1. Welcome & Introductions

Westgate Surgery
Patient Focus Group

Meeting Minutes

16^th September 2014

1. Welcome & Introductions:
Rosalind Morton welcomed members to the group and asked if there were any new members. There were two new members who were welcomed to the group and Rosalind introduced herself as chairperson and explained the purpose of the group was to act as a critical friend to the surgery and give helpful feedback to help the surgery move forward.
Dr Jha was welcomed to the Patient Focus Group.

Present: Apologies:
Mrs Rosalind Morton– Chairperson Mrs Jill Burgess

Nicky Macdougald Mrs Rosemary Gibson

Mrs Heather Gillespie Mrs Barbara House

Dr Gauri Jha Mr Fred Piggott

Mrs Jean Glover Mrs Gillian Vass

Mrs Ann Clark

Mrs Pat Bailey

Mr Richard Robinson

Mrs Diane Coe

Mr Gerry Hussey

Mrs Marina Jeffrey-Watson

Mr Geoffrey Lafford

Mrs Pam Lucas

Mrs Pamela Piggott

Mrs Ruth Shilling

Mr Peter Wootton

Mrs Katrina Lawson

Mrs Deanna Sewell

Mr Douglas Sewell

2. Minutes of Last Meeting
Rosalind highlighted a typing error in the minutes, but this was the only amendment inaccuracy to the minutes of the last meeting.

3. Matters arising from Last Meeting
Rosalind stated that the only item from the last meeting needing attention was to put information in the next Newsletter about the information leaflets availble to patients.
Nicky stated that she and Heather had been working on creating a new newsletter which will be going to print shortly and a copy was given to each member of the group to look at and coment upon. Nicky continued to say that unfortunately the list of information leaflets was not included this time, but it does make note to the “How Your Doctor Works” information leaflet was being updated. The full list of information leaflets will be published in the next newsletter.

ACTION: Newletter to include list of information leaflets available

HG
4. Patient Involvement:
Nicky advised the group that there had only been a small number of volunteers for the working groups. The areas which have had the greatest interest shown is Over 75s and Young People and that these would now be progressed.
She said that she had asked two members of surgery staff to faciliate each group and that they are going to contact the members/patients who expressed interest in joining these pilot groups and hopefully an update will be avilable before the next meeting.
Christine Carpenter will be chairing the Over75s pilot group.

Kirsty Caswell will be chairing the Young People’s group.

One member asked about Bereavement Counselling for young people and whether this would be considered in the young people’s group and Nicky responded by saying that the Hospice are very good at giving information/arranging this if it is an expected death.
Another member asked how we were going to embrace communication with the younger patients of the surgery and Nicky said that she hoped the working group would address this perhaps through Facebook and Twitter accounts. The group agreed it would be good to have the younger patients of the surgery feeding back their thoughts and the pilot group is a good idea.

5. 
   Practice Improvement:
   

Nicky told the group that this year the Government has said that GP surgeries do not have to do a survey, however they have stated that the surgery needs to agree three priority areas and put an action plan in place to address these.

Nicky reported that she had put on the back of the last Newsletter a request for patients to offer feedback and suggest improvements, but she only had one reply and this was regarding higher chairs in the waiting room and that the toilets are too low, cannot be used by anyone with a hip problem.

ACTION: Nicky to Look into this
Post Meeting Note- Disabled toilet has been reviewed and it is sufficiently raised for those with hip problems
A member of the group asked if there was a timescale for actions. Nicky replied that it needs to be done by the end of the financial year. Agreed to wait for small working groups and identify actions from them as no other suggestions were forthcoming

PLAN: Wait for feedback/input from Pilot Groups
Mr Lafford asked about the low level mental health problems and gaps in information on available resources he suggested that maybe Dr Walton could attend one of our meetings as he is lead on Mental Health. Nicky replied by saying that Westgate Surgery had a Mental Health Specialist attached to the practice, but agreed that this is something that the group could look at more closely at one of its meetings. The member of the group who raised this item will email Nicky with his concerns/the information he would like to be covered
6. Friends & Family Test:
Nicky explained that this is an initiative by the government to see whether patients would recommend the surgery to friends and family based on their experience as a form of rating for all surgeries. This is compulsory for all surgeries from the 1^st December 2014. Westgate are currently trying two methods of implementing the friends and family test.
The first was a text message sent to patients after an appointment asking them questions, but there has been only been 1% feedback to all the texts sent out. The second option is patients can visit a website www.iwantgreatcare.com and answer questions on the screen.
Nicky stated that she doesn’t think that the texting system meets the Government guidelines and does not provide quick feedback so they will probably switch this off. The website option allows us to publish results straight away, which has to be done every month.
Members of the group raised how patients could take part in this if they did not use a computer or texts. Nicky reported that the government were keen on instant feedback and electronic routes are the best way to do this but she is investigating how a paper based method could be added as an alternative.

