Patient Group Minutes




2nd Meeting Monday 29th November 17.30 – 19.00 


In attendance 

For the Practice: Ravi Iyer (RI) (PM) Richard Tosh (RT) (Partner) 

For the PPG: Wendy Bardell (WB) (Chair) Rosie Claxton (RC) Caro Cluskey (CC) Tony Hayday (TH) Richard Mais (RM) Melanie McInerney (MM) Joanne Pennington -Davis (JD) David Townsend (DT) 
RI and RT were not present for the full meeting 

Apologies: Simon Bull 


3 Review of Minutes 

The minutes from the previous meeting were accepted. However, one concern was raised by  SB who could not attend the meeting but asked for his statement to be read out and discussed. 


Statement SB 

In the old PPG there were eleven people by last reckoning. Two were Alison (my wife for info to everyone who is new) and I. Of the other nine, I have had confirmation from six that they were not told of the PPG change and only learned of it with the new newsletter. Am sure we all can understand that is not a great way to learn one has been “stood down”. Something clearly went wrong here and especially for those that put so much in can I please ask that a thank you from AMP is sent for all the efforts they made over the years? Even belatedly this is important. 



During the Pandemic there was limited communication with then PPG. Ravi had understood that at the last meeting of the previous PPG members were stood down.
None of the previous PPG members had contacted RI but had communicated with SB. 
Ravi had reached out personally to two previous members. 
RI has agreed to put this right and will send official thanks. PPG felt this would be best to come from a partner. This was later discussed with RT who supported a practice action and regretted any mis communication. 


9 Amherst Website Update 

Following our previous meeting when members were asked to review websites. All members spent considerable time reviewing sites and sent in reports.
Treeview was the preferred option. 
RI reports there was some early delay because the Federation were going to change their website provider which might have ruled out Treeview. 
However, the Partners have now agreed to support and fund Treeview. 
Due to pressure of work RI reports the revised website may not be until April at the earliest. The recent newsletter had indicated January. 
MI proposed that the practice could send out an email update to patients highlighting just a few key areas of concern. 
MI agreed to produce the bulletin with the key bullet points. 

Concerns regarding the delay in the practice having a new website were raised with RT. 
There are concerns from members that the change to a new website is taking too long and this was discussed with RT. The group have learnt from RT that RI will be relinquishing his position as the PCN Manager and therefore may have more time for practice business. The group have asked RT to take to the partners if RI can be given some protected time for a review of the current website so this can be taken over by Treeview at the earliest opportunity. 
The alternative would be to re-engage with the previous website daily manager (at a fee) to get the current website updated. The PPG members consider it was a false economy to save money when RI really does not have the time for regular website updating. 


7 Covid Booster and Amherst Involvement 

RI Amherst is the lead practice for the PCN, and RI is Operational Manager for the Covid Vaccine Booster Programme. 
The Pfizer vaccine is delivered to the practice via a weekly order by Ravi for the PCN. 
Practices collect the vaccine from Amherst using special portable refrigeration. 
The practice re currently boosting cohorts 1- 9, all over-fifties and the 16-64 at-risk. 
They have been running clinics every Saturday at St Botolph’s since the first Saturday in October. If flu vaccine is available for the patient this can be given at the same time. 
Patients have been invited at the 6 months interval for their booster. 
Patients are invited for the vaccine in a number of ways. Via the NHS, or a text from the practice. 
This booster programme has had to be managed in addition to the daily work and has meant extra work for Doctors, Nurses, and some staff. 
Following this discussion RI will be joining a meeting relating to today’s announcement of the age-related additions to the booster programme. RI is not certain the practice will deliver this element. 

There will be a PCN announcement regarding how patients will obtain their booster. 

There have been problems with the delivery of flu vaccines and clinics and administration of the vaccine has had to be managed as and when vaccine is available. This requires additional planning. 
RI reports that 85% of the over sixty-fives have been vaccinated and the target has been met. 
Currently they have run out of vaccine for the under sixty-fives, but deliveries are expected. 
All of this requires additional planning and workforce. 
MI due to the pressures on staffing can retired staff, St John’s personnel be used for this programme. 
RI these are not registered professionals so cannot dilute vaccines; they cannot consent, so the practice has chosen to use only Registered Health Care Professionals for this programme. 
MI has there been a spacing issue? 
RI now this is reduced to one metre this has been managed and they allow only four clinicians to vaccinate at any one session which allows sufficient space for social distancing. 

Having regard for day-to-day pressures general practice 
RI reports he has never worked with such a hard-working group of partners. The practice is supported by an amazing team who all work very hard and are always incredibly busy. 
By following the triage system, they can offer more appointments than just the face-to-face option. 
Doctors and their families have been affected by Covid with their families, though when isolating at home in that situation, they can support their colleagues by making phone calls, doing referrals, processing pathology, and issuing prescriptions. 
The practice has met all the mandatory requirements for Health Workers and all the team have received all he appropriate vaccinations. 
TH enquires if any special arrangements regarding Christmas/New Year can be placed onto the website. 


