Patient Group Meeting Minutes

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PPG Minutes - Tuesday 17th September 2024 at 5:30pm to 7pm

Introduction and Welcome

• Chair: Dr Alkizwini
• (EA): (PPG Member)

PPG Members Present:

• Jane Shaw (JS)
• Jill Ackroyd (JA)
• Tove Steedman (TS)
• Sean Baine (SB)
• Neil Fletcher (NF)
• Charles Boucher (CB)

Surgery Staff Present:

• Dr Ehsan Alkizini (EA)
• Dr Ben Bromilow, (BB) – GP Partners

Apologies from PPG members: 

• Dr Birgit Curtis (BC)
• Karen McCormack (KM)
• David Richards (DR)
• Renee Bernstein (RB)
• Leon Douglas (LD)
• David Lavis (DL)
• Elizabeth Horridge ( EH)

Items for Discussion

Approval of last meeting minutes and closure of any matters arising from minutes.

Minutes approved by the group. No further action required.

1. Meeting with Councillor Richard Olszewski

Discussion regarding ongoing Estates issues and their impact on the ability to offer a Neighbourhood / Multidisciplinary team model of care. There had previously been an attempt to invite Councillor Olszewski to meet with
the PPG Steering Group to discuss the ongoing estates issue to see if Camden Council can assist. Preliminary discussions had suggested a meeting would be possible however as of yet one has not been confirmed.

Action:

EA/KM to reach out to Councillor Olszewski to get a date confirmed. NF has links with Councillor Olszewski and can speak to him on behalf of PPGSG if needed.

2. New members of PPG Steering Group

Discussion regarding current capacity for new members to join the Patient Participation Steering Group. At previous meeting LD was due to speak to two patients that had come forward. Action- LD to update PPGSG via e-mail.

3. Process for increasing ability to communicate with patients

Discussion regarding the ongoing issues experienced by the PPGSG in being able to send out to patients the Newsletter and highlighting the open meetings. Currently just under 2000 patients have provided consent. At last meeting BB agreed to add a video message to the screens highlighting the newsletter etc and that we could only contact patients with these updates if they consent. Shortly after the last meetings the screens stopped working / video functionality broke. Action – BB - new screens installed- video to be added. 

4. Discussion re-extended access, inequalities workpiece

EA updated the PPGSG on the current extended access capacity with current usage being fairly low and unused appointments. A childrens flu nasal spray clinic has however had good uptake. Current capacity being provided by the Practice is in excess of the specified amount therefore some excess capacity from the extended access clinics may be moved into weekday appointments for the moment (though with the option of moving it back onto the Saturdays if demand increases over winter).

EA advised the PPGSG that the PCN inequalities workpiece was looking at patients with SMI (severe mental illness) who had CKD (chronic kidney disease). The workpiece was to look at the benefit / impact of involving the voluntary sector to encourage and assist with patient recall and engagement in order to try and improve the CKD outcomes for this patient cohort. BB stated that the funding was relatively modest and yet the PCN needed to ensure the cohort in question was small enough to be achievable yet large enough to have sufficient patient numbers to show benefit. BB also stated that to an extent it felt like the inequalities workpiece was a programme which ticked a number of boxes of the current “ask” of General Practice- the idea of working at scale (at PCN level), targeting inequalities for additional support / care and involving the voluntary / third sector. 

He continued that as additional funding is being provided and PCNs will have a desire to show outcomes / benefits from the workpiece it will likely appear that the current ask of General Practice is evidence-based. SB agreed that in the absence of a control group it will be difficult to ascertain benefit of the approach beyond (as suggested) that increased funding / resourcing of a particular area is likely to result in net benefit. 

5. Collective Action

We discussed the Practice’s current position on collective action specifically the desire not to unduly impact on patient care. BB confirmed that this topic of discussion had come up earlier that day in the Camden Local Medical Committee meeting and that there was a concern that collective action which could not be specifically attributed to the ongoing GP contract issues would not have any obvious association to the issues and would rather just make a difficult situation worse without have impact. The conversation then moved to collective action being partially aimed at the primary : secondary care interface and that some of the ”push back” being recommended as part of collective action is a sign of a difficult interface in which problems occurring at secondary care level result in significant additional / unwarranted work in Primary Care which creates additional pressures.

BB mentioned that increased interfacing between primary and secondary care was currently not without challenges. The Whittington interface committee has been successful and productive, the UCLH meetings had been overall beneficial but that challenges remained at the Royal Free Hospital interface and that to date the meetings had been of limited benefit.

SB stated that as a Governor of the RFH trust he was keen to explore the interfacing issues in more detail. BB stated that he felt the issues were perhaps not so much an issue with the people attending the meetings or intention but perhaps more what questions the interface meeting was asking itself and whether a desire to resolve all issues across the trust / at scale was resulting in complexity and scale that prevented things from being actioned / resolved and whether targeting simpler / small scale issues might be more effective. BB agreed to meet with SB to explore this outside of the meeting. Action: It was agreed that a standing item of contractual issues / collective action would be added to the agenda. 

6. Continuity of care / population health

SB brought up the topic of continuity of care and to what extent the Practice wanted to encourage it given the clear benefits and improved outcomes (for patients) from continuity. EA stated that although the Practice was in strong favour of continuity, a burn-out rate / pressures on clinicians mean that no clinicians currently work 10 sessions a week and with the majority working less. This creates a challenge for continuity. EA also stated that the general consensus was that unlike most practices (who make patients traverse complex multi-stage triaging steps) WHMC tried to ensure open access and good availability so patients can book in easily, hopefully with a clinician of their choosing.

BB stated that not only is continuity of care better for patients it is better for clinicians- that traditionally clinicians entering General Practice, when asked why they wanted to become GPs, would state it was due to a desire to provide continuity of care for their patients and to be able to view their symptoms and conditions with knowledge of their family situation, their community links etc. The challenge, however, is how to enable continuity given the challenges and pressures on the system currently. CB stated that in relation to the idea of a “named GP” while he had not met his actual named GP he had 2-3 clinicians within the practice that he knew and was happy seeing and therefore booked in predominantly with them. EA confirmed that patients can change their “named GP” to one of their choosing. 

7. AOB

JA raised concerns about the digital advertising screen being located too close to the practice television screen and that it is distracting for patients.

Action:

BB to install new ethernet cabling and move to more appropriate location.

BB suggested it would be worth adding a video to highlight that the Practice is now a Parkrun practice. This could be followed by a slide showing the locations of the local Parkruns (#1: Gladstone Park and #2: Hampstead Heath). General approval for this suggestion.

Action:

BB to add Parkrun video.

BB asked if the patients within the PPGSG felt that the current BBC News RSS feed displayed on the screens was a useful / appropriate thing or better switched off so that the focus was more the health messages. Unanimous agreement to switch off.

Action:

BB to switch off the RSS feed. 

Proposed Future Meeting Dates

• Tuesday 3rd December 2024 – RB to chair
• Tuesday 4th February 2025 – RB to chair 

Meeting closed.