7. Staff Changes:
New GP – Dr Jha:
A question was raised as to how the surgery is going to manage Dr Jha’s list when she has one?
Rosalind asked if there was going to be guidance given to patients on how they can change GPs to Dr Jha. Nicky replied Dr Jha has been with the practice since early August and that sometime before Christmas they are hoping that she will have her own list. The GPs are trying to decide how best to do this and would welcome feedback from the group. Options are to:

• 
  transfer 500 patients from each current GP list to Dr Jha?
  
• 
  Does the surgery build the list up gradually with those patients asking to move and the new patients registering?
  

In the past patients have been written to, to advise them that their GP has changed but this did not go down well at all.

One patient suggested writing to the selected patients and asking them if they would like to move. Nicky felt this might be very difficult to implement and felt that whatever the surgery does they will be challenged by patients who do not want to move, it has in the past been practice preference to keep families with the same GP as the surgery is a family practice and this can help when family members are poorly and the doctor knows both patients. A point was raised by a member of the group that the surgery shouldn’t lose sight of the fact that some families do want to be split up and given that opportunity.
Another member of the group raised the question that if Dr Jha has her own list, but one of the other GP’s female patients specifically want to see a female GP, what provision is being put in place for that. Nicky replied that the practice is still considering this.
Dr Jha also replied that although she has a gynaecology background, the reason she became a GP was to experience the variety of the work, not just gynaecology and that she is keen to be a general practitioner.
Nicky stated that previously this problem has been got round by having a Nurse Practitioner, but the practice nurses can advise and examine the patients and then advise the GP if a referral is needed.
Dr Jha also raised the point that some of the male patients placed on her list may prefer to see a male GP.
One member of the group asked if the surgery was going to have another Nurse Practitioner. Nicky replied that at present it is something that we are looking at, but would need to look at capacity and room availability.
Practice Nurses
Nicky informed the group that we have two new practice nurses,
Julia Butler who has been with the surgery since August and she specialises in women’s health and vaccinations and:

Melissa Cooper who has only been with the surgery since the beginning of September, who specialises in COPD/Asthma.

8. 
   Work Programme for Coming Year:
   

Nicky stated that when she started pulling the agenda together for this meeting, there were a few things that we have to do on an annual basis, i.e. discuss the complaints (about Feb 2015) and also decide on our three action points, but what else would the group like to see on future agendas?

We have already identified the following points:

• 
  Low level mental health
  
• 
  Look at Complaints
  
• 
  Look at regular feedback, i.e. from questions
  
• 
  Action Plan arising from the working groups
  
• 
  Missed appointments
  

Other suggestions welcome.
A member of the group asked if there was any further news on the Federation. Nicky replied by saying that Westgate Surgery is now in a Federation with East Cliff Surgery in Ramsgate and Minster Surgery. In response to questions about how this might affect patient care Nicky replied that the federation would work together on joint bids for new services rather than doing this individually, the possibility of sharing back office functions and support for each of the practices. Nicky promised to update the group with information as the work of the federation developed.
In response to other questions Nicky advised that the new Over 75s Team has started work and are based at Westgate Surgery who host the service on behalf of Birchington and Garlinge surgery. When asked why these were not the same as the federation practices, Nicky replied that this collaboration was down to geography.
One member of the group asked why the Reception staff do not have name badges. Nicky replied that it was something that had been looked into in the past, but not acted upon. Many members of the group agreed that it would be helpful if the staff had name badges so that they know who they are talking to, would only need to be first names.
ACTION: Nicky to implement Name Badges to Practice Staff
Another member of the group asked if the surgery has any news on the Local Hospital that was in the news about being placed under special measures by CQC and what does this mean?
Both Nicky and Dr Jha said that the Doctors at Westgate have no concerns over the treatment being provided and that they would still recommend having treatment there. Margate hospital was rated as better than the other sites and that although there were some management issues, clinical care across what is a large trust was not worrying. The only other alternative is Medway or Maidstone & Tunbridge Wells and both these have been in the news recently for the same if not worse inspections. The problem with inspections is they create concerns and that this is not always helpful.
Rosalind asked each member of the group if they had anything further they wished to ask and no further questions were raised. The meeting was then closed at 7.10pm.

8. 
   Date and time of Next Meeting
   

Wednesday 19^th November at 2.30pm – Downstairs waiting area

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