Meeting Minutes December 2022
Meeting Date: 8th December 2022
Time: 7:30pm via Zoom
Chair: Chris Greenwood
Minutes taken by: Yvonne Barrett.
Introduction of New Members
Chris introduced CG to the group and thanked her for attending.
CG gave a brief description of her role as Operational Nursing Manager, a post that she has held for 18 months.
CG manages the Phlebotomists, HCAs and Practice Nurses and deals with core services across all 5 sites. She is aware that some sites don’t have quite as much access to services as others, and she is looking into this. She explained that her team was currently understaffed, had difficultly recruiting, and was 25% down due to staff retiring or moving on. She has now recruited into new roles as there is difficulty getting practice nurses to apply. There have been 8 applicants recently who want to come into general practice and she has managed to fill one position with someone who already works in General Practice.
CG explained that training someone takes resources out of the practice and takes time.
PVG member raised that the recent NHS data released doesn’t seem to show a shortage of nurses, however he also noted that it is difficult to distinguish appointments. CG noted that anything that isn’t a GP appointment seems to go down as a nurse appointment (including ACPS, Dietitians etc) which obviously they aren’t. This is down to national mapping and what we can put appointments down as.
- Action- CaG ask rota to look at mapping for DPC/nurse appointments
Conflicts of Interest
Minutes of the Previous Meeting
Read and agreed.
Actions from the Previous Meeting
As per agenda number 7.
Trauma informed training
As per agenda number 8. Helen look into the reply for AW’s AccuRX request - Action ongoing
Participation of promotion of NHS App
GO has had no further updates. CM will email, ask if he wants to add a patient who has digital help in the home to the promotion- Action ongoing
Covid clinics are booked through a different appointment service so they don’t show up on the NHS App. CM confirmed they wont, but said that come the next vaccine season this shouldn’t cause a problem.
RT (Stanleys) has helped many patients book their covid appointments as patients have been invited by the national booking service to book, which has been causing problems as it is offering appointments in Barrow etc. RT has helped them book appts locally- Action completed
Autumn vaccination campaign
Currently trying to book in the remaining patients for their vaccines- Action completed
Update from previous minutes around patient access
AW has not had any update on this, will report back any info.
CM contacted the Product Manager, asked for private advertising to be taken off however has been unsuccessful- Action completed
Chris updated the group on the new clinical recruits. Dr Fran Rowat has recently joined BMG. An SGP will be joining in January who will be working in a role partly funded by HEE which involves a population health project.
A Pharmacist has also joined the team.
Dr Moore is stepping back from this group as he is taking on more of a clinical meeting role.
Dr A Maddox has recently retired, however he is happy to do some locum work for BMG in the future.
Dr Price has taken over as PCN Lead in place of Dr Maddox.
Introduction to the Integrated Care Community
AS was unable to attend so this will be discussed at a further meeting.
Update on patient access
HM updated the group on the recent recruitment drive that was done early summer, taking on 10 new Patient Advisors who came into rota at the end of August having had their 6 week training plan. This recruitment has made a massive difference to the team, boosted morale.
Recruited again, appointed 5, 2 gave backword and 1 left, however we are doing another drive with interviews being held at the end of January and they should be trained up by the end of April.
We are looking for around 100 hours to fill the gaps. Some hours will be protected for staff members who should return in April.
One staff member is due to go off on maternity leave.
Positions are being filled in other areas temporarily to cover maternity.
HM highlighted that the new recruitment of Patient Advisors has brought positive changes to the team, morale is good, more staff across the board. She is looking at keeping minimum levels of Patient Advisors in the phone room in the morning to 14, and 10 in the afternoon. For safety reasons we need minimum amounts of Patient Advisors on the desks and we are trying to avoid pulling them from the phone room.
Site Managers now have a wall board, this therefore allows them to be more proactive with call STATS.
Performance management will be introduced from January.
HM explained that we are not at the consistent target of 90% yet for answered calls, however she expressed that we have hit it numerous times and are regularly hitting the high 80s.
Answered call STAT figures are displayed on a board in the phone room and this is positive and motivational for the team, as they can see how we are doing.
HM highlighted that we are unfortunately still having staff sickness and this affects call STATS.
The one minute wrap up time has been removed from the phone calls as it wasn’t always being used productively, codes have now been created. Patient Advisors can now put themselves into a “not ready” code and this can be broken down to see exactly how this time is spent. This change has improved the waiting times.
