PPG Minutes 21/11/2024

Please can we stop sending these as some patients find them annoying. It was the view of one patient that we are providing a service and shouldn’t need to seek approval for this; it wasn’t necessary.

Members asked what this related to. CMA advised that this was the Friends and Family test that asked how likely you would be to recommend the practice’s service to friends and family. This was sent out as a text message to patients after each appointment. CMA advised that this formed part of the GP contract, and that the practice received around 400 responses each month.

Members were advised that it wasn’t possible to switch of this aspect of messaging for individual patients without either switching it off for everyone or opting that specific patient out of all messages. Members suggested that it was easy enough to ignore the messages and delete them.

Several patients had reported that they had tried to book appointments through the website and several times it had allowed all the information to be input, only to crash at the end, losing everything. Eventually the patient had to call the practice, which is what they (and the practice) were trying to avoid.

Action: CMA to look into this – unsure whether this is a system error, or a network error, but CMA had experienced a similar problem when trying to support a patient to submit photographs on their phone.

Dedicated phone App – a patient asked if the Partnership were considering having a dedicated phone app. – This isn’t something that is currently being considered.

Patients said that they fill in the information on the form, then if they need to send a photo, they have to fill the information in again, and then a different clinician may see them when they come for their appointment, requiring them to share the information again. Was there anything that could be done to stop the repetition of information?

It was advised that, specifically in the case of needing to send follow-up photos, the message does say that the patient doesn’t need to repeat any information already provided. The concern is that, for those who aren’t confident with technology, the technology becomes the barrier. The practice is considering running clinics with a member of the management team, to provide technical support and guidance.

In terms of being asked for information at the appointment; all information that is shared in the initial request is saved into the patient’s record, but it isn’t unusual for the clinician to want to get this direct from the patient.

Particularly where a patient has ongoing issues, some patients felt that they were repeating information where it had been necessary for them to see a different clinician. The practice stated that it recognised the importance of continuity of care, and when triaging requests, would always look to see if it was an ongoing issue that was already known, and where it was, would recommend the patient booked in with the same person. Unfortunately, this wasn’t always possible as patients sometimes wanted to be seen sooner than an appointment was available.

CMA also clarified that patients were welcome to request a specific clinician, but where this was the case, they needed to be aware that there may be an additional wait for an appointment.

Some patients had attended for tests and were worried waiting for the results and never received a notification from the practice to tell them everything was okay. Some patients said they would appreciate a message being sent.

It was explained that unfortunately there were not the resources available to notify the outcome of every normal test result, although the practice appreciated that patients would value this. When patients attend for bloods tests etc, the clinician should let the patient know that if they didn’t hear anything, everything was fine.

Action: CMA to remind staff about doing this

A patient had shared an experience of misleading communication, where their record on the NHS App indicated that they had been informed of some blood test results, but they had never actually been contacted by the practice.

CMA advised that she had recently spoken to the patient regarding this, and it was helpful to review what the patient could see, compared to what the clinical system said. CMA agreed that in this instance, the message was misleading. The clinical system had notified the patient automatically via the NHS App and recorded this as “patient informed” on the record, but this was a system generated notification and not something that the practice had instigated or carried out. This was a consequence of patient prospective access to records.

Appointments were running 30-minutes behind at one point and the long periods of standing were difficult for those who were elderly or infirm, although measures were put in place to support this group of patients. This was a bigger problem at Moss Valley than at Gosforth Valley.

CMA advised that the queues were longer than had been anticipated and a full analysis of the day had taken place to look at what needed to happen to address this at the second event. As a result, the wait time was significantly reduced on 5 November, to no longer than 5-minutes, with most patients walking straight in.

Patient didn’t understand why this couldn’t be done straight away and ended up taking the form somewhere else.

CMA explained that some patient requests, for example private letters, forms, and medical reports, which fell outside of the scope of the NHS contract and as a result, the practice were not funded to complete. It was therefore necessary to charge a separate fee to complete this work. The process meant that the request had to be reviewed, costed, and then passed through to GPs to complete. As this took time away from processing the hundreds of documents that were received each day, as well as pathology results and other work, it wasn’t possible to prioritise this work over contracted work, particularly as the volume of private work requests were increasing. The ambition was that requests were turned around in 28-days, although at busy times this wasn’t always achievable.

Due to time restrictions, it wasn’t possible to discuss all aspects that had been raised, but a full report from both events had been shared with the practice, who were reviewing this. CMA advised that the key theme was the need to continue to look at ways in which communication to patients could be improved.

CMA said that she valued the role of the PPG as critical friend, because this provided opportunity to discuss concerns and understand the experience of patients in more depth.

The Chair advised that he had been made aware of recent examples where medication that had been stopped, was still included when repeat templates had been processed. The Chair was unclear whether this was because the pharmacists did not check the patient record thoroughly. The main concerns were wastage, avoidable spend and patient safety, and members were and asked if they were aware of similar issues.

Whilst there were no further contributions in terms of this specifically, a member did raise the repeated written reminders they have received from the NHS centrally about vaccinations and felt this was a waste of money and time, particularly because they had an appointment for the vaccination booked. CMA explained that the set-up of appointments, and how vaccinations were managed, was different in each practice. As a result, it would only be the actual vaccination being administered that would stop the reminders, and not the appointment being made.

The Chair outlined to members that the Terms of Reference for the PPG had not been reviewed since 2017, Given that members were now beginning to do more outreach work, it was important that these were up to date, appropriate, and reflective of the work of the PPG. The intention was to review these at the meeting, however, due to time constraints and the number of changes that are potentially needed, the Chair proposed that he and CMA look at this outside of the meeting and bring the revised version back for PPG members to review at the next meeting.

Action: Chair and CMA to review Terms of Reference and present revised version for agreement at the February 2025 meeting.

The Chair advised that the need to review the Terms of Reference had been brought about because of a patient sending through a complaint that they had raised with the practice. The Chair advised that it wasn’t the role of the PPG to respond to complaints, but he had checked that the Practice were aware of the complaint, and that this was in process, which CMA had confirmed it was.

The Chair had however, asked CMA to review the results of the patient survey to see if there were any similar trends in the comments. The complaint centred around record keeping and continuity of care. CMA advised that there wasn’t a trend evident, although continuity of care was an ongoing focus for the practice.