintance was having an intimate examination and a member of the practice team came into the room for some supplies- all agreed that this was not appropriate. Dr Hilton and Emma will feed this back to the practice and discuss at a wider practice meeting.

The group had positive feedback regarding the receptionists on duty- they found them to be helpful and polite. It was commented that a new apprentice was smiling at patients when they left and was very approachable.  Emma thanked the group for this feedback and would pass this to the team leader.

Carterknowle and Dore Medical Practice
Patient Participation Group Meeting
Tuesday 27th April 2016 at 5pm

Dr Hilton opened the meeting by thanking everybody for attending.
Minutes 3.3.16

The minutes from the last meeting were agreed by the group. It was agreed for the next set of minutes should state action clearly along with the initial of the responsible person.
It was agreed to circulate the PPG email contacts, allowing them to contact each other between meetings.
It was agreed for the practice to contact group members with the date of the next PPG meeting at Sloan or Woodseats Medical Practice.

PPG Newsletter
LH updated the group of her developments with the second issue of the newsletter; the aim is to publish this in July.
Topics so far-
   1: Trainee Clinical Staff- it was agreed that the practice will liaise with Dr Lees to contribute a short article.
   2: Introduction of new staff
   3: PPG email contact update
   4: Local clubs- PG agreed to write an article for inclusion
   5: Later life- ID agreed to write a short article on the groups plans to hold monthly discussion groups at the practice.

Patient Survey Results
The results were made available to group members via email, along with some early thoughts from the practice on proposed action.
The results showed that patients were on the whole satisfied with the change to a local telephone number along with upgrades to the telephone queuing system. Those that were not satisfied felt this was a result of the delay in getting through to the practice. The practice already have all available staff handling telephone calls throughout day, so instead have looked to other changes that may reduce the call traffic.
It was agreed that increasing patient use of online/automated systems may improve this, such as- SystmOnline, Electronic Prescribing and Repeat Dispensing. The results showed that there is a number of patients that are not aware of the services or are aware but do not utilise them- it was felt that more patient information was required. It was agreed that an article should be included in the next issue of the PPG newsletter.

ES updated of the practice aim to start collecting email addresses from patients. The practice currently uses letter, telephone and text message to communicate with patients; however with the ever increasing cost of mail we aim to start using email correspondence. Dr Hilton updated that NHS England will increasingly push practices to liaise with patients via email, with GPs offering this line of communication with patients on health matters. It was agreed that to have an 'email submission' button on the website would be a good way as the patient has to then type in the email- it was agreed that due to the format of email addresses it would be difficult to note these verbally from patients. The group agreed to think of ways to collect patient email addresses.

Electronic Prescribing & Repeat Dispensing
Electronic Prescribing allows prescriptions to be sent to the patient’s choice of pharmacy electronically, saving them having to collect from the practice. Receptionists discuss this with patients over the telephone and face to face, the receptionist is then able to nominate a pharmacy through the patients’ medical record.
As part of the joint working with Sloan and Woodseats Medical Practices, a leaflet has been created that will be made available to all patients with a printed repeat prescription over a period of two months. The group were asked to share their opinions and suggestions for improvement on the leaflets.

Patient Self-Help Groups
It was agreed that ID will chair the steering group that will develop this area- supported by LH, KG and PG. All PPG members are invited to join the steering group- the aim would be to have a diverse group as possible, including different gender, age groups and ethnic origin- please contact ID via email to express your interest in the project.
Dr Hilton thanked ID for her hard work in putting this together.
Birthday Medication Review
ES updated the group of the practice move to a new method of reviewing patients with long term conditions. The practice is in the planning stage of a new system that will call patients on their month of birth and all necessary tests carried out during one appointment and then followed up as appropriate. All agreed it would be better for patients to only have to attend at one point throughout  the year, if stable and felt that patients will find it easier to remember as it coincide with the month of their birth.

Any Other Business
The liquid nitrogen tank was discussed, that is safety checked every 6-8 weeks and a risk assessment carried out to ensure safe storage and ventilation.

Communicating results with patients via telephone was discussed- it was felt that patients may worry about abnormal results during the wait for the GP to call them. Dr Hilton advised that of a result was abnormal and action required as soon as possible, the patient would be contacted straight away. Reception staff are not trained to read results and pass these onto patients.

It was pointed out that the waiting room was looking in the need of updating. Dr Hilton updated the group on the bid submitted by the practice for a number of improvements including a lift and a general upgrade of the reception area. The practice expects to hear about the bid in July and will inform the group of the outcome.

The patient information displays were suggested to be in the need of an upgrade. Over recent years the practice has put considerable effort in upgrading these, ensuring all information is displayed in a Perspex board rather than loose papers. The boards are updated regularly, to include new information. The practice work with a tight budget in order to make these improvements. PG agreed to look at the boards and suggest improvements.

Carterknowle and Dore Medical Practice
Patient Participation Group Meeting
Thursday 3rd March 2016 at 12pm- Carterknowle Practice

Dr Hilton opened the meeting by thanking those present for attending the meeting and sharing the apologies received.
New members were welcomed and introduced.
The minutes of the last meeting were reviewed by the group. No amendments were required.

The group had received no emails from patients for discussion at the meeting. It was agreed that the email contacts should be reviewed and updated. Irene Dalton and Linda Heywood kindly agreed to make their email contacts available for patients to contact them.
Patient feedback was discussed and the variety of method available to patients- patient survey, friends & family test, suggestion box, website suggestions, complaint procedure.

The practice now has staff name badges for the reception team.

All agreed that the translation of the practice mission statement into other languages is a step in the right direction. The practice is now working on a translation facility within the practice website and the patient check-in screen.
Dr Hilton asked the group to share ideas around translation facilities that the practice could access.

Emma thanked the group for their hard work with the PPG newsletter. It was agreed to check that copies are available in surgery and on the website.
It was agreed that the PPG newsletter should be issued twice annually; the group will share ideas and pull the information together to form the next newsletter.

The annual patient survey is now available for patients to complete- on the website and in the waiting room. To inform patients, the practice has sent a SMS text message to all patients with a mobile contact (7700 patients); the message directed the patient to the practice website.
The survey is a method to gain the opinions of a wider patient group; whilst it was acknowledged that it was not as representative as we would hope for it was agreed that the practice try to reach as many patients as possible with the resources available. Group members were asked to share ideas on how the representativeness of the response could be improved; Emma suggested that group members could take copies to local clubs or locations for patients to complete.

