Litchdon Patient Participation Group, Barnstaple Devon

Latest Meeting Minutes

These are the minutes of the latest meeting. Previous meeting minutes can be viewed here.

PPG Minutes 21 November 2018 
Main Surgery Building Conference Room 6.30 pm

Present; Sharon Bates (Practice Manager) Paula Ward (Assistant PM), Dr. Hazel Warner, Sue Matthews (Chair) Rosie Haworth-Booth (Secretary, Minutes).  Micky Squire (Deputy Chair), David Adams, Richard Passmore, Cathy Chick.

Minutes of Last Meeting +Matters arising. (Rosie Haworth-Booth/Sharon Bates) P.2  Facility to amend online booking screen to take patient’s amendments/additions on their condition. Sharon reported that providers SystmOne will only change screen provision with a tipping point of requests on specific actions. This request did not yet enter that category. ACTION Sharon to ask the Doctors if they would be interested in taking this further and possibly discussing at their regional forum meeting.
Enlargement of Font size on waiting room screen: Sharon reported that one part has been enlarged but no further adjustment possible on other side of screen.
P3: The Green Awards questionnaire was drawn up and delivered to patients in time -  see Practice Update below.

Practice update (Sharon)
Staff Dr Hunt retired and Dr Carlino is new partner.
New GPs Dr Tyler starting end of Jan and Dr Fothergill starting March both working 2 days a week.
New paramedic working 2 days a week in Same Day Team (SDT) and visiting.
4 new receptionists in last few months replacing staff who have left.
Sophie McDonald retired from nursing team after 17 years here, but still doing some locum shifts.
Student nurses and student paramedics have been on placement and there will be continued placements in the practice (from Plymouth University).

Patient numbers continue to grow: up to 15,600 now.

UNESCO/NUS Green Impact Project Litchdon has now achieved the Gold Award for being green, sustainable and environmentally friendly – this includes recognition for our social prescribing.

National Patient Survey - results came out in August. The document is attached as an appendix to the minutes. Web link:  https://gp-patient.co.uk/report?w=1&practicecode=L83035External Website Link
For all questions Litchdon scored above both the local CCG average and the national average –The surgery is very pleased with the results as they do try hard to provide a good service.

E consultations – these are aiming to offer advice to patients via a specific email system that is being rolled out nationally by the NHS. Patients will be able to access the site and get advice and sign-posting to appropriate services, including a facility to email the GP and receive a direct email reply.  If anyone is interested in helping the surgery to test the system you can get into it, to use it as a patient would, and feedback your opinions.  ACTION Please let Sharon know if you would like to take part.  Aim to start in Dec or New Year.

Improved Access
Government initiative to have more surgeries open for prolonged hours - called Improved Access.  Across North Devon some practices are offering appts in the evening and at weekends.  Litchdon already has an extended surgery 2 evenings per week but more on offer in the Torridge side and all N Devon patients can use the service.  Litchdon can book the appts. directly.
Litchdon has made a policy decision not to extend surgery access under the scheme but retain current hours of service to concentrate on the care and services it provides its own patients, rather than opening appts up to other patients across North Devon.
It is now also possible for patients to make appts with 2 Barnstaple pharmacists in the evening and weekends as well as being able to just drop in to a pharmacy (Tesco and Sainsburys). Direct tel. numbers are given out for the patient to contact the pharmacy for an appt.

Emergency/urgent care is still with Devon Doctors. SM wonders if the new extended GP access will reduce MIU and A&E attendance.

Closer communication between Healthcare campaign (SOHS) and Healthcare management.  (Sue Matthews)

SOHS started life as a campaign against the threat to services in North Devon and is now Devon-wide. The potential loss of major services like Maternity and Stroke was addressed in the Acute Services Review. This concluded with the necessity of retention at NDDH but travel for patients is still a major issue and some services are still vulnerable e.g. ENT, Urology.

SOHS members are now in dialogue with the CCG and NDHT and have shared patient stories and experience of which they hitherto were not aware. Primary care is also an issue as some people find it very difficult to reach a GP practice.  The CCG and NDHT have declared an interest in using the SOHS survey/questionnaire with its independent input from patients post-treatment. Suzanne Tracey, New Joint CEO of NDHT and RD&E, has been surprised by significant differences, often complementary, in care between the two hospitals – e.g. breast screening – which has affected her attitude toward transport and e-consultations and the day to day impact of procedures.

