Report of the fifth Annual General Meeting of the Bearsted ...



Report of the fifth Annual General Meeting of the Bearsted Patient Participation Group

Thursday 21st September 2017

Present: Committee Members – Terry Armstrong, Arlene Broadhurst, Helen Denny, Chris Dobson (secretary), Harjinder Nerwal, Goff Norrington (treasurer), Christine Shade, Tony Spice, Jeannette Ward (Chair). From the Practice – Gill McDermott, Dr Dolman, Dr Laurent. Twenty-one PPG members.

1. Welcome and Introductions.

Jeannette welcomed everyone to the meeting and asked the Practice representatives and committee members to introduce themselves.

2. Apologies.

Andy Fairhurst from the committee and four members of the PPG sent their apologies.

3. Minutes of the previous AGM.

The minutes of the previous Annual General Meeting on 15h September 2016 were approved and signed by the chair.

4. Terms of reference.

Chris introduced this item and noted that when the PPG began fundraising a little over a year ago, this was not actually covered by the Terms-of-Reference. It follows that they didn’t cover what would happen to any residual funds if the group were to close down. The opportunity of the review had been taken to clarify and amend a few other points and then the revised Terms of Reference were approved at one of the Joint Practice / PPG committee meetings. It had been agreed that henceforth the Terms-of-Reference would be reviewed annually and published at the AGM. It was noted that they were not being tabled for approval at the AGM but if anybody wishes to comment on them, then they can do so via an e-mail or even through the suggestion box.

5. Chair’s Report.

Jeannette opened her report by referring to the pop-up poster advertising the workings of the PPG that is now located close to the entrance of the surgery. She noted that its presence is a good indication that the PPG has truly arrived as part of the operations of the practice and is more visible to the patients than in the past. She noted it had taken some time to develop the partnership with the staff but that there is now greater clarity about the role of the PPG and that constructive conversations and feedback about the experience of coming to the surgery are now easier and more frequent.

She then reported on the recent patient survey and noted that whilst the number of respondents represented only approximately 2.3% of the patients, it is nevertheless possible to draw some conclusions. Of particular note is the fact that around 75% of those respondents’ experiences were satisfactory, good or excellent. This reflects very well on all the practice staff.

The survey did highlight the difficulties of communicating with approximately 13000 patients about processes and changes to them, and she noted that the PPG and practice are working together to try to improve this area. She referred to the new poster about the walk-in clinic which clarified the broad principles of its operation and noted that, for example, when it is busy it is acceptable for a patient to register and then go away from the surgery for some time provided they notify reception on departure and return. Jeannette referred to the use of the texting system managed by Gill and which could reach 8000 patients, potential improvements to the waiting room screen and the PPG newsletter which is distributed in hard copy as well as electronically. She hoped that these efforts would combine to improve communication.

Jeannette reported on the Diabetes Health Talk that had been delivered earlier in the year but noted that the proposal to start a self-help group had not taken off since there was nobody prepared to sponsor and run it. Further Health Talks have been proposed for the future with the first, Living with Cancer, likely to be delivered later this year. There were suggestions that the talks could be delivered in the surgery waiting area to save on costs and Jeannette confirmed this would be considered. However she also noted that many had expressed a preference for talks during the day.

The meeting was updated on the regular newsletter and Arlene noted that the next edition was almost ready but had been held back so that a brief report on this AGM could be included.

The PPG continue to provide a cleaning service for the toys and a rota is run by Christine Shade. The toys need to be cleaned every 2 weeks and Jeannette encouraged others to put their names forward to help with this task with rostered members typically only called upon about once every 2 months.

The meeting was reminded about the Suggestion Box but it was also noted that complaints must be directed to the reception staff and could not be dealt with by the PPG.

Finally Jeannette noted that she regularly attends a PPG Chairs’ meeting where PPG Chairs from around the area meet with the Kent Clinical Commissioning Group to share experiences and to learn about changes and initiatives within the CCG.

The future focus of the PPG would be Health Talks, the Healthy Walking Group, the Newsletter, fundraising, communications and the expansion of the PPG Virtual Group.