Following the last meeting where a review of the TOR of the group was suggested, a copy was made available for discussion.
It was agreed that the group aids the practice in patient engagement and is to be included in the TOR.
It was agreed that all members have responsibilities to the group and must uphold confidentiality at all times.
It was agreed that it is very important that members do not use the meeting to discuss personal issues as more appropriate channels exist for this.
It was agreed that the group discuss, encourage and develop patient feedback and is to be included in the TOR.
The ground rules were agreed.
It was agreed that the group is responsible for developing a twice annual patient newsletter and should be added to the TOR.
Dr Hilton is noted as the group chair- however an invitation to all members to take up this position or rotate on an annual basis was issued.
It was agreed that this is a working document; a copy will be emailed to all members for review and added to the agenda of the next meeting for further discussion.
The representativeness of the group was discussed; although we have 19 listed members a smaller number regularly attend. The meetings are varied- by time, days and location to try to fit in with members as much as possible. I was agreed for everybody to keep in mind that we would like to actively recruit new members to the group.
It was suggested that a patient forum could be established via the practice website to discuss and share ideas.

Emma updated the group by introducing new members of the team- Tom and Lorraine to reception,  Ilse to the nursing team and Dr Varian as our new GP Registrar.
Dr Hilton explained the practice commitment to training a wide range of healthcare professionals- GPs, medical students, Nurses and Physicians Associates. It was agreed that this was positive for the practice as it ensured we kept up to date with the latest developments, maintained protocols and encouraged the workforce of the future. It was suggested that an explanation of this would be helpful for the next issue of the PPG newsletter- maybe wrote by a trainee GP.

It was agreed that the practice would make contact with local practices and ask if members would be able to attend their next PPG meeting.

Dr Hilton felt that the provision of healthcare moving forward will be focussed on supporting patients in self-care and community resilience; as a result of the financial pressures faced. The group agreed that this could become a focus for the next meeting.

A discussion was had around patient support groups that could cover a number of topics-
•    Discussion/ support for patients planning end of life care
•    Obesity/ Exercise/ Diet- walking groups
•    Pre-hab. Irene updated the group of a push from the Department of Health to get patients fit prior to surgery
•    Isolation in the elderly- support/ craft groups

These support groups could be introduced to patients via the PPG newsletter.

It was suggested that the photocopying quality of the patient survey was making it difficult for patients to read- it was agreed that the practice would check this.
It was agreed that a poster should be displayed informing patients why it is not appropriate to have toys available in the waiting room and the reasons behind this.

Carterknowle and Dore Medical Practice
Patient Participation Group Meeting
Tuesday 15th September 2015 at 5pm- Carterknowle Practice

Dr Hilton opened the meeting by thanking those present for attending the meeting. A copy of the agenda was made available to all present. The minutes of the last meeting were reviewed by the group.
New group members were welcomed and introduced.
A discussion around the introduction and development of the group was had. The group gives patients a voice that the practice can use to help with service design and delivery. We have issues around representativeness of our group but are always making efforts to recruit new members. The practice can act upon suggestions and improvements whilst considering its limitations and pressure. Over recent years the practice has made a number of positive changes as a result of discussions with our PPG members; the ongoing support and commitment of the group is appreciated by the practice.

The group had received no emails from patients for discussion at the meeting. It was agreed that email details would be included in the PPG newsletter.

The practice has ordered lanyards and is in the process of creating staff name badges.

All agreed that the switch to a local telephone number was positive however it was highlighted that the practice was receiving a significant increase in call traffic since the switch. It was agreed that the volume may decrease after a settling in period.

The practice was pleased to report that the problems at Dore had improved and it seemed the installation of CCTV was working.

The group discussed different ways of communicating with patients and the following ideas suggested-
•    Translating material into other languages. It was suggested that the practice could contact a local school to help with the translation
•    Picture/photographic help sheets to aid patients when using the checking in screen.
•    Patient/ PPG member volunteers helping and talking with patients in the waiting area.

At the last meeting it was agreed to discuss patient feedback. The following comments were discussed by the group-
“I was on the telephone for 25 minutes this morning, ringing constantly before I could get through”. The practice make efforts to answer all calls in a timely manner however as discussed above we have seen a significant increase in calls incoming; this is therefore impacting upon the wait for calls to be answered. It was agreed to see if the volume of calls settles down in coming months and review.
“Weekly half day closing is not convenient”. The practice is involved in Enhanced Primary Care Sheffield and its current pilot project to improve access to the GP. As a result of this Carterknowle Practice will be open on Thursday afternoons initially 2.30-4.30pm for pre-booked appointments with the telephones still being transferred to the GP collaborative. It was also thought that the introduction of Web GP will provide more access out of hours for patients. The group agreed this was a positive step and we would review whether these appointments are accessed by patients later in the year.
“Get info or consult doctor over the phone for some small issues”. The practice already offer telephone consultations however it was thought the introduction of Web GP may save patients time and actually having to come into practice.
“No toys in the waiting room”. Although all agreed this was a shame everybody agreed that due to health and safety reasons and infection control risk that toys had to be kept to a minimum with only wipe clean books available.
“Have a Nurse Practitioner at Dore”. All agreed that having a nurse practitioner at Dore was a positive step and group members gave positive feedback from their own experiences of seeing the Nurse Practitioner.
“I contacted the surgery at a time of need. I was dealt with kindly and professionally. The service received was excellent at a time when the NHS is stretched”. All agreed that positive comments were as important for discussion as were constructive criticism.

Web GP is a tool that sits in the practice website and will enable patients to access help and advice at all times. There will also be a facility for patients to undertake an e-consultation; whereby they would receive feedback from a GP within 24 hours. It was agreed that this was a positive move for patients that work longer hours and may struggle to attend surgery. This is a one year pilot that the practice has agreed to be involved in.

The practice thanked the group for their help in developing the practice mission statement-
Carterknowle and Dore Medical Practice are committed to providing compassionate, patient-centred, high quality care to all of its patients.
Our ethos is to be understanding, respectful and caring to all whilst maintaining privacy, confidentiality and dignity at all times.
We strive to offer a warm, welcoming environment; ensuring our patients feel safe and supported.
It was agreed that the mission statement should be made available online and on the ‘What’s New’ board. It was suggested that if possible we should try and make this available in other languages.

The first edition of the newsletter is almost ready to be made available to patients. The practice has created a logo that will be emailed to group members following the meeting.
It was agreed that the newsletter would be issued twice yearly, however this may be more frequent if the group members can support this.
The newsletter will be made available in the practice and online- along with tweeted on twitter. The importance of social media was discussed and it was agreed that this is an important method of communication with patients. The next step for the practice would be to create a facebook page.
The practice thanked group members for all their hard work in putting together the newsletter and appreciate the ongoing support of the group in creating this.

Whilst the voice of the group is important each year the group members work with the practice to develop a questionnaire that is available for all patients to complete online and in reception. This helps the group gain the opinion of the wider patient population.
After discussion it was felt that the focus of the group could be to extend work undertaken previously to ensure patients feel more included within the community. The group has previously developed a leaflet to include information on local groups, clubs and activities; this is available online and in reception. It was thought that this could be extended with group members along with other patients by running self-help groups within the surgery or community whereby people could come together for support- these could be to discuss topics or provide support for specific ailments.
It was agreed that group members would think about questions that could be included in the questionnaire and liaise via email with the practice within the next few weeks. A questionnaire can then be collated and made available to patients in coming months.

