PPG Minutes: Tuesday 8th November 2022





Staffing Changes

GP Changes

  • Dr Fenske has reduced her hours by one day a week
  • Dr Avril Culatto has joined us as part of the Coastal Fellowship programme and will be

GP Teams - our current teams are:

  • Blue Team - Dr Catherine Neden, Dr John Neden, Dr Pick, Dr Woodward, Dr Mash, Dr Philip (currently on Maternity leave), Dr Sivasubramaniam, Dr Peirce
  • Green Team - Dr Kent, Dr Sivakumar, Dr Dawes, Dr Fenske, Dr Culatto
  • Acute Care Team - Dr Macpherson

Our current patient list has risen to 16068

Clinical Team

  • Zara, pharmacy technician, has left the practice.
  • Hannah our new pharmacy technician has joined us this week
  • Faye is joining us in December as an Advanced Clinical Practitioner

Non- Clinical Team

  • Elise has joined the medical secretary team, replacing Emma

Other staff changes

  • Our current GP registrars are Dr Zaveri and Dr Mahmoud. Dr Ivchenko will be returning to us for a 4 month placement in December
  • We continue to host Year 1 and Year 2 Kent and Medway Medical school students on a regular basis for their GP placements as the Kent and Medway School enters its 3rd year

Ongoing Challenges

Gerald shared a slide detailing an article from Kent Online, showing that Kent and Medway has the worst GP to patient ratio in the country.

The national average is 60 GPs per 100,000 patients, the local area has only 38 per 100,000 patients

  • Across the UK there are currently more than 61.8 million patients accessing surgeries but the number of fully-qualified GPs has fallen from 28,700 to 27,700 in the last three years
  • In Kent there were 9 million practice appointments available last year, a rise from 7.5 million appointments pre-pandemic
  • The average patient list is around 1800 patients per GP. In Thanet this number is 2500-3000 patients per GP

Our Changing Workforce

Our workforce is made up of many different health care professionals including:

  • Physician Associates
  • Clinical Pharmacist
  • Pharmacy Technician
  • Trainee Nursing Associates
  • Care Navigators
  • Advanced Nurse Practitioners
  • Advanced Clinical Practitioners
  • Physiotherapists
  • Paramedic
  • Primary Care Mental Health Practitioner
  • Focused Care Team

All of these colleagues need support and mentoring from the GPs, but do increase the services and types of appointments that we can offer our patients.

Other Changes Within Practice

New Telephone System with new features:

  • No engaged tone
  • Queueing system
  • Options to select ‘prescriptions’ and ‘test results’
  • Call back facility if more than ten calls in the queue
  • Integrated with our clinical system
  • Easier to listen to calls
  • Better call statistic information

Telephone statistics between 04/08/22 and 31/10/22:

  • Total attempts to call the practice 40,954
  • Total calls answered 19,847
  • Equates to 315 calls answered per day
  • Equates to one call dealt with every 2 minutes
  • Average wait to speak to a member of staff is 9.5 minutes


In response to a rise in demand for e-consults, which was in turn impacting on appointments, the decision was taken in June to restrict the times that e-consults were available. We initially noticed a fall in numbers but these are now rising once more and the practice received 960 requests in October.

E-consult times currently match surgery opening hours of Sam to 6.30pm Monday to Friday

Face to Face Appointments

We have increased the number of F2F appointments:

  • All nurse appointments are offered face to face
  • Acute Care Team appointments are face to face
  • We are moving to towards returning all GP appointments being offered as face to face unless the patient prefers to have a phone call (which many do), or the GP needs to see the patient in person. We are hopeful this will happen sometime in the New Year.

Covid Vaccination Programme

Covid and Flu vaccinations are currently underway. As of the 7th November we had administered 64,149 covid vaccinations from the Montefiore site since the start of the pandemic.

We have already held two flu clinics in October with further clinic planned.

Complaints against the Practice

We report the number of formal complaints made against the practice annually.

  • A total of 19 complaints which were treated as formal complaints were received in the year and responded to
  • Two complaints were made via NHSE (NHS England)
  • All complaints were resolved locally
  • Year on year complaints number remain stable
  • The key themes from complaints were:
    • Appointment availability
    • Prescription Problems
    • Staff attitude

Lessons learned from complaints

  • Attitude issues were generally directed towards the Reception Team
  • Two complaints turned out not to be the fault of the practice. One was related to the hospital ART team and the second a local pharmacy
  • Seven complaints were from people who have previously complained

National Patient Survey

The latest results from the National Patient Survey are available.

A low number of surveys are generally received but they provide a flavour of how patients feel which is very useful

  • 277 surveys were sent out, and 116 sent back
  • 73% of respondents described their overall experience of this GP practice as good which was higher than the local and national result

AOB - Discussion

Our PPG members have found the new ring back feature on the phone system helpful.

A comment was made that being told you are a long way down in the phone queue is not necessarily helpful - instead could messages be placed on the phone holding system, such as 'we answer a call every 2 minutes'. It was felt this could help promote a more positive message to patients

Regarding obtaining test results. PPG member felt that onus is often placed back on patient to make an appointment, which in turn means phoning in or using e-consult to obtain an appointment. This restarts the cycle of trying to get appointments - is there a better way to deal with this situation?

A member enquired if E-consult could be removed as it creates a demand that cannot be met. In contrast another member would prefer the times for e-consult to be expanded e.g. open until 9pm in the week and at weekends.

Could we restart using the screens in the waiting room to disseminate information as it was felt these screens are well-read by patients. Can we highlight statistics such as we have seen at the meeting, to help manage patient expectations and give a greater understanding of the challenges that the practice faces.

Can the surgery promote positive messaging on the website- could these reinforcement messages be put on the phone hold cycle - there was a discussion as to whether patients would listen to these messages on the phone.

How is patient monitoring being picked up since the pandemic - can some of this be done by the patients themselves?

Yes - systems had been set up for patients to self- monitor, e.g.

BP can be measured at home and readings sent in to practice
Asthma - patients are asked to report if well controlled
Diabetes - we now have a more streamlined process where the patient can come in and have a blood test, BP check and foot check in one appointment and then have a follow-up with the GP

Comment made by PPG member that patients could potentially do more to help the practice - we are always open to your suggestions - please let us know if you have any

Question - has dermatology clinic been set up?

Yes - this is now up and running at the practice.

We have a GP with special interest in dermatology visiting at least once a month, along with a consultant led clinic and a further GP led clinic. These clinicians are able to undertake minor skin treatments in clinic  but some conditions would still need to be seen in hospital. It was raised that there is still an extremely long wait to be seen at this clinic - this will be queried with the dermatology team


Our next PPG meeting will be Tuesday 28thFebruary 2023 at 6pm