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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
Friday 17th March 2017

Welcome
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.

CQC
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

Welcome
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.


CQC
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.


Neighbourhoods
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

Welcome
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


WELCOME
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.

PPG EMAIL CORRESPONDANCE
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.

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

TRANSLATION OF PATIENT INFORMATION
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.

PPG NEWSLETTER
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.

PATIENT SURVEY
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.

TERMS OF REFERENCE (TOR)
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.

RECRUITMENT
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.

PPG MEETINGS
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.

PATIENT SUPPORT/ SELF HELP
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.

ANY OTHER BUSINESS
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


WELCOME
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.

PPG EMAIL CORRESPONDENCE
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.

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

TELEPHONE SYSTEM
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.

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

COMMUNICATION WITH PATIENTS
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.

FRIENDS AND FAMILY TEST- PATIENT FEEDBACK
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
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.

MISSION STATEMENT
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.

NEWSLETTER
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.

PATIENT QUESTIONNAIRE 2015
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.

FEDERATED WORKING
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.

ENHANCED PRIMARY CARE
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.

FLU CAMPAIGN 2015
The practice has started to invite patients in for their flu vaccine.

HEALTHWATCH
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.

RIGHT FIRST TIME- CITIZEN REFERENCE GROUP
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

WELCOME
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.

PPG EMAIL CORRESPONDENCE
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
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.

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

PPG GROUP
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.

PATIENT QUESTIONNAIRE 2015
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.

MISSION STATEMENT
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.

NEWSLETTER
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.

PRACTICE STAFF
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.

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

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

PRIME MINISTERS CHALLENGE FUND
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.

WORKING WITH OTHER PRACTICES
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.

NHS CHOICES/ PATIENT FEEDBACK
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.

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

COMPLAINTS PROCEDURE
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.

SECURITY
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.

PARKING
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.

CLINICAL BINS
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

WELCOME
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.

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

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

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

NAME BADGES
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.

PPG GROUP FOCUS
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.

PRACTICE STAFF
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.

TELEPHONE SYSTEM
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.

ELECTRONIC PRESCRIBING
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.

FAMILY AND FRIENDS TEST
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.

NHS CHOICES
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.

SYSTMONLINE
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

WELCOME
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.

PPG EMAIL CORRESPONDENCE
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.

RECORD SHARING
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.

STAFF CHANGES
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.

PRACTICE TIDY UP
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.

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

ANNUAL PATIENT QUESTIONNAIRE
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.  

Results-
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.

TELEPHONE SYSTEM
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.

ELECTRONIC PRESCRIBING
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- www.carterknowlesurgery.co.uk

AOB
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


WELCOME
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.

PPG EMAIL CORRESPONDENCE
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.

PPG NEWSLETTER
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.

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

APPOINTMENT SYSTEM
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.

TELEPHONE SYSTEM
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.

ANNUAL PATIENT QUESTIONNAIRE
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.

ELECTRONIC PRESCRIBING
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- www.carterknowlesurgery.co.uk

STAFF CHANGES
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.

PATIENT FIRST CAMPAIGN
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.

OVER 75 YEAR OLDS- NAMED GP
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.

HEDGE AT CARTERKNOWLE
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.

AOB
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

WELCOME
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.

RECORD SHARING- CONSENT FORMS
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.

APPOINTMENT SYSTEM
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.

PRACTICE STAFF
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.

PUT PATIENTS FIRST- BACK GENERAL PRACTICE CAMPAIGN
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.

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

ENTRANCE TO CARTERKNOWLE PRACTICE
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.

AOB
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

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

CLINICIANS JOINING THE TEAM
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.

CARE.DATA
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 RECORD SHARING
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.

DATA SHARING- ADVANTAGES AND CONCERNS
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).

DATA SHARING- HOW TO GET THE INFORMATION TO PATIENTS
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.

PRACTICE TELEPHONE SYSTEM
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.

BP MONITORS
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

WELCOME
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.

WHATS NEW BOARD
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.

CQC
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.

2013 PATIENT QUESTIONNAIRE RESULTS
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.

PPG LEAFLET – LOCAL GROUPS/ ACTIVITIES
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.

HEALTHY LIVING
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.

BP MACHINES
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.

NEXT MEETING
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.

AOB

NAME BADGES
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.

ACCESS AT CARTERKNOWLE
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.

GP APPOINTMENTS
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.

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

CCG
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.

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

PPG MEETINGS
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.

RECRUITING NEW MEMBERS TO THE PPG
The practice are advertising for some new younger members to join the group; making the group more representative of the practice patient population.

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

WHATS NEW BOARD
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.

CARE PLANNING
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.

HEALTHY LIVING / 2013 PATIENT QUESTIONNAIRE
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.

APPOINTMENT SYSTEM
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.

AOB
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.



MINUTES OF PATIENT PARTICIPATION MEETING HELD ON WEDNESDAY, 15TH FEBRUARY, 2013.

Matters Arising
Dr. King explained that the missing suggestions box at Dore surgery had been
replaced.
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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