The practice is continuing its work with local practices- Woodseats Medical Practice and Sloan Medical Practice. The group is looking at ways to share ideas and skills with the aim to improve services to our patients.
The project the group is currently looking at will involve community pharmacists working more closely with the practice. PPG members thought this was a good area to look at.

Dr Hilton updated that group on Enhanced Primary Care in Sheffield. The aim is to improve access for patients to a GP at evening and weekends. The city will have four satellite units- our closest is Sloan Medical Practice; these will be open 6-10pm mid-week and 10am-6pm at the weekends. The units will be staffed by GPs across the city. All agreed this was positive for patients.
A discussion was had around the changing pressure on primary care; it was agreed that over the past ten years the demand and expectation of patients had increased, we have an increased elderly population and more care is moving from the hospital to the GP.
It was agreed by the group that the focus should be ‘health’ rather than ‘illness’ – they felt that by developing the self-help groups would support this in practice.

The practice has started to invite patients in for their flu vaccine.

Our PPG members are invited to attend an information and networking event for PPG members based in Sheffield Central Consistency with Paul Blomfield on Monday 21st September at The Circle, Rockingham Lane, S1 4FW.
Healthwatch is about local voices helping influence the design and delivery of local services. Healthwatch Sheffield is your independent watchdog for health and social care.

Group members are invited to attend the Right First Time Citizen Reference Group meetings. The meetings will be held on- 16.9.2015, 10.11.2015, 3.2.2016. For more information please telephone Liz Hartlebury on 0114 2052926 or 07815707403.
Right First Time is a partnership project working to transform the way health and social care is delivered.

Carterknowle and Dore Medical Practice
Patient Participation Group Meeting
Wednesday 8th July 2015 at 5pm- Dore Practice

Dr Hilton opened the meeting by thanking those present for attending the meeting. A copy of the agenda was made available to all present. The minutes of the last meeting were reviewed by the group.

The group had received no emails from patients for discussion at the meeting.

It was agreed that this is disappointing despite a renewed effort to publicise the email addresses following the last meeting. It was agreed that this information should be included on the television presentation in the waiting room.

Record sharing will become an ongoing focus for the practice and we will renew our efforts to seek consent from patients.
In Sheffield a lot of work is going on to integrate services, including primary, secondary and community care. The sharing of electronic medical records will enhance these services.

The practice is looking toward having lanyards for reception staff members instead of pin badges; to prevent damage to uniform.

It was suggested that we could display posters in local toddler groups and colleges/school in order to attract new members to attend the meetings.

A discussion was had around the topic of the patient questionnaire; it was agreed that we should seek patient’s opinions on communication channels. Group members agreed to think more about this and bring suggestions to the next meeting. It was agreed that we would aim to publish the questionnaire in Autumn/Winter 2015.

The practice wants to create a short statement that delivers a positive introduction to the practice. We want to involve all staff and patients in the process. Group members agreed to think about this over coming weeks and email ideas and suggestions to the practice.

Since the last meeting group members have drafted ideas for the bi-annual newsletter. They asked if the practice could ask a member of staff to develop a logo for the group that can be printed on the top of the newsletter.
It was agreed that members would meet at Carterknowle Practice to further develop their ideas. The newsletter will be an item for discussion on the agenda for the next meeting.

Following recent retirements, Dr Harriet Bird has recently joined the practice and Dr Alex Rawlings will continue with the practice following completion of his training in August. We will also have two trainee GPs starting in August- Dr Liam Lees and Dr Ruth Garside.
We have also recruited Kerry Mellor as a Nurse Practitioner; this has enabled the practice to respond to the outcome of the patient survey 2014 and have a Nurse Practitioner based at Dore surgery along with Carterknowle.
We have also took the decision to increase the hours in our Healthcare Assistant team- Gemma has now started with the practice and will be working both in practice and visiting housebound patients in the community.
The practice is committed to engendering a culture of training as we it is good for the team along with developing and protecting the future primary care workforce. We have a wide range of trainees at the practice- GPs, medical students and receptionist and are looking to become involved in training practice nurses and healthcare assistants. All agreed that this was positive for the practice.

All agreed that the new telephone number was positive for all patients. The practice thanked the group for their support in making this change.

The electronic prescribing system is working well for the practice and patients.

Sheffield has been successful in bidding for funding to improve access to primary care in the evenings and at the weekend. This will involve practices working together to staff four satellite units across the city that will open until 10pm weekdays and 10am-6pm at the weekends. Patients will be able to access urgent out of hour appointments at the unit closest to them geographically; for us the closest site is Sloan Medical Practice. This will be one year pilot service and is in addition to the GP Collaborative service.
All agreed that this would be positive for patients.
The group members agreed to be involved in the evaluation process; feedback enables the CCG to plan for the future.

Over recent months the practice has been working with two other local practices –Woodseats and Sloan. We are holding regular meetings to discuss and share ideas. It is still very early days but we hope that this relationship will improve the services we can offer our patients. It was noted that we could potentially offer a wider range of services, should the practices share specialities and skills.

It was suggested that the practice could produce a comments card that patients are able to complete for the practice to then add the comments to the NHS Choices website. It was agreed that patients often do not have the time to add comments to the site when they are at home and the group members thought that this would help.
Dr Hilton often has patients made positive comments and constructive criticism in his clinics that could be wrote on these cards.

It was agreed that patient suggestions would be brought along to PPG meeting and discussed as a group.

The practice has a robust complaints procedure that is available to patients in the practice leaflet and on the website. It was agreed that the practice would check the practice website to ensure that the information is clearly displayed.

A discussion was had around security at Dore practice; recently youths have been hanging around the practice at night and causing damage to the property. CCTV and parking bollards have been installed; all agreed this was a step in the right direction.

A discussion around parking was had; however no conclusions could be drawn. The practice is limited by the little amount of parking space available around Carterknowle practice; making it difficult to allocate parking spaces for disabled patients. Patient with blue badges are welcome to park in the carpark off Carterknowle Road and on the double yellow lines near the post box. This is an issue the practice is aware of and looks to solve but currently we are unable to create more space.

It was agreed that it would be ideal to have a gated unit to enclose the bins; the practice have submitted two CCG development bids for funding towards this but both were unsuccessful. This is something the practice is aware of and looks to improve. All clinical bins are securely locked at all times.

Carterknowle and Dore Medical Practice
Patient Participation Group Meeting
Wednesday 4th February 2015 at 11.45am- Carterknowle Practice

Dr Hilton opened the meeting by thanking those present for attending the meeting. A copy of the agenda was made available to all present. The minutes of the last meeting were reviewed by the group.

The group had received no emails from patients for discussion at the meeting.

We have information regarding record sharing available on the practice website.

