PPG: Meeting Minutes 14th August 2023

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Name	Organisation/Representative	Initials
Sheila Pitt	PPG Chair	SP
Breda Pooke	PPG Chair	BP
Colin Brown	PPG Member	CB
Theresa Houghton	PPG Member	TH
Brian White	PPG Member	BW
Lucy Spencer	BMC Assistant Practice Manager	lS
Kelly Evans – Note Taker	Invicta Health CIC, Corporate Affairs Manager	KE

Agenda Items

Welcome

• SP welcomed attendees and outlined the agenda items and topics for discussion. 

Apologies

• Elizabeth Carlton (EC), Katy Thomas (KT), Fay Godby (FG), Ann Bay (AB), Don Bay (DB), Christine March (CM), Stephen March (SM), Tracey Moon (TM), Stephen Crump (SC), Neville Hudson (NH), Karen Wilshaw (KW), Daniel O’Connell (DOC), Andy Walsh (AW), Frances Westerman (FW).
• Nil apologies received from: Margaret Coombes (MC), Brenda Garroway (BG), William Wraith (WW).

Notes and matters arising from 13th July 2023

• Minutes were a true reflection of meeting. 
• Action updates
  • Veterans accreditation: Nursing meeting to be held to nominate a team member to lead on accreditation for practice. Local centre opened for veterans (charity). 
  • Patient Information Leaflet: copies to be printed for surgery and local chemists, added to the webpage and contact ‘Soundings’ to have an audio file to be added to the webpage. KE to forward to BMC management and PPG for final approval (Action: KE). 

BMC Updates

Dashboard

• Dashboard shared. Thresholds to be included in monthly reports (Action: DOC). Noted increase in response time for e-Consult.  Time for managing e-consults is being reviewed.  Appointment timings have increased which has impacted on admin time. Audit on DNA’s underway.  Letters being sent to patients who DNA on three occasions. Patients who make attempts to cancel appointment are unable to do so as the system is switched off over the weekend. Patients with Patient Access are still able to cancel their appointments at any time. New complaints process explained (managed centrally). Nursing appointment waiting time has increased for August and September and this is due to staff leave and associated backlog. 

Flu Clinics

• Clinics arranged for September and October. Set-up of clinic rooms as before.  Improved ramp has been installed. Housebound patients will be visited by home visiting team. 

Other

• PPG members to perform a telephone audit in near future. Outcome of audit to be relayed at PLT.
• Covid campaign commences on Monday 18th September. Expectation that all Covid inoculations take place before end of October. Will be offered to 65+, vulnerable, and patients living with persons who are medically compromised. Information on Covid vaccinations has been added to the automated telephone service. To be added to the next parish council meeting for discussion (Action for CB).  

PPG Updates

Website

• TH has undertaken audit of website.  Banner wearing mask in the practice has now been removed and no longer relevant. Campaigns to be saved direct into the practice news and not as ‘Breaking News’. KE to discuss with web designers. Explanation of the reasoning as to why Orchard House Surgery is a branch surgery. Covid helpdesk link out of date.  Patient access is working well with a good turnaround to initiate. Process to be shared in newsletter to encourage more people to sign-up. ID can be supplied via email/shown on phone. Terms and Conditions for registering at surgery to be checked by LS. Access to records must have online access on surgery initially. E-consult has a number of questions (excessive) but this is necessary to ensure that patients are set on the right pathway for treatment. E-consult to appointment time is dependent on which clinician is needed.  Acknowledge of all e-consults is provided within 72 hours. Staff page has limited information on some clinicians. Consideration for alternative images to be used rather than the silhouettes and qualifications to be added. NHS Symptom checker to be added to webpages (Actions for KE). 

Education Sessions – Dementia

• Sep and Oct sessions will be paused due to expected demand of service. Future of education sessions to be discussed at the next Quality and Assurance meeting.  Attendance at sessions has seen low numbers.  Patients who do attend find it useful.  Consideration for a recorded message to be shared on webpage and on reception screens. Dementia awareness to be incorporated within a larger event.

ICB Engagement

• Collective response from PPG to be sent to ICB regarding below questions.
• Have you been an effective voice within a public structure?  Do not feel that PPG’s are an effective voice as never heard. No representation from groups to challenge. 
• What support do public representatives need? More representatives needed in high-pedestrian traffic areas in order to get rounded feedback.  For different services being developed needs input from people who are affected by the changes.  Not enough time given to find out what is needed before initiating processes.
• How can we improve governance at Kent and Medway?
• How can we be inclusive? Reaching out to all people and how it is advertised within the community.  PPG newsletter used to be distributed to local pharmacies but stopped due to Covid.  Already use the parish magazines. Practice and PPG relationship has improved.  PPG notice board to be moved to a more visible place in reception area. BMC PPG is a listening group.
• How can health and care partnerships include people? 

Issues raised by members

Infrastructure regarding large planning proposals of new houses 

• PPG has had input into neighbourhood plan 2021-2031. Neighbourhood and housing plan are separate programs and follow different processes. Neighbourhood Plan is being led by local Parish Council.  Plan has gone to TDC and then will go to a referendum (26.10.23). If 51% vote is in favour, this will be accepted. Housing plan for 1600 homes has gone to outline planning consultation.  Consultation ended on 31st August.  Currently with TDC.  Parish council reviews all planning applications.  Decision has already been made that building of home will go ahead.  Road structures and home layouts is decided by the Neighbourhood Plan.  Extension of practice money will not come from developer. A copy of the Neighbourhood plan is available at Library, Parsih Council office, and Parish Council website. Additional services (i.e. medical facilities and primary schools) are considered after homes have been built. 

Atmosphere in reception area

• Raised following a complaint to the surgery whereby a member of staff did not greet a patient.   Patient did not feel welcomed. LS acknowledge this but this is hard to quantify and resolve.  Consideration for artwork and impactful posters (Action for BMC Staff). 

Triage questions at reception

• Patient confidentiality has been raised when triage questions are asked.  Patients who do not want divulge/share information, reception will follow some of the triage questions.  If it is deemed ‘personal’, an appointment will be arranged with an ACP but this may cause issues with the patient not being seen be the correct person. Patient can discuss at ‘wheelchair’ window at side or write it down.  Lack of space is available in order to discuss privately away from reception area.  Note: triage questions are created by the clinicians.  If confidentiality is a problem, this can be raised online (Patient Access). Some patients do not understand that reception is managed by highly trained (not medical qualified) staff and are not there to provide medical advice.  Answers lead to the correct pathway and conversations are held in strictest confidence. Patients need to be educated that staff are not just receptionists.  Avoidable appointment data (if patient was correctly triage to the right clinician) company may approach surgery. LS to contact Herman Grau (Action for LS). 

AOB and Meetings Management

• KE to forward accessibility standards for webpage to CB (Action for KE).
• ‘Top tip’ for cough management to be added to the next newsletter.
•  Patient reported that conversation was overhead from nursing staff (on first floor).  Consideration for a radio to be in place (Action for BMC Staff). 
• Improvements on reception noted.
• Automated telephone message informs patients that their message will be deleted if it does not relate to their department.  This is linked to the medical secretarial lines.  This has been added as patients have been known to try to make an appointment etc in this way to bypass the correct pathway.  Consideration for this to be reworded.  LS to review and amend (Action for LS). 
   

Date of Next Meeting

• 9th November 2023. Oena Windibank and Lisa Barclay will be in attendance to provide a financial overview of fund flow for practices.
• 11th January 2024
• 14th March 2024