PPG Minutes - Sept 2023

6th September 2023


PPG - Amanda Harvey (minute taker), Christine Mott, Derek Jerome, Faye Godfrey, Alison Allen. Helen Price.

WHMP staff – David Owen-Smith (CEO), Angie Sammut (Practice Manager), Beth Needham (guest – Dispensary Manager).

1. Minutes of last meeting

  • Not completed.

2. Appointment of Chair and Secretary

  • Helen Price volunteered and was accepted unanimously as the new Chair.
  • Future agendas will be started by Helen. She will forward them to Michelle Cozens who will circulate to all members for further agenda items.
  • Amanda Harvey volunteered and was accepted as minute taker for this meeting. It was agreed that we would continue to revolve the role of taking minutes rather than appoint a secretary. Minute takers will send minutes to Helen Price (swiftly please) for her to OK as Chair. They will then be supplied to WHMP for secondary check before being circulated by Michelle Cozens to the PPG members, as usual.

3. Property update (David Owen-Smith) (DOS)

  • Tenancy on current surgery building to expire in two years, four months. David Owen-Smith has identified a suitable plot (near back of Tesco) and is bidding for funding from the ICB (Integrated Care Boad) for BOB (Bucks, Oxon. and Berks). There will also be Section 106 money from Bloor Homes, and may be CIL money (Community Infrastructure Levy) from Oxon. County Council.
  • Architects’/builders’ estimate for land and building (without internal fit-out) is £6M.
  • WHMP is already the second biggest surgery in Oxfordshire, with 83 staff including 14 GPs. Current (“weighted”) patient list is 19000, expected to be 25000 by 2026.
  • History: When current premises opened in 2002, it was for 12,000 patients and 10 % growth. DOS is confident there is no way current site can be extended for2026 numbers. Any on-site extension would waste money and not provide for expected growth.
  • A tie-up/joint build with the Shrivenham surgery is impossible, as they are part of a different ICB (though we are getting a lot of patients from their catchment area.

4. PCN/Botley and Kennington (DOS)

  • Botley and Kennington surgery have handed back their NHS contract and cease to exist on 30/9/23. 507 of the patients come to WHMP, the rest will be divided between the Manor and Beaumont Street practices in Oxford. The Manor will take over the Kennington building. Beaumont Street will take over the Botley building.
  • The WHMP ‘border’ will extend further along the A420 towards Oxford to the other side of Kinston Bagpuize, Appleton, Eaton and Wootton.

5. Autumn CoVid/flu vaccination programme (DOS)

  • Both are available to over 65s, the immunosuppressed and some other categories of ‘at risk’ patients.
  • The campaign runs from September to March and begins with an intensive over-80s weekend on 16th/17th September at the surgery as per last year, with the aim of vaccinating 1248 patients. It is not clear which CoVid vaccine will be sent.
  • Further appointments will be available at the RAC.
  • Only 60% of surgeries have opted to vaccinate this year, so there is pressure for WHMP’s clinic to be on the National Booking System (NBS) as last year (so anyone can attend, regardless of their location). DOS expects WHMP will not go onto this system until our patients have been vaccinated.

6. WHMP dispensary: update from Beth Needham, Dispensary Manager

  • Beth oversees a team of 14 dispensers dealing with a huge number of items (14-15000 items in an average month).
  • Repeat prescriptions from the dispensary officially take seven days to dispense, but the majority are fulfilled faster.
  • Patients who live within 1.6km of a commercial pharmacy must use that (the WHMP dispensary cannot serve them due to an NHS agreement not to impinge on commercial businesses). In Faringdon, this applies to the London St pharmacy and Boots.
  • There are many medicine shortages at present which can make it impossible for the Dispensary (or commercial pharmacies) to supply prescribed items. If this happens, the dispensary alerts patients by text.
  • GPs are asked to prescribe generic drugs, not trademarked ones, to make it possible for the dispensary/pharmacies to dispense alternatives if one is not available.
  • The dispensary deals with repeat prescriptions, generating the prescriptions and sending them to GP in-boxes to sign off (usually 48 hours). Patients can request repeat prescriptions by emailing Whitehorse.scripts@nhs.net, the NHS app, or by dropping the repeat form into the box outside the prescription hatch at the surgery.
  • Prescriptions are for one month following NHS guidelines, to reduce wastage and ensure surgeries can keep track of patients’ welfare. However, more can be prescribed by arrangement for a specific reason eg long term travel.
  • If re-ordering several drugs, patients should order early enough to allow for those which come in a 28 day pack (rather than 30).

