Patient Participation Group

Healthwatch Bromley is your local health and social care champion. From Beckenham to Biggin Hill and everywhere in between, we make sure National Health Services (NHS) leaders and other decision makers hear your voice and use your feedback to improve care. Please take five minutes to share your story with us.

Our PPG

The surgery strives to provide excellent healthcare.

We welcome constructive feedback and suggestions to help shape our services to serve the needs of all of our patients.

Our Patient Participation Group (PPG) meets at the surgery periodically to provide a forum for discussion about the surgery.

View the outcomes of previous PPG meetings and Patient Surveys here.

The PPG has contributed towards improvements in the surgery, this includes:

  • Waiting area refurbishment
  • Upgraded Telephone system
  • Updated website

If you are a patient registered at the surgery, with a positive contribution to make, please complete the below application form to apply to join the group.

Places are limited and applicants will be selected with the aim that the group will consist of a representative cross-section of our patients.



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PPG Meeting Minutes

25.07.24

 1.IntroductionAction
 Chris Doorbar was welcomed to her first meeting and Renee Evenett and Elizabeth Strachan were welcomed back.   
   
 2.  Matters Arising from the meeting held on 18th January 2024 Car Park – noted that the new signs were now in place.Website – this had been updated and now included reference to Teresa (new Manager) who had been welcomed to the meeting.PRUH Building Works – to provide an Endoscopy Unit. Janet gave an update and confirmed it was still due for completion in 2025.Econsult/Accurx – econsult has now been replaced by Accurx. It was noted that the system could be used for prescription requests and general enquiries and was now working well.NHS App – Rak reported that a meeting had been held earlier in the day with a Manager from the ICB and his help had been requested in helping patients to use the App.                 
 3.Patient POD & Waiting Room 
 It was confirmed that the POD was working although the paper print outs were no longer available. With posters being grouped on the noticeboards it was generally considered to look better. In response to a query regarding a Children’s Corner which the Surgery used to have it was confirmed that this had to be withdrawn due to infection control.   
   
 4.Cyber Attack 
 This had affected blood tests. Summercroft were unsure of the total          numbers of their patients affected but were expecting an updated list next week. Urgent requests, based on clinical needs are still being processed and patients are able to have these at Summercroft and the Orpington Health and Wellbeing Centre. Rak said that GPs had been asked to look at alternative BP medications that don’t need so many reviews. 
   
 5.Five Elms PCN 
 Meetings – Carol reported that she and Penny attend a meeting every 6 weeks with representatives from the other PCN Surgeries although they’d been unable to attend the last meeting as they were on holiday.Well Being Café – still very popular although not many Summercroft patients attend. This was attributed to the location. The meeting is held on the last Friday of the month and 4 Summercroft patients attended the last meeting. The Orpington Wellbeing Café is also very well attended with 90 attendees and is now closed to new attendees. Talks have been given on various topics including Dementia, Long Covid and Prescriptions. A keep fit session is also included.Office Space – the PCN need to find alternative office space as Global House is being sold. Premises at Farnborough and Bromley South had been considered although it was now likely they would remain at Global House.         
   
 6.Staffing Update 
 Teresa Dyson Appointed as Operations/Business Manager and started last week. Teresa advised the PPG members that she’d spent 6 years as Deputy Practice Manager at Swanscombe and had been involved with the PPG in her role there. GP Trainee – Josh Thevarajah is leaving in September. A new Trainee, Nataliya Perera, is due to commence on 7th August.Reception – Kay confirmed Reception was now fully staffed with the recent appointments of 2 new staff.       
   
 7.Meeting Days 
 Agreed that these should alternate between Wednesdays and Thursdays as previously. 
   
 8.Booking Appointments on line/ DNA Appointments (Did Not Attend) 
 It was confirmed that some Nurse appointments could be booked online but not GP appointments. Rak explained that certain patients monopolised these in the past thereby reducing the number of GP appointments available for other patients and that the system now was fairer. One member reported that Rak’s telephone message had been replaced by an automated message. Kay to look into. Chris D said she found the call back option works well. This was seconded by Jenny who had previously commented similarly. Chris H has had to contact the Surgery frequently and has found the service friendly and helpful. In response to a question from Sheila Kay stated that Receptionists are initially on 6 months probation which is generally sufficient for training although this is on-going. Carol queried whether DNAs were still a problem. It was confirmed that it was. One of the GPs had held a coil clinic this afternoon with 5 appointments, 2 of whom did not attend despite a phone call to the patients prior to the clinic asking them to confirm attendance. Victor also questioned whether text messages asking patients to confirm attendance were able to be sent. Noted that currently text messages are not sent following the transition from iPlato to Accurx. Teresa agreed to provide a report of DNAs for the next meeting. Agreed that DNA patients be sent a text message re their missed appointment and that this be coded. Elizabeth stated that the Leisure Centre sent messages to those not attending. Although they weren’t penalised it appeared to help. Victor commented that some NHS Foundation Trusts warn patients who have missed 2 or more appointments.          KS                         TD
   
