In attendance

• BB @ HF    
• SK    
• JH @ HF    
• AH HF
• AS@ HF        
• VR @ HO    
• MB @ HF
• BB@HF        
• JE @ BH    
• CK Operations Manager @STK
• LB @HF            
• Dr CG Partner @ STJ
• TS @ STJ            
• NDD @BH            
• PDD @BH            

Welcome introductions

JH welcomed everyone.

Terms of engagement:

• Confidentiality – must be maintained at all times
• Safe environment – we are here to support each other
• Respect – we are respectful of each other’s views/ opinions
• Learn – we are here to share knowledge and experiences, and we will not judge and point fingers
• Positive – please use positive language

Carers

SK outlined how Imago operates and supports unpaid carers. He highlighted the benefits and government support options available to unpaid carers.

LB raised some questions regarding support for unpaid carers and how they can access more information. SK agreed to send detailed information to her via email.

Carers Champions at Site-Level was explained.

SK has agreed for providing training to the Carers Champions to improve support and outreach.

There was confusion regarding the visibility of carer support resources/materials/poster at surgeries. VR clarified that informational posters are displayed at all sites, and relevant resources are also accessible on the website.

VR encouraged PPF members to visit sites to see first-hand how services could be improved, particularly in arranging carer support materials like posters. She also proposed that the agenda for the next meeting be posted on the website so that PPG members can stay informed and prepared.

Few PPF members recommended that surgeries take a more active role in identifying carers, educating them about available support, and directly sharing information on assistance options either via post or some information leaflet.

Update on achievements with support of PPF

JH shared recent accomplishments made possible with the support of PPF members and explained how PPF members are being promoted on the organization's website, where meeting minutes and schedules are also accessible.

All sites are holding regular meetings with their PPF members.

PPF Members have agreed to the constitution, and they are in the process of selecting a chair.

The job description and constitution for PPF are available on the website.

JH explained how PPF members provide invaluable suggestions to improve patient experience. One member contributed to a poster that is now displayed in surgeries.

TS inquired about the purpose of screens in the surgery, questioning if they were for virus protection or other reasons. JH explained that they serve both purposes—protection from viruses and safety for staff. JE added that the screens are also necessary due to instances of aggressive behaviour from some patients.

It was suggested that, by law, the surgery staff should provide a full name when answering calls from patients. JH agreed to review this requirement.

PDD recommended sending important information to patients via post and suggested checking with the post office on cost-effective mailing options. JH noted the financial constraints but agreed to explore this option.

It was suggested to distribute informational leaflets at local pharmacies for easier patient access.

The group discussed the idea of recruiting volunteers to assist, but JH noted difficulties in finding volunteers. However, this option will be further considered.

It was suggested that surgery staff contact elderly patients via phone calls rather than text messages sent to carers, as many elderly patients have only landlines and limited experience with mobile devices, information is missing when carers gets notification on their mobile phones via a text informing they are due for their asthma review. It was agreed that this will be reviewed. JH

Annual GP survey in house results

Time: 6:45 PM (Meeting extended beyond scheduled end time)

VR presented a summary of the in-house results from the Annual GP Survey. (Please see attached slides for details.)

Discussion highlighted TLCP's performance in comparison to national data marginal progress in several areas of General Practice management.

The survey indicated a general lack of patient awareness regarding the "extended access" service. TLCP is planning to enhance the promotion of this service to ensure patients are informed and can utilize the service fully.

Positive patient experiences with the GP practice were noted in the survey results.

PDD expressed concerns about the lack of continuity in patient care due to recent changes in the GP staff leading to patients seeing new doctors regularly.

VR addressed these concerns, explaining that several GPs had retired or relocated, but TLCP has proactively recruited over 10 new GPs to maintain continuity and increase appointment capacity.

Survey Findings and Next Steps

VR summarized the overall survey findings, including the areas for improvement.
TLCP shared planned changes based on the survey feedback to further enhance patient experience and practice performance.