1 Receptionist report on Daily Life on the Front Line at the Practice 

Ines represented the Amherst receptionist team who work daily at the St Botolph’s site. 

The reception team feel that patients’ fuses are short, they are stressed, and they want it yesterday. 

Patients can be abusive which should not have to be tolerated by the team. 

They find patients are not prepared to listen to the AMP phone message, they try to bypass by using the emergency button for matters that are not emergencies. When advised to ring the appointments line they can be known to be abusive and use swearing and bad language. In general, a minority of patients can be extremely rude. 

Receptionists do have the option to advise patients that they will record the call. 

Patients are not generally accepting of telephone triage, and they want to book face-to-face appointments. 
By utilising the telephone triage service, the doctors can cover more patients than a full day of face-to-face. 

Some patients can be very demanding they do not appear to accept how fortunate they are with the services that Amherst provide. 

Questions for Ines from the group 

MI enquired if the reception team had to field more enquiries relating to the website.

Receptionists are fielding additional enquiries from patients because they rarely check the website but then waste time calling in for information that is already on there.

RM enquired what is the process for dealing with rude and abusive patients. 

Ines we would value visible support and a protocol- something we could follow and act upon when we have had to deal with an abusive patient. 
In general, the reception team feel unsupported regarding these abusive patients. The team would like abusive patients to always receive a warning letter. 

TH Following the recent PPG newsletter and the published photos of the group members have been contacted and in support of the reception team, congratulations are in order because patients have told PPG members how much they appreciate the service they are getting. 

WB will email RI and RT for circulation to the reception and wider team. 

The group found the update from Ines extremely enlightening and were shocked to learn of patient abuse. They are keen to make sure the team are supported.


2 Rosie Claxton 

We welcomed Rose to the group. Rosie has transitioned from the previous PPG. Rosie is a long-standing Amherst patient. Rosie has a healthcare background and a healthcare family. 


5 Dr Richard Tosh Current Practice Challenges 

Currently General Practice is stimulating, hard going and challenging. 
You do feel the daily pressure to meet the demands. 
The team have adapted to working in different ways, managing the demand in a safe way. 
Partners are working long hours, and often till very late in the evening keeping on top of all the paperwork. There is no slack in the system. 

Very few doctors work full time (RT) being the only AMP full time GP.

They have standardised systems. 
Additional challenges arising have been the regulations within the medical profession as to how coronavirus in managed in the practice.

DT are requests to see a GP now more genuine 
RT Patents gave varying thresholds of their need to see a GP. 

TH Do Doctors currently have time to keep abreast of new treatments and diseases? 
RT Currently Education is not at the forefront of doctors’ minds. Keeping abreast of developments is difficult. 

MI The PPG could support the practice with a rolling Health Promotion Programme. Promote seasonal things. 
RT welcomed that proposal. 
(Future agenda item) 

RC has patients working from home caused any concerns. 
RT It was easier to contact patents, now with return to the office this can make things difficult. 


10 Amherst Newsletter Feedback 

Unfortunately, we have not yet been able to obtain patient feedback regarding the newsletter. 
When Andrea sent it out with it went the standard Amherst message “please do not reply to this email” and this may have prevented patient feedback. 

However, PPG members report that since their photos appeared in the newsletter this has produced positive patient feedback which is very encouraging. PPG members have been asked to follow up where they can and request the positive feedback in writing to the practice. This benefits the team and provides practice support for a future CQC visit. 

It was agreed that the photos should continue the newsletter as it prompted discussions with known contacts of the members.

WB will discuss with Ravi the options for a PPG email address via the NHS. We would then use this in our next newsletter to begin to seek patient feedback initially regarding the newsletter and hoping in future we could expand to encourage other feedback. 

Regarding points made by Simon, we did discuss how patients with poor eyesight might have viewed the newsletter. The group felt that they must of course already have options in place regarding other reading matter, enlarge on screen, enlarge, and print out and computer vocalisation etc. 


12 Resourcing patient feedback 

Referred to under Amherst newsletter. Initially consider e mail address. 

PPG feedback to the practice. 

PPG members speaking to family and friends who attend other practices, 

“The Amherst team are to be congratulated as what the practice offers seems to be so much better than many other practices.” 

WB will communicate the final message by email to RI RT and CL for circulation to the wider team. 


4 PPG Secretary. 

This was postponed to the next meeting. WB would like to request this is given further consideration by members prior to the February meeting as having a dedicated secretary is important for the group. 


6 How General Practice is funded. 

Postponed to next meeting


8 Discussion and feedback from members regarding the To R 

As Ravi had to attend another meeting this item postponed until the next meeting. 


11 Google Stats 

Postponed for next meeting 

No A O B and the meeting closed at 7pm.


Next meeting Date 

Monday February 28 at 6pm
(We did discuss changing the meeting date and time Monday suited RT best)

Items for next agenda
All items postponed plus 
Health Promotion

If you require a copy of previous minutes please contact the surgery