All agreed that the practice looked better as a result of the tidy up outside.

Staff name badges were discussed as in previous meetings; this is on the list of tasks for the practice to undertake however these things take time and come at a cost so items on the list have to be prioritised.

The purpose and aim of the group was discussed. It was felt that the group was not representative of the patient population however attempts are ongoing to recruit new members to the groups.
It was felt that the aim of the group was to improve the experience of patients.
It was agreed that the practice will display new posters with the email contacts of the members to try to engage public interest.
It was agreed that the group would develop the idea of a newsletter; compiled by members of the group then published to all patients. It was suggested that this could include information regarding the group (including photographs), the practice and answers to frequently asked questions.
Fundraising events at the practice was suggested as a way for the group to engage with patients.
Before the next meeting the group agreed to look at other practice websites in order to read about their patient’s participation groups in order to gain ideas on how we could move forward.

Dr Nathan is new to the practice; he started mid-December working full time. Dr Rawlings is the GP Registrar and will be with the practice until August. The practice hopes to have another Registrar in post in September. Dr O’Connor is leaving the practice at the end of March so we are currently recruiting a GP in replacement.
The optimum number of sessions was discussed however this is a very complex measure and can be dependent upon the skill mix. Currently the practice have a very good coverage of skills and also advanced components including individual GP special interest.
The reception team was discussed; whilst it was recognised that the team did a very difficult job they could sometimes be abrupt when on the phone. Training is ongoing with the team.

The practice has signed an agreement with BT to switch over to a local telephone number. The change was due to happen on 28.11.14 but due to delays/problems with BT this date has been severely delayed. We have logged numerous complaints and are yet to receive a response to the letters we have sent.
Once the new system is in place we will be moving all phone calls to Carterknowle making Dore reception area quieter to better aid confidentiality. The triage team will be based in the back reception area at Carterknowle and will be supported by a Nurse Practitioner. Walk in same day appointment requests will not be booked at the front desk- all patients will be contacted by the triage team in order to discuss the problem and book the most appropriate appointment. A detailed questionnaire has been compiled in order to take information from people without phones. We believe this will go towards addressing the issue of confidentiality at the front desk highlighted in the patient questionnaire.
At Dore we now have a radio to also aid confidentiality; a patient has commented on the positive impact this has had.

The electronic prescribing system went live yesterday.  The new system removes the need to print out prescriptions as they will be sent to the patient’s nominated pharmacy electronically; we hope this will run more efficiently and be more environmentally friendly. Patients can arrange their nomination directly with the pharmacy.

The practice is taking part in the Family and Friends Test- this is available online and in reception. It is a short questionnaire comprising of two questionnaires- the results aid the practice in planning and are also fed back to the CCG.
This went live in December and the initial feedback has been very good; with a large proportion of respondents ‘extremely likely’ to recommend the practice to family and friends.

The NHS Choices website enables patient to post comments and reviews regarding the practice. Dr Hilton asked the PPG members to have a look and asked for suggestions of how we could improve these comments. He did recognise that there were negative comments for the majority of larger practices with the exception of a few single handed practices.

Through the online system patients are now able to book and cancel appointments, order repeat prescriptions and view their summary care record (demographics, allergies and adverse reactions, repeat medication, ceased repeat medication and acute medication in the last 12 months).

Carterknowle and Dore Medical Practice
Patient Participation Group Meeting
Monday 15th September 2014 12noon- Carterknowle Practice

Dr Hilton opened the meeting by thanking those present for attending the meeting. A copy of the agenda was made available to all present. The minutes of the last meeting were reviewed by the group.

At a previous meeting it was agreed that some members of the PPG were happy to make their email address available to patients who may want to send suggestions or comments that can be discussed in the meetings. This information is available on the ‘What’s New’ board and on the website. As yet no emails had been received; but it was agreed to keep this as a regular agenda item to discuss at each meeting.

The practice is still receiving a steady number of consent forms from patients. We have information regarding record sharing available on the ‘What’s New’ board and on the practice website.

At the last meeting we reported that we had recruited a second Nurse Practitioner; however sadly she has since resigned due to personal circumstances. We are currently in the process of recruiting a Nurse Practitioner as the practice feel that the role is integral.
A discussion was had around the role and responsibilities of the Nurse Practitioner; this is different from the GP and Practice Nurse however they work in a similar way to the GPs. At the practice the Nurse Practitioner sees patients with acute illness along with visiting patients at home, supporting the GPs with patient hospital correspondence and aiding telephone triage by supporting the reception team.

Following up from the work to tidy the hedge up at Carterknowle we have now organised for a gardener and handy man to tidy up the practice and surrounding land at both Carterknowle and Dore.

The practice is continuing to review the appointment system to best meet the demand.

Dr Hilton and Emma thanked the group for their support in compiling the patient survey and ensuring the questions covered all relevant areas of the telephone system.
The patient questionnaire was available in surgery and on the practice website from Tuesday 12th August – Thursday 4th September 2014. 6500 SMS text messages were sent inviting patients to complete the survey online. Patients presenting to the front desk were asked to complete the questionnaire. In total 69 questionnaires were completed in surgery and 476 were completed online.  

Overall we were surprised to see that 37% of respondents were ‘satisfied’ or ‘very satisfied’ with the current telephone system, which is more that 33% that were ‘not satisfied’ or ‘very dissatisfied’. However we hope that the changes we propose to the telephone system will increase the numbers that are satisfied, as we aim for this to be higher.
The cost of the call and been unable to get through are the largest contributors to patient dissatisfaction. Whilst we are unable to increase staffing, we hope that by streamlining the telephone system with all calls to all be answered at one site the system will become more efficient. The calls will all be charged as a local geographical number.

30% of respondents order their repeat prescriptions via the telephone. 34% of respondents would to prefer to order their prescriptions in a way other than online. The group discussed whether the practice should keep the telephone prescription order line; it was agreed that this should be maintained as it is very helpful for the varied demographic of patients. Some practices have stopped operating a prescription order line due to workload and safety issues in ensuring the correct item is ordered; however the GPs at the practice agree with the PPG with regards to keeping this operational.

26% of respondents were unaware that patients are able to order prescriptions via the online system. It was highlighted at the meeting that using the internet is not for everybody and other methods of ordering and communication are required.

26% of respondents arrange same day appointments in person rather than via telephone; this is because they are unable to get through, cost of the call and they feel more likely to be offered an appointment face to face. In order to ensure the appointment booking system is deemed fair and efficient all calls will be answered at Carterknowle by the triage team with the support of the Nurse Practitioner. Carterknowle has a purpose built area for this that enables the triage team to work in a calm, quiet area and discuss the patient’s case with the Nurse Practitioner to ensure the most appropriate appointment is booked. We will be moving away from booking patients in face to face; instead the patients presenting at the desk will be asked for a contact number and a member of the triage team will ring them to discuss the need for an appointment.
We aim for the front desk at both practices to be quieter, therefore much more efficient for patients collecting prescriptions or wishing to discuss general queries. This will also aid the reception team to uphold patient confidentiality.