TLCP to implement initiatives to increase patient awareness of extended access services.
Continued recruitment and retention efforts to ensure consistent patient care

BB raised concerns about the reception staff at HF, expressing dissatisfaction with the perceived lack of teamwork and specifically mentioning staff member OR, whose manner was felt to negatively influence the team.
VR assured that this feedback will be reviewed, and steps will be taken to address any issues identified.

New Telephone System Update

Update on New Telephone System and Patient Support Initiatives were explained

PDD emphasized the need for a text message reminder system for patient appointments, they feel this initiative aims to help patients particularly the elderly who may otherwise forget their appointments. However, it was noted that there is a limited number of text messages available to send each month, which restricts the frequency of reminders.

They also explained about a system in the telephony called “barge and whisper” which allows managers to listen in on active calls. If necessary, team members can join the call midway to provide additional support or guidance while the patient is still on the line. 

VR provided an overview of how the new telephone system operates, including data on the number of calls answered. Some issues with the call back facility were also discussed. In cases where patients call from withheld numbers or work phones (which are not registered in the system), the call back option may fail. This limitation is being addressed, but it currently impacts the reliability of returning missed calls.

VR also explained the challenges in recruitment for care navigators. Efforts are underway to recruit more care navigators to improve patient support and manage call volumes effectively. However, recruitment has been increasingly challenging as staff quitting rates are high due to various factors.

The document also includes data on the new phone system's performance.

Close

Attendees

TLCP:

• Jyothi Eregowda (Jo)
• (Operations Manager for Belmont Hill and Modern Hill Surgery)
• Paula Gordon (Operations Supervisor MH)

PPG Members: 

Welcome and Introductions

Jo ( Operations Manager Belmont Hill and Modern Hill)
Paula ( Operations Supervisor Modern Hill)

Introductions – members introduced themselves. Paula and Jo gave a brief description of their role within TLCP. 

Terms of engagement

• Confidentiality – must be maintained at all times 
• Safe environment – we are here to support each other 
• Respect – we are respectful of each other’s views/ opinions 
• Learn – we are here to share knowledge and experiences, and we will not judge and point fingers 
• Positive – please use positive language

TLCP Updates

New Salaried GP recruitment is complete for TLCP
At MH we have 2 new GP who have started. The GPs have settled in well and have managed very well and are quite happy within their roles. We wish them all success with TLCP and we are there to support as an organisation should they need any help.

Introduction of the proposed TLCP PPG Structure/ AGM

TLCP PPG will consist of Site Patient Forum Members and TLCP-wide PPG representatives, members drawn from the patient population at TLCP. 

TLCP Site Patient Forums - each site within TLCP will host a quarterly Patient Forum -  all groups will aim to establish and embed an effective relationship between TLCP sites and the patient population, objectively communicating patient experience, concerns, suggestions and comments. TLCP Site Patient Forums aim to represent all patients regardless of age, gender and ethnicity to provide accountable methods of input and feedback from each TLCP site. 

TLCP Site Patient Forum Members will be asked to select two representatives to attend TLCP PPG-wide meetings, which will be held every six months. TLCP PPG-wide meetings and members will contribute to TLCP-wide decisions and facilitate the smooth operation of TLCP as ONE practice.

TLCP PPG Open Day (Annual General Meeting) - TLCP aims to hold an annual Open Day for TLCP Site Patient Forums and TLCP PPG-wide members; the annual general meeting will also be open to all patients of TLCP. The purpose of the annual general meeting is to present the activities and achievements of the Group and promote TLCP Site Patient Forums.

AGM

The AGM was held on 30.11.24.
The main item on AGM was information regarding 

1. Carers
2. Update on achievements with support of PPF
3. Annual GP survery in house results
4. New telephone system update

The meeting minutes have been complied and will soon be available on TLCP website. Please look through and let me know if you have any queries.

