Club News

Minutes of the Carlisle Healthcare PPG meeting on 11 September 2017, held at North Carlisle Surgery, Eden Street, Carlisle.

Present:                 Tim Hazard, Yvonne Craig, Dr Robert Westgate, John Burrows, James Gosling, Jane Ferrer, Catriona Ferguson

Apologies:            Formal apologies were received from Arthur Carr and Brian Leather Elizabeth Mallinson

Minutes of last meeting: agreed.

Matters Arising:

  1. Phone system: The new system has been in place since May and is slowly settling in and improving patient experience. Traffic is being monitored with the aim of increasing the responsiveness of call centre staff. At peak times prompt answering is still a challenge, and it was noted that some patients prefer to attend the surgery at 8 am to secure a same day appointment.
  2. Appointments system: There is an acknowledged problem with triage appointments later in the day, and a review is currently being held. Dr Westgate explained some of the challenges for the practice in allocating urgent and routine appointments.
  3. Prescriptions: Some patients appear to have unrealistic expectations about emailed prescriptions. When a prescription is sent from the surgery, it leaves immediately and is stored in a “cloud”, but pharmacies may download from the cloud only two or three times a day. Not all pharmacy staff are trained to download prescriptions, and there may be a delay if the authorised staff member(s) is/are unavailable. Prescribers have now been advised to issue acute scripts in surgery in paper form so that the patient can take it directly to the pharmacy.

    There is an ongoing audit to look for issues and solutions in prescribing practices. Dr Westgate ran through some of the procedures that a prescription needs to undergo before being filled by the pharmacy, and explained that electronic prescriptions are safer because they are entered into the computer system only once. Paper prescriptions have to be entered separately on up to three different computer systems which do not communicate with each other, so there is more scope for errors to occur.

    There is an ongoing audit to look for issues and solutions in prescribing practices. Dr Westgate ran through some of the procedures that a prescription needs to undergo before being filled by the pharmacy, and explained that electronic prescriptions are safer because they are entered into the computer system only once. Paper prescriptions have to be entered separately on up to three different computer systems which do not communicate with each other, so there is more scope for errors to occur.

    There are also issues around changes of medication which is issued in a blister pack. There is a standard procedure between practices and pharmacies, but pharmacies are business concerns and compete with each other, which makes standardisation more difficult.

    The practice is instituting a system of annual review of repeat medications, which will normally be done in the patient’s birth month. Patients need to know when this review is due so that they can order their medication in good time.

  1. Communication with patients: There has been an IPSOS-MORI survey of patients of Carlisle Healthcare, and the results are available at gp-patient.co.uk.

    A patients’ newsletter is an ambition which is currently being worked on. Dr Westgate is planning an annual report and public newsletter, reviewing what has happened in the past year and what the practice’s ambitions are.

    There has been a press release regarding flu jabs, and information is freely available at all surgeries. There was a half-page advert in the Cumberland News on Friday 8 September. Patients who are eligible but do not attend one of the flu clinics will receive a reminder letter.

Any other business:

  1. Tim Hazard has met with Christine Harrington from the Cumbria CCG, who has a great deal of experience with PPGs and lots of helpful information. It was agreed that she should be asked to attend one of our meetings, possibly December, to give a talk.
  2. PPG membership. There was a disappointing turnout tonight with only eight members present. There is a need to broaden the base of the group, in particular in recruiting younger patients. Methods of contacting potential members include newsletters, emails from the practice, electronic notices on the surgery boards and through the website. Tim Hazard agreed to sort out a survey and an explanation of the PPG’s function. The meeting to be attended by Christine Harrington should be advertised and could be a public meeting. It was also suggested that contacting sixth formers and student might be helpful.
  3. Practice report by Dr Westgate: A monthly clinical governance meeting which addresses complaints per month since the merger has shown a steep decline in complaints about the phone system, dropping to just 2 in August. Appointment complaints are also showing a downward trend, and may have been connected to phone issues. The practice has gained around 400 patients since the merger a year ago, and a full report is being prepared for the end of the year.

    There was a question about whether concerns could be raised without instituting a formal complaint. Dr Westgate said that initial concerns could be raised with reception staff, who would then escalate to the complaints manager, and often issues can be resolved without the requirement for a formal complaint.

  1. Constitution/Terms of Reference: It was agreed that, at least for the moment, we don’t need a formal constitution. Terms of reference, on the other hand, would be very useful, and Tim Hazard has copies of those used in West Cumbria PPGs. Tim Hazard is willing to continue as Chair, and Jane Fenner and Catriona Ferguson have agreed to cover secretarial duties. The practice staff will distribute emails to members/patients.
  2. Tim Hazard has prepared a document showing the organisation and structure of the new merged practice for information, copies of which were distributed at the meeting.

Date of next meetings: 11th December 2017; 13 March 2018; 12 June 2018; 11 September 2018. Meetings will be held at North Carlisle at 5.30 pm.