 9.Breast Cancer Awareness 
 This is a Public Health Awareness talk originally planned for 16th July but is now to be held on Wednesday 18th September at 1330. Hedwig will be delivering the talk. Planned initially for Admin and Reception staff but open to PPG members too as well as other patients. Colour posters to be displayed in the Surgery (done).        JC
   
10.AOB Medication Reviews – queried whether patients are asked if they still need medication. Rak said that each case was different, depended on the patient’s history and that each case was looked at on an individual basis. Jenny felt that these reviews with the Clinical Pharmacists worked well. Rak also mentioned that if a Consultant recommends that a medication be changed the GPs can action this.  Diabetes – Sheila was aware that currently our only Nurse undertaking reviews is Heather. Noted that Shola is currently undertaking Diabetes training and Dr Nehul Patel is also undertaking a monthly diabetic clinic to help. Jane queried the issue of Accu-Chek meters. Rak said that the Practice are told what to issue but that if a Consultant requests a different meter the GPs will prescribe it.IT Outage – this occurred Friday 19th July resulting in GP Surgeries having no access to the medical information system. The problem had been rectified by Monday and cancelled appointments were being rebooked.Barbara, Bob & Ellen – Penny reported that the last 2 of Barbara’s PET scans had been stable and that she’d been able to get into Locksbottom. Sheila reported that Bob and his wife now had a live-in carer. Janet forgot to report that Ellen had tendered her apologies due to having a hip replacement on Saturday 20th. The PPG wished all of them well.   Carol thanked everyone for coming and likewise she was thanked for her stirling efforts at Chairing the meetings.                     
   
8.Next Meeting – Wednesday 23rd October 1730 in the Surgery.   

18.01.24

Summercroft Surgery Patient Participation Group Meeting

Minutes

Thursday 18th January 2024,  1730 – 1850

Patient Attendees:   Chris Heaney, Carol Robjohns, Ellen Killeen, Sheila Ivery, Jenny McCarthy, Mike Titheridge, Vincent Wolf

Surgery Attendees:  Dr Rak Balendran, Kay Stevens

Apologies:              Barbara Blackmore, Hedwig Hegtermans, Naima Wolf, Penny Yogarajah, Jane Clark, Brian Street, Chris Doorbar, Carla Michalska

Chair:                     Carol Robjohns

Minutes:                 Janet Carlo

 1.Matters ArisingAction
   
 Know Your Team – the TV Screen and Patient Check in will be activated shortly.Ordering Repeat Prescriptions on NHS App & Patient Access – the problems and confusion being experienced have been rectified.Unreasonable Patients – confirmed that these patients are sent a warning letter stating their behaviour is unacceptable. 
   
 2.Linking Summercroft to Epic 
   
 Vincent explained that this is an interactive computer system that some hospitals are using including Guys & St Thomas’. All patient information for the various healthcare providers is available in one place. It was further noted that the system gives the option to link GP Practices potentially saving time for GP Practices. It was noted that My Chart is a new app and online service allowing patients to access their health record and is linked to Epic.  
   
 3.Car Park 
   
 Rak stated that the car park is cause for concern and is a major issue. Patient and staff safety is paramount. Previously it was suggested that the car park be restricted to staff and disabled patients. More recently ANPR had been considered which would involve patients needing to report in to Reception. Too many problems were foreseen and the owner of the surgery was not in favour. Various options were discussed to improve the current situation. Good signage was considered essential, possibly large red signs including parking at your own risk. BGPA to be requested to inform patients coming for blood tests that parking is not available at Summercroft. This would not apply to Summercroft patients. Unlike other surgeries there is very little parking nearby although the surgery is well served with buses stopping nearby.            CM
   
 4.Five Elms PCN 
   
 Well Being Café – Carol stated this is held on the last Friday of each month from 1100 – 1300 and is proving very popular. Five or six Summercroft patients attended the last meeting and is especially helpful for patients living on their own or recently bereaved. Most attendees are 70 years +. A keep fit session is always included and a talk is given with a Pharmacist coming to the next meeting. 
   
 5.Staffing Update 
   
 Monica Hakeem, Salaried GP is returning from Maternity Leave on 1st April. Dr Osman first year GP Trainee is leaving in February. Dr Josh Thevarajah, a final year trainee is with Summercroft until the end of July. Shola Azeez, Practice Nurse will soon be able to undertake smears. The PCN staff now includes a Physiotherapist who is able to undertake assessments and refer for scans. A second Mental Health Practitioner has also been appointed. Paramedics are at Summercroft on a Monday and are able to deal with acute problems such as chest infections, ECGs. The Surgery is now full to capacity and cannot accommodate any further staff. Carol stated that she believes the PCN are exploring accommodation to rent, possibly in Farnborough.                     
   
