Patient Participation Group

CM

RB confirmed that the vaccines could now be mixed (e.g. Pfizer and Astra Zenica). HH reported that 99% of the boosters were Pfizer.

Update – late October it was agreed that the Surgery would be providing covid boosters for the Housebound and this is planned for week commencing 22^nd November.

EK queried why other European countries GP Surgeries had remained fully open throughout the pandemic. HH commented that she thought there were probably less patients per GP than in the UK and also the service was not free in other countries.

RB stated that contrary to reports in the media etc. it was a misconception that GPs preferred digital appointments to F2F and they much prefer F2F.

The types of appointments offered had to be balanced with patient and staff safety paramount; a further Covid outbreak in the Surgery would result in diminished services and it was anticipated that Covid cases would increase. It was also confirmed that the Surgery was continuing to follow national guidance on the way they operated and would continue to do so.

It was acknowledged that patients telephone consultations were not always as explicit as they could be.

HH likes F2F appointments but has found phone/zoom communication saves time. JMcC feels zoom meetings are more focussed although some patients may be put off, EK is happy with both as is PY.

Regarding future PPG meetings and whether they should be F2F or via zoom it was agreed to continue with zoom for the time being which was the recommended route but to keep the position under review.

1)   Time for Care (discussed at the last meeting) – being run by NHS England and Summercroft have signed up. This will give the Surgery protected time to look at systems and see how improvements can be made. The Chair of the CCG is to visit the Surgery and discuss with staff additional support systems which will come with funding. The PPG are fully supportive of the Surgery and don’t see how they can do more at the current time. They can also see things from the Surgery’s point of view rather than just as a patient and don’t see social media as being helpful.

2)   Salaried GP – this post has currently been advertised and 2 candidates have applied with interviews scheduled. CM stated that she felt the Surgery were lucky in this respect as there’s a national shortage of GPs and 14 Surgeries within Bromley are currently advertising. The vacant sessions are currently being covered by regular locums such as Dr Stuart Robertson. Locums don’t have the associated administrative work which deters some from applying for regular posts.

3)   Training Practice – the Surgery is now accredited as a training practice for GPs. Our first trainee will be starting in January.

4)   Pharmacists – employed and funded via the PCN. Raghad Taha has now rotated from Summercroft to the Biggin Hill Practices. A newly appointed Pharmacist (Sarah) has joined Summercroft and Krina currently at Bromley Common & Southborough Surgeries is rotating to Summercroft increasing Pharmacist input at Summercroft from 3 days to 5. The Surgery also benefits from a Social Prescriber employed by the PCN and other new staff such as Physiotherapists are planned.

5)   CM drew everyone’s attention to a poem she had added to the website; JC to send a link along with the Minutes.

CM

Originally the deadline to opt out was June but this has been extended to the end of September in order to give Surgeries and patients time to consider the implications.

CM explained that information had always been extracted from NHS Digital but the changes affected the way it was going to take place. Information has now been uploaded onto the website by way of a series of links. There are basically 2 choices –

1)   Can opt out entirely so information is not shared with anyone

2)   Can opt out of NHS Digital sharing information.

CM explained that Summercroft has no control or say in what is extracted by NHS Digital; patients have a choice about what is shared but Surgeries don’t.

RH recalled a previous digital extraction which had ended in disaster and had cost a huge amount of money; SI remembered this. CM commented that she thought that was slightly different and related to the complete digitalisation of patient records thereby eliminating all paper completely.

MK commented that data was now more valuable than gold. He had recently been contacted by Track and Trace on a daily basis and had been told that his information would be shared; on querying who with no-one could give him an answer.

RH agreed and added that since going to Guys for his covid vaccinations he has been receiving marketing information aimed at the elderly e.g. retirement homes, hearing aids etc.

BB stated that she felt the latest development would have an impact on patient trust for GP Surgeries but that if it was under the control of the Surgeries there would be less patient concern. CM agreed and mentioned that in the first week patients were angry with the Surgery about the proposal and also that the Surgery could not provide further information.

CM reported that there was a national initiative to get as many people vaccinated as possible due to the Delta variant but only had a week to implement this. She asked for the views of the PPG on patients to target and mentioned that the Housebound and Learning Disability patients had been vaccinated by the Surgery. Reasons for patients not taking up the vaccine ranged from those not wanting it at all with some undecided and some having problems in arranging it. The vulnerable and those with health conditions were a concern and the Surgery has not managed to arrange for all of these to be vaccinated. Although CM did not have the exact figures to hand she estimated that approx. 270 of eligible patients had not been vaccinated and of these approx. 50 had declined the vaccination. Approx. 300 were due a second dose. RB asked for suggestions in encouraging unvaccinated patients to take the vaccine up. RH felt that some patients were now so used to not being able to attend GP Surgeries/Hospitals that they now didn’t want to. PY thought the younger patients would be keen to take the vaccination up as without it they would be limited e.g. travelling.

MK asked who made the ultimate decision on the type of appointments offered. RB responded that the Surgery was following BMA guidelines on how to proceed.