AOB

In attendance

PPG Members: 

• BO’C
• AS (chair)
• AH (Note taker)
• BB
• CM

TLCP Representative:​​​​​​​  

• Jacqueline– Practice Manager, HR, Comms, Complaints  
• Anushka - HR, Comms, Complaints
• Isatu – HR, Comms, Complaints

Welcome introductions

AS welcomed all attendees. Attendees introduced themselves.

Apologies

• RS
• SP

Minutes from Last Meeting

JH reviewed the minutes from the previous meeting and discussed the actions taken:

• Further work has been carried out on providing carer guidance which is now published on the website. However, this work is ongoing with Imago. 
• BO’C provided input to the newsletter, and this is now on the website and available in hard copy ion the waiting area.

Booking Appointments

CM fed back some observations on the appointment booking system and same day appointments. She had found the distributed guidance impenetrable. She had more success in booking an appointment when attending reception in person. JH explained where the website guidance could be found. She also said that practice staff had been allocating time on Tuesdays to talk through the booking system with patients and the new digital front door to assist patients with online access. The best way to book urgent appointments is through the website, this saves the patient coming to the practice and queuing, it can be done from the comfort of their own home. Appointments booked this way quickly go through triage. Alternatively, reception can send a link to patients attending practice so that they can book through the website or assist the patient in manually submitting their request. JH discussed the new telephone system and the call back facility available.AS agreed that time would be required for the new processes to become embedded.

BB commented that when things go wrong (eg. an appointment is accidentally cancelled or the patient does not receive a call back), practice staff need to admit their mistakes and not blame the patient. JH requested this example be shared separately as the practice would like to think this is what would happen, however will investigate.

BO’C asked whether urgent appointment capacity ever gets used up. JH said that she only knew of one instance where this had happened. BO’C pointed out that there seem to be a current problem where urgent appointments were not available. JH said that she would get someone to investigate.

There is a problem that non-urgent appointments are booked up far in advance so that it is quite difficult to get one for the NHS app, forcing patients to use the urgent on the day process. The meeting all agreed that putting all appointment types (both urgent and non-urgent) into the same triage process, so that they are processed in a similar way would be the preferable way to go. JH to follow up on this.

Communication with hospital and GP practice

AS raised concern about delays experienced by a patient in a case where a diagnosis required urgent action (medication). JH explained how the communications worked. Comms from the hospital go to a generic email address (for the practice as a whole) where they get directed as appropriate by the Docman team. JH confirms that urgent medications are brought to the attention of a clinician within 24 hours. There are some situations where the paper communication is received first. This gets scanned into the patients note and sent to the relevant GP as high priority.

However, although the practice tries its best in processing communications in a timely manner, it has no control over hospitals and how quickly they send letters/emails. Therefore, where there appears to be a delay, patients may need to follow up (eg. on prescription changes).JH confirms that all letters are filed into the patients notes within a week for non-urgent once receiving. It was acknowledged that this might be more difficult for some patients. E.g. those who are housebound.

How is Hillyfields working with Imago for the benefit of carers?

BO’C is working with Imago, but there are some questions about how they are communicating with GPs. JH explained they had recently had a national carers day where they encouraged carers to self identify. There is now a 64-page document on the website with all information carers may need. Imago had been invited to attend the meeting and the practice are awaiting a date for the staff meeting and also invited to  the next PPF wide forum in October 2024.

GP Survey

JH explained that the feedback was not as extensive as they would have liked. Also many changes have been made since the original survey in January, particularly with the introduction of changes to appointment booking in May 24. 829 Surveys went out and 201 surveys were sent back 24% completion rate.

The Practice is going to run the survey again and push to get at least 500 replies so that they have a better representation. The survey is on the website, and it can be completed either by scanning a QR code or it can be filled in manually and handed back to reception. AS suggested that perhaps the survey could ask which site the patient attends. However, since the survey has been published, it is too late to change it to include this. AS suggested that perhaps introduction of the survey could be changed to explain that the focus is on recent experience, rather than long past. JH to look at whether this is possible.

