Meeting Minutes September 2022

Meeting Date: 15th September 2022
Time: 7:30pm via Zoom

Chair: Cath McLennan

Minutes taken by: Yvonne Barrett.

Introduction of New Members 

No new members to introduce however Chris is in discussions with a new member who could possibly be joining the group next month. 

Conflicts of Interest

None.

Minutes of the Previous Meeting

Read and agreed.      

Actions from the Previous Meeting

 

Phone access - Have had a discussion with HM, new PAs started live on Monday, getting back to good staff levels, noticed some good days, longest wait on Monday was 30 mins.   Recruiting again, some PAs have moved into other areas within the practice.  Work being done around PA roles, changed a few things to protect time. Need to allow the changes to get imbedded and Chris will feedback - Action ongoing

 

Trauma informed training - Chris emailed the organisation twice and has had no response.   Looking at doing training of our own. Chris will feedback – Action ongoing

 

Access to appointments- HM fed back to all the Patient Advisors about wording regarding making appointments- Action completed 

 

Digital access - Ongoing, signed contract with AccuRX.  Soft launch in November. PVG member (GO) happy to look at patient communication side.  HM to contact GO- Action ongoing 

 

Medication synchronisation form – Form has been amended.  MMT manager is pleased with the changes and the form has now been implemented- Action completed

 

Participation of promotion of NHS App – PVG member (GO) had MS teams meeting, going ahead with the film, organising a schedule, finalising scenes and locations. GO happy to be involved on behalf of the practice. 

NHS app asked for a doctor volunteer, CM asked Dr Akhtar for his help with this, he agreed- Action ongoing

 

NHS App- CM contact PVG member (GC) regarding access to notes - Action ongoing

It was noted that patients who don’t have digital access can still use the traditional methods of contact to the practice.

Practice update

Dr Wooldridge gave an update on the practice.  She noted that we have a few new Patient Advisors who have done their lengthy induction and training and are now starting in practice. She expressed that we have an ongoing recruitment programme for Patient Advisors.

A GP is returning from maternity leave soon and another new GP is starting next month.

There are a few new faces around the practice due to trainee change over.

Visiting team have recruited a nurse frailty matron who will work with care home residents.

There are some trainee nurse practitioners within the visiting team.

An introduction to our Patient Advisors

Chris introduced CB and SD to the group and explained that they will be regularly joining the meetings.

 

CB gave a brief overview of the role of a Patient Advisor noting that they were previously known as a doctor’s receptionist, however the role now entails a lot more than this and are now known as Patient Advisors.  She referred to the Patient Advisor’s job description and briefly read this to the group, highlighting that Patient Advisors are not clinically trained, however their role is to advise the patient in the correct pathway of their appointment.  CB explained this brings questions so they can best place the patient in the correct appointment. 

CB expressed that she feels excited to be involved in the PVG meetings and is happy to answer any questions.

 

PVG member asked, “what proportion of time when someone rings in do you end up referring them to someone other than who they have asked for.”  CB replied saying this happens often, unable to pinpoint a time element.  She explained that they may have a patient call for an appointment with a doctor, but on discussion sometimes it can be quicker and more efficient for the patient to be routed down a different path, i.e., if they phone for knee pain, they could speak to or see the physiotherapist.    

 

PVG member asked, “what proportion of your time are you answering calls?”  SD explained that this varies, she noted there is a phone room which is like a call centre and staff are dedicated a full shift in this room.  Patient Advisors work across all five sites alongside the phone room, trying to keep the phone room as full as possible.  She expressed that the phone room is a large focus, manned by as many staff as possible every day.  Every Patient Advisor has to do a phone shift, keeping them all in the loop.

 

PVG member noted as a consumer it takes a minute and a half to go down by one in the phone queue, therefore leading to a lengthy wait. 

 

CB confirmed that HM fed back to all the Patient Advisors about wording regarding making appointments.  

Introduction to our Care Co-ordinators and Social Prescribers

Chris was hoping that the Care Co-Ordinators and Social Prescribers could attend the meeting but this was not possible, however he is hopeful they can attend a future meeting.  Chris gave a brief description of their roles.

 

Care Co-Ordinators are a large part of the practice.  Social need is much on the agenda nowadays as it has become more apparent that social need has such an impact on physical health. Isolation, loneliness etc are a few things they deal with.  They are sent out to find out the patient’s needs and find out what is available in the area for the patient.  Chris noted that some patients are now regularly attending social cafes, thus helping to break the isolation down.

They are linked to the ICC but are employed by BMG. 

 

Social prescribers look at what is going on in the area that they can go along to, meeting up with the Social Prescribers, chatting and interacting with them. 

They are part of the PCN.  

 

Chris explained that these are both extremely important roles, and all groups work closely together.  

Autumn vaccination campaign

We are coming up to the start of flu and covid vaccine campaign.

HF gave an update.  She encouraged all to make appointments for their vaccines.  First clinic is the 26.9.22 and most slots are filled until early October, adding more appointments as we go along.   Most sessions will be at the Mazuma, felt this was the best place to do at scale.  Flu vaccination can possibly be done in surgery if a patient attends for something else, however it is best to book in.  You can access the flu vaccine at the chemist.  The mass vaccination centres have wound down. 

Using Moderna for covid vaccinations.