 7. Update on relationship with Altogether Better (www.altogetherbetter.org.uk) by Angie Sammut

  • This is an NHS organisation which works with surgeries to in social prescribing/health support.
  • There will be an initial online meeting with Altogether Better on 28th September, 2.45-3.30. The meeting will be on Teams. Invitations will be sent to PPG members soon.
  • From: OLIVER, Sarah (WHITE HORSE MEDICAL PRACTICE) <sarah.oliver5@nhs.net>
    Sent: Tuesday, September 5, 2023 9:23:14 AM
    To: SAMMUT, Angela (WHITE HORSE MEDICAL PRACTICE) <angela.sammut@nhs.net>
    Subject: Collaborative Practice - New project - PPG
  • At the end of September we will start to work with a company called Altogether Better (AB). They will work with us for 6 months
  • The idea of the project is for WHMP to work collaboratively with some of our patients  (though they do not need to be patients of ours but should probably people living in our community).
  • Altogether Better will help us to find around 20 'Practice Champions' (PCs) amongst our patient population.
  • These people are likely to be community minded, a desire to help others to get along side others and maybe have a special interest in something which doesn't have to be health related - but also, it might be.
  • The idea is that with the Practice Champions we will start by setting up three groups - might be a singing group in a local cafe or a group for people living with chronic pain or a someone who is keen to share their passion for healthy eating/cooking/nutrition - it really can be anything.
  • Text messages should go out to patients at the very end of September I think. We are having a check in meeting next Tuesday with AB
  • We will have a small group of staff here at WHMP who will run the project and work closely with the PCs.

The PPG will be invited to join our first meeting on September 28th on Teams at 2.45pm for 45m as will the whole team at WHMP. We haven't had the invitation yet.

Altogether Better told us about another practice where there are 60 Practice Champions and 40 groups!

I am very excited about this project and I believe there is potential for a big impact.

If anyone would like to talk to me further, I will be very happy to have a chat about it.

Very best wishes

Sarah  (detailed sign off – available if wanted)

8. AOB

  • Helen Price – Engage Consult does not work well on mobile phones, especially for those unused to the system. Angie said patients can get guidance in the surgery on filling in EC. We suggest the following
    • the EC team be asked to work on mobile optimisation.
    • Add a message on the WHMP website suggesting patients use a larger screen in an obvious place before patients get into EC. Message also to say that patients can get help at the surgery with EC.

Helen will send Angie a screen shot to suggest the position of the above message.

  • Derek – GP working hours (days)– can these be made clearer by adding them to EC please.
  • Derek – PSA testing. Derek cited an example of a patient asking for a test and being given conflicting advice by two members of WHMP staff. Angie will clarify the position with the medical team.
  • Derek – podiatry services – these are managed centrally by the district nurse team. Patients who are not getting their appointments should contact patient services at WHMP.
  • Faye – recent Facebook comments from people who did an EC request but were not contacted. If we see these comments in future, we should respond by suggesting patients email the surgery on Whitehorse.pmanager@nhs.net.
  • Alison suggested adding a PPG blog to the WHMP website.
  • Angie asked for suggestions for future meetings. She can invite other members of staff to update the group.

9. Next PPG meeting date

6.30-8.30pm 29th November 2023, WHMP.

Appendix A

Following the last PPG Meeting, Amanda Harvey on behalf of the PPG members kindly submitted the following question:

Dear David

You asked me to frame the question we were discussing tonight, so you can pass it on to the GP Partners.

We’ve discussed the Engage Consult system, and capacity issues at length at the last two meetings. This question is about an historical change in the basic principle of how appointments are set, not about the mechanism for doing that.

WHMP used to run a ‘book ahead’ system ie the patient contacted the surgery and an appointment was made for the future (or the same day if necessary/possible). Now, the system is to be allocated a phone/in-person appointment on the day the patient contacts the surgery. This seems to be part of a national trend (reported in the press, shared by friends and relatives). It is less convenient for some patients, (including some members of the PPG) and it’s not clear why it is better for WHMP. So members of the PPG would like to know why there has been this change.

Please let me know if you want me to elaborate any further.

Best wishes,  Amanda Harvey.

DO-S referred the question to the Partners, as the change had been made before he started. The responses are as below:

This was not a change made for COVID but one several years before then.  The reasons were presented the PPG at the time and unanimously accepted. Dr Rob Russ

Dr. Kerrin Masterman, said: As Rob says, this pre-dated covid by a few years and proved incredibly effective over covid. Advantages include:

  • Not having to cancel multiple patients and rearrange when someone calls in sick (which has happened with increased frequency during covid)
  • Being able to make rapid adjustments to appointment types if someone needs to work from home at short notice (again, more frequent since covid)
  • Reduce DNA rates - what can happen with advance booking is that people actually feel better by the time of the appointment but forget to cancel, or do turn up to the appointment just to tell you they feel better and 'didn't want to waste the appointment'
  • Helps match supply and demand - we get real time data on demand for appointments and can match this with how we provide clinical cover across the week
  • When short staffed due to things like sickness/annual leave we can reduce the number of available appointments that day
  • We can keep patient numbers to a safe limit within BMA recommendations to avoid staff burnout and ensure good quality service delivery
  • There is no 'waiting time' for an appointment so people can be assessed promptly when they feel unwell.