 6.AOB 
   
 Pharmacy – Mike asked about having a Pharmacy in Locksbottom. Historically there was one although this was bought by Sainsburys who opened their own Pharmacy in the supermarket. This was subsequently sold to Lloyds who have now gone. Rak said that the provision of Pharmacies was outside GP Surgeries remit.  A petition was suggested. Tesco and Crofton Pharmacies are the closest to the surgery.Semaglutide – an injection for diabetic patients not currently available. Rak stated that GPs can prescribe this providing the patient complies with very strict guidelines.Call Back – Ellen is very impressed with this system and has found that Reception generally call back within 15 minutes. Jenny and Vincent agree. Kay added that there are generally 5 Receptionists answering the phones at the beginning of the day so calls are generally answered fairly quickly. Vincent commented that there would always be some difficult to please patients.PRUH Building Works – an Endoscopy Unit is to be built with the works expected to take 2 years. Some of the works resulted in room 8 in the surgery being flooded. The builders are going to rectify the damage. Concrete piling is due to start this month which may cause some damage.econsult/Accurx – Bromley are moving away from econsult and going to Accurx which is a similar system. Kay attended a webinar on Accurx and said some aspects were better, limits could be set, replies were autosaved but the system does not red flag issues as Econsult does. Likely to start in April but possibly earlier.Website – in response to a question from Ellen Janet said that the website had been updated earlier in the week. 
   
7.Next Meeting – Thursday 25th April 2024.   

21.07.23

Summercroft Surgery Patient Participation Group Meeting

Minutes

Thursday 21st July 2022, 1730 – 1915 (face2face)

Patient Attendees:  

Surgery Attendees:  Dr Rak Balendran, Carla Michalska, Kay Williams

 1.Matters ArisingAction
 Following the last meeting in relation to item 2 Penny wanted it recorded that she in no way thinks GPs should not be able to work part time. 
 2.Agenda Items and Circulation 
 Barbara reported that she had met with Penny, Carol, Bob, Brian, Sheila, Jenny and Mike to discuss possible agenda items. Barbara was unable to contact all PPG members as she did not have contact details for all of them but would like to include them in future if contact details could be provided. The group were keen to learn more about the appointment system and services provided by Five Elms PCN. It was suggested that the agenda be circulated one week before the meeting date – agreed. During Covid and with zoom meetings the format had been different and focussed largely on an update on how the Surgery was managing covid, the appointment system etc. It was also agreed that a copy of the Minutes should be available in the Surgery waiting room and also on the website. Barbara stated that the group wanted everyone to be proud of Summercroft but has heard a lot of negative comments. Carla added that there has been a lot of negativity in the press regarding General Practice and it was difficult to rebuild good relationships when the faith and trust has been lost. Carol considered that communication was key and as a PCN representative had found it useful to be made aware of the costs of GP, A/E and other services.      PPG Members                      
   
 3.Website 
 Members did not find this welcoming and felt the messages relayed were aimed at directing patients away from the Surgery to seek advice/treatment elsewhere. Similarly they found posters in the Surgery giving the same message. Carla stated that Surgery websites throughout Bromley were standardised although there was some room for variation. The possibility of linking Summercroft’s website with that of Five Elms PCN was also a consideration. 
 4.EConsults/GP Contract 
 It was noted that econsults were now part of the GP contract and therefore had to be provided. In response to a query from Chris, Carla reported that General Practices are potentially told what services they have to provide by the Government. Core services are covered by the contract although Practices can choose to provide other additional local services. 
   
 5.Covid 
 Covid still continues to have an impact on the Surgery and services provided. Carla said that the Surgery were still trying to build these up following covid when everything changed and appointments offered were just book on the day. RB commented that during covid the staffing position changed daily due to sick leave making it impossible to plan. The Surgery are aiming to find a happy medium and although not there yet were heading in the right direction.           
   