Chris then provided an update on the Healthy Walking Group. He noted that the group continues to thrive. It was started in March 2016 and has missed just one Tuesday since then, when it was thought that the weather was too bad. There are 10 walk leaders with 8 of those currently active on a regular basis. Well over a hundred walkers have registered and there are typically between 20 and 30 walkers every week. The majority of those join the longer, 60 to 80-minute walk but there are always a few who opt for a 30 minute one. New walkers are always welcome, particularly those recovering from illness or with health problems, and it is usually possible to tailor the short walk to take account of any limitations, unless there is a particular shortage of leaders on the day. The walk meets every Tuesday at 1015 for a 1030 start at Holy Cross Church.

Three of our leaders are also on a rota to support a Dementia-friendly walk at the same time in Mote Park. That walk is popular with a small number of individuals who want a short walk but has not actually attracted any dementia sufferers and their carers.

6. Treasurer’s report

Goff noted that this time last year we had just started fund-raising, recently opening the account and with £80 in it. Since that time over £1700 has been raised from gaining sponsorship from two of the Health Walks, a Quiz Night, a Christmas Hamper raffle and donations. The funds have been used to purchase two paediatric pulse oximeters and a portable electrocardiogram (ECG), leaving £249 in the bank. The next target is the purchase of a hand-held doppler machine which can be used to measure blood flow, particularly in the legs, helping with the diagnosis of arterial disease.

Goff noted that funds were also required /used for hiring premises for the health talks and for such as the quiz night. Looking forward there is to be another Quiz Night at The Memorial Hall, Manor Rise on Friday 20th October and another Christmas Hamper Raffle. All members were encouraged to come along to the Quiz Night making up tables of six or eight. However, if anyone wants to attend but is unable to make up a table, they should contact Goff whose details are on the advertising poster. He will then attempt to make up additional tables. It was noted that the practice would be entering at least one table.

A summary of the accounts is attached.

7. Surgery Report and feedback on Patient Survey

Gill McDermott updated the meeting on several items. She noted that the practice is designated as a training practice with 4 registrars. One has gone on maternity leave and will not return but the other three will be with the practice until next year.

The dates for the ‘flu clinics have been published and that the one on 7th October will run for the whole day giving patients more choice. Appointments need to be booked over the phone or in person.

The waiting room will be redecorated over a 4 week period beginning 25th September. There will be some disruption but the work will be carried out after the surgery is closed.

Gill expressed the gratitude of the practice for the fund-raising efforts of the PPG. Dr Dolman and Dr Laurent supported her comments, giving their thanks too.

Following Gill’s update, Drs Lisa Dolman and Richard Laurent took turns to address some of the issues raised in the patient survey. Dr Dolman began the section by thanking the PPG for undertaking the survey and noted that amongst the specific questions, some were old and had been addressed before and some were new ones:

a. Could there be a ticketing system so that people could wait in the car?

This was considered when the walk-in clinic was first developed. However, the reception staff and doctors need to retain flexibility to deal with urgent cases and some of the younger children on a needs basis. Furthermore, some patients want to see a specific doctor and this would make a ticketing system inordinately complicated.

b. Could they improve mental health treatment with a specialist GP?

This is actually a much bigger issue than the provision of a specialist GP since other support staff are also needed. Mental Health issues were receiving greater attention and the situation would change in the future.

c. Why can’t the surgery open up earlier, rather than us waiting outside. Is there a good reason not to?

The surgery does not have a full complement of staff before 0830 and therefore would not be able to fulfil all safety and welfare issues if the doors were opened and patients allowed in. This situation is further complicated by the need for clinical and staff meetings ahead of the start of the walk-in clinic. Dr Dolman restated the practice position that they did not encourage queuing because all patients are guaranteed an appointment provided they arrive by 1030. She also pointed out that if the doors were opened earlier, it was likely the queue would simply start earlier as well.

d. It gets hot in the waiting area. Is there a fan or air conditioning?

Dr Laurent noted that the practice had been misled by the builders who indicated that the modern structure would ensure air-conditioning would not be needed. Unfortunately, a retrofit was very unlikely to be undertaken by the owners of the building and there are risks associated with fans where small children are present.

e. Could there be a tea/coffee machine?

