Eastlands Medical Practice
Patient Participation Group Meeting
Thursday 28 February 2013
Monica (practice manager) thanked everyone for attending and opened the meeting by explaining why we had invited people to take part in these discussions.
All three doctors, the practice manager, Helen Speed (from North Manchester PCT) and four patients attended the meeting.
The practice intends to have PPG meetings every three months and will put notices of the dates they are to be held on the website. Any patients interested in attending can notify the practice in person (at reception), by telephoning the practice or by sending an e-mail to the practice manager ( firstname.lastname@example.org ).
Currently the practice provides extended hours access, three hours a week between the hours of 7am to 8am. Over the years this has proved very popular with all appointment being booked more often than not. Advanced booked appointments are available for up to six months. This means anyone wishing to book an appointment with a doctor or nurse can do so at any time and there is no restriction on how far in advance this can be done during the six month period. There are several emergency appointments available for patients who require emergency treatment, on the same day, available Monday to Friday and these can be accessed by telephoning the surgery or in person at the reception desk. The surgery has, over the past year or so began to stagger surgery times so that there are a variety of appointment times available throughout the day.
Helen was asked to attend the meeting to discuss alternative forms of patient access. However, discussions involving the patients made it clear that they are happy with the form of access being provided by the practice at present and change was not necessary.
A participant asked the practice how many patient fail to attend the surgery without cancelling their appointments?
Dr Glass stated that patients who do not attend (DNA) have always been an ongoing problem for the surgery and that a significant amount of time is lost each day due to patients not cancelling their appointment. This results in patients who do need to see a doctor may not be seen. The practice has tried on numerous occasions to address this; posters have been displayed in waiting areas highlighting the number of DNA’s occurred in a week. However, nothing seems to resolve the issue. The group was reassured that people who frequently DNA their appointment are ‘taken to task’.
It was also asked how the practice coped with patients who are violent.
The group was reassured that it is very rare that the practice experiences violent behaviour and when we have; the patient has been removed from the practice list.
Helen posed the question of telephone consultation and asked if the practice provided this.
The practice has an informal telephone consultation system. Any patient requesting to speak to a doctor rather than making an appointment is able to do so. The patients details will be taken by the receptionist together with a brief description of what the patient would like to discuss and the GP will call the patient back at a time when he is not in surgery.
Other practices have a very formal telephone triage system whereby a doctor will speak to all patients requesting a same day appointment and will either deal with the call over the telephone or arrange an appointment for the patient to be seen. The doctors of the practice feel that this would result in fewer appointments being available for patients as it would take up a lot of their time and result in them not being available to do a surgery.
After discussion amongst the group it was agreed that the informal telephone consultation system currently used by the practice was acceptable.
A participant asked if the practice had considered opening on a Saturday morning for patients not feeling very well at the weekend. The doctors are not considering this at the moment due to the number of hours they already spend at the practice Monday to Friday which can be in excess of 50 hours a week.
Helen informed the group that when the surgery is closed there are alternative services available such as GOTODOC, which is the out of hour’s provider when the surgery is closed. There are also Walk-in Centres that can be accessed across Manchester. Dr Glass asked if these services are advertised in local libraries etc, and would it be a good idea to do this.
Helen asked about patients accessing hospital services such as A&E especially for sick children. She expressed her concern about practices not being set up to cope with children who come home from school feeling poorly and this can result in them being taken to A&E. The practice will always see a poorly child if asked to do so or direct them to the nearest Walk-in Centre.
Helen asked the group what they thought makes access to their doctor good.
It was agreed that continuity; seeing the same doctor helps as the doctor gets to know them. It was stated that they had not had any problems getting appointments to see a doctor of their choice. It was also stated that the reception staff are always polite and helpful.
As it was highlighted that the doctors are very busy and work a lot of hours each week, Helen asked if our practice nurses could do anything to help. It was explained that the nursing team mainly deal with patients with chronic illnesses such as diabetes, asthma, coronary heart disease and so on. However, we have employed a nurse who provided this care in the community for housebound patients. This has resulted in reducing the number of home visits the doctors now do and has proved very popular.
The group was informed that the practice has monthly Multidisciplinary Team Meetings. Community staff such as District Nurses, the Falls Team, Health Visitors, MacMillan Nurses, Active Case Managers etc are given a list of dates for the year and can attend the meeting to discuss any concerns they have about a patient. These meetings are also attended by people from Social Services and the Mental Health Team.
Finally, there was a discussion about the practice texting patients to remind them of their appointments.
The practice is currently attempting to set up this service which can also be used to remind people about getting their flu jab etc. However, there are some issues with compatibility regarding the clinical software system we use and the text messaging service we have chosen. If this cannot be resolved an alternative provider will have to be considered. Once the system is in place a generic text message will be sent to every mobile we have on the system informing patients about the service and giving them the opportunity to ‘opt out’ should they not wish to be involved. It was agreed that there could be some problems regarding confidentiality as people do change their phone number frequently and fail to inform the practice.