The
GARDENS PATIENT GROUP
Notes of a meeting held on Wednesday, 15 July 2015 at The Gardens Surgery
Present: (SS, Chair); (DA); (MD); (RH); (PH); (GH); (PmcQ), (SMcQ); (DO); (ST) and (VV)
1.
Welcome and Introductions
SS, the new Practice Manager, introduced herself and explained that she had come from another
surgery in Lambeth where she been involved in establishing a Patient Participation Group. Just
before she left, one of the patients in this group had taken over as Chair.
RMcP. had now left The Gardens Surgery, and VV, who had previously worked there as a
receptionist, had taken over as Assistant Practice Manager.
Everyone present then introduced themselves. As the meeting was being held in the waiting room
and two patients had yet to be seen, both were present for the first part of the meeting and one, ST,
returned after being seen by the doctor and participated in the meeting – hopefully she will join the
Group.
2.
Minutes of the meeting held on 14 April 2015
The Minutes of the previous meeting had been circulated but as not everyone appeared to have
received these, members were asked to give their email addresses to SS so she could ensure these
were correct in her records.
3.
Patient Surveys
SS explained that she had only been sent a link to the GP Survey the previous week so had not been
able to go through the result in detail, but they appeared to be quite good. The surgery staff team
would discuss the results at their next meeting, and SS would email a report, together with a link, to
all Group members.
Action: SS
MD explained that this was the survey sent out by NHS England, she thought to a random selection
of patients, but she did not know if there was any criteria for this selection and it would be
interesting to find out.
4.
Extended Primary Care Service (EPCS)
As had been discussed at previous meetings, this was a response to the Government's policy that all
patients should have access to a GP from 8 a.m. to 8 p.m., 7 days a week. (For the benefit of
anyone who hadn't been at previous meetings, Southwark had been given Challenge funding to
participate in a pilot programme, and the South Southwark practices had joined together to form a
company, setting up facilities for shared additional cover at the Lister Centre. The EPCS could
offer appointments both for patients who had a medical emergency but couldn't be seen at their own
surgery during normal opening hours because there weren't sufficient appointment slots, or those
who needed to be seen a outside their surgery's normal daytime hours or at weekends).
SS explained that there were now plans to use this also to extend the 'telephone triage' appointments
system, so that if, for example, the surgery had only ten telephone slots and another person wanted
to speak to the doctor on the telephone, the surgery receptionist could book a call directly with the
duty GP at the EPCS at Lister. The EPCS was also thinking about having a nurse always present
between 8 a.m. - 8 p.m., Monday to Friday so that if a surgery's own nurse was, for example, on
holiday, and a patient needed a wound to be dressed, an appointment could be made for them at the
EPCS. Child immunisation was also being considered though this was not an 'emergency' as such,
just an overflow facility.
SS asked if anyone present had used the EPCS service, and SMcQ said she had used it one
weekend, when after calling Seldoc, they had recommended going to the EPCS at Lister.
Some surgeries were still not making much use of the EPCS; SS wasn't sure of the reasons for this
(it might be particularly a problem for patients whose surgeries were further from the Lister, and
who didn't have direct public transport links). If the system wasn't utilised enough, each individual
surgery might be required to extend its opening hours to cover 8 a.m. - 8 p.m., 7 days a week. SS
reported that one review of the EPCS service had already taken place but she was not sure when the
pilot programme was due to end. DO thought funding had been for two years, but was not sure; the
EPCS in the Lister had opened in November 2014 so if this was the case the final review should be
at the end of 2016 or early in 2017 (as the North Southwark EPCS had opened later).
5.
Pharmacy First
As MD had explained at the previous meeting, the aim of this scheme was to encourage people to
go to their pharmacy, rather than their GP, for advice on the treatment of minor things like coughs
and colds and conditions which could easily be treated with non-prescription medication.
Pharmacies would be required to have a private consulting room in which they could see such
patients. The aim was to free up surgery appointments for people with more serious, urgent or
complex, long-term conditions.
RH commented that this needed some further thought, as she had been in a long queue at Lloyds
Pharmacy when someone needed to discuss a problem with the pharmacist, and the rest of the
queue were getting very impatient. GH agreed that it would present real difficulties for a single
pharmacist who was having to dispense prescriptions at the same time as giving advice, and the
staffing implications had to be considered. PH was also concerned that the pharmacist wouldn't
have access to the patient's medical records and might suggest something which shouldn't be taken
by that particular individual either because of their condition or the other, prescribed medication
they were taking. (The pharmacist would normally ask about this, but patients with complex
conditions might not be able to list all their medication).
It was generally agreed that this system needed to be monitored and evaluated.