RB requested that the PPG pass the word on why the restraints are still in place.

It was agreed that communicating the above to the patients was important and both SI and MK considered that the website was the most appropriate way of doing this.

CM

1)   Time for Care – being run by NHS England and Summercroft have signed up. This will give the Surgery protected time to look at systems and see how improvements can be made.

2)   PCN Project – aimed at patients recognising early signs of cancer to improve diagnosis rates. Previously patients would have been made aware by posters in the Surgery but with limited patients attending the Surgery this was not considered effective. RH suggested a page on the website; MK suggested asking patients having been treated for cancer to give their experiences and thought this would carry most weight. MK also suggested the local radio, especially the BBC and also proposed this could be undertaken for the CCG as a whole. WhatsApp was not considered feasible but texts could be sent via AccurX.

CM agreed to feedback to the cancer lead with a view to a local campaign and also to seek funding from the CCG.

CM

CM

ii)            Sites – BGPA had organised delivery of the vaccine from 3 sites including Community House in Bromley. Three Bromley GP Surgeries did not renew their contract with the BGPA following which Community House was no longer being used by the BGPA for the programme. The Mosque in Keston is being used for the delivery of the Astra Zenica vaccination and this satellite clinic had been set up by Dr Omar Taha (locum at SC covering Dr Jiskoot’s maternity leave and Dr Taraq Waheed, Partner at Southborough Lane and Clinical Director of Five Elms PCN of which SC is a member practice). Although both are Muslims the clinic is open to all patients. CM reported that the CCG had found it to be very successful in targeting ethnic minorities.

Vaccination delivery was automatically uploaded into patient’s records irrespective of where it was provided.

iii)           Housebound – Summercroft had undertaken to vaccinate their own housebound patients and this had been completed. They would be providing second vaccinations to these patients. Payment for delivery of the vaccine is reliant on the same provider administering both so it was in all providers interests to deliver the second vaccination. It was noted that Summercroft are currently receiving many queries regarding the second vaccination.

iv)          Statistics  – CM reported that Bromley overall had done very well with vaccinating the 4 priority groups by 15^th February. SC had achieved the following:

80 years +                    95.1%

70 – 79 years                97.6%

60 – 69 years                89.3%

Clinically vulnerable       97.8%

v)            Long Covid – in response to a query from JM regarding the support to be provided to these patients CM stated that a service may be introduced locally; further details are awaited. RB added that  Hospitals are currently holding Long Covid Clinics and it is expected that the number of patients will increase. JMcC and EK are both participating in a Covid Symptom Study (Zoe).

It was noted that many GPs are not interested in becoming Partners due to the additional workload involved in managing the business as well as patient services.

The PPG Members all wanted to wish Rachel well on her retirement.

RB further added that if staff were required to work from home a remote service could still be provided.

It was anticipated that e-consults and telephone triage would continue and this model of working had been introduced/increased due to the pandemic.

Although it is possible to request a consultation with a named GP via an e-consult these are normally allocated to the Duty Doctor. RB said that the most important factor was to deal with these in a timely fashion. Patients can still telephone the Surgery if they have a serious issue to discuss.

It was also noted that some Surgeries in the Bromley area require all contact to be via e-consult. CM commented that the younger patients preferred this method of contact.

EK asked if there would be a choice of vaccine; it was not thought so at this stage, only whether to receive it or not. In response to a query from JM re shielding patients CM was unaware of what arrangements would be made but felt sure they would be made and agreed to feedback to the CCG/BGPA on this.

A message had been added to the phone greeting regarding the vaccination programme.

CM expected to be given criteria for the first patients to be notified about the vaccine (e.g. age or medical conditions) but this would not be decided by Summercroft. Realistically it was predicted this would be rolled out in January/February.

It was noted that the Surgery are aiming to increase/improve the video consultations.

JM commented that she had a F2F appointment in the Surgery and felt she had been kept safe; entering via one door and exiting through another.

RH mentioned that he had a telephone appointment which had worked well and felt congratulations to the Surgery were in order. HH and BB also agreed and felt for some people they were beneficial. Similarly PY had been referred urgently by RB; she received a letter 8 days later with an appointment 5 days after this.

JM queried the need to upload a photo when completing an e-consult; CM stated this was not normal procedure.

CM reported that the Surgery were undertaking quality improvement work to audit how urgent referrals were processed and safety netted.

RB stated that urgent referrals were normally dealt with on the day and that the Hospitals were still catching up with delayed referrals but the situation was improving. Information from the Hospitals was coming through quite quickly. As with GP Surgeries the Hospitals are governed by guidance from NHS England/DOH.

The national target for take up of the over 65 age group was 75% and for the PCN was 77%; Summercroft had achieved 81%.

It was not compulsory for shielding patients to have the vaccine but it was recommended in order to reduce the risk of contracting flu. Household members of shielding patients are entitled to the flu vaccine but are difficult to identify.

The Surgery had been asked to contact patients considered to be frail to determine their wishes.