 6.Face 2 Face Appointments 
 An analysis of telephone/F2F appointments was made available with the agenda. This showed that 56% of appointments were telephone and 44% F2F. Telephone appointments took an average of 12.5 minutes and F2F 16 minutes. Carla also said that the telephone consultations did not include time needed to complete the patient’s consultation notes, generate referrals etc. She further Carla explained that the system was not user friendly in breaking down the appointments and explained how she’d arrived at the outcome. Carla estimated that pre covid approximately 20% of appointments would have been phone. Brian suggested that the analysis be undertaken on a monthly basis with the findings being made available at future meetings. It was noted that the number of calls being received by the Surgery had increased. In response to a query from Bob, Rak stated that it depended on individual GPs and their experience as to their preference for telephone/F2F appointments. Rak personally likes telephone appointments although overall they take longer. He always offers patients the opportunity to come in. Patients with a strong preference for F2F are generally offered one. Ellen queried whether patients were able to come in and make an appointment at the desk. Currently patients are encouraged to phone. Rak stated that pre covid there would be a lengthy queue at 8 a.m wanting to make appointments which resulted in very little being available when phoning. One member said that his wife had had 3 telephone appointments and medication prescribed over an ear problem. It transpired that this was due to wax and he felt that the telephone appointments/medication prescribed could have been avoided if she’d had a F2F appointment.                  CM
   
 7.PCN PPG 
 The PCN now has its own PPG and Carol is a representative. She reported that the Saturday clinics provided by the PCN have proved popular with working people and also the elderly who rely on people to take them. Carla explained that PCNs were formed in 2019 and are contractual. They were introduced in order to encourage Practices to work together. Summercroft are part of Five Elms PCN with the other Practices being Bromley Common and Southborough Lane both based at The Crown and Norheads Lane and Stock Hill both located in Biggin Hill. At the outset bank accounts had to be set up, extended hours had to be provided across the PCN (22.75 hours per week). As there was no PCN Manager initially Carla was seconded to undertake this role. PCN staff providing services to all of Five Elms are funded via the PCN. These staff providing extra services and appointments within each of the Surgeries include Clinical Pharmacists, Paramedics, Care Co-ordinators, Mental Health Practitioners. More new roles will be coming e.g. Physiotherapists. Carla commented that a good thing to come out of covid was that the PCN had really bonded and built good relationships between the 5 Practices.       
   
 8.Reception/Phone 
 Brian stated that he’d phoned recently and the queue position was not given out. Kay to investigate on Monday. Barbara queried whether the desk was staffed on a full time basis. Kay responded that it was not always possible to do so at present due to annual and sick leave and vacancies. However, the aim was to do so staff permitting. Sheila asked whether there were people the Surgery could call on if short. It was noted that students had in the past provided cover but the amount of training involved for bank staff often precluded this.  KW
   
 9.Summercroft Relationship with Local Pharmacies 
 One member considered that sometimes local pharmacies were very good but not so on other occasions and that he’d witnessed the phone not being answered whilst in the pharmacy. Carla confirmed that Summercroft’s relationships with pharmacies was fine although it could always be improved. Rak explained that there was a national incentive recommending patients approach pharmacies in the first instance rather than their GP. Rak also informed those present that it is now possible to make appointments with pharmacies for certain conditions e.g. blood pressure checks etc. Repeat Dispensing where a years prescriptions can be sent to pharmacies to issue monthly. It was noted that this was only suitable for patients on certain drugs and that pharmacies are not keen on this system as it can cause technical problems. Rak also explained that the surgery issues generic prescriptions and it is up to the pharmacy which brand they issue. Specific brands cannot be ordered. 
10.Patient Communication 
 Barbara suggested that communicating the way the Surgery operates and its relationship with Five Elms was key and also proposed that something be made available in writing for patients who may not be computer literate. To include the last 6 months recruitment drive and new roles which in turn offer additional appointments, the different types of appointments available to patients, how the Practice is developing, the PCN in relation to new roles and how it works. The website was one form of communication and should be updated. Sheila suggested the local residents association and Carol considered the Newsletter was an excellent form of communication. Carla agreed to put something together and send to all PPG Members for comment and to ensure everything had been encompassed. Barbara explained that the current Newsletter is distributed to 2,200 homes in the area. Further distribution was considered but this might be costly. Carla was also keen to find out what the PPG members got out of the meetings etc.                    CM
11.Staffing Update 
 Carla confirmed that a new salaried GP had been appointed, namely Dr Jane Matthews and she would be working on a Wednesday and Friday. Jane had undertaken part of her training at the Surgery and was interested in teaching. Carla also added that there are 16 GP vacancies within the Bromley area and that Summercroft had been fortunate in being able to recruit 2 permanent GPs in the last 6 months (Jane & Monica). Locums are still being used to cover annual leave. Part time permanent GPs in the Surgery also undertake some additional sessions to cover leave. Carla reported that the Healthcare Assistant had left recently in order to undertake a Nursing Degree to become a fully qualified Nurse. There are currently 6 HCA vacancies within Bromley but Summercroft have been fortunate again in being able to recruit. It was also noted that Summercroft also have a qualified Nurse in the Surgery undertaking training to become a Practice Nurse. Carla mentioned that having new staff was good for the Practice. Recruitment is also under way for Reception and Admin vacancies. 
   