AOB

JH explained that the practice was now working extended hours. The attendees fed back that this was a positive change and happy with the enhance hours offered of early 07.00am start, 18.30pm -20.00pm late and all Saturdays 9.00am to 5.00pm.

JH explained the situation with Sanofi and blood tests. They have contacted all urgent cases. They are currently putting a process in place to contact all patients with routine tests and trying to remove the backlog. They are now closer to getting back to normal. GPs can now request routine at consultation again.

JH explained how the seasonal flu campaign would work. This year the practice is rolling out an additional RSV vaccine to certain demographics (incl over 75s and pregnant women). This means that the vaccination program for flu will not start until beginning of October. It is expected that there will be Saturdays for four weeks where patients can either opt for walk in or pre-booked appointments, this service will be available at the St Johns site and The Hillyfields site. Volunteers from the PPF would be appreciate to welcome patients and ask them to get ready by taking coats off and rolling up sleeves.

There needs to be some action to ensure that housebound patients get visited and vaccinated but the logistics are difficult as they do not have the extra staff to do this. BO’C fed back that this did not happen last year and so is a major concern. Plans are being worked on currently to ensure this happens.

AS had raised a suggestion that the practice sets up a Patient information evening where patients can come in and ask questions regarding the current service. It would be good if the Patient participation forum members attend to answer these questions so patients can see their involvement. A provisional date was agreed for Tuesday 24th September. 6.30pm to 7.30pm.

Action

• JH to feedback about a single triage system for all appointment types, urgent and non-urgent.
• JH to investigate whether there are current problems with providing urgent appointment capacity today.
• JH and HR/comms to liaise regarding the introduction to the patient survey and whether it can be changed to clarify that the focus is on recent experience.
• AS and PPF members to firm up on plans for a patient information day and for advance advertising.

Dates for the diary of our upcoming meetings

24 September 2024: Open Evening  Hillyfields Site 6.30pm to 7.30pm

31 October 2024: Annual General meeting (Outlining achievements)  @ St Johns Medical Centre 5.30pm to 6.30pm

26 November 2024: Next meeting date @ Hillyfields site 12pm to 1pm

Welcome and Introductions

• Attendees: Jyothi Eregowda (Jo) ( Operations Manager Belmont Hill and Modern Hill)

No members attended the meeting.

In attendance

• PPG Members - OC, KW, EW, HR
• TLCP HO Representative- VR(Manager),AO(Site Ops Supervisor), IJ(Ops Admin), WT(Receptionist),SK(Recepetionist).

Introductions were made for the benefit of new members.

VR opened the meeting and discussed the need to restart the PPG and the terms of reference should be circulated to members again. This was to fully understand the structure of what the Patient Participation Group is about.

Discussed the need for PPG members to create a structure and assign a chair.

Digital Front Door

Explained the role of digital front door – triage online via AI enforced by NHS. This allows allocating resources for patients and signpost them to the right consultants within 24 hours. We will have a digital inclusion hub, trained receptionists who will be able to triage effectively and teach/support patients who are not IT literate.

KM suggests to have tablets with several languages available for non-native English speakers. Hellen suggests to have cafes to train elderly in digitalisation.

KM informs us he works with dementia patients and end of life care, he explains how his organisation is promoting diversity and looking at how black people are treated within dementia/mental illness environments.

VR proceeds in sharing the footfall audit for TLCP and shares the documents across.

VR explains how the care navigation hub works and when it will go live, further explanation of TLCP structure and its hubs.

TLCP Vision and Terms of Reference

VR shares TLCP vision and terms of reference – what would excellence be? How to involve the community more?

Hellen suggests to remove mission statement and use the term vision instead.

OC asks re research/feedback – Is it independent or PPG working with the Practice?

Suggestion on the fundraising – help support the practice and get more involved in the processes, PPG members to volunteer to cooperate with the practice.

How to prove the PPG are actually representing their members?