Since August the average handled call time has reduced. In November it slightly went up again, but HM puts this down to staff sickness. Covid and Strep A is rearing its head around the team.
Positive comments have come from patients saying they can get through to the practice on the phone much quicker, and HM hopes this will continue as more Patient Advisors join the team.
The Patient Advisor Team have met together at the half day training sessions and shared ideas.
PVG member noted things are massively improved and he praised Helen and the team for this. Well done.
Update on the new digital access platform
HM discussed AccuRX/front line triage with the group. She explained that this has been soft launched and a PVG member GO has helped both her and CM with the website from a patient’s perspective. There is a homepage banner and landing page on the website. This launch has not been promoted, and we have solely relied on patient’s finding it from the website homepage or from through the NHS app. CM noted that it is not that easy to find through the NHS app, so when we eventually promote this then some help and explanation will need to be done with regards to the NHS app.
The launch went live on the 1st Nov 2022 and so far for November we have completed 427 requests (16 doctor’s letters, 64 fit or sick notes, 160 something else help, 89 medical requests, 31 referral updates, 19 repeat prescriptions, 47 test results). In December so far we have had 180 requests, so it is ramping up already and seems to be working well.
Patient Advisors in the phone room and the Medicine Management Team are currently using this, GPs are not involved at the moment. Patient Advisors have expressed that they are enjoying using it, they say it brings a variety into their job role, it is easy to use, and a convenient way for patients to reach us.
PVG member has used this and has had one good result with this, however had problems with a repeat prescription. She used the patient access app and the repeat prescription wasn’t on there. She said the reply she received wasn’t very helpful and therefore phoned the surgery, where she was helped by a Patient Advisor and the problem was solved.
MMT deal with prescription requests alongside the PA team, however MMT are not giving an automated response whereas the Patient Advisor Team is, meaning some patients had put in medication requests and not heard back. HM and JB met, discussed and updated this, and now a confirmation text is sent in response saying that you won’t get a reply to medication requests unless there is a query.
PVG member used the system on the 1st Nov to trial it out, he received a reply that contact would be made but he has heard nothing. Coincidentally he was rung by a locum Doctor about another matter and had the request dealt with through that channel.
- Action- HM look into reply for AW’s request
HM discussed that a survey has been sent by text to the 427 patients who have used this, and we have had 66 responses so far. 90% said it is easy to use, 77% found it more convenient than their usual contact method, 75.8% would use this again, 75.8% were satisfied with the outcome.
Smartphones have been used by the majority of patients, 49.2% were aged between 51-70, and 20% were aged between 71-80.
This was found through the website, the NHS app, social media and word of mouth. 41% preferred to make contact via the phone, 30% via the website, and 27% by coming into the surgery.
We have also received comments from patients in the comment box. Most liked it, saying it is a brilliant idea, queries are resolved quickly, and easier access.
Information is being fedback to the teams.
We have had two negative comments in the comments box. These seem to be from the same patient and will be fedback.
Staff training is being done individually and this is being slowly introduced to the Patient Advisors.
HM expressed that she is hoping to promote this soon, however as more urgent surgeries will be held during Christmas and New Year it was decided to promote this in the New Year. HM is working with CM on promotions in the practice, scanning QR codes, message on the phone line, screens, website, FB promotions.
Recall team is currently using AccuRX for booking appts. Nursing team are trailing it for non Hyperglycaemic Diabetes.
CM said that she is happy to go through AccuRX/digital access with any of the PVG members if they would like help. RT (Stanleys) asked CM to show various members of her team how to use AccuRX.
Traditional contacting methods will still be in place also for those who don’t want to use digital platforms.
HM explained that the AccuRX appointment system is live and when any appointments are booked they will no longer show as available.
- Action CM show Stanleys how to use AccurX.
Age limit for usage is 13+ HM is currently creating a protocol for this to protect patients. As for supported patients where the parent needs access due to patient need, proxy access will continue. HM looking at this.
PVG member asked if messages go into the patient records?
HM confirmed they do.
CG noted that we have prebookable nursing team appointments 6-7 weeks ahead.
Outstanding tasks - minimum 7 day turn around for general tasks at the moment.
Appointments and online booking – The practice is proactively inviting patients into a specific clinic. PVG member asked if there was any progress on opening up online booking. HM explained that due to appointments being precious, the Patient Advisors are trained to navigate where best to book patients into. Appointments are booked through the Patient Advisor Team, however there could be opportunities in the future to book through the NHS App if we were able to offer this, but currently we are not able to offer free reign online booking of appointments.
