PPG Minutes: Tuesday 28th February 2023

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Update 

Staffing Changes

GP Changes

• Due to relocation, Dr Peirce has now left the practice after providing us with temporary maternity cover
• Dr Philip will be returning from maternity leave on the 10th March

GP Teams - our current teams are:

• Blue Team - Dr Catherine Neden, Dr John Neden, Dr Pick, Dr Woodward, Dr Mash, Dr Philip ( returning on the 10th March), Dr Sivasubramaniam
• Green Team - Dr Kent, Dr Sivakumar, Dr Dawes, Dr Fenske, Dr Culatto
• Acute Care Team - Dr Macpherson

Clinical Team

• Asta our clinical pharmacist has now left the practice
• Helen, who is a clinical pharmacist based at St Peters, is currently helping to support the practice by providing 3 additional sessions per week 

Non- Clinical Team

•     Tia has joined our team as the Nurse Team Administrator

Other staff changes

• As we are a training practice, our current GP registrars are Dr Zaveri, Dr Mahmoud and Dr Ivchenko (who leaves in April to move onto his next 4 month placement)
• Dr Ucha will be re-joining us in April for his final 16 months of training.
• Dr Ivchenko will be re-joining us for his final 12 months of training in August this year
• We continue to host Kent and Medway Medical school students on a regular basis for their GP placements as the Kent and Medway School enters its 3rd year, and we currently have year 1 students in practice with us.

Other evolving changes within the practice

• New telephone system – we continue to have generally positive feedback from patients and staff about our new phone system.
• E-consult hours – we have had to further restrict the operational hours for this service
• Following a trial in December 2022, we are currently offering more face to face appointments.
• Changes to our extended opening hours

New phone system features

• No engaged tone
• Queueing system
• Options to select ‘prescriptions’ and ‘test results’
• Integrated with our clinical system
• Easier to listen back to calls if required
• Better call statistic information which was not a feature of our old system

Phone statistics over 6 months Sep 22 to Feb 23

• Total attempts to call the practice 81,404 – this included those callers who didn’t wait to be connected and chose to hang up
• Total calls answered 42584
• This equates to 323 calls answered per day 9 (around 1 call every 2 mins)
• Average wait time to speak to a member of staff is 9.5 minutes

E-Consults

• It is a contractual requirement that we offer e-consults to our patients. In response to a rise in demand for e-consults, which was in turn impacting on appointments, the decision was taken in June 2022 to restrict the times that e-consults were available. At that time we were receiving the equivalent of 50 e-consults a day.
• We amended our operating hours to match surgery phone opening hours of 08.00 to 18.30, Monday to Friday. After an initial dip, numbers started to climb again, and by November 2022 we were again receiving more than 50 e-consults per day
• In response to this we reached an agreement with the commissioners that from 16th February 2023, we could further restrict the time e-consults are available to between 08.00 and 14.00. This will be a 2 month trial.

Access to Appointments

• We currently have a team of 12 GPs (excluding our Acute Care Team doctor) and access is seen as quite good. BMA guidance suggests that surgeries should be providing around 72 appointments per 1000 patient population.
• East Cliff currently offers around 95 appointments per 1000 of practice population – these appointments are spread across doctors, nurses and other clinics.

Face to Face Appointments (F2F)

• As a result of our trial we have increased the number of F2F appointments. Around 67% of our appointments are now face to face.
• We now offer a mix of appointments and patients are still happy to use telephone consultations to avoid the need to travel to the surgery and for greater convenience when a F2F appointment is not necessary

Did Not Attend Rates

• We are seeing a rise in DNAs. On average one in seventeen appointments over the last few months were missed. These are sometimes on the day appointments that are booked in the morning and then not attended in the afternoon.
• These appointments have resulted in 114 hours of wasted practitioner time which is equivalent to a 1.1 full time equivalent clinician

Changes to Opening Hours

• Due to rising costs in all areas we have taken the decision to no longer open on a Saturday morning unless there is a specific clinic running. We have extended opening hours on Tuesday evenings and some clinics will be running during this time. Saturdays may still be used in the future for vaccination clinics when necessary
• We now remain open until 8pm on a Tuesday evening and are currently testing different types of clinic on offer
• Patients may still be offered appointments on a Saturday and Sunday but these will be at the GP led clinic at the QEQM Urgent Treatment Centre

Update on Covid/Flu Vaccination Programmes

• We have administered more than 66000 Covid Vaccines since the pandemic from the Montefiore Medical Centre
• We are currently in discussion with the Grange practice as to whether we will be involved in the Spring booster campaign or whether these vaccinations will be administered at a different vaccination centre
• During October 22  to January 23 we administered 3200 flu vaccines

AOB - Discussion

E-consults – The question was raised as to whether it would be better to offer our e-consult service between the hours of 13.00 and 17.00, rather than have it run alongside the phone opening times of 8am. This would mean that we don’t have both services running at maximum capacity at the same time of day.  It was felt that there may be too many channels of contact into the surgery at peak times which exacerbated the problem of patients being able to book into appointments. It was suggested a better method may be to have all resources funnelled into contact via phone at the peak time of day starting at 08.00.

Our next PPG meeting will be Tuesday 27th June 2023 at 6pm