12.Other 
 Mike queried what happened to clinical letters addressed to a GP who had left. It was explained that these automatically went to the appropriate or named GP. He also said that he wasn’t sure if GP action recommended in one letter had been followed up. Carla to look into.CM – actioned
   
 13.Next Meeting – 20th October 1730 – 1900, face to face/zoom depending on covid guidelines.ALL

PPG Minutes 12.07.23

Summercroft Surgery Patient Participation Group Meeting

Minutes

Wednesday 12th July 1745 – 1900 (F2F)

Surgery Attendees:  Dr Rak Balendran, Carla Michalska, Kay Stevens

 1.IntroductionAction
 Carol Robjohns to chair the Meeting in the absence of Barbara who is unwell. The PPG were sorry to hear Barbara’s news and requested their best wishes be extended to her. 
   
 2.Matters Arising from the meeting held on 20th April 2023 Telephone – the telephone provider had been unable to identify the problem with calls from landlines to the Surgery not connecting but mobiles were. They requested that any further issues be reported as they arise. It was noted that the message on telephoning the Surgery had been changed from the generic one and was now provided by Rak as this was more personal.Booking Appointments –it was unclear from the Minutes that Nurse appointments could be made at the desk but not GP. Mike queried why. Carla stated that the number of appointments varies depending on staffing levels. The weather also has an impact. There are insufficient GPs to give patients an appointment every time requested. Other roles are able to see and assess patients. Jenny commented that the call back system works well. Jane queried the training for Receptionists. This is on the job, appraisals and direction from Healthcare Professionals. If a problem is identified a review is undertaken in order to prevent it happening again. Carla reported that a New Assessment Tool was being introduced in order to measure consistency. Naima voiced concerns regarding Receptionists asking patients the nature of their call and felt they were not qualified to diagnose problems. Carla & Kay stated this was at the request of the GPs and that the Receptionists were not diagnosing conditions but signposting patients to the most appropriate healthcare professional or service. Bob likened this to dialling 999 and being asked which service was required.      ALL
   
 3.Well Being Cafe 
 Penny reported that the first one had been held last Friday and both she and Carol attended and were very impressed. To be held monthly on the last Friday of the month at St Augustine’s Church, Southborough Lane. Coffee and cake is provided on arrival. Seated exercise classes available. Informative talks e.g. Diabetes planned. The Cafe is not funded by the Surgery but by NHS England following a bid put together by Carla for the PCN.             
   
 4.Information Boards in the Surgery 
 It was suggested that these could include details of staff, the days the GPs work etc and the availability of evening and weekend appointments. Carla stated that she had just ordered a poster giving details of the new and different roles in Primary Care working in the Practice.      CM
   
 5.Prescriptions and changes at Crofton Pharmacy 
 Brian reported that you can no longer phone a prescription request to Crofton and either need to request via the App or go in. It was noted that the closure of Lloyds in Sainsburys has had an impact and also that Crofton also experienced a systems failure with email requests not being received. Carla agreed to establish whether this was short term or long term as Summercroft need to know what to advise patients. Summercroft requests need to be in writing, on-line or via a Pharmacy although a few telephone requests have been actioned following on from the problems at Crofton. It was acknowledged that Namish generally looks after his patients. Jenny stated that there was previously another Pharmacy in Locksbottom which was subsequently bought by Sainsburys who then sold it to Lloyds and this has now closed.        CM        
   
 6.Different Services Provided by the Surgery and PCN 
 There are problems recruiting to some roles due to demand. Enhanced Access appointments (similar to the Hub) are available in the evening and weekends provided by GPs, Nurses, Clinical Pharmacists and Paramedics. Currently provided at Stock Hill and The Crown although Carla has requested that this be rotated to include Summercroft. Agreed that this be advertised on the Noticeboards and Carla agreed to check the website for this information.            CM
   
 7.Referral System Explained and Delays in Referrals 
 Jenny queried this. It was noted that a GP generates a referral, marks it as urgent or routine and sends a message to the Referrals Team to process via the ERS system. Information includes the specialty and sub clinic. On processing the referral the ERS system shows the Referral Team what sub clinics are available and where and waiting times. In some cases no information is available in which cases the Referral Team have to send the referral to the Provider for them to arrange with the patient. Carla said that generally it takes around 2 weeks to process a referral. If the patient is not happy with the Hospital or wait they are able to change the appointment. 2 Week Wait referrals are sent to a different inbox but are still dealt with by the Referral Team. Jenny also asked if private referrals are given over NHS. It was confirmed this was not the case. Rak added that it takes a few minutes to generate a private referral and GPs often do these during the patient consultation. There is no need for Referral Team input and they are not processed via the ERS system.       
   