The risks to small children associated with a hot drinks machine preclude such an introduction. There is no objection to individuals bringing in hot drinks as take-aways from local coffee shops and the walk-in clinic guidelines do allow for patients who have registered to leave the waiting room and subsequently return provided they keep the reception staff informed of their departure and return.

f. Could the waiting room chairs be improved?

Unfortunately the chairs are likely to be changed in the not-too-distant future but they are unlikely to be more comfortable than the existing ones, and may be less so. This is because there is a requirement from the Care Quality Commission for waiting room chairs to be easily cleaned for hygiene purposes and they need to have plastic cushions. The practice is only permitted to retain the current fabric covered chairs if a strict regime of steam-cleaning is maintained.

g. I’m not clear who is eligible for a regular health check. I don’t understand why I can’t have my cholesterol checked more frequently.

Patients between 40 and 74 are eligible for health checks every 5 years if they do not have pre-existing conditions that are monitored separately. Dr Laurent did note that there have been a number of studies which have challenged the effectiveness of such checks because it is typically those in better health who attend for monitoring.

h. Any chance of Saturday morning appointments?

In the interests of work-life balance for the staff, there are no plans to introduce Saturday morning appointments.

i. Can you keep the monitor up to date?

There have been a number of technical issues with the monitor which have still not been fully resolved. The practice and PPG are working together to try to improve the system.

j. Closing for lunch baffles me. Why?

It has been agreed that in the near future the surgery will begin to stay open over the lunch time. This will be for administrative issues such as submitting repeat prescription forms and collecting prescriptions. There will not be any clinical appointments during this time and the appointments booking system will not be available.

k. I’d like the option to pay a fee to see a GP for a consultation working round hours that suit me.

This is simply not allowed by NHS contracts.

l. The British Heart Donation boxes look a mess in the entrance.

Dr Laurent noted that they may not be very elegant but over £30,000 has been raised for the BHF over three years.

m. If I go to the Walk-in and wait clinic it would be very helpful if the receptionist indicated the wait time. If it’s longer than an hour, I could do some chores at home and come back.

The receptionist will be able to give some indication of the wait time and, as already noted, patients are able to register and then go away again if the wait times are quite long, provided they keep the reception staff updated on their departure and return. However, these are only ever going to be estimates.

n. Could there be some hand gel by the automatic check-in?

This is being looked into.

o. Is there a place away from reception where private matters can be kept private?

A patient simply needs to alert the receptionist to their desire for a confidential conversation and this can take place in the small room between the reception area and the dispensary.

p. What happens to lost property?

It is retained at reception for a period of time.

q. Can we get health checks done elsewhere?

Patients are at liberty to have health checks carried out elsewhere. It would be the responsibility of the individual to update their GP of any outcomes that they wished to discuss since the information would not reach the practice any other way.

8. Election of Officers

Chris introduced this item and noted that the Terms of Reference require the re-election of officers at each AGM. This includes the Chair, Vice Chair, Treasurer and Secretary. Since the committee is currently at full strength, those positions are actually only open to committee members this year. However, if any PPG member has aspirations to one of the committee officer positions, then they should let Jeannette know and they can be put on a waiting list for when a vacancy arises on the committee. He noted that anyone present is able to make a nomination, second a nomination and vote, should there need to be one. In a vote, and in the event of a tie, the chair has casting vote.

The first position is that of Chair and Chris Dobson nominated Jeannette. The nomination was seconded by Terry Armstrong. Since there were no other nominations, the position was confirmed.

The second position is that of Vice Chair. The previous Vice Chair resigned during the year and the post is currently vacant. Chris Dobson nominated Tony Spice and this was seconded by Helen Denny. Since there were no other nominations, the position was confirmed.

The third position is that of treasurer. Chris Dobson nominated Goff Norrington and this was seconded by Christine Shade. Since there were no other nominations, the position was confirmed.

The final position is that of secretary. Jeannette Ward nominated Chris Dobson and this was seconded by Lisa Dolman. Since there were no other nominations, the position was confirmed.

