PPG Minutes - June 2024

Latest Meeting Notes

12th June 2024 - Face to Face

• 1pm to 2pm with Dr Helen Salisbury and Jon Frank (Practice manager)

Patients:

• Elaine
• Cicely
• Maggie
• Christopher
• Kathy
• Barbara L
• Tim
• David

Apologies were received from:

• Mike, Deirdre, Roger, Alison, Lesley, Diane, Shelagh, Trudy, Paul D., Wendy and Judith

1. Welcome

Elaine welcomed everyone to the first face to face meeting since 2019. There were lots of apologies – mostly because members were on holiday.

2. Matters Arising

Botley Road closure

Elaine reported back that she had been in contact with the Northgate practices, and they are not having similar issues with access.  They have many more students and less patients living in the Botley area.

Christopher (who has expertise in community transport issues) reported that he has been in touch with an organisation in Banbury that organises patient lift services. They recruit and vet drivers and have a computer-based booking service.  The cost is around 45p per mile.

David said that he knew about this service, and it was well thought of.

Dr Salisbury noted that access is definitely still an issue for patients.  Some of them are getting less care than they need.

We also discussed what will happen when the bus gates come into operation in November.  It was noted that there are all kinds of planned exemptions for various groups and that we needed to understand this better.

ACTION:  Find out more about planned exemptions for the traffic gates and discuss at next meeting.

Primary Care Strategy

Elaine reported that the proposed plans for Same Day Access Hubs, for patients needing same day appointments, was approved at a recent Integrated Care Board (ICB)meeting.  However, there was no information about how or when these were to be implemented.  There was mention of local models – but no further details.

Jon said that he understood that the ICB was asking for volunteer pilot sites, and that Horsfair practice in Banbury might be considering whether to do this.  However, there are no additional resources available.  We also discussed whether some of the larger Primary Care Networks which are groups of practices (PCNs) might consider taking this forward.

Dr Salisbury mentioned that the other major item in the Primary Care Strategy is the establishment of Neighbourhood care teams.  We discussed that this is not a new idea, and with the decreased numbers of district and other community nurses this may be difficult to implement.

ACTION: to keep a watching brief and report back as necessary.

Barbara asked about the current clinical commissioning arrangements. It was explained that the current arrangements are across 3 counties, Buckinghamshire, Oxfordshire and Berkshire West (BOB) and the organisation is called the Integrated Care Board (ICB).  

Find further information on the Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board (BOB ICB) website

Dr Salisbury noted that, as is often the case, they are currently making heavy cuts in staffing – to reduce its costs by 40% (up to 80 posts?).

3. Patient Survey

Elaine introduced the survey.  The survey was done during the week of 29th April.  Paper copies were handed out to patients in the waiting room and the practice sent out an email with a link on the website.  A total of 326 responses were received. 

Due to lack of time, Elaine did not go through the entire presentation (circulated with the agenda) but the discussion focused on the key issues.

Discussion summary:

Urgent/Same day appointments

Patients felt that this system worked well.  It was noted that this is the service that the ICB is suggesting gets handled by a Same Day Access Centre.  But it was agreed that with the high levels of satisfaction, it seems pointless to change it (for this practice).

Face to face Vs telephone appointments

Dr Salisbury wondered why we had asked this question – as patients are always asked what type of appointment people wanted.  However, this is not always the case, and some of us reported confusion about the kind of appointment that had been booked.  It was suggested that it provides evidence for people (eg the media) who complain that everything is on online and you cannot get to see a doctor face to face.

Routine Appointments

This was the main cause of dissatisfaction raised by the survey.  Patients citing waits of 4 or more weeks to see their own GP.

The practice checks (every Monday) to see the waiting times for the 3rd available appointment.  Until recently this was 11 (working) days but is now down to 9 (working) days.  Dr Salisbury said that they have kept the number of GP sessions per patient the same – but it appears that demand is increasing – so despite more doctors the waiting times are getting longer.

Some members noted that when they tried to book appointments on-line the doctor they wanted to see was not on the system.  It was explained that this was probably because they were already fully booked.  Jon also explained that the appointments are not updated on a rolling weekly basis, but on a monthly basis.