 8.AOB 
 Sheila queried whether ear waxing has to be paid for as it’s no longer provided in the Surgery. Carla stated that there was a new Community Ear Waxing Service (provided by Specsavers) that patients could be referred to.Mike queried whether annual blood tests were required when a patient reaches a certain age. It was confirmed that bloods were ordered solely on a patient’s condition.Mike queried the process with reviewing prescription medication. This depends on the medication. Carla suggested that Mike have a medication review with the Clinical Pharmacist. It was also noted that medication reviews can be done automatically by the GP without involving the patient if they are happy with test results etc.    Jane asked for clarification on a Consultant requesting blood tests from a GP. This is an ongoing problem with an increased number of  requests being received. If GPs order tests they are then responsible for the result. Summercroft contacts the Consultant direct when they are not prepared to organise these. Mike commented that his wife has just been discharged by her Diabetic Team but on the discharge there was a request for the Surgery to arrange blood tests.      Hedwig asked if the 5 yearly NHS Checks were still being provided by the Surgery as she had not had one since 2016. Carla confirmed they were but there was a huge backlog. A new Nurse has recently been appointed who is being trained to do these. The NHS Health Checks can also be organised via the Bromley GP Alliance. Hedwig happy to wait for Summercroft.     Hedwig also asked if an immunisation was given by a Healthcare Professional outside the Surgery would it be recorded on the patient’s record. Carla confirmed this should happen and would check the documentation Hedwig had dropped off.                  MK                                       CM
   
 9.Next Meeting – Thursday 19th October, face to face 1730.  ALL

PPG Minutes 20.04.23

Summercroft Surgery Patient Participation Group Meeting

Summercroft Surgery Patient Participation Group Meeting

Minutes

Thursday 20th April 2023,  1730 – 1900

Surgery Attendees:  Dr Rak Balendran, Carla Michalska, Kay Stevens

Minutes:                 Janet Carlo

 1.IntroductionAction
 BB introduced everyone and said that she was aiming for the meeting to finish at 1900 hours.   
   
 2.  Matters Arising from the meeting held on 15th February 2023 Telephone – a problem had been identified where patients calling from landlines were unable to contact the surgery but could from a mobile. CM had reported this to the Surgery telephone provider who had been unable to identify the problem which was under further investigation.PCN Minutes – EK requested that where initials were used could they be explained. PY gave an explanation re ICS & ICB. 
 3.Noticeable Improvements at the Surgery 
 BB gave the following examples: More welcomingBetter atmosphereDesk manned more oftenPhone – call back system works well although the answerphone message could be more explicit re the call back. CM to contact Surgery Connect (telephone provider) to see if the message re the call back could be earlier in the overall message.Booking a Blood Test – Surgery staff were helping new users rather directing them to the website. It was noted that there was also a telephone no. to call and this was printed on the blood test form. CM stated that she would also see if the telephone message could be more explicit on how to book a blood test. Following on from this VW suggested there could be 2 systems, one for patients with smart phones and one for others. He also commented that blood test results were quickly received via a tablet/phone. It was suggested that the new website could include details on how to obtain test results.111 was working well if patients can’t make an appointment at the Surgery. One of the main points was to help patients who don’t understand systems.              CM         CM         CM
   
 4.Booking Appointments 
 Online – it was noted that certain Nurse appointments could be booked online. In response to a query from JM CM responded that she wasn’t sure yet if GP appointments would be released for booking online. With the new roles Reception were aiming to direct patients to these roles where appropriate. The holders of these roles were usually able to book their patients with a GP where necessary.Desk – KS stated that patients are able to book appointments at the desk at present. She also commented that some appointments could be booked 11 days in advance. CM stated that telephone was the preferred method of making appointments and this avoided queries at the desk. She also said that she was aware how difficult it was for patients to make appointments at 0800 and this has been recognised as a national problem re access by NHS England. She further stated that Five Elms PCN would be looking at this issue mid-May with a view to providing support to address the problem.                 
   
 5.Covid Spring Vaccination Programme 
 It was noted that several PPG members had already received invites and CH had her vaccination earlier in the day. It was noted that the BGPA were running the programme, not the Surgery. JC commented that she’d been unable to find accessible sites – CM to investigate.      CM
   
 6.Feedback from Five Elms PPG Meeting on 6th February 
 The Orpington Well Being Café has proved so popular that it is no longer being promoted. Darren Girling PCN Manager has asked for suggestions for a further site. St Pauls, the Mosque and the Church Hall in Gravel Road were all suggested. PY & CR to take back to the PCN at their meeting on Monday 24th April.        CR/PY
   
 7.E-consults & Utilisation of Junior Doctors 
 RB stated that the Surgery doesn’t have the resources to meet demand for GP appointments and E-consults. VW commented that Junior Doctors are highly qualified but a much cheaper resource than a qualified GP. RB commented that Summercroft currently have one GP Trainee who needs a qualified Trainer and Dr Rajiv Samarasinghe is a qualified Trainer. He also added that Dr Jane Matthews was also a qualified Trainer and would also be taking a Trainee taking the total to 2 Trainees. 
   
