Oct. 26, 2023

Agenda

AGENDA PPG MEETING 26th OCTOBER 2023

5.20 HEALTH AND SAFETY LOGISTIC

5.30 WELCOME AND INTRODUCTORY REMARKS

5.40 PRESENTATIONS BY PRACTICE MANAGERS:

WEY FAMILY PRACTICE - LIZ REYNOLDS

PARISHES BRIDGE - KIM AUSTIN

MADEIRA MEDICAL - FAYE HARVEY

6.00 Q&A FACILITATED BY CAROL LEONG-SON

6.20 REVIEW/EXPLANATION INFORMATION SHEET

6.25 PPG UPCOMING MEETING INFO

6.30 CLOSING REMARKS

Minutes

Patient Participation Group (PPG) Minutes

Church of St John the Baptist, West Byfleet

5.30 - 7.00 pm, Thursday October 26th 2023

Subject: New Appointment System at West Byfleet Health Centre (WBHC)

1. Introduction

The Chair of the PPG Steering Committee, Davida Whimster, opened the meeting by welcoming everyone. She then summarised the role of the PPG and frequency of meetings (3x pa) for PPG members. She explained that because of the importance of today’s subject (The Appointments System), all patients had been invited to attend. Demand far outstripped the capacity of the Church, so to accommodate as many people as possible the PPG Committee decided to host a ‘hybrid’ meeting (in person & on zoom). Davida explained that the presenters would need to position themselves close to the laptop for zoom users to hear clearly which could result in some of the church audience having a restricted view.

Davida then explained the purpose of the PPG committee is to work with WBHC staff and patients using patient feedback to improve both patient and staff experience. She pointed out that each of the three GP Practices are separate businesses so despite central NHS directives there would always be some minor differences in each Practice’s operating arrangements and this was why a forum like this was so useful in raising patient awareness.

Davida then introduced the 3 other members of the PPG Steering Committee, Carol Leong-Son, Andy Grimshaw and John Langan, whose biographical details were in the information pack each participant had been given/emailed. Other pages in the pack would be explained in detail during the meeting.

She finished by acknowledging some people might be disappointed not to be able to ask questions during the meeting but we would answer questions raised in advance to allow the meeting to finish on time.

2 Presentation by Practice Managers

Carol Leong-Son introduced the Practice Managers - Liz Reynolds (Wey Family), Kim Austin (Parishes Bridge) and Faye Harvey (Madeira Medical) who would explain the new appointment system.

Liz Reynolds said the new system had been implemented first in the Wey Family Practice starting in September. NHS England had specified how appointment systems were to be managed across England and all three practices at WBHC had to comply as this was a requirement of the GP contract. Previously the 8.30 to 9.30 am queue on the phone had led to all appointments being allocated on a ‘first come first served ’basis and for those who failed to get an appointment their only options were to call back next day or go to the Woking ‘walk in clinic’. This led to great frustration and many complaints about the telephone system.

The Government now required that on first contact with a practice all patients must get an assessment of need or be signposted to an appropriate service. In addition, practices needed to try to offer routine appointments up to 14 days in advance. The only way to achieve this was to introduce a patient triage system considering the huge demand for appointments. The Wey Practice has over 12,000 patients and on a typical Monday just under 200 medical requests for appointments are made. In the past many patients have not been comfortable giving medical information to a receptionist assuming it was the receptionist who made the decision as to the urgency of their request. The practice now has a duty doctor who is trained to sort all those requests (based on the clinical information provided to them) into the available appointments that day and assign the most appropriate patients to urgent slots for the day and less urgent patients to the available routine appointments. The doctor will also decide which member of the practice team can best assess the problem and whether this should be by telephone or face to face. Wey Family is a training practice and often has GP Registrar’s working there and shares five clinical pharmacists across the three practices to help with medication reviews and queries. A new Advanced Nurse Practitioner has been appointed and additional GP appointments were available at the acute illness clinic at Woking Community Hospital.

Two new digital platforms were introduced by NHS England to ensure that all patients get the right help at the right time from the right person. These were the practice website and the NHS App. Neither was perfect but unfortunately the practices had no say in the layout or design of these national

platforms. People often ask which platform they should use. NHS England had asked practices to promote use of the NHS App which is less time consuming as once a patient had set it up they don’t need to reload their personal information each time they use it whereas that is required if using the practice website. Both platforms only allow a patient to request an appointment between 8 am and 4 pm. The online forms are closed at 4 pm to allow the triage doctor time to process requests that have come in that day before the practice closes at 6.30 pm. The practice tries to process all requests within one day.

Wey Family went live with the new triage system in September which was not without its problems as some of the digital interfaces were ‘clunky ’but much has been learned over recent weeks and the practice is trying to streamline the processes. The new triage system is for GP appointment requests only. All other queries should also come via one of the digital platforms but nurse appointments, blood tests etc. can be booked over the phone as usual. It had been suggested that the new system discriminates against the elderly, disabled and those who are not technologically savvy. However, those patients can still phone the practice and the receptionists will complete the online form for them. If they prefer not to be contacted by text or a link to book an appointment, they can request that they be contacted by phone as before.

