PPG Meeting Minutes

Ashford Medical Partnership (AMP)

Patients Participation Group

Minutes of face to face meeting Willesborough Health Centre

Held Tuesday 10th September 2024 18:30

Attendees:

AMP:

                Jo Shepherd      

                Tim Pethick

PPG:

                Melany Sandor-Klinyec (MSK) Chair

                Martin Bennett

                David Pieris

                Cyrus Keeka

                Liz Wright

Apologies:

                Dr Navin Kumta

                Chailean Dottin-John

                Patricia Campbell

                Lorraine Monkhouse

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. Note apologies noted are from those who had confirmed attendance which then had to withdraw.

227 invites sent of which 6 PPG members confirmed attendance with 2 having to withdraw. 8 others replied of non attendance. 1 member asked to be removed from the PPG list and 1 member no longer wants to attend meetings but will continue to receive minutes unless otherwise informed. 3 members emails were not delivered with full mailbox notification. 1 person is also removed as believed it was due to her appointment request and not wanting to be part of the PPG.

As notification of the PPG meetings come from my personal email this could be the reason for lack of acknowledgement from 227 listed PPG members therefore request that these now come from the surgery.

ACTION: Melany send upto date PPG members list to Jo

Minutes of meeting 5th March 2024

The minutes are agreed by all those in attendance. Jo confirmed the spelling error of Dr Kumta in the minutes and is now corrected with apologies for the error.

Matters arising from meeting 5th March 2024

Action list was added to the minutes and will be updated after each meeting and distributed with minutes.

Jo has completed the action list and will send a copy by email. This will be distributed with these minutes and updated accordingly.

Gina passed on useful contact details at the ICB and Melany had a meeting with the new MP Sojan Joseph to discuss the issues and the need for a meeting with the ICB. He will have an initial meeting with the ICB on 20th September and feedback on moving these issues forward.

Nepalese specific issues reported was passed to Tim and confirms contact was previously known to AMP, issues have been addressed and now have a Nepalese speaking health care coordinator.

Jo will present the complaints data in the AMP update.

PPG Update

Following an email forwarded by Tim, Melany has been in touch with IC24 integrate care service. They are keen to work with PPGs and willing to work with the team and share more about the services they provide.

I have arranged for them to talk at the next PPG meeting on 111/out of hours service and awareness of the service.

Although Helen Bowen could not attend the meeting, she highlighted an issue with prescriptions she and others have experienced. This has included items missing on collection, items left off of prescriptions and items not requested along with old medication prescribed instead of new medication (HRT) Note on leaving the Pharmacy with the incorrect item results in that medication having to be disposed of as it cannot be re-issued .

There are a few parts to this issue:

The process for prescriptions is that should a chemist not have the prescribed medication in place then there are two courses of action (1) they provide a slip to the patient advising them to return in a couple of days as they need to order/waiting for an order to be delivered or (2) if they cannot supply in a short space of time they should return that prescribed items back to the cloud (SPINE) for another Pharmacy to pick up that request. The patient can nominate the alternative Pharmacy at the point of being informed it is unavailable or by contacting the practice.

For incorrect prescriptions this will require investigation into what had happened by the practice.

ACTION: Melany to forward details to AMP to investigate by their Director of Medicine.

ACTION: Jo to invite Mo their Director of Medicine to the next meeting to present an overview on the process for prescriptions.

Melany has drafted a news letter with the proposal to send out to all listed PPG members on the mailing list. Comments back would be welcome and then assistance will be needed in a polished version to be sent out. This hopefully will inform people of the PPG and how they can be involved. Volunteer for this would be welcome!

ACTION: Review the draft news letter/flyer by PPG

It was raised that Diabetic Clinic appointment had been cancelled due to no nurse available.

ACTION: Jo to review

Melany asked a question of AMP the position of strike action of GPs and if this is going to be communicated to patients.

Tim advised that the BMA action proposed is that the number of appointments seen by a GP will be reduced to seeing 25 patients per day in accordance with contractual obligations. However, AMP currently operate under that model to ensure GPs are not overstretched and can fulfil the patient needs that they interact with whilst protecting the health of the GPs.

AMP Update

Jo presented complaints data collated from the 12 month period 1/4/23 to 31/3/24

Whilst there were some minor issues raised these were downgraded to grumbles rather that complaints and all handled by AMP customer complaints officer who contacted those patients and closed out satisfactorily.

There were 35 registered complaints which include those directed through NHS England. Note complaints that are reported to NHS England are concluded through them and not AMP. AMP are asked to investigate and feedback only and not concluded through the practice.

From 35 complaints 4 are upheld, 7 partially upheld and 24 not upheld. In all instances patients are contacted and the system is closed loop to ensure finalised.

Systematic complaints are discussed at the MDT and internal meetings.

Note prescription issues were the lowest reported complaints with the highest around appointment availability.

Tim provided an update following discussion that the appropriate process mandated is that if there are no appointments then 111 is the correct course of action. This then feeds into the ongoing discussion with the ICB that practices including AMP have adopted the total triage system to ensure the most in need are identified and seen speedily. 30%-40% of surgeries operated a triage system.

 The patient survey recently sent out shows the key issue of appointment availability which is problematic across the country. On average AMP have a shortfall of not meeting demand by 25% the only resolve to address this is investment and funding for new premises and equipment along with people both clinical and support staff.

The demand for appointments are measured through the KLINIK system which we all agree has improved how we book appointments and patients can interact with requests, it also enables good data to be reported.

The KLINIK system is AI supported and an initial sort of patient needs is done. This sorting is passed to the GPs and 2 partners review all care needs as the deciding factor not the AI. The GPs then ask the care navigators to book appointments or calls for same day needs and contact patients for routine appointments. Routine appointments target is within 2 weeks although demand is high and is currently reaching up to 3 weeks.

45% of the capacity is taken for long term illness, of the remaining requirement demand for acute/same day appoints is 60% and 40% routine to appointments.

PPG asked if demand is high for capacity then why actively take on new patients to register. AMP advise the reality is that 30% of registered patients actually rarely require the practice surgeries. For each patient registered they will receive funding and this offsets those with long term need or frequent individual patient needs.

PPG asked if frequent users of the service could be reviewed to see if the several issues may have some underlying cause. This in turn could potentially reduce their future visits if a route cause could be identified.

AMP advise that like many instances NHS have run a trial on this and has shown positive results in reducing future needs. It is the case however that it is not contractually how the NHS work with GPs from a preventative approach.

PPG asked if GP practices are ultimately a private business, then surely it is in their interest to do this anyway to reduce the demand. AMP confirm that this potentially could in the short term impact their capacity further and that practices in the Ashford area sway to changes already implemented and proven by other surgeries in that area and no desire to be the first to make change.

PPG asked in AMP have social prescribers to assist in directing patients with non clinical needs to assist with demand of those who actually would benefit from some other support. AMP confirm they no longer have a Health & Wellbeing member of staff but have access to the new EKHP (East Kent Health Partnership) delivering social prescribing along with referrals to AGE UK etc as part of their MDT meetings.

Liz Wright mentioned she is actively working at community engagement to address loneliness with meetings in the church Inspire café daily. Providing a service that people can talk and run ideas past others and provide a listening ear which sometimes they would approach the GP for when actually needing a friend. The PPG will support this and discuss in more detail with Liz to promoted the service

As per the last meeting AGE UK can also offer a befriending service.

Date of next meeting Tuesday 3rd December 2024