While on the subject of prescriptions, SMcQ commented that she had been told by the surgery that
her medication had not been reviewed since 2013, whereas in fact it had been reviewed every year.
This had also happened to others. VV explained that there had been a glitch in the computer system
which had probably caused this and she would look into it.
Action: VV
In response to a question from DO, SS confirmed that if a patient was taking a number of different
medications, when the time came for one of them to be reviewed, the doctor would look at this
along with everything else they were taking to ensure all were still necessary.
6.
Loss of Inhealth
SS explained that Inhealth was a company commissioned to contact out ultrasound, audiology and
other services, directing patients to the nearest place in the shortest time. Their contract had ended
on 1 July 2015, which meant that now GPs have to find out where to best refer their patients, and
this is likely to take longer than the previous centralised service. SS did not think the 'locally
developed pathway guidance' referred to was as yet actually available. The direct access hearing
services for patients over 50 has not been affected, and GH thought that the services in Chadwick
Road remained.
7.
'Relaunch' of Gardens Patient Group
SS suggested hosting a charity event – her previous surgery had held a MacMillan fundraiser which
had brought people in and it was used as an opportunity to tell them about the PPG in a more
relaxed environment than if they were visiting the surgery for an appointment. She explained that it
was now a contractual requirement for surgeries to have a PPG.
In discussion, the following points were made:
 PH said a prominent notice was needed in the surgery about the Gardens Patient Group,
especially when a meeting was coming up (there had only been a small typed notice this
time).
 GH said that a notice didn't always work, and suggested that GPs should ask a good crosssection of people if they would like to come to the meetings and have a voice. There could
be a brief list of bullet points about the purpose and work of the Group. DO had done this
for a previous meeting and would email a copy to SS.
Action: DO
 RH said that if open meetings were to be held, thought would need to be given as to how these
would be conducted in order to integrate the existing and new members.
 Also, if recruitment was successful and a bigger group convened, where would their meetings
be held?
 RH recommended that some meetings at least could have a particular focus which would
attract people interested in that area – for example, children and families. It was important
to 'sell' to people what the Group is and what it is doing and has done.
 SS recommended that a patient should chair the meeting, and another take the minutes.
 She also mentioned that one of the improvements which had come up from her previous PPG
was having a TV screen in the surgery – but this had been discussed by the Gardens Patient
Group and many really didn't like the idea!
 Diversity was seen as important, and DA suggested targetting people from particular underrepresented groups (such as young men). A greater ethnic mix would also be good. This
reflected back to the idea of having themed sessions at meetings which would be more likely
to attract particular target groups.
 MD pointed out that there was plenty of information already available about the work and
purpose of PPGs, and lots of training days on offer. Essentially the Groups were about both
receiving information, giving feedback to influence the development of services, and the
meetings could also be educative if there was a talk about, say, managing a particular
condition. There were also opportunities for wider involvement as many groups, including
clinical commissioning groups (CCGs) now wanted more patient participation. (Diagrams
showing areas CCGs covered and how they worked are available).
 DO suggested an emailed newsletter and ST agreed this would be a good idea (paper copies
could also be made available). There could also be more exciting stuff on the PPG page of
the surgery's website.
 There might need to be more timing options, especially if involving parents of young or
school-age children.
There was general support for the idea of themed meetings with a talk by a health care professional
or other expert, and the following subjects were suggested:
 Eating a healthy diet (this could encompass avoiding or managing Type 2 diabetes, which is
on the increase, or there could be a separate talk on diabetes)
 Managing stress
 Public health issues generally
 Services for babies and young children
 Healthy ageing
8.
Any Other Business
Named GPs: In response to a comment from PH, SS confirmed that, while having a 'named GP'
responsible for oversight of your care had previously only applied to elderly or vulnerable patients
and those with complex conditions, surgeries were now required to give every patient a 'named GP'.
However this was really just a box-ticking exercise as any patient could still see any GP and test
results could still just be sent to the surgery.
Dulwich Hospital: In response to an earlier question from PH, GH explained that there had been a
consultation about the provision of a health centre within the former hospital; this had gone through
the various committees earlier this year and now had the go-ahead. A list of the services to be
provided had been drawn up and there would be a meeting on 30 July at 1 p.m at Cambridge House
to discuss this, which representatives of the Group would be most welcome to attend. The rest of
the site had to be offered, first, for education purposes, and it was thought that a school had already
committed to buy this. PH asked what would happen about the blood tests currently being carried
out at Dulwich; GH thought the new centre would continue to provide this service and hopefully
there might not be a gap in provision.
9.
Date of next meeting
The next meeting of the Gardens Patient Group would take place on Wednesday, 14 October,
probably still at 6.30 p.m but this would be confirmed nearer the date (depending on the theme of
the meeting/speaker).