57% of respondents had recently had a consultation with the Nurse Practitioner at the practice; 72% were satisfied and the problems were resolved. In response to this satisfaction we are currently recruiting another Nurse Practitioner to our team. The Nurse Practitioners can see patients for acute illness are able to prescribe for this; they are involved in completing care plans with patients along with supporting telephone triage. The practice feels that the Nurse Practitioner is an integral part of the team and is actively trying to recruit a new Nurse Practitioner to the team.

75% of patients who had recently had a telephone consultation with the GP were ‘Satisfied’ as a result. Telephone consultations do create more work for the GPs but it was agreed by all at the meeting to be positive as often patients can discuss the issues over the phone rather than coming in for an appointment. Although it is often difficult for the GP if patients are not in to answer the call; it was suggested that patients should be made aware that a telephone consultation should be treated the same as a face to face appointment and they are prepared to take the call.

A copy of the results will be made available in reception at both practices and on the website.

Patient Comments/ Issues-
‘Don’t like giving details of problems to receptionists. They are in an open office with the public within hearing distance’
All calls will be answered in a purpose built office away from the public front desk. All receptionists are trained in telephone triage, and are all supported by the Nurse Practitioner and on-call GP.

‘Expensive calls’
Calls will be charged at a local geographical rate. All agreed that this will be a big improvement.

‘Not enough staff in reception to deal with calls’
The streamlining of the telephone system and move away from face to face booking of same day appointment, will free reception staff up to deal with general queries and prescription collections.

Following the completion of the patient questionnaire the practice have signed a contract with another telephone provider and aim to have a local (0114) telephone number towards the New Year. We plan to organise a trial week in October in order to highlight and rectify any problems before we go live with the new system.

Dr Hilton explained that the practice will be moving over to the electronic prescribing service during October. The new system removes the need to print out prescriptions as they will be sent to the patient’s nominated pharmacy electronically; we hope this will run more efficiently and be more environmentally friendly.
Currently patients can organise the chemist to collect their prescriptions on their behalf. Also prescriptions can be ordered from the practice via the practice website-

Name badges were mentioned; the practice have looked into these however have not yet purchased them. Pin badges can often damage clothing; lanyards can pose a safety risk and magnet badges get misplaced. It was suggested that reception should introduce themselves using their names to enable patient to identify who they are.

Carterknowle and Dore Medical Practice
Patient Participation Group Meeting
Wednesday 9th July 2014 5.00pm- Dore Practice

Dr Hilton opened the meeting by thanking those present for attending the meeting. A copy of the agenda was made available to all present. The minutes of the last meeting were reviewed by the group.

At the last meeting it was agreed that some members of the PPG were happy to make their email address available to patients who may want to send suggestions or comments that can be discussed in the meetings. This information is available on the ‘What’s New’ board and on the website. As yet no emails had been received; but it was agreed to keep this as a regular agenda item to discuss at each meeting.

Emma thanked the PPG for their work in putting together the leaflet on local groups, clubs and activities; this has been very well received. It is available in reception and on the website; also it is given out by clinicians during appointments.
As an extension of this it was agreed that the PPG could create a bi-annual newsletter that can be distributed around the local area. This will include a variety of information regarding the practice and wider heath issues.

The practice is still receiving a steady number of consent forms from patients.

The practice is continuing to review the appointment system to best meet the demand.
Recently we have trialled a chronic disease management clinic for complex patients with multiple diagnoses; the patient sees both the nurse and GP and if necessary have had a blood test prior. The clinical team are able to fully review the patient, medications and plan their care in one appointment.
Skype appointments were discussed; we don’t currently offer these as they are not seen to be of a great benefit for our demographic of patients. The picture quality does not allow the clinicians an accurate view of the ailment in order to diagnose.
The practice does offer telephone appointments with the GP; these are used for discussions with patients that don’t need to be done face to face.

We are now in the final stages of switching to another telephone provider; both the companies we are in discussions with will revert back to a local geographical telephone number. Once the contract is signed it will take 3-4 months to set up the systems in the practice.
To ensure we make the right decision as both contracts are for five years it was agreed to make the telephone system the topic of the annual patient survey.

The practice is not required to undertake an annual questionnaire this year; after discussion the group agreed that we should still do this. A big change this year will be the switching of the telephone system; so it was agreed that this should be the central topic of the survey.

Dr Hilton explained that the practice will be moving over to the electronic prescribing service towards the end of the year. The system had a few issues at the first but these seemed to have been ironed out so we hope for a seamless transfer.
Currently patients can organise the chemist to collect their prescriptions on their behalf. Also prescriptions can be ordered from the practice via the practice website-

Dr Rihal is our new GP and Nikki Henson is our new Nurse Practitioner.
The practice has recently achieved accreditation to become a training practice; a trainee GP will be in post by August this year and will stay with the practice for one year. The trainee GP will see patients so this will create more bookable appointments for our patients.
Going forward the practice aspire to develop its training status with more trainee GPs in post along with medical students.

All agreed that the letter drafted by the PPG group in support of the campaign was clear and concise. The letter will be posted and a response awaited.
The BMA have launched a campaign- ‘Your GP Cares’. The aim of the campaign is to support GPs and their practices by protecting NHS resources.

Dr Hilton explained that practices are required to assign a named GP to all patients aged 75 years and over. This has recently been undertaken and patients will be informed via a message on their next prescription or letter. All patients are still entitled to see any GP at the practice; they are not required to arrange an appointment with their named GP. The named GP will be included in correspondence for administrative purposes.

Work has been started on the hedge at Carterknowle; all agreed that this is already looking a lot better. However it was noted that the bin area could benefit from a tidy up.

The changing nature of the NHS and the impending financial difficulties were discussed; some smaller practices are finding it difficult in the current climate. These changes are affecting all practices and they have to look at ways of coping financially.
The cryotherapy clinics were discussed; we are looking to perhaps stop these soon. There is little evidence for the success of the treatment against home remedies and over the counter preparations. By stopping these clinics it would enable the GP to see more patients. The decision to stop/ change services are difficult to make but are always made based upon evidence and discussion as a team.
The Darlington Mums will be partaking in a rally from Weston Park on 25.8.2014; this is in celebration of the NHS.

Carterknowle and Dore Medical Practice
Patient Participation Group Meeting
Wednesday 30th April 2014 11.45am- Carterknowle Practice

Dr Hilton opened the meeting by thanking those present for attending the meeting. A copy of the agenda was made available to all present.
PPG 2014-15
The focus of the PPG was discussed; other practices have had the PPG involved in health talks, starting exercise programmes and fundraising.
It was agreed that the focus of our PPG would be Healthy Living along with opening up communication channels with patients. The practice hope to improve health through patient education.
PPG members agreed for their email contacts to be given to patients via receptionists should a patient wish to pass on any comments to the PPG. These emails will be discussed at each meeting; if any members have any concerns they can contact Emma at the practice. The information offering this contact to patients is to be displayed on the TV, on the ‘what’s new’ board and on the website.