Further Questionnaires.
During discussion at the most recent Public Stakeholder Network (PSN) meeting between CCG and PPG Reps Northern Locality CCG Chair, John Womersley indicated that feedback from PPGs on the most important problems encountered by patients  are being sought by management, to assist in reprioritising and improving services.
What issues can we take forward from patients to the CCG?
Sue suggests the following:

ACTION Rosie & Sue to discuss and draw up questionnaire to send to PPG Member group and discuss further with Sharon, for potential use in Surgery waiting room.
 
Relating to point 1 above, at a District Council Scrutiny Committee meeting last week John Womersley said that the Care Closer to Home project had not been implemented in North Devon. This contradicts all previous information relating to Care Closer to Home, from CCG and NDHT, and the care of patients at home immediately after hospital inpatient treatment.
Sue also mentioned the use of patient stories and support groups for cancer treatment survivors. At a recent NDHT Board meeting, the group already set up requested more patient participation. Contact via the PPG would be a good place to start. At present there is a good service from NDDH for patient support while they are still in treatment but as soon as treatment stops, most support services stop too. The surgery could put up posters to promote. ACTION Sue to forward details of cancer survivors group to Paula for a poster to be drawn up.  Could be a poster asking patients to come forward with their Care Closer To Home stories.

It is clear from NDHT and NEW Devon CCG, that the difficulty of recruiting to the healthcare workforce is the greatest challenge to providing services to patients. This is a national problem but the impact is more acute in North Devon because of the lack of local access to University training for nursing students, physios and radiographers.  The new CEO at NDHT is promoting joint appointments with RD&E to encourage medical staff recruitment and we understand that training opportunities for nurses should improve next year. The government removed Student Nurse Bursaries in 2016/17, reducing the number of candidates at Plymouth University by over 25% in the last 2 years. SOHS has started a campaign to re-instate the bursary and Sue will be meeting with MP Peter Heaton Jones to lobby for his support in this matter.

Funding for the NHS has always been challenging. Most services are free to patients at the point of need, paid for from general taxation (NOT national insurance). The funding formula is complex – the largest part is based on capitation but added factors of rurality and ageing population are taken into account. SOHS are challenging the funding formula, which favours inner city and urban populations, which tend to be younger and able to access services unaided – unlike North Devons’ increasingly ageing population. Another factor affecting funding is the Market Forces Factor: the mean local labour force pay and property price which means that somewhere like North Devon gets less funding than a heavily urban,  high-property-price, high-income area like Bath or Salisbury. Suzanne Tracey is in agreement with Sue that this formula is not fit for purpose.

Dates of Next Meetings
A decision was made that meetings should be held quarterly here on the 3RD Wednesday of the month every three months, starting on 20 February 2019. ACTION Rosie to draw up the list of dates and circulate to the group.

AOB David Adams noted that the online prescription form fails to print out further notes added online by the patient and asked if anything could be done about this. Sharon pointed out that this is linked to the same online system, SystmOne, as used for the GP appointment bookings (see above under mins. of last meeting) and can’t be dealt with locally. ACTION- Sharon to add to  request to doctors re online booking with possibility of feeding back to company .

Cathy noted that follow ups from Breast Screening go to Exeter but they could go to Barnstaple – can something be done about this? This is another matter that SOHS have taken forward with the NEW Devon CCG, as commissioners of the service. ACTION Sue to report back when a response is received.

Richard Passmore offered his services as an expert patient on Neurology treatment and would be happy to meet up with patients who would like counseling. It was suggested that a list of expert patients could be added to the social prescribing list.  (Patient Gill Robb has also offered her services regarding advice, consultations, help, for patients with visual difficulties and needs). Paula noted that Hannah Doidge would be back at the practice in December and would be able to discuss such a list – a dementia carers group already exists.

Dr Warner thanked Micky Squire for his help at the Flu vaccination days.

Date of next meeting 20 February 2019.  Please note this meeting will be in the Conference Room again as structural changes are being made to the Dermatology Clinic.

NHS England national patient survey results for Litchdon.

Result

Latest report –
Report Aug 2018 (from surveys carried out 01/01/18– 31/03/18
108/234 surveys returned -
46% completion rate)   

Previous report –
Report July 2017 (from surveys carried out 01/01/17 – 31/03/17
118/223 surveys returned -
53% completion rate)   

Previous report –
Report July 2016 (from surveys carried out 01/07/15 – 31/03/16.
120/219 surveys returned – 55% completion rate)

% of patients who find it easy to get through to this surgery by phone

91%

Local (CCG) Average: 81%

National Average: 70%

92%

Local (CCG) Average: 82%

National Average: 71%

92%

Local (CCG) Average: 85%

National Average: 73%

% of patients who find the receptionists at this surgery helpful

95%

Local (CCG) Average: 94%

National Average: 90%

90%

Local (CCG) Average: 90%

National Average: 87%

91%
Local (CCG) Average: 90%
National Average: 87%

% of patients who with a preferred GP usually get to see or speak to that GP

77%

Local (CCG) Average: 63%

National Average: 50%

67%

Local (CCG) Average: 67%

National Average: 56%

65%

Local (CCG) Average: 71%
National Average: 59%

% of patients who were able to get an appointment to see or speak to someone the last time they tried