VR(Manager) advise to have a specific PPG structure – chair/vice chair, email and request availability. Deadline on 13th September, next meeting can be arranged for 23rd.

O asks if it’s possible to get JDs for these roles and requests to shadow the most senior PPGs meetings in other practices once the chair has been established.

The meeting closed with members agreeing the 23rd September 2023

In attendance

PPF Members: 

• MC
• VM
• SG
• AG

TLCP Representative:  

• Khaled Chowdhury (Operations Manager St Johns)
• Jennifer Gayle (Reception Supervisor St Johns)
• Rabbiya Shahbaz (Care Navigator)    

Welcome introductions

AS welcomed all attendees. Attendees introduced themselves.

Apologies

• Dr Chrisanthan Ferdinand (GP Partner)

Minutes

• Claire Thomas

Welcome and Introductions

Khaled welcomed everyone.

TLCP Updates

Salaried GPs

• Update on recruitment drive for Salaried GPs across TLCP to reduce the use of Locum GPs, with hire of new GPs at St Johns Medical Centre and other sites
• St John’s is also a Training Practice, with 2 students who are training to become General Practitioners, and the practice is now registered as a GP Skilled Worker Visa Sponsor meaning we have the option to hire GPs from outside the UK.

Telephone System

New telephone system offers call back service to save patient’s from waiting on the line, once the system registers patient’s ‘queue number’ is coming up then it will automatically call and add patient back to their place.
Reporting options on telephone system allows TLCP to learn the volume of calls that come in and are picked up by our Care Navigation Hub; from this we have determined that more Care Navigators are required which we are in the process of recruiting.

We are currently in the process of exploring an option in the telephone system to cancel unwanted appointments by phoning and choosing an option; this will help reduce DNA’d (did not attend) appointments, opening them up for other patients, and for when the surgery is closed, and patients are unable to notify the practice.

Flu/RSV Campaign

• Flu campaign begins from 03/10/2024.
• RSV campaign begins from 07/09/2024 and will be by invitation only on selected cohorts (75yrs+ and women who are 28+ weeks pregnant)

PPF Meetings

• St John’s PPF Meetings are to occur 4 times a year, with a TLCP wide PPF meeting to take place 2 times a year.
• The minutes will be uploaded to the Practice website.
• PPF members to nominate a chair, job description passed to attendees.

PPF Comments

• Frustration at having to re-explain to GP the reason for the appointment request, especially after having to provide these details to Care Navigators/at previous appointments already
• TLCP to send email/message to staff reminding them to provide synopsis of appointment reason when booking and for clinicians to check booking notes and previous GP visits before seeing patient 
• Test Results on NHS App – not all are available to view even after they have been actioned by clinician
• Management to discuss this issue with the Digital Facilitator
• Instances of Call Back option entering you into another queue when giving a call back.
• Issue stems from emergency calls going into the patient’s call queue as bypass number not working. Management in discussions with telephone supplier to have this resolved as soon as possible.
• Changes to services provided to be relayed to patients
• Staff to be updated on any changes made within the practice and information passed to patients.
• Request for a list of services provided by outside organisations i.e. pharmacies, for when appointments are unavailable with clinician at site; providing the name of the organisation, address, contact details and opening times.
• Management to investigate providing list/poster for reception for patients and staff to refer to

PPF Compliments

New telephone system and online form have made contacting the practice much easier and more efficient, less waiting on the phone lines. Communication was positive between request for clinician and the response they received.

AOB

• Rabbiya Shahabz was introduced to PPF attendees as the new coordinator between St John’s PPF members and the management team.
• Enhanced Access appointments available through the week from 6.30pm to 8.00pm and Saturdays 9.00am to 5.00pm. Addition of Physiotherapist appointments Mondays after 6.30 and on Saturday to help patients access the service outside of work hours.

Next Meeting

• Next date and venue to be confirmed with Dr Ferdinand. Information to be relayed to PPF attendees and members by Rabbiya Shahbaz.
• Discussion on PPF chair nomination at next meeting