Consent forms are now distributed around Dore village and in the pharmacies in the Carterknowle area. The practice is now seeing growing numbers opting out of the Care.Data along with an increase of consent obtained for record sharing.

The practice appointment systems along with an open access system was discussed. A mix of both was suggested however this may cause an overload of work on certain days. Appointment systems allow GPs to manage and plan their workload. The practice moved from open access to an appointment system through patient consultation. The current wait for a routine appointment is two weeks however we aim to reduce this to 7-10 days. The ideal would be to have another GP; however the reality is that this is not affordable for the practice.
It was suggested that a definition of routine and urgent should be written and displayed on the ‘what’s new’ board and on the website.
The practice workload was discussed; the GPs are working harder than ever due to bureaucracy, meetings, paperwork and offering improved quality of care. The GPs feel the stress of time pressures. It was agreed that primary care has changed considerably over the last decade; with the improvement in care, medical advances and the introduction of preventative medicine. These changes coincide with a decline in funding.   
Evening surgeries were discussed; these are always booked however not always by patients who are out at work all day. The extension of practice hours started as a government initiative supported with funding; allowing extra staff to be put in place. However as funding is cut it may not be financially viable for the practice to offer these sessions.
The practice is currently reviewing the way in which patients with long term chronic conditions are managed; we are looking to run a clinic with both the GP and nurse in order to undertake a comprehensive review in one appointment.

Dr Charles and Dr King have now both retired. We have Dr Rihal in post as the new GP partner and Nikki as your Nurse Practitioner. Now we have two Nurse Practitioners we are able to have them based at both sites. Also we hope to have a trainee GP in post by September.

This campaign recognises the cut in funding to primary care; the aim is to persuade the government to increase investments in to general practice. It was agreed that the PPG support this campaign and its message.
It was agreed that the PPG would draft a letter to our local politician.

The practice would be happy to host and advertise health talks to our patients.

Following the last meeting we had enquired with regards to fitting a panel under the hedge outside the practice. As this would be at a cost to the practice we have agreed to look at other solutions before making a final decision; such as removing the hedge completely to open up the entrance. In the meantime we will ask the practice housekeeper to remove litter from this area.

NHS health checks were discussed; this is a government preventative health programme offered to patients aged 40-74 with no chronic long term conditions. The practice uses the ‘what’s new’ board to promote various health initiatives.

Carterknowle and Dore Medical Practice
Patient Participation Group Meeting
Wednesday 19th February 2014 -5.30pm- Dore Practice

Dr Hilton opened the meeting by thanking those present for attending the meeting. A copy of the agenda was made available to all present.

The practice has recruited a new partner GP –Dr J Rihal along with an Advanced Nurse Practitioner- Nikki Henson. They will both be starting at the beginning of April. Dr Rihal is a young enthusiastic GP with links to the University Research department for primary care. Nikki has 25 years experience in the health service, including nursing along with working with the CCG (Clinical Commissioning Group). It was agreed that the new staff members would have a positive impact upon the practice and its appointment system.
The retirement of both Dr Charles and Dr King was discussed; both would retire at the end of March.

This is a record sharing model that will allow confidential information from your medical records be used by the NHS to improve the services offered so we can provide the best possible care for everyone. This information along with your postcode and NHS number but not your name, are sent to a secure system where it can be linked with other health information. This allows those planning NHS Service or carrying out medical research to use information from different parts of the NHS in a way which does not identify you.
Patient can choose to opt out; if not they will automatically be opted in.
Yesterday it was announced that this would be delayed until autumn; this gives patients more time to decide whether to opt in or out.
Further information is on the practice website and on the ‘What’s New’ board.

Electronic records are kept in all places where you receive healthcare. These places can usually only share information from your records by letter, email, fax or phone. At times this can slow down your treatment and mean information is hard to access.
The practice uses a clinical computer system called SystmOne to record patient information securely. This information can then be shared with other clinicians and healthcare services so that everybody caring for you is informed about your medical history, including medication and allergies.
Patients can inform the practice of their choice in person, over the phone and by completing a consent form.
After discussion it was agreed that this method of sharing data had advantages for patients following discharge from hospital and requiring community nursing input as it would allow good communication between agencies.

The group discussed concerns around the sharing of data; it was agreed consenting to sharing would come down to trust- like everything with information technology it has a risk.
Dr Hilton explained that data (similar to that collated through Care.Data) is collected in secondary care already; this along with primary care data would give a holistic view of health care. This would be a huge benefit to those planning and commissioning health care in different parts of the country.
The data would not include the patients name; only their postcode and NHS number would be sent to HSCIC (Health and Social Care Information Centre).

The practice has included information on the two methods of data sharing on the website and displayed posters on the ‘What’s New’ board at both practices. An opt out form is available on the website and in reception at both sites.
However the group discussed getting the information out to a wider audience.
We currently have 6000 mobile telephone numbers and it was agreed that this would be a good way to signpost patients to the website or the ‘What’s New’ board for more information.
A message could be added to the repeat side of the prescription signposting patients to the website or ‘What’s New’ board.

The practice is currently in talks with telecom companies with regards to the change to a local telephone number. There are a variety of options available but we want to make the right decision as we would again be signing a contract.

PPG MEETINGS 2014-2015
We agreed to start thinking about the aims of the meeting in the upcoming year and what the focus should be. The practice hopes we can use our group and meetings to move the practice forward we will begin the next meeting looking at ideas.

A group of local practices are able to purchase blood pressure monitors and make these available for patients to purchase. The GPs also loan these to patients to aid in diagnosing Hypertension.

Carterknowle and Dore Medical Practice
Patient Participation Group Meeting
Monday 9th December 2013- 12pm- Carterknowle Practice

Dr Hilton opened the meeting by thanking those present for attending the meeting. The focus of the meeting would be the results of the 2013 Patient Questionnaire.

In August we put together a ‘What’s New’ board to be displayed in reception at both practices; this is updated regularly with current information of interest to patients. It was suggested that the font on some of the articles should be larger to aid patients in reading the information.

Sarah introduced the work of the Care Quality Commission and explained that the inspection of GP practices has begun.
We have been working towards the required standards for over two years now and this has led to the upgrading of the clinical rooms and some changes to the building layout, particularly at Carterknowle. Work has also been done on infection control and both clinical and administrative protocols.
Members of our PPG will be contacted as part of the CQC inspection and asked to be part of the process; all members present consented to the CQC team contacting them.