 8.Staffing Update 
 Receptionist – an appointment has now been made following an ongoing vacancy.Practice Nurse and Health Care Assistant (HCA) – CM reported that a 2nd round of recruitment had recently finished but had failed. It was noted that Dee Moseling had returned to the Surgery and was undertaking an HCA clinic weekly. In relation to the Practice Nurse CM was currently looking at recruiting newly qualified Practice Nurses. It was noted that these were not the same as Advanced Nurse Practitioners who were able to assess patients and also prescribe. It was noted that the recruitment of Practice Nurses would be problematic in Bromley as many Nurses are due to retire in the next 5 years.     
   
 9.New Website 
 The new provider had been commissioned throughout Bromley. Certain things could be changed such as adding and removing pages and changing the colour scheme. CM would like some patient input/feedback. It was suggested that the website be checked and updated on a regular basis and CM said that this would be undertaken by the IT staff. Another suggestion was to include names of staff on the website and to have a list of Partners and GPs on a noticeboard in the Surgery.    ALL       CM
   
10.AOB 
 JC requested that both her and her husband’s medications be bought into line. KS agreed to make them appointments with a Pharmacist.MT queried the procedure where a 3 month review by a GP was requested by a Hospital. It was noted that the Workflow Team would forward the letter to a GP but it was not possible to book appointments 3 months ahead. It was generally agreed that the patient should take responsibility for this. If it was purely a request for blood tests the form would be generated for the patient.KS had met with Alice Palmer from HCA Healthcare UK who was able to organise educational events covering a wide range of specialties. CR & PY to take to Five Elms PCN PPG.  KS                 PY/CR
   
8.Next Meeting – Wednesday 12th July 1730 in the Surgery.  ALL
 1.Matters ArisingAction
   
 2.Covid Update/Vaccination Programme 
 i)             Invitations – RB reported that the Bromley GP Alliance (BGPA) had undertaken the delivery of vaccinations for Summercroft and had been provided with details of patients in the various priority groups. RB stated that there were some initial teething problems but that since Christmas delivery of the vaccine had been straightforward. Some patients had received 3 invitations from different sources e.g. NHS national booking system and Hospitals. It was noted that on the NHS site both the first and second vaccination had to be booked and it was not possible to book the second vaccination separately. The second vaccination will be provided at the same site as delivery of the first vaccine and the second vaccine will be the same as the first, e.g. Pfizer. RB also added that Summercroft patients had been amongst the first to be vaccinated. Also, that Bromley overall had performed well culminating with a visit from the Prime Minister at OHWBC.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 15th 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). 
   
 3.Staff Changes 
 It was noted that Dr Rachel White would be retiring on 31st March and it was recognised that she would be missed by patients and staff alike. From 1st April the Practice would have 3 Partners – Rak (Senior Partner), Dr Vicky O’Brien and Dr Annika Jiskoot. RB reported that he and the other 2 Partners communicated well and worked well together as a team. In addition there would be 3 Salaried GPs – Dr Rajiv Samarasinghe who has been in post for several years, Dr Nehul Patel who has been employed as a regular locum by SC for a number of years and Dr Beena Ashok who has experience of working in the Bromley area. CM stated that all GPs were being encouraged to share their expertise rather than having specialisms.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. 
   
 4.Appointments/Opening the Surgery 
 CM stated that the GPs were continuing to triage patients by phone, video consultation or e-consult in line with NHS guidance. The system was reviewed at each stage of the pandemic. The GP is able to book a F2F (face to face) appointment for the patient if he/she decides a physical examination is required. RB reiterated that the GPs miss the F2F contact but the overriding factor is patient and staff safety.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.                
   
5.Training Practice 
 Summercroft had been a recognised Training Practice until Dr Jonathan Palin who was an accredited Trainer left. Dr Rajiv Samarasinghe had always expressed an interest in training future GPs and had started the process of becoming a Trainer about a year ago. In recent weeks both Dr Samarasinghe and SC had been approved which raised the profile of the Surgery. Trainee GPs would be allocated to the Surgery for training. 
   
6.Prescriptions 
 BS commented that these were being turned around much more quickly. This was thought to be due to them being sent electronically. 
   
7.Telephones 
 Noted there had been problems with the phone system on 2 consecutive days (not related to SC) which had led to delays in patients being able to contact the Surgery and a subsequent increase in e-consults. 
   
8.Next Meeting – June – date to be confirmed, either 3rd or 24thRB/CM

PPG Minutes 15.02.23

Summercroft Surgery Patient Participation Group Meeting

Minutes

Wednesday 15th February 2023, 1730 – 1930 (face2face)

Patient Attendees:         

Surgery Attendees:         Dr Rak Balendran, Carla Michalska,

 1.WelcomeAction
 Naima Wolf and Jane Clarke were welcomed to their first PPG meeting. 
   