There was considerable discussion on this topic but unfortunately no solution was forthcoming.

Accrux

The survey showed that the majority of patients had not heard about Accrux.  

This is an online consultation system that has replaced e-consult.  Dr Salisbury explained that every practice is obliged to offer an electronic system.  It is useful as it allows patients to provide the practice with information, eg. “I saw the doctor at the hospital” but less useful when patients describe lots of things that are wrong with them.  

It doesn’t always save time.

Some practices use it for everything – and this is the only way that patients can access their GPs.   Observatory only have it on during office hours.  Outside office hours patients will have to use the NHS111 service if they need an urgent response.

The practice was not keen on bringing too much attention to Accrux and inviting patients to use it more widely – because it actually makes more work for the practice.  However, it was agreed that a short explanation of what it is – for the website – might be useful.  The PPG agreed to draft something.

ACTION: Elaine to draft explanation of Accrux.

4. Issues raised by patients

Covid vaccine – side effects

Some patients reported having more severe side effects from the last Covid Vaccine (spring 2024).  One reported having to contact NHS 111 because she felt so unwell.  Those at the meeting had various experiences – some had no issues while others had more severe side effects than previously.

Repeat prescription guidelines

Several patients had raised these issues with Elaine prior to the meeting.  The current guideline for patients is that it takes the practice 3 (working) days to issue a repeat prescription.  However, there were reports of a number of issues:

• Where medication had been recently changed only some items were issued.
• Not all medications issued for the same length of time – eg. some for one month and some for two months
• Receptionists having to ask the duty doctor to do a prescription urgently
• Pharmacy not receiving prescriptions
• Medicines shortages resulting in it taking longer for the pharmacy to obtain the medication – or having to go back to the GP to ask them to prescribe an alternative

Jon reported that he gets complaints that 3 days is too long – but the PPG members suggested that patients on long-term repeat medication should be able to organise themselves to order medication a week in advance of running out.

It was suggested, and agreed, that the practice guideline should be changed to FIVE (working) days to avoid these issues and allow sufficient time for both the practice and the pharmacy to obtain medication.

Ordering repeat medication online – NHS App or Patient Access

We had a discussion about which was better – the NHS App or Patient Access as they seem to offer the same services.  It was agreed that the NHS App is better if using a smartphone but that the Patient Access site is better if you are using a computer.  Dr Salisbury also asked that when using the message box that they only related to the prescription request and not to ask about other problems.

Recall Process for regular health reviews

Dr Salisbury told us that the practice is changing the recall process for those patients who have regular (annual) reviews for conditions such as diabetes, asthma, COPD, Blood pressure etc.  The recall month will now be your birthday month.  The practice is sending out text messages to let patients know.  There will be a transitional phase (so you may get called sooner than expected) while they move over to the new system.

5. Changes to services run by Oxford Health

Oxford Health NHS Trust is the organisation that runs community health services.  Many people have not heard of them – or think they are part of the Oxford University Hospitals NHS Trust.  They provide physical and mental health services in the community.  These include services such as district nursing, health visiting, podiatry, speech and language therapy to name but a few.

Elaine (and other PPG chairs in Oxford) have been working with Oxford Health as they are planning to relocate some of their services in Oxford.  Although many of the services they provide are in patients’ homes they also run clinics from 9 sites across the city.  They have plans to reduce these sites to 3 ‘hubs’ – in Jordan Hill in the north, Manzil Way (where they already have a base) and Blackbird Leys.

This will be a change for patients and carers who have to travel to clinics, especially those who use public transport.  The base at Jordan Hill is 12 stops on a bus up the Banbury Road.

They are establishing a Patient Reference Group to help them to shape how services are provided and are looking for anyone who is interested to join this group.  They may set up sub-groups to look at specific issues, such as transport.

Anyone who is interested in knowing more, or joining the reference group should see the Oxford Health website. 

6. Any Other Business

There was no time for any other business.

7. Date of next meeting

Although there were only 8 of us (10 including Jon and Dr Salisbury) the meeting room was full.  We will need to consider different arrangements for future face to face meetings.  Perhaps moving back to an early evening meeting in the main waiting area.  If you have any views on this please let Elaine know.