Ashford Medical Partnership (AMP)
Patients Participation Group
Minutes of face to face meeting Willesborough Health Centre
Held Tuesday 4th June 2024 18:30
Attendees:
AMP:
Jo Shepherd
Dr Navin Kumta
Tim Pethick
PPG:
Melany Sandor-Klinyec (MSK) Chair
Martin Bennett
Gina English
Chailean Dottin-John
Patricia Campbell
David Pieris
Lorraine Monkhouse
Robert Carr
Desmond Henley
Age UK Guest:
Helen Gibbs
Apologies:
Shobhraj Gurung
Gillian Clark
Helen Bowen
Fran Turner
Aftab Khan
Welcome:
Melany Sandor welcomed everyone to the PPG meeting and reminded everyone the importance of confirming attendance in advance in order to manage attendee numbers given space constraint.
Request for PPG member to take notes of the meeting which Gina kindly agreed to on this occasion.
Minutes of meeting 5th March 2024
The minutes are agreed by all those in attendance and noted Lorraine Monkhouse should have appeared on the apologies of the previous meeting. Helen Bowen also confirmed the typing error in her name where Brown should have read Bowen.
Matters arising from meeting 5th March 2024
ACTION Melany: Collate a separate action list to be attached for clarity on actions
ACTION Jo: A request has also been made to collate a list of acronyms.
PPG Update
Melany introduced Helen Gibbs from Age UK who supports Personal Independence Programme within Ashford.
Helen spoke with everyone about the service in which Age UK provide direct support to people over 55 in order to help them improve confidence, access services and promote their independence.
The service offers up to a maximum of 12 weeks intensive, free support to those that need help to remain independent and improve their health and wellbeing
The service is commissioned by NHS Kent & Medway and is led by a Service Manager on behalf of the NHS and offer a consistent supportive presence, avoid duplication of service provision by other agencies and ensure that care and support is personalised and timely and can provide equipment
support such as Handrails etc
For anything they can’t help directly with, Helen will be able to provide signposting to other local services who can.
Helen made clear that anyone can make a referral to them (in the correct geographical
areas) the range of partners, include GP’s, social care and community nursing GP, Social Services and self referrals.
DR Kumpta advised they currently use SBAR form which is completed and reviewed by a multi
disciplinary team who decide on the best course of action or referral if it is a non clinical
need. Lorraine asked about services elsewhere in Kent and also for people under the age of
18 as she works wit in the education sector and info would be useful. Helen mentioned services such as Connect Well, Red Zebra, Imago who are all social prescribing services. Gina also followed
up with the Cost of Living Support services offered by SEK.
ICB Update
Mel and Martin met with Tim and Jo to uncover the barriers and issues. Main barrier is there
is a lack of communication and in part due to their lengthy restructure process. Two main issues to focus on with the ICB were:
111 Triage resulting in duplication and delay of providing service to patients
Lack of specialist wound care provision post surgery
A meeting with the Damien Green MP was set up where these issues were discussed in detail for him to facilitate further discission with the ICB directly. Following the dissolution of parliament due to the call for an election Melany spoke again with Damien Green on how his discussions had progressed. He informed that he had only briefly spoken with the ICB in passing and has said he was
waiting for a date from them to meet with them properly.
The AMP team along with Mel and Martin met with the Willesborough councillor Sojan Joseph who ran for Labour and has now been elected as the new MP. Mel will now take this up with him to progress.
ACTION Gina: To assist with possible contact pathway.
ACTION Me:l To contact Sojan Joseph MP to move things along
Medication
Mel brought forward the issues patients have reported surrounding delays in receiving
medication both via the surgery and via the surgery following hospital appointments. Some
patients have had to wait months for a consultant prescribed medication to be prescribed from the surgery and when they talk to the surgery they have no record of the letter sent by the hospital.
There is also an issue when medication is rejected, sometimes patients give an explanation
in the comments, there is no reason given in the rejection or reply to the comments on the
email and there have been other general delays.
Tim explained that there have been a number of factors that have inflated the issue recently.
All Lloyds pharmacies, including this one, has been sold off. The new provider deleted a
number of patients prescriptions off the system during the transfer (approx. 300)
The system AMP have to use to reject prescriptions does not have the capability to add a
note from the medical team as to why a prescriptions has been rejected.
Mel asked Tim if they can see the comments entered by patients.
Tim advised they can but cannot act without the letters from consultant etc. Repeat prescriptions can also be sent via EMIS/Patient Access
The Primary Care and Secondary Care computer systems are not joined up and do not
communicate with each other. AMP receives an average of 14,000 letter a month and has to
process them all individually as the letters are not received in a standardised format and
information has to be manually extracted.
Dr Kumpta Explained that there is another issue with perception of speed of processing
when patients use the app. The app is available 24/7 and patients complete requests
outside of working hours. If a request is submitted on a Saturday, that’s not getting seen until
the Monday.
In addition, there has been staffing absences and changes, they have recognised there was
a gap in capacity and recruited and extra person into the Medication Management team and
they are almost up to speed, this has had further impacts on the turn around of some
prescriptions.