 2.Analysis of Face to Face (F2F) Appointments/Appointments in General 
 A handout from the GP Appointment Dashboard was distributed. This showed various information for Summercroft with comparisons to the National average, SELondonICB and Five Elms PCN.   Findings: The proportion of F2F appointments has increased since February 2022. Now more or less 50/50. Noted that F2F appointments take longer than telephone. Rak commented that this was reassuring as it had caused patient dissatisfaction in the past. Carla also stated that F2F/telephone appointments can be changed at a patient’s request. There was still some dissatisfaction with the current system; Brian commented that he had been able to obtain an appointment 7/10 days in advance. The total number of appointments has increased over the last two years. Duration – Summercroft appointments are 15 minutes, most other Surgeries are 10 minutes.  Some of this table (e.g. 0 minute appointments) needs further clarification. Appointments by Healthcare Professional – the number of supporting roles has increased enabling more appointments overall. S/C is again very similar to SELICB. The number of PCN staff (not funded by S/C) is still increasing. These new roles will deal with less complex patients.   It was noted that 9 Clinicians at S/C were able to prescribe and S/C has the equivalent of 5 WTE GPs (3 Partners and 4 Salaried GPs), a GP Trainee and Advanced Nurse Practitioner. In response to a query regarding the recommended number of GPs Rak commented that previously 2,200 patients was considered appropriate per GP. S/C currently has just under 10,000 patients.   One member suggested that instead of releasing all appointments at 0800 some be released at 1330. S/C previously did this but Rak pointed out that one of the disadvantages were patients then waiting over 5 hours from 0800 and still not being able to have an appointment whereas they could have sought advice from 111 or attended Urgent Care or A/E earlier in the day.   Agency Staff – in response to a query Carla said she was currently looking at the availability of Nursing staff as S/C have a vacancy which is proving difficult to recruit to. This is a problem throughout Bromley.   Named GP – can change as the number of GPs change and is largely for administrative purposes. Patients can request an appointment with any GP, not just their named GP. Patients can also request to have their named GP changed. One member commented they were told by a Receptionist that this was not possible. Carla to advise Reception.   One appointment, one issue/problem – Rak stated that GPs are unable to deal with several problems in one appointment.   Levels of Patient Satisfaction – Barbara asked if there were ways of calculating patient satisfaction. Rak said that some patients who had left the Surgery had since returned.   Inefficiencies – Carla agreed these existed and will try to identify and resolve.                CM                                                     CM                     CM
   
 3.Telephone 
 Mike commented that he’d experienced problems ringing the Surgery from his landline but not his mobile. Carla to investigate.  CM
   
 4.EConsults/GP Contract 
 Carla is currently looking into the number of EConsults being received by the Practice which amounted to 168 in January. Of these 68 resulted in a further GP appointment; Carla is trying to breakdown by type and make the system more efficient. Some patients find EConsults an effective form of communication. 
   
 5.Online Appointments/Text Messages 
 Victor suggested text messages to remind patients of their appointments. This was happening with some appointments but not all. Carla to look into. Online appointments are gradually being phased in as before and currently Nurse appointments for Smears, Diabetic Reviews etc can be booked in this way. Carla confirmed that GP bookable online appointments would be reintroduced in due course although this doesn’t work in the favour of the less computer literate.  CM
   
 6.Feedback from Five Elms PCN PPG 
 Carol and Penny, S/C representatives on the Five Elms PPG fed back on a meeting they attended on 13th February. Enhanced Access appointments run by the Bromley GP Alliance are currently available Monday to Friday and Saturdays until the end of March. In addition to GP appointments (additional 140 appointments per week) Clinical Pharmacist and Nurse appointments are also available with the possibility of Paramedic appointments too. Paediatric Hub – this had been introduced as a result of the Scarlet Fever outbreak and was very effective. Now being run down.Respiratory Hub – available for patients with respiratory problems.Well Being Café – one is already up and running in Orpington and originally attracted approx.. 30 patients but this has now increased to 90. Held on alternate Thursdays from 1100 – 1300 in the Methodist Church. Provides a social platform.  A further Well Being Café is to be set up in Bromley near the Metro Bank. Education – agreed that patients needed to be made aware of the availability of other services/appointments available to them.                            CM
   
  7.Any Other Business 
 Waiting Room & Notice Boards – Carla looking into this currently. Need to meet Health & Safety requirements.Check in Machine/TV – these had been discontinued during Covid. Carla is  negotiating costs for the reintroduction of these facilities.      CM
   
  8.Next Meeting – Thursday 20th April 1730. In the Surgery unless guidance changes.ALL