Kim Austin highlighted that Parishes Bridge had been using a triage system of this kind since the COVID pandemic because their GP’s believed it to be the most efficient system for all patients to get the appropriate care from the right healthcare professional. That professional could be a GP, but for some conditions it could be a nurse or advanced nurse practitioner, a physiotherapist, a clinical pharmacist, or other staff member. She said that Parishes Bridge patients would continue to do as they had always done as, for the moment, nothing had really changed in terms of how to request an appointment. The NHS App and the website looked different and the Practice Managers would demonstrate how to use them later. She stressed that if a patient had a genuine medical emergency on the day, they should still phone Parishes Bridge reception from 8.30 am and the receptionists would ask some questions about the issues of concern and the request would be triaged in the same way as they had been doing for some years. If the GP felt the patient needed an urgent appointment that day this would be arranged. Requests for nurse appointments, blood

tests etc. could continue to be made as before. The major change across the NHS was digitisation and if all those who had access to and were able to use the NHS App or the practice website did so then this would free up the phone lines for those unable to utilise the new technology. It would also save time waiting on the phone as the response time would be the same whichever method was used. When any changes were planned these would be communicated to patients in advance but in the final analysis patients can always phone the practice if they have a problem.

Faye Harvey said that the changes had stemmed from the new update of the GP contract and applied equally to all three practices who would each be running a triage system. Madeira Medical had not yet implemented this but would be doing so from mid-November. However, before doing so the practice would communicate with all patients so that they knew when and how the changes would take effect. They would be asking patients to use the online form for urgent and non-urgent appointments. She stressed that patients should provide as much detail as possible to help the GP understand their condition and assess their priority following which they would be contacted via their chosen method whether phone, text or link to book their appointment. This could be with a GP or other health professional but that would be decided by a doctor. Routine nursing clinics and others. such as diabetic clinics would continue as previously. The practice acknowledges that not all patients would be able to use the internet to make bookings. In those cases, the patient should call reception and the requisite information would be recorded onto the online form for the patient by the receptionist. The aim of the changes was to free up more appointments, stop the 8.30 am phone queues and provide a bigger booking window. She said that some teething problems were expected and welcomed feedback once the practice went live with the new system as this would help to improve the service.

3. Review/Explanation of Information sheet

Carol Leong Son said patients would notice two key differences from the previous appointment system. Firstly that patients don’t book a GP appointment they have to request an appointment using a standard form available electronically and secondly, requests will be triaged by a GP who will assess what kind of appointment was needed,

when and with whom. She then explained the purpose of this part of the meeting was to demonstrate how to make that appointment request and the physical steps required. She drew attention to the information pack and the ‘step by step ’guide showing the 4 ways (via a flow chart) of how to request an appointment. She explained that whilst ‘phoning ’or ‘visiting the practice ’looked like the simplest options with the fewest steps o paper, an electronic request form must be completed because it is used by the doctor to triage the request, so the receptionists would need to fill in the standard forms behalf of the patient. Carol asked, for all who could do so, that they use either the NHS App or the practice website to request appointments to reduce the pressure on the phone lines. She said that the NHS App was the easiest and quickest way to request an appointment as it did not require the repeated entry of personal data. Carol then took participants through the details of the various methods and recommended patients practice requesting an appointment via the NHS App the in order to familiarise themselves with the process, but not submitting the request. She then highlighted the process for cancelling an appointment which was very important as it then freed up a slot for another patient. Following this she provided various hints and tips and how to make the most of an appointment bearing in mind the limited time available.

4. Q&A facilitated by Carol Leong Son

Carol was joined by the Practice Managers to provide answers to key questions submitted before the meeting. She stated that any questions submitted after the meeting would also receive an answer.

(See attachment for a list of all questions and answers)

5. PPG Upcoming meeting information

Andy Grimshaw said the PPG Steering Committee currently consists of only four people and that organising such a large meeting in the Church and online had stretched its resources. It was important to increase that number particularly with someone with IT experience. Anyone wishing to join the Steering Group should e-mail wbhcppg@gmail.com

He said the next meeting was planned for February 2024. It would only be open to PPG members (and those who have

expressed a wish to join the PPG today). It will be held at The Church of the Good Shepherd, Pyrford. The meeting format (in person only, or a hybrid) would depend on today’s feedback. He asked all participants to return their feedback forms to aid this decision. Finally, each practice had been asked to have one of their GP’s attend the meeting.

6. Closing remarks

Davida Whimster reiterated her apology for the zoom limitations and difficulties balancing speaking to the live and zoom audiences. She reiterated that the PPG Steering Committee was very keen to expand its membership from four to (ideally) six with at least one having an IT background. Other relevant experience might also include an NHS background. She invited interested parties to e-mail their details to wbhcppg@gmail.com

The Steering Group would try to make the February ‘24 meeting hybrid. In addition, we plan to run a Zoom PPG meeting covering all aspects of pregnancy and child health care, including early years school health service. This will be an extension of a similar PPG session run successfully earlier this year. It will be scheduled for summer 2024.

To finish, Davida hoped the meeting had been helpful in explaining the new system and that it offered a practical alternative to the interminable 8.30 am queue and hopefully a better outcome for all patients.

The meeting was then declared closed.

DW/JL