The letters sent from the hospitals to the surgery vary greatly in timeframe of arrival, for
example:
Gastronomist 3-4 weeks
Cardiology 3+ months
Tim spoke about the NHS App and the push for all patients to take up the App and use it. All
GPs have been targeted to have 80 of patients sign up (date TBC) at present they sit at 56%
David asked if the EMIS system was going to remain in place?
Dr Kumpata said no reason at present it wouldn’t.
Lorraine asked if medication requests we’re rejected due to mandatory appointments being
needed such as blood tests.
Dr Kumpata said that is sometimes the reason, which they have identified and they are
currently implementing a pre-emptive system to call patients in before their mandatory
checks to ensure there is no break in medication.
Charlean D asked about the patient access app and asked why there was some barriers
around authorisation when logging on. There was discussion amongst the group saying that
depending on the route you were logging in by, depended if you had to double authorise as
there were two ways to access it.
Nepalese Community
There has been long standing issues raised by the Nepalese community surrounding access
to the surgery due to language and technology barriers. Mel has been contacted by a patient who highlighted that many do not speak English or have access to a computer or online device. The
patients find it difficult to get an appointment in the 8am rush with less reported issues containg Hayesbank Surgery.
ACTION Mel: Pass on the email of the details to Tim/Jo
Tim agreed there are two issues key issues, Language barrier and Technology barrier.
Unfortunately at this time Klinik is only available in English, there maybe an update at some
time in the future. But right now, it is one language. It terms of the language barrier, they have
now managed to recruit a Nepalese speaking receptionist at St Stephens Walk. Although, he
added that they have always had and still have an interpretation service available for
patients. They have a larger proportion of Polish speaking patients than Nepalese, but they
seem to be able to access the surgery okay. They also have a number of non reading and
writing patients who are able to get in touch over the phone.
The phone usage stats have improved significantly and uptake on Klink has increased.
Average call time has fallen from 40 minutes to 4 and sometimes they have had no patients
waiting. AMO is 12 month into the Klink system and there have been many improvements to
access.
Klinik has also given them a lot of data and insights into patient needs and trends and they
now have a data analyst working for them once a week to make the most of the data they
now collect to inform them of future expected trends and they are able to be proactive about
flexing their services to ensure efficiency. They only see more improvements for patients on
the Horizon. At present they have an average of 75% same day demand. They don’t have the
capacity to do any more currently. They have converted two rooms upstairs but they
can’t use them yet as they are waiting for the ICB to sign off the computers and get them
integrated onto their systems.
Everyone agreed over all the Klinik system has transformed the service and AMP
Charlean asked if the automatic reply from Klinik could have better information, at present
the email received is just a jumble or numbers
Tim said this is not possible at this time.
Gina asked if the tablets that are stored behind the counter, could be mounted on the wall or
in a lectern, so they are out on show and people can see that they can use them if they can’t
access at home or if they need help. It would also be a good way to promote the app if one
has a sign up for it.
Complaints
The rise in complaints and the increase time to gain a response is something that is
concerning and needs addressing.
Jo explained that they are aware of a backlog and the backlog has been caused due
to the complaints person having time off due to illness and then after briefly returning
unfortunately injuring themselves which has resulted in further absence. Jo and Tim have
been working through the backlog and normal service should resume soon.
They also wanted to note that if a complaint has been escalated to NHS England, the
surgery are no longer able to conduct the investigation into the complaint, they have to wait
for NHS England to get in touch with them and they give them the information needed and
NHS England will respond to the complaint, this causes significant delays to responses.
They confirmed they do send a confirmation email to complaints within 7 days with the aim to
investigate and reply in 4 weeks, but this is not always possible.
Mel asked if there is the gathered data surrounding complaints and if so can the PPG have
access to it as it could be useful as an agenda point for future meetings.
ACTION Jo to compose complaints data for PPG Review
Jo said there are several routes for people to complaining and there is a policy on the
website. She is in the process of reviewing and updating the policy.
AMP Update
Tim said AMP capacity is at an historic high, they have 23 whole time equivalent GP’s and
Clinicians.
Dr Kumpta reiterated the benefits if the data they can draw from the Klinik system as it
enables them to be more proactive. The first step was Klinik and the second steps is
processing the gathered data to inform future capacity planning. They are already planning
to help manage capacity in winter during high periods of demand by ensure routine
appointments are scheduled at quieter times of the year.
Mel asked when they are going to send out the patient survey?
There was some back and forth discussion around the effectiveness of the survey as people
only reply when they have an issue and there is better data to be gathered from the
complaints and Klinik, no date was given.
Tim had a Complex wound care update, they had a visit from the UK Health Sector Agency
due to the recent Group A Strep outbreak in Kent and they asked about the Complex Wound
Care provision? Tim was able to inform them that there wasn’t one and there was no
movement from the ICB when the matter has been raised by AMP. The agency have said
they will contact the ICB to find out what action they are taking and they will feed back to
AMP the outcomes.
Martin asked if there was anything AMP wanted the PPG to support them with?
– Promoting the use of NHS App
– Continued promotion of Klinik
– Speaking with the ICB to keep putting pressure on communication and resolving issues that seem to be effected within our area.
Date of next meeting Tuesday 3rd September 2024