As part of the national agenda the practice was tasked with undertaking an annual patient questionnaire. The practice uses this feedback from patients to look at areas that work well and areas where we may need change.
The results from the 2013 questionnaire are now available; these will be displayed in reception and online following the meeting. The PPG members were shown the display board that had been put together.
It was agreed that the response included a fair mix of ages, gender and postal areas. 110 responses were written and 355 were made online. The practice sent out over 5000 SMS Text messages to patients with mobile numbers inviting them to partake in the questionnaire.
The practice does recognise that not all patients are confident in using a computer or have access to one so ensure that all patients have fair opportunities.

The group looked through the results and discussed the findings.

•    Booking Appointments -  62% phone, 24% person, 15% online
•    31% of same day requests seen by Nurse Practitioner
•    75% -satisfied/ very satisfied with the outcome of the appointment request. It was agreed that this was positive.
•    50% suffer with a long term condition
•    39% part of a local club/ activity
•    56% of those involved in clubs found out about it through family/ friends. Only 12% through leaflets/ Posters/ Postal information
•    26% would like leaflets in reception, 27% on the website
•    Patients would like information on Diet, Healthy Living, Fitness and Exercise

A discussion was had around the booking time for a routine appointment and the process of triaging same day requests for appointments. As a GP Dr Hilton felt that often appointments booked in with a GP on the same day could have been dealt with another way; such as the Nurse Practitioner, telephone call or pharmacy. Triaging is a way of working out the most appropriate way of dealing with the appointment request; however it was felt that this put the onus upon the patient to convince the practice they need an appointment. Dr Hilton explained the triage process; it is not about testing patients it was about booking the right appointment for the patient and this means taking some details regarding the request over the phone. Question 4 shows that a very small number of patients felt to not be offered an appointment or appropriate advice on their request for a same day appointment; this supports the triage system we have in place is working.

After much discussion no other suggestions were made as to how to manage the demand upon GP appointments. The practice is currently in the process of recruiting clinicians with the aim of increasing capacity. Dr Hilton also explained the national move towards pharmacies managing more minor ailments reducing the pressure on the GP surgery.

The ‘Choose Well’ campaign was discussed and it was agreed that the leaflet was very useful. The practice has included this information on the practice website and the TV. New ‘Choose Well’ leaflets are in production and will be in practice once they arrive.
The group discussed the length of appointments; this is a balancing act for the practice as we need to manage the system to allow for enough appointments each day and enough time for the GP to assess the patient. The practice currently has 10 minute slots with some 7.5 same day appointments within each clinic.

Dr Hilton thanked those members who had contributed to the creation of this leaflet. We have put together a draft copy of a leaflet; this was shown to the group and a copy will be emailed to the PPG for them to pass on comments.
It was agreed that from the questionnaire results it was felt that patients would welcome this information; currently 56% of respondents find out about local clubs through friends and family so hopefully this leaflet may reach more people.

The results of the questionnaire showed that our patients would welcome advice and information on maintaining a healthy lifestyle. We have put together information and made it available in the formats below:

•    New ‘Healthy Living’ boards
•    TV
•    Website information
•    Patient leaflets

Julie advised that the talks held at the Virgin gym were very informative and it was felt to be a shame that only 36% of patients would attend a talk at the practice. It was agreed that Julie would pass on the information and we would display the date of the talks on the ‘Healthy Living’ board.
The board was discussed by the group and it was agreed that this will help support and guide our patients; the group felt that the activities and talks displayed would be useful to patients.
It was suggested that we could have a ‘health tip of the month’ on the board which is updated.

A change in diagnosing blood pressure problems was discussed; Dr Hilton explained that 24 hour readings and 7 day home readings are used for diagnosis. The practice has been able to purchase a supply of BP machines and can offer these for sale to patients for £20.

The next meeting will be held on Wednesday 19th February 2014 at 5.30pm at Dore Practice.
Dr Hilton asked the group to email agenda items to the practice a few weeks ahead of the meeting.


It was requested for staff to have name badges so they can be identified to aid continuity of care. Staff members have had badges in the past but they have damaged the uniform or got lost over time.
It was requested for a photo to be displayed in reception and on the website with photographs and names of staff members to allow patients to recognise members of staff.

The access and building layout at Carterknowle was discussed; some members had concerns as the building has two levels and no lift. Although it was felt that installing a lift was the ideal situation due to the limited space available and high installation costs this was not currently an option for the practice.
The practice always ensure that some clinicians are based downstairs; in the case of a particular clinic been held upstairs the staff member would come downstairs to see a patient if unable to safely climb the stairs. Patients are welcomed to ask to be seen downstairs and only those who can safely climb the stairs are booked in upstairs.
Fire safety procedures were discussed by the group. The practice currently has two routes of escape from the upper floors and three external doors on ground level. Staff members are trained as Fire Marshalls and in the event of an evacuation will help and ensure the safe evacuation of staff and patients.
In the event of a fire, lifts would cease operation so would not aid a quicker evacuation of the building.
It was suggested that the practice install a panel under the hedgerow outside the practice; it was noted that unsightly items were found in this area.

It was suggested that when a GP is running late the reception team should inform the patients in the waiting room of this delay. The check-in screen does not currently have the capacity to include this information due to its programming.

The Shingles vaccination programme was discussed; this is a national programme that is currently only available to patients aged 70 and 79 years.

The group asked if the meeting could be the forum to discuss issues and proposals from the CCG; it was agreed that any relevant information will be passed on.
It was thought that Mrs Crookes attends the public meetings so was suggested that she could update the group at the next meeting.

The practice can issue 1 months tablets only on one prescription; 2 prescriptions can be issued at one time.

The aims of the PPG meetings were discussed; the meeting should be used to discuss wider issues that will create a positive impact on the practice population as a whole.

Carterknowle and Dore Medical Practice
Patient Participation Group Meeting
Monday 23rd September 2013- 12pm- Carterknowle Practice
Website Notes

Dr Hilton opened the meeting by thanking those present for attending. The focus of the meeting would be the creation of the 2013 Patient Questionnaire.

The practice are advertising for some new younger members to join the group; making the group more representative of the practice patient population.

Dr Brown started working at the practice in August. Dr Brown will also be involved in the ‘Well Women’ clinic.

In August we put together a ‘What’s New’ board to be displayed in reception at both practices following a suggestion from the PPG. We have included photographs of new staff members, national and local changes and practice news. The boards will be updated regularly. The group agreed that this was a positive step and could be utilised to promote the local groups and activities available to patients.
The practice has suggestion boxes at both sites that are frequently utilised by patients.

FLU 2013-2014
The practice is starting its Flu campaign this week with the first clinic on Thursday. We have sent invitations via post and SMS text messages. The Flu campaign is a major piece of work for the practice and often includes the practice catching up with patients to ensure their health monitoring is all up to date.