9. Presentation by Paul Clarke.

Jeannette introduced the guest speaker, Paul Clarke, Healthy Lifestyle Commissioning Officer for Maidstone Borough Council. In doing so she noted that it was through Paul’s office that our successful Healthy Walking Group had been funded.

Paul introduced his presentation by noting that less than 10% of the population’s health is linked to primary healthcare and that the majority is associated with lifestyle.

He went on to provide some statistics showing the difference in life expectancy across local areas with the highest in the more affluent areas averaging 90 and the lowest 79. However, the healthy life expectancy is much lower with the affluent areas averaging 71 and the less affluent just 57. Given that this last number is well below normal retirement age it presents a significant issue for both employers and employees. The role of Paul and his colleagues is to develop and deliver programmes that help to address lifestyle issues either directly for individuals or through sponsoring and supporting initiatives by employers.

He described Healthy Living Programmes covering weight management and exercise; The Counterweight programme for individuals with BMI > 28; Adult Weight Management at The Leisure Centre covering lifestyle, diet and exercise; Family Weight Management supporting families with overweight children; Exercise referral, and the Kent Healthy Business Awards. Most recently 40 companies had entered the business awards covering 36,500 employees. Of these 10 achieved national recognition with 4 of these achieving excellence. Since only 7 businesses had been designated as excellent nationally, having 4 in Kent is a tremendous achievement.

Enrolment in the individual programmes is usually by referral but Paul noted that all of them are oversubscribed with waiting lists. Hence there is little additional publicity given to them other than through advertising in GP surgeries.

Paul also described how the local programmes interact with county and national ones and drew attention to the home page for “One You” a website and programme managed by Public Health England which provides resources and support associated with a wide range of lifestyle issues such as smoking, exercise, alcohol and diet.

In answer to a question from the floor, Paul noted that there is no specific occupational health support provided by the Borough Council and that each employer would make their own arrangements depending on size and resources. He also responded to a question about support for the Healthy Walking scheme since changes are taking place within East Kent NHS who have previously provided support. He noted that the scheme would continue to be support by East Kent NHS until March next year but the situation after that had not been resolved.

A member of the audience led the thanks and applause for Paul’s interesting and informative presentation. The Chair repeated the thanks on behalf of the PPG.

10. Questions from the floor

There were several other questions from the floor during the meeting and these are collated here:

Some surgeries are deregistering patients, is that happening at Bearsted?

It is not happening at Bearsted and in fact 500 new patients are currently being registered and inducted following such actions elsewhere. However Dr Laurent did note that if patients move outside the practice catchment area, they should notify the practice and register with a different, local surgery.

Will the reports of private treatment be sent to my GP?

This would depend on how the treatment was commissioned. If the patient instigated the treatment without involvement of the practice, then it is unlikely a report would be sent to the GP.

Why not e-mail letters as much as possible?

Patients are asked for their e-mail addresses but there are very many who do not have access to e-mail and so the only way to communicate with everyone is via the postal system. The surgery does have a franking machine which helps to reduce the costs. Text messaging is used extensively for reminding patients of appointments and for short messages.

The Chair closed the meeting at 2040hrs.

Minutes approved by the Chair:

|BEARSTED PATIENT PATICIPATION GROUP |

|Income & Expenditure For 2017 - Updated 21/09/17 |

|Date |Description |Income (£) |Expenditure (£) |

|01/01/2017 |Balance B'fwd from 2016 |1205.50 |  |

|02/02/2017 |2 x Junior Pulse Oximeters | |161.90 |

|16/03/2017 |Memorial hall hire cost |  |47.25 |

|16/03/2017 |Memorial Hall deposit |  |50.00 |

|06/04/2017 |Deposit returned/hall cancelled |50.00 |  |

|13/04/2017 |Donation |300.00 |  |

|02/05/2017 |Donation |200.00 | |

|11/05/2017 |Purchase of portable ECG machine |  |1247.04 |

| | | |  |

|  |  |  |  |

| | |1755.50 |1506.19 |

| | |249.31 |

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