Island Health Patient participation group meeting
1st December 2020. Held Virtually via zoom
Attendees: Dr Sonal Shah, Dr Katarzyna Kizilates, Stacey Franks, Nana B-A, Claire Murphy, Debbie S and Michelle Shileds. 25 patients.
Introduction – Nana
Introductions and welcome to the many patients who have joined the PPG for the first time today as well as our regular attenders.
Purpose of the meeting is to share information about how the practice is performing and changes that have been made in response to the current pandemic. Also, to learn from patient experiences, discuss patient suggestions and address patient concerns.
Rules of the meeting, personal issues are not to be discussed, instead patients can address their concerns with Nana via email.
Total Triage/E consult
Process described by Nana
Patients are recommended to use an econsult consultation, which is accessed through the Island health website for quick and easy access for clinical concerns or admin support.
Dr S Shah – Presentation Click here to view PowerPoint Presentation
- How the practice has coped during the pandemic and steps that have been taken to keep staff and patients safe, such as the new buzzer system.
- New changes to the practice premise
- Changes to staff and additions to the Island Health team e.g new in house physiotherapist and health coaches.
- Data on increased access to the practice’s services (127 more appointments per week compared to same time last year)
- Data on increased workload(12% increase compared to same time last year)
- Feedback from NHS Reviews, 80% of review gave 4 stars or more.
Patient Feedback (anonymized)
- Patients feel the e consult software being time consuming or defaults you to ring GP. There are a number of conditions where this is a particular issue, for example those with chronic pain. A number of patients shared these comments. KK and SS responded that the econsult software is implemented tower hamlets wide. We are unable to tailor the questions or make it more user friendly. However, we regularly feedback these comments to our local CCG (Clinical commissioning Group). The practice always sends representation to relevant meetings and ensures patient feedback is passed on. SS also explained that this software programme is due to be reviewed in the next few months to simplify the process.
- Miss A raised the issue of difficulties in wanting to see a particular GP. NAB explained we ask patients to submit e consult on the day preferred doctor is working, requesting that doctor in the econsult and where possible that GP will address the query. This is not always possible as doctors maybe involved with other emergencies, clinical responsibilities, meetings, or study leave. With the total triage and econsult system the aim is to avoid building a waiting list so all econsults and in particular urgent issues are dealt with on the day, anytime between 8-6.30, and 48 hours from when they were first submitted.
- Question from Miss B “If you are not English speaking or cannot articulate in English how is this dealt with”? Nana explained patients are still able to call the surgery. Interpreters are available if required. Dr Kasia gave an example re patient from abroad using the ‘telephone interpreter service’. This can be sorted on the day very quickly.
- Mr A asked “which app to use”. Nana suggested using website and Link to E Consult or NHS GP app on a smartphone. We want to get as many patients as possible to use the digital technology to leave the phone lines more accessible for the patients that cannot use the new technology.
- With regards to booking an appointment for a child or a pregnant woman, Nana explained 4 choices on E Consult. For non clinical conditions you can use admin option and free text the question.
- KK explained how the IH team works together, admin and clinical, to distribute the work to the person most suitable to sort. SS explained medication requests and letters can be done via an admin query leaving GPs to focus on clinical issues.
- Miss C “She feels to have to fill in an econsult just to get back in touch with GP after appointment. Is there a shortcut for this”? Nana advised using the general advice option for follow up. This one is more of a free text solution and not so long.
- Miss D question “re requesting repeat prescription and requiring a medication review”. Sometimes you don’t find out till 48 hours after request. Could we send patients notification in advance? Dr Kizilates replied: Covid has disrupted our usual protocols for reviewing medication, for a long period GPs were advised to focus their efforts on dealing with acute problems and clinical emergencies. There was also restriction on blood testing, which meant many conditions such as diabetes and hypertension could not be adequately reviewed. Therefore there is a large volume of patients that require reviews and GPs are working through these. Doctors have a responsibility to ensure that medications are appropriately being issued so medication reviews are essential. The practice is aware this is an area that requires some developement. GPs can improve the process by sending reminders via text messages if a review is required and this will be discussed with clinicians at the next clinical meeting. The new Pharmacist will help support the practice to improve this process when we get one in post.
Action: Dr Shah said to bring up with GPs at our next whole team meeting re texting back if a review is required so they can feed back to all doctors.
- MR E “needing a 12 week hormone injection at the practice. He used to book 3 weeks in advance. But this has changed with new system”. DR SS explained due to covid we can not book appointments 3 weeks advance as every patient coming into the practice has to be triaged to make sure they do not have covid symptoms. But we can perhaps review our appointment system to support those requiring regular monthly/3monthly appointments.
Action: We will review this for patient needing regular hormone injections.
- Mr F asking re EPS. Nana described the EPS system and repeat dispensing. This is possible for some stable patients on certain medications. At the beginning of covid crisis doctors were asked not to issue more than a month of medication at a time, so patients were taken off repeat dispensing. But over next few months those patients on regular medication who are stable, and have had their review, will be switched back to repeat dispensing. This is not a system for all patients though. This is an area where the practice plan to do some work on. The Pharmacist (when in post) will help improve this process also.
- Miss F” where can she get 24 hour monitors (ECG). Could we offer the machines in the practice also she felt practice machine not accurate”. Michelle explained we have the top of the range ECG technology which writes back to our clinical system. She also explained re 24 hour BP monitor we recommend patients use a BP diary and get their own GP monitors. We are looking into a BP pod in the surgery but not main priority at the minute.
- Mr G “confirmation of prescription on line. Would it be possible for GPs to confirm what they are going to prescribe”? “Also is there an NHS approved BP monitor”? Michelle responded there is no approved one. Need EU standards and cost around £20/25 no more. Sonal replied re routine meds requests we do not routinely send a text. Drs may do for new medications requested. Nana replied we have looked into responding to all requests but we do not have the capacity to respond to everyone. We do send an automatic reply. Patient was wondering if when prescription sent to pharmacy something could be sent to patient at this stage. This is something we would have to look at.
- Miss H asked “if we can bring back massage into the practice”. We would welcome back Jane for sure. Sonal explained re landlords and rent. This is for extra time Jane wanted. She can return for half day.
- Mr T re trust. New Trustees are keen to listen to people views so good to email them if there are concerns. They are local and very much on side and want to get the upper floor of the health center up and being used.
Positive experience please leave feedback on NHS choices.
SS: We will be looking for volunteers to join a network of volunteers. To include Choir, Gardening, Walking etc with an aim to improve lifestyle especially those with anxiety and depression etc. We are looking for people living local to help out and support. Sonal will keep the PPG updated with progress.
Next meeting Agenda – Is there anything patients want to be added, please email firstname.lastname@example.org.