Offering children under 11 Pfizer.

 

PVG member noted he received a text message asking him to ring to book his appointment, he tried to do this but it was not a good experience, name not given, not given a choice of times, was told it was a vaccination but not which kind etc or both, and he had to ask all the questions.  He fed this information back to Chris and Chris has since spoken to the team who takes the calls.  Further training has been given to this member of staff. 

 

PVG member highlighted that his appointment for his covid appointment has disappeared off the system.  He noted that the venue was also wrong, and this has now been changed to the Mazuma.

Action

• Look into appointments disappearing from the app.  Check GO has an appointment

 

PVG member had asked previously if her husband could attend at her appointment and was told he could, however she got a call to say the clinic had cancelled and now when she looks on Patient Access or on the NHS app, it is not showing that there is any appointment there. 

Action

• Check GW/GC has an appointment

 

PVG member asked about the shingles injection and whether she will be offered this when she turns 70.  HF confirmed she wouldn’t have all three on the same day, but she will be called for the shingles vaccination at some point.  She advised the PVG member to ring and get booked in for this.  

 

Update from previous meeting around patient access

PVG member had highlighted advertising for paid services at the last meeting, Chris looked into this and found the advertisement was on Patient Access which is a different organisation to us.  Chris contacted emis and they confirmed that there is nothing on our system.  Many services that are advertised aren’t showing as available for the NHS even though they provide this, PVG member suggested that all services should be advertised, including NHS and not just private. 

Is there any means to adding to Patient Access?  BMG are unable to add anything.  CM confirmed emis is a national database and we buy into this programme and Patient Access is a part of emis.   CM had asked them if this section could be obscured but this was also not possible.

CM confirmed the NHS app do not advertise private services. 

Dr Akhtar asked the PVG member to raise this with the portal directly and ask why they are advertising as they are.  

Action

• PVG member make contact with the portal directly as a user, ask why they are advertising private services/not NHS and feedback

 

Chris has spoken to Dr Maddox recently and they both agreed patient access has always been an issue, demand always outweighs the appointments we have available, and this means we need to learn to work smartly.

Chris thanked a PVG member for his help with highlighting and shifting our focus on this, and he explained that we will continue to work on this and will carry on making changes to produce the best system possible.

 

Call back service

PVG member suggested a call back service.  He explained that he had been extremely frustrated with a number of outside organisations recently, however some of these had a call back service and he felt he didn’t get quite so frustrated with the ones that had a call back service available.  Is this something that could be built in? does it save time?

A discussion took place following this suggestion, however it was agreed that we are getting to a point where we are answering calls well and the feeling was it is unsure if this would work for us due to various reasons. 

PVG member noted that from a patient point of view, a call back service wouldn’t work as the call doesn’t always come in when it is convenient to answer, so he feels this would not be a sensible option within BMG.  Dr Akhtar agreed with this, he explained when calling patients back it can often come up as an unknown number or even a Kendal number, so patients don’t answer as they are unsure who is ringing. 

 

It was agreed that a call back service could raise all sorts of challenges and therefore would not be a good idea.

 

Triage list calls

Dr Akhtar explained that GPs often try to phone patients who are on the triage list but they don’t answer their phone for various reasons.   This becomes frustrating and an unconstructive use of time.    Various methods will continue to be used, texts, video consultations, face to face appointments, picture messages etc. The pandemic has brought digital technology change much sooner than planned.  On going forward over the next few years we should become more advanced.

 

Sicknotes

Dr Akhtar briefly explained that in the past if a patient required a sicknote they would have to request this, speak to the GP and collect from the surgery, however due to the advances of technology these are often now done via text, which although is efficient for the patient, from the GPs point of view he is now dealing with many more patient’s sicknotes than previously due to the time saved with using technology.  This means the GP is now looking into more patient’s records/history and issuing more sicknotes.   

CM noted that AccuRX is the text messaging service used and this  filters into our clinical data base. 

 

Proactive phone calls

PVG member had a text from the practice asking them to ring in to make a telephone appointment.  The Patient Advisor was unsure who requested this and therefore arranged for a doctor to ring them. PVG member feels this was time wasted for the PA, the doctor and himself, alongside being irritating and frustrating especially when it is something the practice wanted done.  He feels a better use of time would be for the practice to ring the patient. 

Dr Akhtar explained that texts are often used, he sends his patients a text if he has previously spoken to the patient and they are happy with this.  He directly communicates with the patient.  He noted that the intention will be to talk to the patient, but texting can be used in addition when appropriate.  This can also aid in the diagnostic tool.

It was noted that when online booking becomes available there will be more efficient communication dialogue. 

 

CM reassured the group that any text message that is sent is recorded in the patient’s records.

 

Dr Akhtar noted that clinician time needs to be put aside for text administration and as a practice we need to go back to the partnership and see how we can support this.   

 

AOB

ICC Event

This was unfortunately cancelled and is being rearranged.  Chris will share this when he knows the date.   This event showcases things outside general practice and highlights how the ICC works alongside general practice.

Chris asked if some members could attend this.

PVG member (AW) expressed that he would be interested to hear of any PCN events and would be happy to attend these.  Chris noted this and will let him know if anything comes up.  

Date of the next meeting

Thursday 8th December 2022

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.