Not asked

86%

Local (CCG) Average: 90%

National Average: 84%

90%

Local (CCG) Average: 90%
National Average: 85%

% of patients who say the last appointment they got was convenient

Not asked

91%

Local (CCG) Average: 88%

National Average: 81%

91%

Local (CCG) Average: 95%
National Average: 92%

% of patients who describe their experience of making an appointment as good

87%

Local (CCG) Average: 78%

National Average: 69%

86%

Local (CCG) Average: 82%

National Average: 73%

81%

Local (CCG) Average: 82%
National Average: 73%

% of patients who usually wait 15 minutes or less after their appointment time to be seen

71%

Local (CCG) Average: 73%

National Average: 69%

67%

Local (CCG) Average: 70%

National Average: 64%

56%

Local (CCG) Average:  69%
National Average: 65%

% of patients who feel they don't normally have to wait too long to be seen

Not asked

56%

Local (CCG) Average: 65%

National Average: 58%

43%

Local (CCG) Average: 64%
National Average: 58%

% of patients who say the last GP they saw or spoke to was good at giving them enough time

Not asked

89%

Local (CCG) Average: 91%

National Average: 86%

84%

Local (CCG) Average: 90%
National Average: 87%

% of patients who say the last GP they saw or spoke to was good at listening to them


Not asked

88%

Local (CCG) Average: 92%

National Average: 89%

85%

Local (CCG) Average: 91%
National Average: 89%

% of patients who say the last GP they saw or spoke to was good at explaining tests and treatments

Not asked

88%

Local (CCG) Average: 90%

National Average: 86%

85%

Local (CCG) Average: 90%
National Average:  86%

% of patients who say the last GP they saw or spoke to was good at involving them in decisions about their care

Not asked

86%

Local (CCG) Average: 88%

National Average: 82%

75%

Local (CCG) Average: 86%
National Average: 82%

% of patients who say the last GP they saw or spoke to was good at treating them with care and concern

Not asked

90%

Local (CCG) Average: 90%

National Average: 86%

83%

Local (CCG) Average:  89%
National Average: 85%

% of patients who had confidence and trust in the last GP they saw or spoke to

Not asked

95%

Local (CCG) Average: 97%

National Average: 95%

93%

Local (CCG) Average: 96%
National Average: 95%

% of patients who say the last nurse they saw or spoke to was good at giving them enough time

Not asked

93%

Local (CCG) Average: 95%

National Average: 92%

89%

Local (CCG) Average: 94%
National Average: 92%

% of patients who say the last nurse they saw or spoke to was good at listening to them

Not asked

91%

Local (CCG) Average: 94%

National Average: 91%

87%

Local (CCG) Average: 93%
National Average: 91%

% of patients who say the last nurse they saw or spoke to was good at explaining tests and treatments

Not asked

91%

Local (CCG) Average: 92%

National Average: 90%

81%

Local (CCG) Average: 92%
National Average: 90%

% of patients who say the last nurse they saw or spoke to was good at involving them in decisions about their care

Not asked

83%

Local (CCG) Average: 89%

National Average: 85%

82%

Local (CCG) Average:  88%
National Average: 85%

% of patients who say the last nurse they saw or spoke to was good at treating them with care and concern

Not asked

91%

Local (CCG) Average: 94%

National Average: 91%

85%

Local (CCG) Average: 93%
National Average: 91%

% of patients who had confidence and trust in the last nurse they saw or spoke to

Not asked

97%

Local (CCG) Average: 99%

National Average: 97%

97%

Local (CCG) Average: 98%
National Average: 97%

% of patients who are satisfied with the surgery's opening hours

Not asked

81%

Local (CCG) Average: 79%

National Average: 76%

75%

Local (CCG) Average: 79%
National Average:  76%

% of patients who describe their overall experience of this surgery as good

92%

Local (CCG) Average: 89%

National Average: 84%

96%

Local (CCG) Average: 91%

National Average: 85%

85%

Local (CCG) Average: 90%
National Average: 85%

% of patients who would recommend this surgery to someone new to the area

Not asked

86%

Local (CCG) Average: 85%

National Average: 77%

85%

Local (CCG) Average: 85%
National Average: 78%

What this practice could improve
The practice has scored higher than their CCG average in every question