Dr Hilton explained that nationally it is becoming an issue to prevent patients with chronic long term conditions getting admitted to hospital. A risk score is compiled for patients; this is available to the GP. When the GP sees a patient deemed ‘at risk’ they are to complete a pre-emptive care plan and see if any improvements in the patient care can be made. This initiative is a huge piece of work for the practice; it can include patients who are currently well along with those who are ill. The aim of this work is to improve patient care and patient experience; however this puts pressure upon the GP’s and appointments available. Despite having a new GP the current waiting time for a routine appointment is two weeks due to GP time allocated to this work. It was agreed that it was important for the carer to be supported along with the patient; this is part of the care planning approach.
Dr Hilton explained that the practice is able to put patients in touch with a Community Support Worker that will visit them at home and provide support and signpost them to different services.

A list of activities and groups running in Dore has been compiled by a member of the group; it was agreed that we can expand on this list by including Carterknowle and Totley. A member brought in a leaflet advertising a service that help people get to appointments- Project Connie, for us to display in the practice.
We feel that patients may not be aware of the activities available to them in the area and would benefit from these. As part of this year’s questionnaire we aim to canvas our patient population to find out if they are aware of current activities and what other activities/ groups would be helpful to them.

A discussion around different appointment systems other practices operate along with the experience of the practice was had.
The practice currently operates a system where calls are answered by the triage team in reception and patients are asked details about their condition. The team have received training and are supported by a Nurse Practitioner in making the most appropriate appointment for the patient. If the team are unsure they will seek advice from the on-call GP.
All practices have to move towards streamlining their system in order to meet the ever changing demands upon it.

A discussion was had regarding the switch of the 0844 telephone number to a local line. Dr Hilton explained that this had been discussed in previous PPG meetings and the practice has investigated changing the telephone number but are bound contractually until mid 2014.


Matters Arising
Dr. King explained that the missing suggestions box at Dore surgery had been
The ‘Whats New’board had not yet been completed but was in hand.

Patient Questionnaire
Cheryl explained that one of the hot topics from the PCT at the moment was to try to cut the number of inappropriate visits to A & E.  There is confusion and lack of information about the services available when GP surgeries are closed and a questionnaire had been compiled to hand out to patients to try to ascertain the level of understanding about these services.  It was felt that it may be necessary to do a practice leaflet about the local services to help to ensure that patients use these appropriately.   Mrs. Crookes was handed a copy of the proposed questionnaire to look at and suggest any changes/additions. Mrs. Crookes asked that a note be put on the questionnaire that the Walk In Centre is now at Broad Lane. The questionnaire will be emailed or sent out to the other members of the Patient Participation Group for their comments; it will then be put on the practice website and handed out to as many patients as possible over the next few weeks.  The aim is to have the results of this survey before the next meeting.

111 Service
The new 111 number was discussed.  This was to be launched early in March but no national publicity campaign was planned until the Autumn.  This number will replace NHS Direct but will also be a patient point of contact when GP surgeries are closed.  Instead of the patient call to the surgery being transferred straight through to the GP Collaborative, at certain times the patients will hear an answering  service which tells them to hang up and dial 111.  This will put them through to an NHS Direct style triaging service which may put them through to the GP Collaborative if it is thought they need doctor advice, an appointment or a visit before the GP surgery is next open.  Dr. King, Cheryl and Mrs. Crookes all expressed obvious concerns about this new system; however it has been rolled out in other parts of the country, successfully, we are told.  The practice will put up posters and put
information on the website to make as many patients as possible aware of this change.

Any Other Business
Mrs. Crookes asked if any more appointments were going to be made available for on-line booking.  Cheryl agreed to look into this and to try to find out how many patients had actually registered for the on-line services and match the percentage of available appointments to this.  It was agreed that this was definitely the way forward for the future for dealing with routine appointments but at the moment, we could not discriminate against patients who did not use a computer or had not got access to the internet.

We have since looked into this and, currently 14.1% of patients (1,765) are registered for on-line services and 12.5% of routine appointments are available on-line.  We will revisit this when we next revise our appointment templates.

The ability of the practice to send sms text messages to patients with mobile phone numbers was also discussed.  This can potentially save the practice a lot of time and means we are able to remind patients about their appointments and save on dnas, tell them when their flu jabs are due, etc.  It is a constant task for the practice to collect and keep these numbers up to date as they tend to change more often than landline numbers.

Patient Participation Group Meeting
 23rd January 2013

1. Matters arising from the previous meeting were discussed.
The practice has taken action into looking at the possibility of changing the telephone number of the practice back to a geographical rate number; the management team have held two meetings with communication companies to discuss this. However the financial impact of making the switch would be too great for the practice to absorb at this current time. To change at the current time would require the practice to purchase new telephone equipment and a complete replacement of the system wiring. The practice is under contract until mid- 2014.
The practice currently takes action in line with government policy until the switch is made; the practice is able to ring patients back on their specified telephone if the patient requests this.
The practice will switch to a geographical telephone number once the current contract expires.
The practice has worked with the current communication company to reduce the time patients are kept on hold while also ensuring that patients can connect to the practice without the engaged tone.  

2. New GP
Dr Kenny started working at the practice in December; he is a GP trainer and we hope to have GP trainees working in the practice within the next 6-8 months.

3. A&E Attendances
The practice is required to monitor and try to decrease A&E attendances; the CCG wants the practice to look at patients who attend A&E inappropriately. Carterknowle and Dore patients don’t have a high A&E attendance rate; the highest rates tend to be practices closer to the hospital.
It was agreed that often patients are not aware of the services available; it was suggested that big posters should be displayed in the waiting areas at the practice. Also the frequent changes made to services can make it difficult for patients to keep up with what is available.
A ‘What’s new’ notice board was suggested; this should be updated regularly and signpost patients to new information. The practice already includes new information on a TV screen presentation played in both reception areas along with leaflets for patients to take.

4. SMS Text Messaging Service
It was agreed that this service was helpful to patients; the practice use this facility to send appointment reminders to patients along with health campaign information. The practice is actively gathering mobile telephone numbers from new and existing patients.

5. Renovations
The renovations are now nearing completion and a new consultation room has been created on the ground floor at both Carterknowle and Dore practice. This will allow the practice more room to become a GP training practice.

6. NHS Health Checks
The practice will soon be started a programme of health checks for healthy patients aged between 40 years -74 years. The checks will include BP, blood tests and dietary advice. The NHS health check programme is a new step in health prevention.
The practice is currently recruiting a new Healthcare Assistant to help with the workload these extra health checks will create.

7. The 111 Number
The 111 number will replace NHS Direct. This will be the first port of call for patients outside practice opening hours and will direct patients to the out of hours service where needed.

8. Any Other Business
The group discussed concerns over the privatisation of healthcare. The practice felt that this may not be the threat some perceive this to be as lots of private companies are run by people working in the NHS.
Online appointments were discussed; the management team monitor the way appointments are booked and have recently added more online appointments
The practice has operated a suggestions box system for many years and it is kept on the reception desk at both practices; this allows patients to post anonymous suggestions to the practice.

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