HM noted there are various ways we can use the platform for online booking, however BMG felt AccuRX requests is the best way currently to improve patient access.
PVG member noted that BMG GPs carry a larger amount of acute appointments, and he is unsure if front end triage does actually prevent GP workload and protect the appointment system.
- Action HM speak to HF about the email PVG member AW sent
Extended access (what does that mean to our patients)
HF provided Chris with some information on Extended Access/additional winter services and he relayed this to the group.
In October 2022 our previous Extended Hours Service (run early mornings 7.30-8pm and from 6.30-8pm during the week) across sites and our Extended Access service (run on Saturday morning 8-1pm and Sunday morning 8-1pm from Morecambe Health Centre) have merged together to form the Enhanced Access Service.
The opening hours of the service are the same as the previous service, except that the Sunday morning service has now moved to Saturday afternoon 1-5pm. This is currently a remote service enabling patients to speak to a GP on the telephone.
The Enhanced Access appointments can be booked via our appointment system as usual.
To support us with this service we are working with Morecambe Bay Primary Care Collaborative (GP Federation) who are providing us with workforce for our telephone service on a Friday evening 6.30-8pm and Saturday afternoon 1-5pm.
Other local services supporting general practice over the winter
In addition to the Enhanced Access scheme we are working with two other providers to support us with appointments over winter.
FCMS who provide the Out of Hours Service are also providing additional appointments for practices to book into at the Urgent Treatment Centre. These appointments are still booked via the practice and are for urgent care and are spread over the week.
Morecambe Bay Primary Care Collaborative are also providing a winter pressures scheme on a Sunday morning at Morecambe Health Centre. These appointments are mainly for routine care with a variety of clinicians to help support General Practice over winter. Again these can be booked via the usual appointment routes.
We continue to work with Push Doctor offering remote video consultations with GPs for those patients who would like to use this service. We are finding this service very supportive in providing us with extra capacity that we can use to boost our resources during this challenging winter period.
Chris noted that we need to make patients aware of this, CM will promote this.
- Action -CM promote the Enhanced Access Service
Strep A info
RT (Stanleys) needs help with giving advice and asked CM for info she can share.
- Action- CM send Strep A info to RT (Stanleys)
RT invited CM to the centre to have a look around as it has changed.
Age Uk- Age UK have commissioned someone (Dave) to work with any of BMG’s patients aged 50 and above who need any form of digital help in the home, offering help getting them online. Digital inclusivity and networking can help with wellbeing so he offers time and expertise in the comfort of their own home. If a patient doesn’t have digital equipment then Age UK can loan these out. Free sims are also often provided for patients who don’t have internet access. These are not one off visits, Dave visits for as long as it takes for a patient to feel comfortable with getting onto the internet and networking. BMG have a good partnership with Age UK.
Age UK have tablets loaned to patients on a temporary basis and the patient has the option to purchase the tablet at the cost of around £80 from Age UK if they wish, often offering instalment payments if needed.
CM asked RT (Stanleys) to send her info of anyone that could benefit from this help.
RT (Stanleys) noted that Age UK are also giving out rubber accessories to go on chairs and sticks, as well as light bulbs that stay on for four hours if there is a power cut (battery back up inside the bulb).
Futures PVG meetings
Chris informed the group that he will be sending a list of meeting dates out to the group for the forthcoming year ahead. He explained that the meetings will be done via face to face or zoom.
April and July’s meetings will be done face to face when the winter months and conditions are behind us.
Face to face meetings will also have the addition of zoom for those who cannot attend.
Young persons dedicated voice - 30.1.23
RT (Stanleys) informed the group that there is a young persons dedicated voice community conversation happening on the 30.1.23 at Morecambe Town Hall.
- Action - RT send Chris an invite
Date of the next meeting
Thurs 9th February 2023
Rules of the meeting/purpose of the Chair
- Read agenda and papers in advance of the meeting and arrive prepared.
- All questions to be through the chair and only one person to speak at a time.
- Stick to the items on the agenda
- Respect the role of the Chair and allow the Chair to undertake the role to the fullest extent.
- For all decisions Chair to invite everyone present to give opinion without interruptions.
- Vote on all decisions and those members not present must inform the Chair of their voting decisions in advance of the meeting.
- Declare conflicts of interests.
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