PPG Minutes: Tuesday 14th June 2022

 

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Update 

Staffing Changes

GP Changes

  • Dr Mash has returned to practice following maternity leave
  • Dr Philip is now on maternity leave
  • Dr Pick has reduced a day
  • Dr Peirce has joined us as a permanent GP and will cover Dr Philip’s list during her maternity leave

Clinical Team

  • Practice Nurse Sam has left
  • ACP Melissa leaves today
  • Practice Nurse Marta leaves later this month
  • Physician Associate Jade joined the team at the beginning of June
  • Mechelle – trainee ACP, joined in May
  • Practice Nurse Laura joins later in June
  • Practice Nurse Natasha joins in June
  • ACP interviews are being held in June

Non- Clinical Team

  • Care navigator Iris has joined reception
  • Chrissie, summariser, leaves this month
  • Emma, medical secretary is leaving in July
  • Care navigator Kirsty to join reception, start date tbc

Other staff changes

  • Our current GP registrars are Dr Bola, Dr Zaveri and Dr Ivchenko
  • Paramedic Rachel will be working at the practice one day a week for around 18 months
  • We continue to host Year 1 and Year 2 Kent and Medway Medical school students on a regular basis for their GP placements

Ongoing Challenges

Gerald shared a slide showing the areas across the UK with the fewest number of GPs per 100,000 patients. Kent and Medway are highlighted as one of the worst areas in the country and we continue to face difficulties recruiting GPs.

The CCG (Kent and Medway) have set aside a sum of money to support the GP workforce and hopes to encourage GPs to work in these under doctored areas. We are involved in this scheme and at some time in the future may have a GP join us on a part time basis. The recruitment will be managed by a national recruitment company

  • Newspapers have printed statistics claiming that an extra 3.1 million patients have registered with GPs since 2017, but during the same period the number of fully qualified family doctors has fallen by 1343.
  • The NHS also faces the challenge of doctors nearing retirement age and others planning to leave the profession as they cope with the increased post pandemic workload

Further challenges facing the practice include:

  • Patient complexity – (patients living longer with multiple conditions)
  • Patients returning to the GP for appointments and treatment because they face long waits for hospital care
  • Patients suffering with the effects of Long Covid
  • Increase in patients with mental health problems, particularly anxiety and depression
  • More push for shared care from the hospital

Appointments

Information from the national dashboard of appointments show that in 2019 East Cliff Practice offered its patients 91342 appointments. This number decreased during the pandemic, but in 2021 it increased to 98856 appointments. It was noted that when the practice moved into the new premises our agreed patient list was 13500, now we have around 16000 patients on our list

Rise in E-consults

This service has provided another route into the practice for our patients.

Figures were shared regarding the e-consult service which showed that the number of e-consults submitted have risen steadily over the last two years to a point where we received 1051 requests in May 22
PPG members were asked their opinions about e-consult and some felt the process was longwinded and outcome not always useful. However some of our patients find it a very useful and flexible service which avoids the need to ring in and wait on the phone.

A concern was raised that phone consultations are becoming the norm and that if a face to face appointment is needed this system can occasionally result in 2 appointments being needed. It was noted that around 60% of appointments across the whole practice are face to face and that these processes are still evolving. Drs can identify e-consult patients that need to be seen face to face, and sometimes a face to face appointment is booked after initial information gathering by phone – this can be more efficient and minimise the number of times patients need to come to the surgery

Covid Vaccinations

As at 6th June we have administered 56040 Covid vaccination doses from the Montefiore site

Upcoming Changes

New phone system

We recognise that our current phone system has been a source of frustration and we are pleased to let you know that the practice will be getting a new phone system in August called Surgery Connect – provided by X-on. It promises:

  • No busy tone
  • Call queuing and messaging including the ability to hold your place in a queue and get back to you when you get to the front of the queue
  • Integration with our clinical system

We expect the new system to provide an improved experience for our patients

Klinik System

We are currently monitoring the use of a new system being trialled by the Grange Surgery called Klinik. This would provide an alternative to e-consult and provide a partly electronic consultation. Patients would be asked to submit their details and symptoms and Klinik would triage and prioritise the requests. Patients would have their request acknowledged and be contacted according to the priority of their request. Urgent issues would be dealt with either on the day if necessary or within 24-48 hours while less immediate issues could take 5-7 days. The same system may be used by reception colleagues when patients phone in, and there may be an option for patients to submit their details on equipment in reception.  We are currently awaiting the results of the trial before any further decisions are made. This system is subject to Data Protection requirements and does not access a patient’s full medical record. NHS digital is the data controller for the system.
Klinik will only use patient demographic data and information that patients submit on the Klinik system when making their request. PPG member feedback cited concerns around what demographic information could be used for in the future and whether it could affect, for example access to healthcare insurance. PPG member does not currently use e-consult as it requires patient to agree access to existing medical records.

Changes to mask wearing requirements

Infection control rules have changed and as a result patients are no longer required to wear a mask in surgery unless they have, or think they may have a respiratory infection. Patients are welcome to continue to wear a mask if they feel more comfortable doing so

 

AOB

Can there be an option on phone system to obtain test results?

The practice does not have the facility to provide this service currently, however the use of text messaging is increasing in order to pass messages and links to further information on to our patients

When attending hospital who should you name as your doctor?

If attending hospital and you are unsure of your named registered doctor, please advise hospital colleagues that you are registered at East Cliff Practice. Any incoming documentation to the practice will be forwarded to your registered doctor

What is comparison between number of GP sessions now and in the past?

Historical comparisons between, for example, the number of GP sessions worked in practice 10 years ago and those worked today are difficult due to the changing workforce model. At the present time we have a workforce consisting of a variety of health professionals in addition to GPs who all consult with patients, such as Advanced Nurse Practitioners working in the Acute Care Team, Nurse specialists and Physician Associates. There are now a wider variety of appointment types available to our patients facilitated by a workforce consisting of a range of healthcare professionals.

Are we recruiting for GPs and Physician Associates?

We currently have a 2 session vacancy for a GP which could potentially be filled through an attraction package such as the one discussed earlier in the meeting. We will have 2 Physician Associates in practice.
We always do our best to recruit new GP colleagues if the situation arises.

What is GP/patient ratio?

Our current ratio is 2200 patients per Full Time Equivalent GP. Newly qualified GPs have a slightly lower ration of 2000 patients per FTE as they need more support at the beginning of their career. The GPs are also supported by the broader workforce in practice such as ANPs, Physician Associates and nursing colleagues to enable them to manage the ratio of patients

Has joining Invicta Health helped with staff support?

Our parent organisation faces the same challenges as we do at practice level when trying to recruit clinical staff. However they do offer support in helping to centralise some functions, for example centralising medicine management policies – in this way they are helping to support the workforce

 

Our next PPG meeting will be Tuesday 13th September at 6pm